Document Type : Original Article
Authors
- . Mateus Dias Antunes 1
- . Letícia Assis Couto 1
- . Letícia Assis Couto1 , Sonia Maria Marques Gomes Bertolini 2
- . Felipe Cayres Nogueira da Rocha Loures3 3
- . Ana Carolina Basso Schmitt 1
- . Amélia Pasqual Marques 1
1 Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
2 Health Promotion Graduate Program and Cesumar Institute of Science, Technology and Innovation, Cesumar University, Maringá, Paraná, Brazil,
3 Department of Medicine, Cesumar University, Maringá, Paraná, Brazil
Abstract
Fibromyalgia has been increasing worldwide and is considered a public health problem.
Nonpharmacological treatment through exercise and education is recommended for
fibromyalgia management. In this sense, there is a need for interdisciplinary programs to
promote health and improve symptoms in fibromyalgia. The purpose of this study was
to verify the effectiveness of interdisciplinary health education programs for individuals
with fibromyalgia. This is a systematic review that followed the Preferred Reporting
Items for Systematic Reviews and Meta‑Analyses recommendations and was registered
at Prospective Register of Systematic Reviews (CRD4201913228). A search was conducted
in the following databases: Scientific Electronic Library Online, Lilacs, Medical Literature
Analysis and Retrieval System Online, Scopus, Web of Knowledge ISI, Physiotherapy
Evidence Database, Excerpta Medica Database, Cumulative Index to Nursing and Allied
Health Literature, Cochrane Library, and SPORTDiscus. The descriptors used were
“Fibromyalgia” and “Health Education.” Clinical trials published between 1990 and 2019
were selected. The Jadad Quality Scale and the Cochrane Risk‑of‑Bias Tool were used to
evaluate the risk of bias and the methodological quality of the clinical trials. The search
found 2887 articles, and only two studies were included in the analysis. Both studies
conducted the interventions through lectures and group activities. In particular, the
topics most frequently approached at the interdisciplinary health education programs
were general information about fibromyalgia, body practices, physical activities, and
pharmacological approaches. An interdisciplinary health education program can improve
pain and quality of life in people with fibromyalgia; however, evidence shows low
methodological quality. This systematic review indicates that studies are of low quality,
interfering with the effectiveness of interdisciplinary health education programs.
Keywords
disease impact, pain catastrophizing and autonomic modulation
in women with fibromyalgia. Int J Exerc Sci 2017;10:1184‑95.
2. Assunção Júnior JC, de Almeida Silva HJ, da Silva JFC, da Silva
Cruz R, de Almeida Lins CA, de Souza MC. Zumba dancing
can improve the pain and functional capacity in women with
fibromyalgia. J Bodyw Mov Ther 2018;22:455‑9. Available from:
https://doi.org/10.1016/j.jbmt. 2017.09.022. [Last accessed on
2020 Sep 13].
3. Lazaridou A, Buliteanu A, Dorado K, Schreiber K. The effects of
yoga on pain, fatigue, and catastrophizing in fibromyalgia. J Pain
2018;19:30‑1. Available from: https://doi.org/10.1016/j.jpain.
2017.12.075. [Last accessed on 2020 Sep 13].
4. Castro Sánchez AM, García López H, Fernández Sánchez M,
Pérez Mármol JM, Aguilar‑Ferrándiz ME, Luque Suárez A, et al.
Improvement in clinical outcomes after dry needling versus
myofascial release on pain pressure thresholds, quality of life,
fatigue, pain intensity, quality of sleep, anxiety, and depression
in patients with fibromyalgia syndrome. Disabil Rehabil
2019;41:2235‑46. Available from: https://doi.org/10.1080/096382
88.2018.1461259. Accessed on: 13 Sep. 2020. Ernberg M, Christidis
N, Ghafouri B, Bileviciute‑Ljungar I, Löfgren M, Bjersing J, et al.
Plasma cytokine levels in fibromyalgia and their response to
15 weeks of progressive resistance exercise or relaxation therapy. Mediators Inflamm 2018;2018:1‑14. Available from: https://doi.
org/10.1155/2018/3985154. [Last accessed on 2020 Sep 13].
5. Fioravanti A, Manica P, Bortolotti R, Cevenini G, Tenti S,
Paolazzi G. Is balneotherapy effective for fibromyalgia? Results
from a 6‑month double‑blind randomized clinical trial. Clin
Rheumatol 2018;37:2203‑12. Available from: https://doi.
org/10.1007/s10067‑018‑4117‑z. [Last accessed on 2020 Sep 13].
6. Mist SD, Jones KD. Randomized controlled trial of acupuncture for
women with fibromyalgia: Group acupuncture with traditional
Chinese medicine diagnosis‑based point Selection. Pain Med
2018;19:1862‑71. Available from: https://doi.org/10.1093/pm/
pn×322. [Last accessed on 2020 Sep 13].
