BEHAVIORAL PREPARATION FOR TREATING FIBROMYALGIA

治疗纤维肌痛的行为准备

• 批准号: 6778889
• 负责人: Akiko Okifuji
• 金额: $ 55.09万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6778889
• 关键词: autogenic training; behavioral /social science research tag; behavioral medicine; chronic pain; clinical research; clinical trials; cognitive behavior therapy; coping; depression; exercise; fibromyalgia; functional ability; health education; human subject; human therapy evaluation; medical rehabilitation related tag; motivation; musculoskeletal disorder therapy; patient oriented research; physical therapy; rehabilitation; self care; self concept; sign /symptom; therapy compliance

DESCRIPTION: Fibromyalgia syndrome (FMS) is a prevalent, chronic musculoskeletal pain disorder. Although no treatment has been shown to be universally effective, research suggests that a multimodal rehabilitative approach including active physical exercise and coping skill training reduces various symptoms of FMS. Nevertheless, there is large variability in treatment response. Since the rehabilitative approach requires patients to adopt a set of new perspectives and behaviors, the clinical benefit of such approach largely depends upon patient readiness and willingness to comply with the regimen. Past research suggests that successful outcomes require patient intent to change, efficacious beliefs about change, and ability to undertake process of change. In this amended application, we propose to evaluate the clinical efficacy of coping skill training and motivation enhancement therapy to prepare sedentary FMS patients to a rehabilitative approach. A total of 300 patients will be screened. Eligible patients will undergo a 10 2-hour weekly treatment sessions consisting of active exercise, physical therapy education, and one of the three behavioral preparation programs: Coping Skill Training program (CST), Motivation Enhancement program (MET), or Educational Lectures (EDS). Ten hours of the therapy hours across the first 6 weeks and one additional hour at the end of the program will be dedicated to behavioral preparation. All patients will receive one hour active physical exercise from Week 5 to Week10 and one hour physical education in Week 7 through Week 9. A comprehensive evaluation including medical, physical, and psychological assessments at the clinic and a home assessment protocol examining daily symptoms, activity levels, and sleep quality for one week will be performed at pre-treatment, post-treatment, and 6 month follow-up phases. At 12 month follow-up, each patient will undergo the home assessment protocol and questionnaire assessment. We will also delineate factors associated with clinically meaningful outcomes for each preparation program and to test mediation paths to better understand the mechanisms of clinical improvement via rehabilitation. We expect that results from this study will facilitate better understanding of how motivation enhancement augments clinical benefit of rehabilitative approach for many chronic pain conditions.

描述：纤维肌痛综合征（FMS）是一种普遍的慢性肌肉骨骼疼痛障碍。尽管没有证明没有治疗是普遍有效的，但研究表明，包括积极体育锻炼和应对技能训练在内的多模式康复方法可减少FMS的各种症状。然而，治疗反应的差异很大。由于康复方法要求患者采用一系列新的观点和行为，因此这种方法的临床益处在很大程度上取决于患者的准备和遵守该方案的意愿。过去的研究表明，成功的结果需要患者意图改变，对变革的有效信念以及实施变革过程的能力。在此修订后的应用中，我们建议评估应对技能培训和动机增强疗法的临床功效，以使久坐的FMS患者成为一种康复方法。总共将筛选300名患者。符合条件的患者将进行10 2小时的每周治疗课程，包括主动运动，物理治疗教育以及三种行为准备计划之一：应对技能培训计划（CST），动机增强计划（MET）或教育讲座（EDS）。在该计划结束时，在最初的6周中的十个小时的治疗时间将用于行为准备。所有患者将在第5周至第7周至第9周的体育课中接受一小时的积极体育锻炼。在诊所进行的全面评估，包括医疗，身体和心理评估以及一项家庭评估协议，检查每日症状，活动水平和睡眠质量一周，将在治疗前，治疗后，训练后以及6个月的随访阶段进行。在12个月的随访中，每个患者将接受家庭评估方案和问卷调查。我们还将描述每个制备计划中与临床上有意义的结果相关的因素，并测试调解路径，以更好地了解通过康复的临床改善的机制。我们预计，这项研究的结果将有助于更好地理解动机的增强如何在许多慢性疼痛状态下增强康复方法的临床益处。