Akash Pathak, Jyotsana Rai, Nirendra K Rai, Ruchi Singh, Girish C Bhatt
{"title":"原发性纤维肌痛综合征康复策略的有效性：系统回顾与荟萃分析。","authors":"Akash Pathak, Jyotsana Rai, Nirendra K Rai, Ruchi Singh, Girish C Bhatt","doi":"10.1177/20494637231168021","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this review was to (1) summarize evidence on the effectiveness of rehabilitation strategies in fibromyalgia syndrome (FMS) and (2) determine the most effective rehabilitation strategy for reducing pain and depression in people with FMS.</p><p><strong>Data sources: </strong>PubMed, Ovid (Sp), and Cochrane search engines were used for identifying relevant studies done up to 1st of July 2022.</p><p><strong>Study selection: </strong>Randomized control trials (RCTs) that have a passive control group and an active control group were included in this review for primary and secondary aim, respectively. The primary outcome measures were pain and depression. Secondary outcome was one from the sleep or fatigue or healthy related quality of life (HRQOL).</p><p><strong>Data extraction: </strong>Two researchers independently selected the studies and extracted the key information.</p><p><strong>Data synthesis: </strong>A total of 25 RCTs were included. Studies with passive control group showed moderate to large positive effects on pain (standard mean difference -0.65, 95% confidence interval -0.93 to -0.38; I<sup>2</sup> = 72%) and HRQOL (MD -5.40, 95% CI -10.17 to -0.62; I<sup>2</sup> = 74%) but were not statistically significant for sleep, fatigue, and depression. Furthermore, on subgroup analysis studies with a short term protocol showed significant effects on pain only, whereas studies with long term protocols showed positive effects on pain and HRQOL only, but no statistical significance at the time of post-trial follow-up. Studies with active control groups gave non-significant results except where there was mixed exercises, which showed a positive effect (mean difference -4.78, 95% CI -7.98 to -1.57; I<sup>2</sup> = 0%) for HRQOL.</p><p><strong>Conclusion: </strong>All rehabilitation strategies were effective for pain and HRQOL, and had a marginal effect on depression, sleep, and fatigue but efficacy was not maintained at the time of post-trial follow-up. However, in this review, we could not differentiate any rehabilitation strategies for the best among those used in the included studies.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395393/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of rehabilitation strategies in primary fibromyalgia syndrome: A systematic review and meta-analysis.\",\"authors\":\"Akash Pathak, Jyotsana Rai, Nirendra K Rai, Ruchi Singh, Girish C Bhatt\",\"doi\":\"10.1177/20494637231168021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The aim of this review was to (1) summarize evidence on the effectiveness of rehabilitation strategies in fibromyalgia syndrome (FMS) and (2) determine the most effective rehabilitation strategy for reducing pain and depression in people with FMS.</p><p><strong>Data sources: </strong>PubMed, Ovid (Sp), and Cochrane search engines were used for identifying relevant studies done up to 1st of July 2022.</p><p><strong>Study selection: </strong>Randomized control trials (RCTs) that have a passive control group and an active control group were included in this review for primary and secondary aim, respectively. The primary outcome measures were pain and depression. Secondary outcome was one from the sleep or fatigue or healthy related quality of life (HRQOL).</p><p><strong>Data extraction: </strong>Two researchers independently selected the studies and extracted the key information.</p><p><strong>Data synthesis: </strong>A total of 25 RCTs were included. Studies with passive control group showed moderate to large positive effects on pain (standard mean difference -0.65, 95% confidence interval -0.93 to -0.38; I<sup>2</sup> = 72%) and HRQOL (MD -5.40, 95% CI -10.17 to -0.62; I<sup>2</sup> = 74%) but were not statistically significant for sleep, fatigue, and depression. Furthermore, on subgroup analysis studies with a short term protocol showed significant effects on pain only, whereas studies with long term protocols showed positive effects on pain and HRQOL only, but no statistical significance at the time of post-trial follow-up. Studies with active control groups gave non-significant results except where there was mixed exercises, which showed a positive effect (mean difference -4.78, 95% CI -7.98 to -1.57; I<sup>2</sup> = 0%) for HRQOL.</p><p><strong>Conclusion: </strong>All rehabilitation strategies were effective for pain and HRQOL, and had a marginal effect on depression, sleep, and fatigue but efficacy was not maintained at the time of post-trial follow-up. However, in this review, we could not differentiate any rehabilitation strategies for the best among those used in the included studies.</p>\",\"PeriodicalId\":46585,\"journal\":{\"name\":\"British Journal of Pain\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395393/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Pain\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20494637231168021\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Pain","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20494637231168021","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Effectiveness of rehabilitation strategies in primary fibromyalgia syndrome: A systematic review and meta-analysis.
Objectives: The aim of this review was to (1) summarize evidence on the effectiveness of rehabilitation strategies in fibromyalgia syndrome (FMS) and (2) determine the most effective rehabilitation strategy for reducing pain and depression in people with FMS.
Data sources: PubMed, Ovid (Sp), and Cochrane search engines were used for identifying relevant studies done up to 1st of July 2022.
Study selection: Randomized control trials (RCTs) that have a passive control group and an active control group were included in this review for primary and secondary aim, respectively. The primary outcome measures were pain and depression. Secondary outcome was one from the sleep or fatigue or healthy related quality of life (HRQOL).
Data extraction: Two researchers independently selected the studies and extracted the key information.
Data synthesis: A total of 25 RCTs were included. Studies with passive control group showed moderate to large positive effects on pain (standard mean difference -0.65, 95% confidence interval -0.93 to -0.38; I2 = 72%) and HRQOL (MD -5.40, 95% CI -10.17 to -0.62; I2 = 74%) but were not statistically significant for sleep, fatigue, and depression. Furthermore, on subgroup analysis studies with a short term protocol showed significant effects on pain only, whereas studies with long term protocols showed positive effects on pain and HRQOL only, but no statistical significance at the time of post-trial follow-up. Studies with active control groups gave non-significant results except where there was mixed exercises, which showed a positive effect (mean difference -4.78, 95% CI -7.98 to -1.57; I2 = 0%) for HRQOL.
Conclusion: All rehabilitation strategies were effective for pain and HRQOL, and had a marginal effect on depression, sleep, and fatigue but efficacy was not maintained at the time of post-trial follow-up. However, in this review, we could not differentiate any rehabilitation strategies for the best among those used in the included studies.
期刊介绍：
British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.
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