Abstract：
BACKGROUND: Sleep disturbance is commonly seen in fibromyalgia syndrome (FMS); however, high quality studies involving manual therapies that target FMS-linked poor sleep quality are lacking for the Indian population.
OBJECTIVE: Craniosacral therapy (CST), Bowen therapy and exercises have been found to influence the autonomic nervous system, which plays a crucial role in sleep physiology. Given the paucity of evidence concerning these effects in individuals with FMS, our study tests the effectiveness of CST, Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS.
METHODS: A placebo-controlled randomized trial was conducted on 132 FMS participants with poor sleep at a hospital in Bangalore. The participants were randomly allocated to one of the four study groups, including CST, Bowen therapy, standard exercise program, and a manual placebo control group that received static touch. CST, Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks; the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks. After 12 weeks, all study participants performed the standard exercises at home for another 12 weeks.
METHODS: Sleep quality, pressure pain threshold (PPT), quality of life and fibromyalgia impact, physical function, fatigue, pain catastrophizing, kinesiophobia, and positive-negative affect were recorded at baseline, and at weeks 12 and 24 of the intervention.
RESULTS: At the end of 12 weeks, the sleep quality improved significantly in the CST group (P = 0.037) and Bowen therapy group (P = 0.023), and the PPT improved significantly in the Bowen therapy group (P = 0.002) and the standard exercise group (P < 0.001), compared to the static touch group. These improvements were maintained at 24 weeks. No between-group differences were observed for other secondary outcomes.
CONCLUSIONS: CST and Bowen therapy improved sleep quality, and Bowen therapy and standard exercises improved pain threshold in the short term. These improvements were retained within the groups in the long term by adding exercises. CST and Bowen therapy are treatment options to improve sleep and reduce pain in FMS.
BACKGROUND: Registered at Clinical Trials Registry of India with the number of CTRI/2020/04/024551. Please cite this article as: Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, Lakshmi VR. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: a randomized controlled trial. J Integr Med. 2024; 22(4): 474-484.
OBJECTIVE: Craniosacral therapy (CST), Bowen therapy and exercises have been found to influence the autonomic nervous system, which plays a crucial role in sleep physiology. Given the paucity of evidence concerning these effects in individuals with FMS, our study tests the effectiveness of CST, Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS.
METHODS: A placebo-controlled randomized trial was conducted on 132 FMS participants with poor sleep at a hospital in Bangalore. The participants were randomly allocated to one of the four study groups, including CST, Bowen therapy, standard exercise program, and a manual placebo control group that received static touch. CST, Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks; the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks. After 12 weeks, all study participants performed the standard exercises at home for another 12 weeks.
METHODS: Sleep quality, pressure pain threshold (PPT), quality of life and fibromyalgia impact, physical function, fatigue, pain catastrophizing, kinesiophobia, and positive-negative affect were recorded at baseline, and at weeks 12 and 24 of the intervention.
RESULTS: At the end of 12 weeks, the sleep quality improved significantly in the CST group (P = 0.037) and Bowen therapy group (P = 0.023), and the PPT improved significantly in the Bowen therapy group (P = 0.002) and the standard exercise group (P < 0.001), compared to the static touch group. These improvements were maintained at 24 weeks. No between-group differences were observed for other secondary outcomes.
CONCLUSIONS: CST and Bowen therapy improved sleep quality, and Bowen therapy and standard exercises improved pain threshold in the short term. These improvements were retained within the groups in the long term by adding exercises. CST and Bowen therapy are treatment options to improve sleep and reduce pain in FMS.
BACKGROUND: Registered at Clinical Trials Registry of India with the number of CTRI/2020/04/024551. Please cite this article as: Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, Lakshmi VR. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: a randomized controlled trial. J Integr Med. 2024; 22(4): 474-484.
