Exercise-based Motivational Interviewing for Fibromyalgia

基于运动的纤维肌痛动机访谈

• 批准号: 7674773
• 负责人: Dennis Chua Ang
• 金额: $ 43.9万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7674773
• 关键词: Adherence; Adoption; Aerobic; Aerobic Exercise; Affect; Attention; Chronic Disease; Clinic; Clinical; Communication; Comorbidity; Control Groups; Diagnosis; Disease; Economics; Effectiveness; Elements; Enrollment; Environment; Equilibrium; Etiology; Exercise; Family; Fatigue; Fibromyalgia; Functional disorder; Future; General Population; Goals; Health Benefit; Home environment; Individual; Intention; Intervention; Intervention Trial; Knowledge; Lead; Licensing; Literature; Maintenance; Mediator of activation protein; Medical; Memory; Modality; Nurses; Outcome; Outcome Assessment; Outcome Measure; Pain; Palpation; Participant; Pathogenesis; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Pharmacotherapy; Phase; Physical Function; Physical activity; Pilot Projects; Population; Productivity; Professional counselor; Randomized; Reporting; Research; Research Personnel; Rheumatology; Self Efficacy; Severities; Sleep; Societies; Stress; Structure; Symptoms; Syndrome; Telephone; Testing; Time; Training; Treatment Protocols; United States Food and Drug Administration; Work; base; chronic back pain; chronic pain; chronic widespread pain; control trial; daily functioning; expectation; experience; improved; innovation; mortality; motivational enhancement therapy; patient oriented; primary outcome; programs; psychological distress; skills; symptomatic improvement

DESCRIPTION (provided by applicant): Fibromyalgia (FMS), defined as the presence of both chronic widespread pain and the finding of 11/18 tender points on examination, affects 2% of the general population. Drug therapy for FMS is largely symptomatic as there is not yet a complete understanding of the pathogenesis of the disease. In the past 17 years, supervised aerobic exercise has emerged as an important treatment modality to improve pain, aerobic capacity, function and well-being. Individuals who are able to adhere to exercise almost always maintain the symptomatic benefits of exercise. Unfortunately, the rate of exercise adherence six months after the completion of a well-structured supervised exercise program is disappointingly low. Furthermore, although the efficacy of supervised aerobic exercise in the research setting is well documented, the applicability of such intervention in the clinic setting is doubtful. Therefore, we propose to conduct the Research to Encourage Exercise for Fibromyalgia (REEF), a randomized attention-controlled trial whose primary Aim is to evaluate the efficacy of telephone-delivered motivational interviewing (Ml) to encourage exercise, in improving exercise adherence and self-report physical function (co-primary outcome measures) for FMS patients. REEF will enroll 200 FMS patients, randomizing them to either the Ml group or the attention-control (AC) group. Participants from each group will receive a total of six telephone calls within a 12-week period. Prior to the phone calls, participants from both groups will receive an individualized exercise prescription and two supervised exercise training sessions to get them started on an exercise program. All subjects will undergo comprehensive outcome assessment at baseline, week 12, week 24 and week 36. The secondary Aim of this application is to determine the mediators between Ml and improvement in self-report physical function. The proposed research is significant because our focus is the promotion of adherence to an exercise program, of adequate intensity, in order to maximize functioning and well-being for patients with FMS. The use of a predominantly home-based exercise program and telephone-delivered Ml by a trained licensed practice nurse (LPN) could potentially make the proposed intervention more accessible to the greater majority of FMS patients. Furthermore, if proven efficacious, Ml could readily be applied to other chronically painful conditions (e.g. chronic back pain).

描述（由申请人提供）：纤维肌痛 (FMS) 定义为同时存在慢性广泛疼痛和检查时发现 11/18 压痛点，影响 2% 的总人口。 FMS 的药物治疗主要是针对症状的，因为尚未完全了解该疾病的发病机制。在过去的 17 年中，监督有氧运动已成为改善疼痛、有氧能力、功能和健康的重要治疗方式。能够坚持运动的人几乎总能保持运动的症状益处。不幸的是，在结构良好的监督锻炼计划完成六个月后，锻炼坚持率低得令人失望。此外，尽管在研究环境中监督有氧运动的功效已有充分记录，但这种干预措施在临床环境中的适用性值得怀疑。因此，我们建议开展鼓励锻炼治疗纤维肌痛的研究（REEF），这是一项随机注意力对照试验，其主要目的是评估电话传递的动机访谈（Ml）鼓励锻炼的功效，以及提高 FMS 患者的锻炼依从性和自我报告身体功能（共同主要结果指标）的效果。 REEF 将招募 200 名 FMS 患者，将他们随机分配到 M1 组或注意力控制 (AC) 组。每组参与者将在 12 周内总共接到 6 个电话。在打电话之前，两组参与者都将收到个性化的运动处方和两次监督下的运动训练课程，以帮助他们开始运动计划。所有受试者将在基线、第12周、第24周和第36周接受全面的结果评估。该应用的次要目的是确定MI和自我报告身体功能改善之间的中介因素。拟议的研究意义重大，因为我们的重点是促进坚持足够强度的锻炼计划，以最大限度地提高 FMS 患者的功能和福祉。使用主要以家庭为基础的锻炼计划以及由经过培训的执业护士 (LPN) 通过电话提供的 Ml 可能会使大多数 FMS 患者更容易接受拟议的干预措施。此外，如果被证明有效，ML可以很容易地应用于其他慢性疼痛病症（例如慢性背痛）。