7. Wang C, Schmid CH, Fielding RA, Harvey WF, Reid KF, Price LL,
et al. Effect of tai chi versus aerobic exercise for fibromyalgia:
Comparative effectiveness randomized controlled trial. BMJ
2018;360:k851. Available from: https://doi.org/10.1136/bmj.
k851. [Last accessed on 2020 Sep 13].
8. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS,
Mease P, et al. The American College of Rheumatology
preliminary diagnostic criteria for fibromyalgia and measurement
of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600‑10.
Available from: https://doi.org/10.1002/acr0.20140. A [Last
accessed on 2020 Sep 13].
9. Marques AP, Santo AD, Berssaneti AA, Matsutani LA, Yuan SL.
Aprevalência de fibromialgia: Atualização da revisão de literatura.
Rev Bras Reumatol 2017;57:356‑63. Available from: http://dx.doi.
org/10.1016/j.rbre. 20170.01.005. [Last accessed on 2020 Sep 13].
10. Brandão PM Jr., Besset VL. Dor crônica: Um problema de saúde
pública, uma questão para a psicanálise. Polêm!ca 2015;15:25‑41.
Available from: https://doi.org/10.12957/polemica. 2015.19359.
[Last accessed on 2020 Sep 13].
11. Ruiz Pérez I, Ubago Linares MC, Bermejo Pérez MJ,
Plazaola Castaño J, Olry de Labry‑Lima A, Hernández Torres E.
Differences in sociodemographic, clinical, psychosocial and
health care characteristics between men and women diagnosed
with fibromyalgia. Rev Clin Esp 2007;207:433‑9. Available from:
https://doi.org/10.1157/13109832. [Last accessed on 2020 Sep 13].
12. Sicras‑Mainar A, Rejas J, Navarro R, Blanca M, Morcillo A,
Larios R, et al. Treating patients with fibromyalgia in primary
care settings under routine medical practice: A claim database
cost and burden of illness study. Arthritis Res Ther 2009;11:R54.
Available from: https://doi.org/10.1186/ar2673. [Last accessed
on 2020 Sep 13].
13. Higgs JB. Fibromyalgia in primary care. Prim Care 2018;45:325‑41.
Available from: https://doi.org/10.1016/j.pop.2018.02.008. [Last
accessed on 2020 Sep 13].
14. Rowe CA, Sirois FM, Toussaint L, Kohls N, Nöfer E,
Offenbächer M, et al. Health beliefs, attitudes, and health‑related
quality of life in persons with fibromyalgia: Mediating role
of treatment adherence. Psychol Health Med 2019;24:962‑77.
Available from: https://doi.org/10.1080/13548506.2019.15769
13. [Last accessed on 2020 Sep 13].
15. Conversano C, Poli A, Ciacchini R, Hitchcott P, Bazzichi L,
Gemignani A. A psychoeducational intervention is a
treatment for fibromyalgia syndrome. Clin Exp Rheumatol
2019;37 Suppl 116:98‑104.4.
16. Oliveira JO Jr., Almeida MB. The current treatment of
fibromyalgia. Br J Pain 2018;1:255‑62. Available from: https://
doi.org/10.5935/2595‑0118.20180049. [Last accessed on 2020 Sep
13].
17. Sosa‑Reina MD, Nunez‑Nagy S, Gallego‑Izquierdo T,
Pecos‑Martín D, Monserrat J, Álvarez‑Mon M. Effectiveness of
therapeutic exercise in fibromyalgia syndrome: A systematic
review and meta‑analysis of randomized clinical trials.
Biomed Res Int 2017;17 (1):1‑14. Available from: https://doi.
org/10.1155/2017/2356346. [Last accessed on 2020 Sep 13].
18. Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E,
et al. EULAR revised recommendations for the management of
fibromyalgia. Ann Rheum Dis 2017;76:318‑28. Available from:
https://doi.org/10.1136/annrheumdis‑2016‑209724. [Last
accessed on 2020 Sep 13].
19. Carneiro AC, de Souza V, Godinho LK, de Faria IC, Silva KL,
Gazzinelli MF. Health promotion education in the context of
primary care. Rev Panam Salud Publica 2012;31:115‑20. Available
from: https://doi.org/10.1590/s1020‑49892012000200004. [Last
accessed on 2020 Sep 13].
20. Candeias NM. Conceitos de educação e de promoção em
saúde: Mudanças individuais e mudanças da saúde no
contexto da atenção primária. Rev Panam Salud Publica
2012;31:115‑20. Available from: https://doi.org/10.1590/
S0034‑89101997000200016. [Last accessed on 2020 Sep 13].
