Therapeutic Neuroscience Education In Fibromyalgia: A Randomized Controlled Trial

Abstract

Objective

To investigate additive effect of Therapeutic Neuroscience Education (TNE) to pilates exercises in female patients with fibromyalgia (FM).

Method

25 female patients FM included in the study. They randomly separated into two groups. There were 11 patients in the intervention group and 14 patients in the control group. Pilates exercises and TNE were applied in the intervention group, and only pilates exercises were applied in the control group. Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA), Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), Fibromyalgia Impact Questionnare (FIQ), Symptom Severity Scale (SSS), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Biopsychosocial Questionnaire (BETY-BQ) and pressure algometer was used for evaluation.

Results

After the treatment, control group improved in the “visuomotor construction” and “thinking operations"cognitive areas andtotal score of DLOTCA, BPI-pain severity score, VAS, FIQ, SSS, PCS-magnification, and only left medial knee mean score of pressure pain thresholds (p<0.05). Intervention group improved in the “thinking operations” cognitive area and total score of DLOTCA, BPI-pain severity score, BPI-pain interference score, VAS, WPI, FIQ, SSS, TSK, BETY-BQ and all pressure pain thresholds (excluding left trapezius) (p<0.05). In the comparison of delta values, the intervention group improved more in WPI, FIQ, right trapezius mean score and left trapezius, right quadriceps femoris, right-left medial knee maximum and mean scores of pressure pain thresholds (p<0.05).

Conclusion

TNE increased the effectiveness of pilates exercises on pain, functional status and pressure pain thresholds in patients with FM.

Zusammenfassung

Ziel

Ziel der Studie war es, die additive Wirkung von therapeutischer neurowissenschaftlicher Ausbildung (Therapeutic Neuroscience Education, TNE) bei Fibromyalgie (FM) zu untersuchen.

Methode

In die Studie wurden 25 Patientinnen mit FM aufgenommen und randomisiert in zwei Gruppen eingeteilt: 11 Patientinnen in die Interventionsgruppe und 14 in die Kontrollgruppe. In der Interventionsgruppe kamen Pilates-Übungen und TNE zur Anwendung, in der Kontrollgruppe nur Pilates-Übungen. Die folgenden Instrumente wurden zur Prüfung verwendet: Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA), visuelle Analog-Skala (VAS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), Fibromyalgia Impact Questionnare (FIQ), Symptom Severity Scale (SSS), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Biopsychosocial Questionnaire (BETY-BQ) und Druckalgometrie.

Ergebnisse

Nach der Behandlung fanden sich in der Kontrollgruppe Verbesserungenin der Kognition in den Bereichen „visuomotorische Konstruktion” und „Denkoperationen“ sowie im Gesamtscore von DLOTCA, BPI-Schmerzschweregrad-Score, VAS, FIQ, SSS, PCS-Magnification und nur im mittleren Score der medial am linken Knie bestimmten Druckschmerz-Schwellen (p<0,05). Die Interventionsgruppe zeigte Verbesserungen in der Kognition im Bereich „Denkoperationen“ sowie im Gesamtscore von DLOTCA, BPI-Schmerzschweregrad-Score, BPI-Schmerz-Interferenz-Score, VAS, WPI, FIQ, SSS, TSK, BETY-BQ und alle Druckschmerzschwellen (außer linker M. trapezius) (p<0,05). Der Vergleich der Delta-Werte ergab für die Interventionsgruppe stärkere Verbesserungen hinsichtlich WPI, FIQ, des mittleren Scores für den rechten und linken M. trapezius, rechten M. quadriceps femoris, das Maximum am medialen Knie rechts-links und des mittleren Scores der Druckschmerzschwellen (p<0,05).

Schlussfolgerung

TNE verbesserte die Wirkung von Pilates-Übungen auf Schmerzen, Funktionsstatusund Druckschmerzschwellen bei Patientinnen mit FM.

Keywords

Cognition - exercise - Fibromyalgia - pain - Kinesiophobia

Schlüsselwörter

Kognition - Übungen - Fibromyalgie - Schmerz - Kinesiophobie

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