Abstract
Background: We compared the effects of therapeutic exercise (TE) combined with pain neurophysiology education (PNE) to those of TE in isolation on pain intensity, general fibromyalgia impact, mechanical pain sensitivity, pain catastrophizing, psychological distress and quality of life in women with fibromyalgia syndrome (FMS). Methods: A feasibility study with a 3 month follow-up was designed. Thirty-two patients with FMS were randomly assigned to PNE + TE group (n = 16) or to TE group (n = 16). Both groups received 30 sessions of TE (3 per week), and the PNE + TE group received eight face-to-face educational sessions. The measuring instruments used were the visual analogue scale, a standard pressure algometer, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale and the Health Assessment Questionnaire. Results: The PNE + TE group showed a statistically significant decrease on pain intensity compared to TE group at short term (p = 0.015). No between-groups differences were found for mechanical pain sensitivity, general fibromyalgia impact, pain catastrophizing, psychological distress or quality of life (p > 0.05). Conclusions: The combination of PNE and TE was more effective than TE for reducing pain intensity in the short-term. No differences were found for psychological distress, pain catastrophizing and quality of life after the intervention or at 3 months of follow-up.
Highlights
Fibromyalgia syndrome (FMS) is a rheumatological disorder characterized by widespread pain and tenderness
The results of our study showed that the pain neurophysiology education (PNE) + therapeutic exercise (TE) group showed a greater improvement in pain intensity after the intervention compared to TE group
The change achieved for pain intensity in the PNE + TE group was higher than the MCID stated for patients with chronic pain [30]
Summary
Fibromyalgia syndrome (FMS) is a rheumatological disorder characterized by widespread pain and tenderness. Previous studies have demonstrated that strengthening and aerobic exercises in isolation were effective in reducing FMS symptoms [9,11,15,17] The comparison of both types of exercise showed similar effects on reducing pain intensity and improving quality of life [10,11,15]. Clinical guidelines recommend the combination of patient education and graded physical exercises, there is a lack of high-quality studies evaluating the effects of PNE combined with TE. The present study aimed to analyze the effects of TE combined with PNE compared to those of TE on pain intensity, mechanical pain sensitivity, catastrophizing thoughts and feelings, psychological distress and quality of life in women with FMS
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