Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial

Abstract

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Pain neuroscience education combined with usual treatment for fibromyalgia syndrome: A randomized controlled trial

“…Furthermore, the PNE + pharmacological treatment group showed greater improvement in functional status compared to pharmacological treatment alone. These results are similar to those of a previous study 24 comparing PNE combined with pharmacological treatment vs pharmacological treatment alone. In another study, a similar group structure was used in patients with migraine, and those who received PNE in addition to usual care were determined to have greater improvement than those only given usual care in terms of disability level and medication intake.…”

“…The primary outcome measure was the FIQ score. Based on a previous study, 24 the effect size was large for FIQ (Cohen d = 0.95) for the time × group interaction. Using this effect size, 30 participants (15 participants in each group) were required to show statistically significant differences at 80% power and an α level of .05.…”

Efficacy of the FIBROWALK Multicomponent Program Moved to a Virtual Setting for Patients with Fibromyalgia during the COVID-19 Pandemic: A Proof-of-Concept RCT Performed Alongside the State of Alarm in Spain

“…Beyond therapeutic exercise and CBT, an important strength of the FIBROWALK protocol is the addition of PNE and mindfulness training, which constitute, respectively, a significant change of perspective regarding the classical pain education and the CBT focus on changing problematic thoughts. In this regard, PNE is aimed at educating patients on the mechanisms behind chronic pain, highlighting that any credible evidence of danger or safety in body tissues can increase or decrease pain perception, respectively [22], and has been found to be effective in patients with FM [18][19][20][21][22][23][24][25][26][27][28]. It is noteworthy that PNE seems even more effective when it is combined with therapeutic exercise, gradual exposure techniques, and CBT [24,70], all of which are integrated elements in the FIBROWALK program.…”

“…Current therapeutic strategies in FM usually combine pharmacological and non-pharmacological approaches [ 10 , 11 , 12 , 13 ], and multicomponent non-pharmacological treatments are currently considered the gold standard [ 12 , 14 , 15 , 16 , 17 ]. Regarding therapy components proved to be effective in FM, Pain Neuroscience Education (PNE) [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] is aimed at changing patients’ pain beliefs, emphasizing how overprotective behaviors can modulate pain experience [ 29 , 30 , 31 ], and it has been found to be effective for reducing pain disability, catastrophizing, avoidance behaviors and physical inactivity in patients with FM [ 32 ]. On the other hand, Cognitive Behavioral Therapy (CBT) and therapeutic exercise are also core pillars of intervention in FM [ 33 , 34 , 35 ], and combining both has been seen to be particularly effective at treating several FM symptoms [ 36 , 37 , 38 ] (e.g., relieving pain, fatigue, depression, and improving psychological well-being and physical functioning [ 12 , 33 ]).…”

Recomendaciones clínicas para la rehabilitación de personas con fibromialgia. Una revisión narrativa.

“…Recientemente, la combinación de ambos modelos en clínica ha demostrado mejorar la calidad de vida y los síntomas en personas con FM (90). La utilización clínica del modelo del error evaluativo es prometedora, pero necesita de mayor investigación.…”