ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1107

A Randomized Trial Of a Physical Self-Management Program For Fibromyalgia Syndrome

Aline Ranzolin1, Suélem S. Barros2, Vanessa M. Fernandes3, Eduardo A. S. Pimentel3, Claudia Diniz L. Marques4 and Angela Luzia B. Pinto Duarte5, 1Rheumatology, Hospital das Clínicas - Universidade Federal de Pernambuco, Recife, Brazil, 2Programa de Pós-Graduação em Ciências da Saúde da Universidade Federal de Pernambuco, Recife, Brazil, 3Centro Universitário Maurício de Nassau, Recife, Brazil, 4Disciplina de Reumatologia, Hospital das Clínicas - Universidade Federal de Pernambuco, Recife, Brazil, 5Hospital das Clínicas - Universidade Federal de Pernambuco, Recife, Brazil

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Fibromyalgia, Soft Tissue Disorders and Pain II

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Fibromyalgia syndrome (FMS) is a painful disorder that interferes directly in the functional capacity and quality of life. Treatment advocates interventions in the physical, pharmacological, cognitive-behavioral and educational aspects. Scientific evidences show that physical exercises minimize pain, fatigue and muscle tension, improving levels of stress, anxiety and depression in individuals with FMS, when performed on a regular basis. Educational policies for self-management of symptoms are increasingly encouraged as complementary treatment, due to the chronicity of the clinical picture. This study was made to evaluate the effectiveness of a physical self-management program for FMS patients.

Methods:

We conducted a single-blind, randomized trial of a physical self-management program for FMS patients compared with a control group. The physical self-management program consisted of sessions lasted 90 minutes each and took place once a week for 10 weeks, aiming to wellness and postural education and active stretching exercises, that were orientated to been done at home. The control group was only monitored through medical appointments, without any physical intervention. No drug changes were allowed during the study period. It was selected 45 FMS patients that were on stable treatment in the last month before the selection. It was excluded patients that were on physical therapy, in use of auxiliary resources gait and those who have autoimmune rheumatic diseases associated or relevant uncontrolled comorbidities. They were evaluated through the Fibromyalgia Impact Questionnaire (FIQ), the Pain Visual Analogue Scale (VAS pain) and the Sit and Reach Test (SRT). The number of analgesic tablets ingested was accounted during the study through diaries. The data were been compared through Student t test, Mann-Whitney test and Wilcoxon test and results are presented as significant differences with 95% confidence intervals.

Results:

There was a loss of 11% of the sample (4 in experimental group and 1 in controls) and the study ended with 40 participants. The experimental group (n=19) had clinically important improvements in the levels of flexibility, VAS pain, FIQ total score and in the FIQ’s issues Feel Good, VAS fatigue and VAS stiffness (table). The VAS depression in the control group (n=21) worsened significantly. The experimental group consumed less analgesic tablets during the study period (p=0.046). There was no difference regarding non-refreshing sleep and anxiety.

Variables

Evaluation

Group

 

Experimental

Control

P Value

Flexibility (cm)

Initial

18.25 ± 10.93

23.23 ± 7.24

p = 0.041†

 

Final

25.74 ± 8.36

21.23 ± 7.49

 

 

P Value

p = 0.001*

p = 0.067*

 

VAS pain

Initial

8.46 ± 1.11

7.70 ± 1.90

p = 0.067†

 

Final

5.77 ± 2.65

7.27 ± 2.20

 

 

P Value

p = 0.004 ‡

p = 0.347*

 

Feel good

Initial

8.73 ± 1.78

8.44 ± 2.21

p = 0.743†

 

Final

4.74 ± 2.66

8.10 ± 2.91

 

 

P Value

p < 0.001*

p = 0.782‡

 

VAS fatigue

Initial

9.11 ± 0.94

8.48 ± 2.46

p = 0.907†

 

Final

7.68 ± 2.11

9.00 ± 1.92

 

 

P Value

p = 0.006‡

p = 0.264*

 

VAS stiffness

Initial

8.26 ± 2.33

7.71 ± 1.95

p = 0.245†

 

Final

7.00 ± 2.49

7.95 ± 2.04

 

 

P Value

p = 0.037*

p = 0.554*

 

VAS depression

Initial

8.74 ± 1.48

7.19 ± 3.46

p = 0.162†

 

Final

7.53 ± 2.91

8.71 ± 2.03

 

 

P Value

p = 0.083‡

p = 0.004‡

 

FIQ total score

Initial

79.17 ± 11.47

73.07 ± 16.22

p = 0.182*

 

Final

64.46 ± 15.66

77.16 ± 12.70

 

 

P Value

p = 0.001*

p = 0.101*

 

Conclusion:

The physical self-management program significantly improved pain, fatigue, stiffness, total FIQ and flexibility in patients with FMS and could be an important complementary therapy, mainly, in a context of public medical assistance.

Disclosure:

A. Ranzolin,
None;

S. S. Barros,
None;

V. M. Fernandes,
None;

E. A. S. Pimentel,
None;

C. D. L. Marques,
None;

A. L. B. P. Duarte,
None.

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