21. Rolls C, Prior Y. Non‑pharmacological interventions for people
with fibromyalgia: A systematic review. Rheumatol 2018;57:164‑5.
Available form: https://doi.org/10.1093/rheumatology/
key075.509 [Last accessed on 2020 Sep 13].
22. Ablin J, Fitzcharles MA, Buskila D, Shir Y, Sommer C,
Häuser W. Treatment of fibromyalgia syndrome: recommendations
of recent evidence‑based interdisciplinary guidelines with special
emphasis on complementary and alternative therapies. Evid Based
Complement Alternat Med 2013;13 (1):1‑7. Available from: https://
doi.org/10.1155/2013/485272. [Last accessed on 2020 Sep 13].
23. Giusti EM, Castelnuovo G, Molinari E. Differences in
multidisciplinary and interdisciplinary treatment programs for
fibromyalgia: A mapping review. Pain Res Manag 2017;17 (1):1‑19.
Available from: https://doi.org/10.1155/2017/7261468. [Last
accessed on 2020 Sep 13].
24. Montesó‑Curto P, García‑Martinez M, Romaguera S, Mateu ML,
Cubí‑Guillén MT, Sarrió‑Colas L, et al. Problems and solutions for
patients with fibromyalgia: Building new helping relationships.
J Adv Nurs 2018;74:339‑49. Available from: https://doi.
org/10.1111/jan.13412. [Last accessed on 2020 Sep 13].
25. Marques AP, Matsutani LA, Ferreira EA, Mendonça LL. A
fisioterapia no tratamento de pacientes com fibromialgia: Uma
revisão da literatura. Rev Bras Reumatol 2002;42:42‑8.
26. Miranda NA, Berardinelli LM, Sabóia VM, Brito ID, Santos RD.
Interdisciplinary care praxis in groups of people living with
fibromyalgia. Rev Bras Enferm 2016;69:1115‑23. Available from:
https://doi.org/10.1590/0034‑7167‑2016‑0279. [Last accessed on
2020 Sep 13].
27. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A,
Petticrew M, et al. Preferred reporting items for systematic review
and meta‑analysis protocols (PRISMA‑P) 2015 statement. Syst Rev
2015;4:1. Available from: https://doi.org/10.1136/bmj.g7647.
[Last accessed on 2020 Sep 13].
28. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C,
Goldenberg DL, et al. The American College of Rheumatology
1990 criteria for the classification of fibromyalgia. Report of the
multicenter criteria committee. Arthritis Rheum 1990;33:160‑72.
Available from: https://doi.org/10.1002/art. 1780330203. [Last
accessed on 2020 Sep 13].
29. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ,
Gavaghan DJ, et al. Assessing the quality of reports of randomized
clinical trials: Is blinding necessary? Control Clin Trials 1996;17:1‑2.
Available from: https://doi.org/10.1016/0197‑2456 (95) 00134‑4.
[Last accessed on 2020 Sep 13].
30. Higgins JP, Green S, editors. Cochrane Handbook for Systematic
Reviews of Interventions Versão 5.1.0. United Kingdom:
The Cochrane Collaboration; 2011. Available from: https://
handbook‑5‑1.cochrane.org. [Updated March 2011].
31. Bosch Romero E, Sáenz Moya N, Valls Esteve M, Viñolas Valer S.
Study of quality of life of patients with fibromyalgia: Impact of
a health education programme. Aten Primaria 2002;30:16‑21.
Available from: https://doi.org/10.1016/s0212‑6567 (02) 78958‑0.
[Last accessed on 2020 Sep 13].
32. Pereira Pernambuco A, de Souza Cota Carvalho L,
Pereira Leite Schetino L, Cunha Polese J, de Souza VianaR, d’ ÁvilaReis D. Effects of a health education program on cytokines and
cortisol levels in fibromyalgia patients: A randomized controlled
trial. Adv Rheumatol 2018;58:21. Available from: https://doi.
org/10.1186/s42358‑018‑0022‑z. Accessed on: 13 Sep. 2020
33. Lally P, Van Jaarsveld CH, Potts HW, Wardle J. How are habits
formed: Modelling habit formation in the real world. Eur Jn
Soc Psychol 2010;40:998‑1009. Available from: https://doi.
org/10.1002/ejsp. 674. Accessed on: 13 Sep. 2020
34. Boland L, Légaré F, Carley M, Graham ID, O’Connor AM,
Lawson ML, et al. Evaluation of a shared decision making
educational program: The Ottawa Decision Support Tutorial.
Patient Educ Couns 2019;102:324‑31. Available from: https://
doi.org/10.1016/j.pec. 2018.09.008. Accessed on: 13 Sep. 2020
)