BIOFEEDBACK AND PHYSICAL THERAPY TREATMENT OF PFS

原发性纤维肌痛综合征(PFS)是最常见的 风湿科医生看到的疾病。尽管PFS患者 在客观体检、疼痛的基础上显得“健康” 和功能障碍是这方面的重大问题 患者组。尽管已报道的短期好处是 药理管理或理疗项目，在那里 没有报告长期益处的对照研究。事实上，PFS是 一种肌筋膜疼痛的状况，经常在 好几年了。心理因素在这一过程中起着重要作用 PFS的维持和恶化。尽管如此，还有 一直没有进行对照研究来评估 对这些患者进行心理干预。具体的 本项目的目标如下：1.评估短期和长期 放松训练/生物反馈计划的学期结果 (第1组)，条件性理疗计划(第2组)，或 跨学科综合治疗方案(第3组) 疼痛、心理困扰、肌肉紧张的改善，以及 产后疲劳综合征患者的功能状态。2.与经济发展最相关的因素 上述结果将被确定。在分层之后 PFS症状变量的心理困扰和持续时间， 120名受试者将被随机分配到三个人中的一个 治疗组或注意安慰剂对照组 接受教育项目。跨学科小组 参加放松训练/生物反馈和 理疗项目。然后，受试者将参加六个 每周培训计划，然后进行为期三年的维护 程序。对这些治疗的有效性进行评估 节目将以痛苦、心理困扰、 心理生理功能、压痛点和功能 地位衡量标准。这些治疗方案将在 为期六周的培训计划结束。为了确定长期的 这些干预措施的长期有效性，患者将 在完成6个月、21个月和36个月后进行评估 周训练计划，同时还在参加 维护计划。治疗，心理，和 与疼痛和疼痛变化相关的人口统计学变量 功能能力将被确定。是否有经过验证的 PFS的干预计划和治疗和识别 产生积极结果的主体变量将 显著改善对PFS患者的护理。

Primary Fibromyalgia Syndrome (PFS) is one of the most common disorders seen by the rheumatologist. Although PFS patients appear "healthy" bases on objective physical examination, pain and functional impairment are significant problems for this patient group. Despite the reported short term benefits of pharmacological management or physical therapy programs, there is no controlled study reporting long term benefits. Indeed PFS is a myofascial pain condition which often"waxes and wanes" for years. Psychological factors play a significant role in the maintenance and exacerbation of PFS. Nevertheless, there has been no controlled study to assess the effectiveness of a psychological intervention among these patients. The specific aims of this project are as follows: 1. Assess the short and long term outcome of a relaxation training/biofeedback program (group 1), a conditioning physical therapy program (group 2), or an interdisciplinary combined treatment program (group 3) on improvements in pain, psychological distress, muscle tension, and functional status of PFS patients. 2. Factors most related to the above outcome will be identified. After stratification on psychological distress and duration of PFS symptoms variables, the 120 subjects will be randomly assigned to one of the three treatment groups or to an attention placebo control group which receives an educational program. The interdisciplinary group participates in both the relaxation training/biofeedback and physical therapy programs. Subjects will then participate in a six week training program followed by a three year maintenance program. Evaluation of the effectiveness of these treatment programs will be based on pain, psychological distress, psychophysiological functioning, tender points, and functional status measures. These treatment programs will be compared at the end of the six week training program. To determine the long term effectiveness of these interventions, patients will be assessed at 6, 21, and 36 months following completion of the 6 week training program and while still participating in the maintenance program. Treatment, psychological, and demographic variables associated with changes in pain and functional ability will be identified. The availability of a proven intervention program for PFS and identification of treatment and subject variables which produce positive outcomes will significantly improve the care of PFS patients.