目的:总结现有证据并评估成人纤维肌痛(FM)的中长期物理治疗的有效性。
方法:本系统综述注册于PROSPERO:CRD42023388356。搜索的数据库是MEDLINE,PEDro,Scopus,Cinhal,LatinIndex,还有Cochrane,使用以下关键字:“纤维肌痛”,“物理治疗”,\"治疗\",“治疗性锻炼”,\"TENS\",“激光治疗”和“手动治疗”。“纳入的文章分析了FM患者的主动或被动物理治疗方法。变量包括结构特征,如:作者,出版年份,研究问题,和主要结果变量。关于文章调查结果的数据包括以下几个方面:参与者人数,干预,后续行动,结果,和主要结论。
结果:分析了33篇文章,总体PRISMA得分为18.63±3.36。分析的积极治疗方法是:运动和身体意识疗法(伸展,太极,瑜伽和普拉提);水疗;物理或有氧运动;和多学科治疗。分析的被动疗法是:手动疗法;重复经颅磁刺激(rTMS);和其他疗法(高压氧疗法,振动疗法,虚拟现实,经皮神经电刺激(TENS),疼痛神经科学教育,和针灸)。发现了物理治疗对纤维肌痛的体征和症状有积极作用的证据,如疼痛,身体能力受损和生活质量恶化。
结论:在大多数研究中,分析的主动和被动疗法在治疗疾病症状和体征方面的有效性是积极的。然而,对治疗方案的更具体描述,频率,强度和治疗剂量需要达成共识,以及延长随访期的主要研究,以更好地评估长期效果。
OBJECTIVE: To summarise the available evidence and assess the effectiveness of medium and long-term physiotherapy treatment in adults with fibromyalgia (FM).
METHODS: This systematic review was registered in PROSPERO: CRD42023388356. The databases searched were MEDLINE, PEDro, Scopus, Cinhal, LatinIndex, and Cochrane, using the following keywords: \"fibromyalgia\", \"physiotherapy\", \"treatment\", \"therapeutic exercise\", \"TENS\", \"laser therapy\" and \"manual therapy.\" The included articles analysed treatments with active or passive physiotherapy approaches in patients with FM. The variables included structural characteristics, such as: author, publication year, research question, and main outcome variables. The data on the findings of the articles comprised the following aspects: number of participants, intervention, follow-up, results, and principal conclusions.
RESULTS: Thirty-three articles were analysed, with an overall PRISMA score of 18.63±3.36. The active treatment methods analysed were: movement and body awareness therapies (stretching, tai chi, yoga and Pilates); hydrotherapy; physical or aerobic exercise; and multidisciplinary therapy. The passive therapies analysed were: manual therapy; repetitive transcranial magnetic stimulation (rTMS); and other therapies (hyperbaric oxygen therapy, vibration therapy, virtual reality, transcutaneous electric nervous stimulation (TENS), pain neuroscience education, and acupuncture). Evidence was found on the positive effect of physiotherapy treatment on the signs and symptoms of fibromyalgia, such as pain, impairment of physical capacity and worse quality of life.
CONCLUSIONS: The effectiveness of the active and passive therapies analysed in the management of the symptoms and signs of the disease was positive in most of the studies. However, more specific descriptions of the treatment protocol, frequency, intensity and treatment dose are required to reach a consensus, as well as primary studies for a more extended follow-up period to better evaluate long-term effects.