纤维肌痛综合征的循证治疗方法:范围综述

IF 0.8 Q4 REHABILITATION Physical Therapy Reviews Pub Date : 2023-01-02 DOI:10.1080/10833196.2022.2157945
N. Adams, J. McVeigh, A. Cuesta-Vargas, Sedik A Abokdeer
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引用次数: 0

摘要

纤维肌痛综合征(FMS)是一种慢性广泛性疼痛综合征,主要表现为广泛性疼痛、疲劳、睡眠障碍和低运动耐受性。病理生理学是复杂的,其理解不断发展,临床管理是困难的,采用异质干预。目的:本综述综述了纤维肌痛综合征,以及主要康复方法的证据。检索了1996年至2021年的CINAHL、Cochrane、Medline和PubMed数据库。康复方法包括运动、基于心理的方法、多成分方法以及补充和替代疗法。由于现有研究方法上的缺陷,以及缺乏个体模式的证据等因素,很难得出关于哪种是FMS中最合适的康复方法的明确结论。然而,荟萃分析和一些国际指导方针的证据表明,可以使用结合锻炼的方法。也有一些证据表明使用心理知情干预,如认知行为疗法(CBT)方法。其他干预措施的证据则更加模棱两可。结论综合干预(如运动结合教育和心理治疗)是治疗FMS患者最有希望的方法。诸如大量的运动项目退出,许多研究缺乏长期随访,以及患者的偏好等问题值得进一步调查。还建议采用基于心理介入程度、症状严重程度和残疾程度的个体化方法。
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Evidence-based approaches for the management of fibromyalgia syndrome: a scoping review
Abstract Background Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome characterized primarily by widespread pain, fatigue, sleep dysfunction and low exercise tolerance. The pathophysiology is complex and its understanding evolving, and clinical management is difficult, with heterogeneous interventions employed. Objectives This scoping review provides an overview of fibromyalgia syndrome, and the evidence for the principal rehabilitation approaches. CINAHL, Cochrane, Medline and PubMed databases were searched from 1996 to 2021. Rehabilitation approaches included exercise, psychologically-based approaches, multicomponent approaches, and complementary and alternative therapies. Major findings Due to factors such as methodological shortcomings of existing studies, and the lack of evidence on individual modalities, it is difficult to draw definitive conclusions as to which is the most appropriate rehabilitation approach in FMS. However, there is evidence from meta-analyses and several international guidelines for the use of approaches incorporating exercise. There is also some evidence for the use of psychologically-informed interventions such as cognitive-behavioural therapy (CBT) approaches. Evidence for other interventions is more equivocal. Conclusions It appears that a combination of interventions (e.g. exercises combined with education and psychological approaches), is the most promising means of managing patients with FMS. Issues such as high numbers of drop-outs from exercise programmes, lack of long-term follow-up in many studies, and patients’ preferences warrant further investigation. An individualized approach based upon extent of psychological involvement, severity of symptoms and level of disability is also recommended.
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来源期刊
Physical Therapy Reviews
Physical Therapy Reviews REHABILITATION-
CiteScore
1.30
自引率
0.00%
发文量
26
期刊介绍: Physical Therapy Reviews is an international journal which aims to publish contemporary reviews, discussion papers and editorials within physical therapy, and in those basic and clinical sciences which are the basis of physical therapy. The journal is aimed at all those involved in research, teaching and practice within the area of physical therapy. Reviews (both descriptive and systematic) are invited in the following areas, which reflect the breadth and diversity of practice within physical therapy: •neurological rehabilitation •movement and exercise •orthopaedics and rheumatology •manual therapy and massage •sports medicine •measurement •chest physiotherapy •electrotherapeutics •obstetrics and gynaecology •complementary therapies •professional issues •musculoskeletal rehabilitation
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