摘要：
背景：睡眠障碍常见于纤维肌痛综合征（FMS）；然而，印度人口缺乏针对与FMS相关的不良睡眠质量的手动治疗的高质量研究。
目的：颅骨治疗（CST），已经发现Bowen疗法和锻炼会影响自主神经系统，在睡眠生理学中起着至关重要的作用。鉴于缺乏有关FMS个体中这些影响的证据，我们的研究测试了CST的有效性，Bowen疗法和针对静态触摸（手动安慰剂组）的标准运动计划对FMS睡眠质量的影响。
方法：在班加罗尔的一家医院对132名睡眠不足的FMS参与者进行了安慰剂对照随机试验。参与者被随机分配到四个研究组之一，包括CST,Bowen疗法,标准锻炼计划，和接受静态触摸的手动安慰剂对照组。CST,Bowen疗法和静态触摸疗法每周一次，每次45分钟，持续12周；标准运动组每周接受有监督的运动，持续6周，并进行家庭运动，直至12周。12周后,所有研究参与者在家中再进行12周的标准锻炼.
方法：睡眠质量，压力痛阈值（PPT），生活质量和纤维肌痛的影响，物理功能，疲劳,痛苦的灾难，运动恐惧症,在基线时记录阳性-阴性影响，在干预的第12周和第24周。
结果：在12周结束时，CST组(P=0.037)和Bowen治疗组(P=0.023)睡眠质量显著改善,Bowen治疗组（P=0.002）和标准运动组（P<0.001）的PPT明显改善，与静态触摸组相比。这些改善在24周保持。其他次要结局没有观察到组间差异。
结论：CST和Bowen疗法改善了睡眠质量，Bowen疗法和标准锻炼在短期内改善了疼痛阈值。通过增加练习，这些改进长期保留在小组中。CST和Bowen疗法是改善睡眠和减轻FMS疼痛的治疗选择。
背景：在印度临床试验注册中心注册，编号为CTRI/2020/04/024551。请引用这篇文章：UghrejaRA，VenkatesanP,GopalakrishnaDB,SinghYP,LakshmiVR.颅骶骨治疗的有效性，Bowen疗法,静态触摸和标准运动计划对纤维肌痛综合征睡眠质量的影响：一项随机对照试验。JIntegrMed。2024年；Epub提前打印。
目的：颅骨治疗（CST），已经发现Bowen疗法和锻炼会影响自主神经系统，在睡眠生理学中起着至关重要的作用。鉴于缺乏有关FMS个体中这些影响的证据，我们的研究测试了CST的有效性，Bowen疗法和针对静态触摸（手动安慰剂组）的标准运动计划对FMS睡眠质量的影响。
方法：在班加罗尔的一家医院对132名睡眠不足的FMS参与者进行了安慰剂对照随机试验。参与者被随机分配到四个研究组之一，包括CST,Bowen疗法,标准锻炼计划，和接受静态触摸的手动安慰剂对照组。CST,Bowen疗法和静态触摸疗法每周一次，每次45分钟，持续12周；标准运动组每周接受有监督的运动，持续6周，并进行家庭运动，直至12周。12周后,所有研究参与者在家中再进行12周的标准锻炼.
方法：睡眠质量，压力痛阈值（PPT），生活质量和纤维肌痛的影响，物理功能，疲劳,痛苦的灾难，运动恐惧症,在基线时记录阳性-阴性影响，在干预的第12周和第24周。
结果：在12周结束时，CST组(P=0.037)和Bowen治疗组(P=0.023)睡眠质量显著改善,Bowen治疗组（P=0.002）和标准运动组（P<0.001）的PPT明显改善，与静态触摸组相比。这些改善在24周保持。其他次要结局没有观察到组间差异。
结论：CST和Bowen疗法改善了睡眠质量，Bowen疗法和标准锻炼在短期内改善了疼痛阈值。通过增加练习，这些改进长期保留在小组中。CST和Bowen疗法是改善睡眠和减轻FMS疼痛的治疗选择。
背景：在印度临床试验注册中心注册，编号为CTRI/2020/04/024551。请引用这篇文章：UghrejaRA，VenkatesanP,GopalakrishnaDB,SinghYP,LakshmiVR.颅骶骨治疗的有效性，Bowen疗法,静态触摸和标准运动计划对纤维肌痛综合征睡眠质量的影响：一项随机对照试验。JIntegrMed。2024年；Epub提前打印。
