探讨纤维肌痛患者坚持中高强度运动:生理和心理因素的作用-一篇叙述性文献综述

Caio V. M. Sarmento, Zhaoyang Liu, Irina V. Smirnova, Wen Liu
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摘要

纤维肌痛(FM)是一种以广泛的慢性疼痛、肌肉压痛、慢性疲劳和睡眠障碍为特征的慢性疾病。FM的治疗侧重于症状管理,通常使用药物、认知行为疗法或中高强度运动(MHIE)。美国运动医学学院和美国心脏协会的现行指导方针强烈推荐MHIE,以减少因久坐不动的生活方式引起的合并症。MHIE也被证明可以改善耐受MHIE的个体的FM症状。然而,FM患者是MHIE依从性最差的人群之一。大多数FM患者在MHIE干预计划开始时报告症状恶化。目的:本文献综述旨在通过参与将MHIE作为干预手段的研究的FM患者的退学率和依从率来估计MHIE的依从性,并研究高退学率和低依从性的可能原因,包括心理和生理因素。了解MHIE干预的潜在退出范围和依从率,以及影响FM患者MHIE依从性的因素,可以帮助研究人员和临床医生更好地设计临床试验研究,并根据患者个体特征开发量身定制的运动干预措施。结论:FM是一种多面综合征,由于心理和生理因素的复杂二元性,其表现因人而异。因此,临床医生在给FM患者开运动处方时应该考虑这两个因素。
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Exploring Adherence to Moderate to High-Intensity Exercises in Patients with Fibromyalgia: The Role of Physiological and Psychological Factors—A Narrative Literature Review
Fibromyalgia (FM) is a chronic condition characterized by widespread chronic pain, muscle tenderness, chronic fatigue, and sleep disturbances. Treatment of FM focuses on the management of symptoms, often using medications, cognitive behavioral therapy, or moderate-to-high-intensity exercises (MHIE). MHIE is highly recommended by the current guidelines from the American College of Sports Medicine and the American Heart Association for people with FM to decrease comorbidities due to sedentary lifestyles. MHIE has also been shown to improve FM symptoms in individuals who can tolerate MHIE. However, individuals with FM present with one of the poorest adherences to MHIE. Most individuals with FM report symptoms worsening at the beginning of an MHIE intervention program. Objectives: This literature review aims to estimate the adherence to MHIE using dropout and compliance rates in individuals with FM who participated in studies that applied MHIE as an intervention and to examine possible reasons for high dropout rates and low compliance with MHIE programs, including psychological and physiological factors. Understanding the scope of potential dropout and compliance rates to MHIE intervention and factors that impact MHIE adherence in people with FM may help researchers and clinicians better design clinical trial studies and develop tailored exercise interventions according to individual patient characteristics. Conclusion: FM is a multi-faceted syndrome that can vary significantly in its presentation from person to person due to the complex duality of psychological and physiological factors. Consequently, clinicians should consider both components when prescribing exercises to FM patients.
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