Eficácia de um programa de tratamento fisioterapêutico sobre a qualidade de vida de pacientes com fibromialgia

Abstract

Fibromyalgia is a syndrome of unknown etiology characterized by the presence of chronic and diffuse pain, and at least 11 of the 18 specific tender points. It's fundamental to find effective options of treatment that look for minimize the impact of fibromyalgia (FM) in the patients' quality of life. The purpose of this study was to evaluate the efficacy of a physical therapy treatment compounded of laser therapy in the tender points and stretching exercises, in quality of life of patients with FM. Twenty eight patients with FM participated of this study were divided in three groups: GLA (n = 10) performed 10 sessions of laser therapy in the tender points and stretching exercises; GA (n = 10) performed 10 sessions of stretching exercises and; GC (n = 8) performed a single session of an educational approach. Measures of visual analogue scale of pain (VAS), dolorimetry of the tender points, Fibromyalgia Impact Questionnaire (FIQ) and SF-36 were assessed. The results showed, comparing initial and final assessments, the groups GLA and GA presented significant differences of VAS (p = 0.006 and p = 0.002; respectively); pain threshold of tender points (p = 0.001 and p = 0.007; respectively); FIQ (p = 0.04 and p = 0.006; respectively) and SF-36 (p = 0.001 and p = 0.000; respectively). There was no significant difference in any of the measures in the GC group. No significant groups GLA and GA differences were found, but compared with the controls (GC) the measures of VAS and pain threshold were significant different. In conclusion, in this study the stretching exercises were effective in the improvement to pain, tenderness threshold of the tender points and quality of life of patients with FM. Some parameters should be reviewed about low-power laser therapy in the treatment of patients with FM, as treatment intervals and laser wavelength. This study suggests that an educational approach could be employed as an integrant part of the treatment, and the relationship between physical therapist and patient plays an essential role in the treatment, since they are important aspects that contribute to the improvement in quality of life of patients with FM.