Does the Addition of Pain Neurophysiology Education to a Therapeutic Exercise Program Improve Physical Function in Women with Fibromyalgia Syndrome? Secondary Analysis of a Randomized Controlled Trial

Abstract

Therapeutic exercise (TE) is one of the most investigated approaches for the management of FMS. Pain neurophysiology education (PNE) helps toward understanding the pain condition, leading to maladaptive pain cognitions and coping strategies in patients with chronic pain. Our study aimed to assess the effects of therapeutic exercise and pain neurophysiology education versus TE in isolation on fatigue, sleep disturbances, and physical function in the short term and at three months of follow-up in women with fibromyalgia syndrome (FMS). A single-blind randomized controlled trial was carried out. A total of 32 women with FMS referred from medical doctors and fibromyalgia association were randomized in 2 groups: PNE + TE group or TE group. Fatigue and sleep disturbances (Visual Analog Score) and physical function (Senior Fitness Test) were assessed before, after intervention, and at three months of follow-up. Significant improvements were achieved in the Timed Up and Go test (p = 0.042) and Arm Curl test (p = 0.043) after intervention and on handgrip in the non-dominant side at three months of follow-up (p = 0.036) on the PNE + TE group. No between-groups differences were found for fatigue, sleep disturbances, and the rest of test included in the Senior Fitness Test. In conclusion, these results suggest that PNE + TE appears to be more effective than TE in isolation for the improvement of physical function (Timed Up and Go test and Arm Curl test) in women with FMS in the short term.

Chronic Pain Self-Management Strategies for Older Adults: An Integrative Review

“…The most-investigated strategy was the individual or group self-management course/program, investigated in 52% of the studies [ 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ], which encompassed a mix of the remaining strategies. Following, the order of the most-investigated strategies was physical exercise (in 34% of the studies), that could be specific [ 32 , 52 , 53 , 54 , 55 ] or general exercises [ 20 , 21 , 25 , 35 , 48 , 49 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ], individually or in groups, followed by education (in 21% of the studies) [ 21 , 32 , 36 , 52 , 53 , 54 , 56 ...…”

“…Self-strategies investigated resulted in the reduction of pain intensity and/or the number of spots presenting pain. In second place were increased self-care, self-efficacy, self-management and/or health behaviors (24.14%) [ 26 , 33 , 36 , 37 , 39 , 42 , 45 , 51 , 53 , 54 , 55 , 56 , 57 , 59 , 73 , 79 ], followed by increased physical function (20.68%) [ 19 , 20 , 21 , 28 , 34 , 36 , 40 , 42 , 45 , 52 , 56 , 58 , 61 , 62 , 73 ] and reduced depression (18.96%) [ 26 , 29 , 30 , 32 , 35 , 37 , 39 , 49 , 66 , 68 , 70 ]. Table 2 presents some examples of positive findings of the studies included, organized according to the main aspect addressed by their outcomes: biological, psychological, social or a mix of them.…”

“…), lack of sleep and physical activity in chronic pain, encouraging gradual exposure to natural movements and physical activity for pain self-management [ 18 ]. However, these studies have been limited to one or a few specific painful body regions, such as low back pain [ 18 ], neck pain, or knee pain [ 19 ], or to a baseline condition in which pain is one of the symptoms, such as osteoarthritis [ 20 ] or fibromyalgia [ 21 ]. Studies on the self-management of chronic pain as a disease in older adults in a more comprehensive way were not found.…”

Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals—A Cross-Sectional Study

“…Although the impact of kinesiophobia has been examined in various musculoskeletal diseases, there is no evidence of how kinesiophobia influences postural control in individuals with FM [ 31 , 32 ]. Therefore, the objectives of this study were to (1) estimate and compare the postural control variables between asymptomatic individuals and individuals with FM, (2) to assess the relationship between kinesiophobia and postural control in individuals with FM, and (3) to assess whether pain intensity mediates the relationship between kinesiophobia and postural control in individuals with FM.…”

The role of physiotherapy in fibromyalgia: Current and future perspectives

“…This association between interventions should be encouraged. A clinical trial by Ceballos-Laita et al (2021) found that pain education combined with physical exercise therapy appears to be more effective than physical exercise alone for improving physical function in women with fibromyalgia in the short term.…”