Effectiveness of a group intervention using pain neuroscience education and exercise in women with fibromyalgia: a pragmatic controlled study in primary care

Paula B Areso-Bóveda; Julia Mambrillas-Varela; Bárbara García-Gómez; José Ignacio Moscosio-Cuevas; Jesús González-Lama; Eva Arnaiz-Rodríguez; María Begoña Arroyo Del Barco; Pilar San Teodoro-Blanco

doi:10.1186/s12891-022-05284-y

Effectiveness of a group intervention using pain neuroscience education and exercise in women with fibromyalgia: a pragmatic controlled study in primary care

BMC Musculoskelet Disord. 2022 Apr 4;23(1):323. doi: 10.1186/s12891-022-05284-y.

Affiliations

¹ Burgos Centre Physiotherapy Unit in Burgos Centre, GAP (Primary Care Management) Burgos (SACYL: Castille and Leon Health Service), C/ José María de la Puente 1, 09006, Burgos, Spain.
² López Sáiz Health Centre, GAP (Primary Care Management) Burgos (SACYL: Castille and Leon Health Service), C/ José María de la Puente 1, 09006, Burgos, Spain.
³ Fuensanta Health Centre, Córdoba-Guadalquivir Primary Care District (SAS: Andalusian Health Service), C/ Núñez de Balboa 2, 14010, Córdoba, Spain.
⁴ Group-Program Communication and Health -GPCyS- (semFYC), c/ Diputació, 320 Bajo, 08009, Barcelona, Spain.
⁵ Group-Program Communication and Health -GPCyS- (semFYC), c/ Diputació, 320 Bajo, 08009, Barcelona, Spain. jegonla@telefonica.net.
⁶ Clinical Management Unit in Cabra, Matrona Antonia Mesa Fernández Health Centre, South Córdoba Health Management Area (SAS: Andalusian Health Service), Avda. Góngora s/n, 14940-Cabra, Córdoba, Spain. jegonla@telefonica.net.
⁷ Prevention and Health Promotion Program -PAPPS- (semFYC), c/ Diputació, 320 Bajo, 08009, Barcelona, Spain. jegonla@telefonica.net.
⁸ Clinical Epidemiology Research Group in Primary Care (GICEAP), Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital / University of Córdoba, Avda. Menéndez Pidal s/n, 14004, Córdoba, Spain. jegonla@telefonica.net.
⁹ San Agustín Physiotherapy Unit, C/ Bonifacio Zamora de Usabel, 09001, Burgos, Spain.
¹⁰ José Luis Santamaría Physiotherapy Unit, C/ Lazarillo de Tormes, 09006, Burgos, Spain.
¹¹ Group-Program Communication and Health -GPCyS- (socalemFYC), C/ Veinte de Febrero 6, 47001, Valladolid, Spain.
¹² Healthcare Ethics Committee in the Burgos University Hospital, Avda. de las Islas Baleares 3, 09006, Burgos, Spain.

Abstract

Background: Very positive effects have been described in the application of pain neuroscience education (PNE) to chronic pain and migraine. However, there are few data on the applicability of this therapeutic approach in actual clinical practice in a primary care (PC) setting. The aim of this study was to explore the efficacy in fibromyalgia (FM) of an intervention based on PNE and exercise compared to treatment as usual (TAU).

Methods: Pragmatic nonrandomised controlled trial set in 5 healthcare centres and one physiotherapy centre in PC. Fifty-three women with FM (2010 American College of Rheumatology Diagnostic Criteria for Fibromyalgia) were studied, 35 in the intervention group (IG) and 18 in the control group (CG). The women in the IG were interviewed individually and then received 6 weekly sessions plus one review session (1 month later): those in the CG received their TAU. The subject assignation to the CG or the IG was determined according to their availability to attend the sessions. They all filled in several questionnaires (prior to and 1 year after the intervention) to evaluate the impact of FM in their daily lives, catastrophism, anxiety and depression, severity and impact of pain in daily personal performance and functional capacity.

Results: The reductions (improvements) in the scores of all tests (baseline-final) were greater in the IG (p < 0.05) when adjusted for age and baseline values, with moderate or high effect size. After 1 year, 20% (CI - 1 to 42%) more women in the IG, compared to the CG, had a FIQ score < 39 (mild functional impairment). 17/38 (49%) women in the IG no longer met FM criteria at the end of follow-up.

Conclusions: An intervention based on PNE and exercise in patients with FM is feasible and seems effective in PC.

Trial registration: The study was retrospectively registered at ClinicalTrials.gov (Trial Registration NCT04539171 ), on 04/09/2020.

Keywords: Central nervous system sensitization; Chronic pain; Fibromyalgia; Neurosciences; Pain measurement; Patient education.

Publication types

Controlled Clinical Trial

MeSH terms

Educational Status
Exercise
Female
Fibromyalgia* / diagnosis
Fibromyalgia* / therapy
Humans
Pain
Primary Health Care

Associated data

ClinicalTrials.gov/NCT04539171