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The aim of this study is to compare the effects of two physiotherapeutic treatments of fibromyalgia: global postural reeducation associated with cognitive behavioral therapy and segmental muscle stretching exercises associated with cognitive behavioral therapy.
Fibromyalgia is characterized mainly by chronic widespread pain. Segmental muscle stretching therapeutic exercises reduce the shortening of myofascial structures and recover the body flexibility. It is indicated for the treatment of chronic pain caused by osteo-myo-articular dysfunction. The pain behavior may be defined as the adoption of body postures and attitudes that a person communicates his/her pain. In this way, the global postural reeducation - a method of muscles chains stretching exercises - could be an important intervention. In addition, negative thoughts and dysfunctional beliefs are usual in situations of chronic pain, compromising the health recovery process. As part of a pain catastrophizing-related therapeutic approach, physiotherapist may help patients with chronic pain to develop positive, realistic and hope attitudes as based on the cognitive behavioral therapy model.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GPR and CBT | Experimental | Global postural reeducation associated with cognitive behavioral therapy; 01 session per week for 10 weeks |
|
| SMSE and CBT | Active Comparator | Segmental muscle stretching exercises associated with cognitive behavioral therapy; 01 session per week for 10 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Global postural reeducation | Other |
| ||
| Segmental muscle stretching exercises |
| Measure | Description | Time Frame |
|---|---|---|
| Visual analogic scale of pain | 11 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| McGill Pain Questionnaire | 11 weeks | |
| Dolorimetry of the 18 tender points | 11 weeks | |
| Survey of Pain Attitudes - brief version |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Luciana A Matsutani, MSc | University of Sao Paulo | Principal Investigator |
| Amelia P Marques, PhD | University of Sao Paulo | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of the University of Sao Paulo | São Paulo | São Paulo | 05360-000 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21769128 | Background | Schmidt-Wilcke T, Clauw DJ. Fibromyalgia: from pathophysiology to therapy. Nat Rev Rheumatol. 2011 Jul 19;7(9):518-27. doi: 10.1038/nrrheum.2011.98. | |
| 17631737 | Background | Matsutani LA, Marques AP, Ferreira EA, Assumpcao A, Lage LV, Casarotto RA, Pereira CA. Effectiveness of muscle stretching exercises with and without laser therapy at tender points for patients with fibromyalgia. Clin Exp Rheumatol. 2007 May-Jun;25(3):410-5. |
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| ID | Term |
|---|---|
| D005356 | Fibromyalgia |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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| Other |
|
| Cognitive behavioral therapy | Other |
|
| 11 weeks |
| Body posture evaluation | 11 weeks |
| Modified Clinical Test of Sensory Interaction for Balance (CTSIBm) | 11 weeks |
| Sit-and-Reach Test | 11 weeks |
| Fibromyalgia Impact Questionnaire | 11 weeks |
| Narrative interview about self-care | 11 weeks |
| 21829981 | Background | Teodori RM, Negri JR, Cruz MC, Marques AP. Global Postural Re-education: a literature review. Rev Bras Fisioter. 2011 May-Jun;15(3):185-9. English, Portuguese. |
| 23098173 | Background | Campbell CM, McCauley L, Bounds SC, Mathur VA, Conn L, Simango M, Edwards RR, Fontaine KR. Changes in pain catastrophizing predict later changes in fibromyalgia clinical and experimental pain report: cross-lagged panel analyses of dispositional and situational catastrophizing. Arthritis Res Ther. 2012 Oct 25;14(5):R231. doi: 10.1186/ar4073. |
| 37280637 | Derived | Matsutani LA, Sousa do Espirito Santo A, Ciscato M, Yuan SLK, Marques AP. Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial. Trials. 2023 Jun 7;24(1):384. doi: 10.1186/s13063-023-07422-w. |
| D009422 |
| Nervous System Diseases |