Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200019
Brazilian Journal of Pain
Artigo Original

Effectiveness of the interactional and interdisciplinary school of fibromyalgia: a long-term randomized control study

Eficácia da escola interrelacional e interdisciplinar de fibromialgia: estudo randomizado controlado em longo prazo

Juliana Barcellos de Souza; Patricia Bourgault; Jacques Charest; Serge Marchand

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Abstract

BACKGROUND AND OBJECTIVES: This study assessed long-term efficacy of an interdisciplinary group intervention of patients with fibromyalgia as compared with standard medical care.

METHODS: A partially randomized controlled study with two groups and repeated measures. Variables were measured at baseline; immediately after the program; 4 months and 1 year later. Fibromyalgia patients were recruited by newspaper ads or physician references from two Quebec regions. Sixty women suffering from fibromyalgia were randomized to the experimental group (ISF) or the control group CG. The program, called Interactional School of Fibromyalgia (ISF), consists of nine sessions with eight participants and two clinicians. Five variables were measured: Fibromyalgia Impact Questionnaire (FIQ), Physical and Mental components summary of Short Form Health Survey 36 (SF-36), Clinical pain, and pressure pain threshold at tender points.

RESULTS: Efficacy analyses from completers, as well as intent-to-treat analyses, showed a treatment effect on measures even one year after the end of the program. The experimental group experienced lower FIQ scores (p<0.01), less clinical pain (p<0.05), higher pressure-pain thresholds (p<0.01), and higher physical component summary scores on the SF-36 (p<0.05).

CONCLUSION: This interdisciplinary group intervention of patients with fibromyalgia demonstrated better long-term outcomes compared with standard medical care.

Keywords

Coping, Exercise therapy, Fibromyalgia, Pain management

Resumo

JUSTIFICATIVA E OBJETIVOS: Este estudo avaliou a eficácia em longo prazo de uma intervenção interdisciplinar em grupo de pacientes com fibromialgia, comparando-a ao atendimento médico padrão.

MÉTODOS: O estudo foi realizado randomicamente com dois grupos e coleta de dados de repetição. As variáveis foram medidas antes do início do programa; imediatamente após o programa; 4 meses e 1 ano depois. Os pacientes com fibromialgia foram recrutados por anúncios em jornais ou referências médicas, de duas regiões de Quebec. Sessenta mulheres que sofriam de fibromialgia foram randomizadas para o grupo experimental (EIF) ou o grupo controle (GC). O programa, denominado Escola Interrelacional de Fibromialgia (EIF), consiste em nove sessões com oito participantes e dois clínicos. Cinco variáveis de resultados foram medidas: Questionário de Impacto da Fibromialgia (QIF), resumo de componentes físicos e mentais do Short Form Health Survey 36 (SF-36), dor clínica e limiar de dor por pressão em pontos sensíveis.

RESULTADOS: As análises de eficácia dos que completaram o programa, bem como as análises de intenção de tratar, mostraram um efeito de tratamento nas medições mesmo um ano após o término do programa. O grupo experimental apresentou pontuações mais baixas do QIF (p<0,01), menos dor clínica (p<0,05), os mais altos limiares de dor por pressão (p<0,01) e as mais altas pontuações do resumo de componente físico no SF-36 (p<0,05).

CONCLUSÃO: Esta intervenção interdisciplinar em grupo de pacientes com fibromialgia demonstrou melhores resultados em longo prazo em comparação com os cuidados médicos padrão.

Palavras-chave

Adaptação psicológica, Fibromialgia, Manejo da dor, Terapia por exercício

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Submetido em:
06/11/2019

Aceito em:
20/03/2020

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