Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: Part 1
Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: Part 1
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DOI：
10.2522/ptj.20070200
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发表时间：
2008-07-01
期刊：
影响因子：
3.2
通讯作者：
Veilleux, L.
中科院分区：
文献类型：
--
作者：
Brosseau, Lucie;Wells, George A.;Veilleux, L.
背景和目的。本研究的目的是为1990年美国风湿病学会标准定义的纤维肌痛成年患者（bb0 - 18岁）的有氧健身运动管理制定指南。遵循Cochrane协作方法，渥太华方法小组从比较对照试验中发现并合成证据，并组成渥太华小组，由主要利益相关者组织提名的专家组成。渥太华小组随后制定了基于实验设计（随机对照试验为1级，非随机研究为11级）和证据强度（A、13、C+、C、D+、D或D-）的建议分级标准。通过严格的文献检索，我们选择了13项随机对照试验和3项临床对照试验。统计分析采用Cochrane Collaboration方法。连续数据用干预组与对照组的加权平均差值计算，二分类数据用相对危险度分析。临床改善是用绝对获益和相对基线变化差异来计算的。当发现相对于对照组改善15%时，具有临床意义。正面建议24条：A级10条，B级1条，C+级13条。在这24项积极建议中，只有5项具有临床益处。讨论与结论。渥太华专家小组根据文献中出现的新证据（等级a、B和C+，尽管大多数试验被评为低质量）推荐有氧健身运动用于纤维肌痛的治疗。
Background and Purpose. The objective of this study was to create guidelines for the use of aerobic fitness exercises in the management of adult patients (> 18 years of age) with fibromyalgia, as defined by the 1990 American College of Rheumatology criteria.Methods. Following Cochrane Collaboration methods, the Ottawa Methods Group found and synthesized evidence from comparative controlled trials and formed the Ottawa Panel, with nominated experts from key stakeholder organizations. The Ottawa Panel then developed criteria for grading the recommendations based on experimental design (I for randomized controlled trials, 11 for nonrandomized studies) and strength of evidence (A, 13, C+, C, D+, D, or D-). From the rigorous literature search, 13 randomized control trials and 3 controlled clinical trials were selected. Statistical analysis was based on Cochrane Collaboration methods. Continuous data were calculated with weighted mean differences between the intervention and control groups, and dichotomous data were analyzed with relative risks. Clinical improvement was calculated using absolute benefit and relative difference in change from baseline. Clinical significance was attained when an improvement of 15% relative to a control was found.Results. There were 24 positive recommendations: 10 grade A, 1 grade B, and 13 grade C+. Of these 24 positive recommendations, only 5 were of clinical benefit.Discussion and Conclusion. The Ottawa Panel recommends aerobic fitness exercises for the management of fibromyalgia as a result of the emerging evidence (grades A, B, and C+, although most trials were rated low quality) shown in the literature.