Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial.
Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial.
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DOI：
10.1097/ajp.0b013e318254ac76
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Saha C
中科院分区：
文献类型：
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作者：
Ang DC;Kaleth AS;Bigatti S;Mazzuca SA;Jensen MP;Hilligoss J;Slaven J;Saha C
定期运动与纤维肌痛（FM）患者的重要益处相关。不幸的是，在结构化的计划之后长期保持锻炼是罕见的。本研究旨在探讨动机性访谈（MI）在促进FM患者运动和改善症状方面的有效性。216例FM患者被随机分配至6个MI疗程（n=107）或相同数量的FM自我管理课程（教育对照/EC，n=109）。共同主要终点是在治疗前、治疗后以及3个月和6个月随访时评估的中等强度体力活动增加30分钟和纤维肌痛影响量表-身体损害（FIQ-PI）评分改善。次要结局包括FIQ评分、疼痛严重程度评分和6分钟步行试验的临床有意义的改善。在6个月随访时，两个治疗组的协同主要终点均无显著差异。然而，在6个月随访时，更多MI参与者的FIQ评分出现有意义的改善（62.9% vs. 49.5%，p=0.06）。与EC受试者相比，MI受试者在6分钟步行试验中也显示出更大的增量（43.9米vs. 24.8米，p=0.03）。此外，MI在增加干预后立即进行体力活动的小时数以及降低干预后立即和3个月随访时的疼痛严重程度方面上级EC。尽管缺乏长期结果的益处，但MI似乎在自我报告的体力活动和临床结果方面具有短期益处。这是FM中第一项明确将运动维持作为主要目标的研究。
Regular exercise is associated with important benefits in patients with fibromyalgia (FM). Unfortunately, long-term maintenance of exercise after a structured program is rare. The present study tested the efficacy of Motivational Interviewing (MI) to promote exercise and improve symptoms in patients with FM. 216 patients with FM were randomized to 6 MI sessions (n=107) or an equal number of FM self-management lessons (education control/EC, n=109). Co-primary endpoints were an increase of 30 minutes in moderate-vigorous physical activity and improvement in the Fibromyalgia Impact Questionnaire-Physical Impairment (FIQ-PI) score, assessed at pre-treatment, post-treatment, and 3- and 6-month follow-up. Secondary outcomes included clinically meaningful improvements in FIQ score, pain severity ratings, and a 6-minute walk test. There were no significant treatment group differences in either co-primary endpoint at 6-month follow-up. However, more MI participants than controls exhibited meaningful improvements in FIQ score at 6-month follow-up (62.9% vs. 49.5%, p=0.06). Compared to EC subjects, MI subjects also displayed a larger increment in their 6-minute walk test (43.9 vs. 24.8 meters, p=0.03). Additionally, MI was superior to EC in increasing the number of hours of physical activity immediately post-intervention and in reducing pain severity both immediately after the intervention and at 3-month follow-up. Despite a lack of benefits on long term outcome, MI appears to have short-term benefits with respect to self-report physical activity and clinical outcomes. This is the first study in FM that explicitly addresses exercise maintenance as a primary aim.