Please use this identifier to cite or link to this item:
Title: Effectiveness of a Multicomponent treatment for fibromyalgia based on Pain neuroscience education, Exercise therapy, Psychological support, and Nature exposure (NAT-FM): A Pragmatic randomized controlled trial
Author: Serrat, Mayte
Almirall, Míriam
Musté, Marta
Sanabria Mazo, Juan P.
Feliu Soler, Albert
Méndez Ulrich, Jorge Luis
Luciano Devis, Juan Vicente
Sanz Ruiz, Antoni
Keywords: Fibromiàlgia
Teràpia cognitiva
Teràpia cognitiva basada en l'atenció plena
Teràpia d'exposició
Exercici terapèutic
Cognitive therapy
Mindfulness-based cognitive therapy
Exposure therapy
Exercise therapy
Issue Date: 18-Oct-2020
Publisher: MDPI
Abstract: A recent study (FIBROWALK) has supported the effectiveness of a multicomponent treatment based on pain neuroscience education (PNE), exercise therapy (TE), cognitive behavioral therapy (CBT), and mindfulness in patients with fibromyalgia. The aim of the present RCT was: (a) to analyze the effectiveness of a 12-week multicomponent treatment (nature activity therapy for fibromyalgia, NAT-FM) based on the same therapeutic components described above plus nature exposure to maximize improvements in functional impairment (primary outcome), as well as pain, fatigue, anxiety-depression, physical functioning, positive and negative a ect, self-esteem, and perceived stress (secondary outcomes), and kinesiophobia, pain catastrophizing thoughts, personal perceived competence, and cognitive emotion regulation (process variables) compared with treatment as usual (TAU); (b) to preliminarily assess the e ects of the nature-based activities included (yoga, Nordic walking, nature photography, and Shinrin Yoku); and (c) to examine whether the positive effects of TAU + NAT-FM on primary and secondary outcomes at post-treatment were mediated through baseline to six-week changes in process variables. A total of 169 FM patients were randomized into two study arms: TAU + NAT-FM vs. TAU alone. Data were collected at baseline, at six-week of treatment, at post-treatment, and throughout treatment by ecological momentary assessment (EMA). Using an intention to treat (ITT) approach, linear mixed-e ects models and mediational models through path analyses were computed. Overall, TAU + NAT-FM was significantly more e ective than TAU at posttreatment for the primary and secondary outcomes evaluated, as well as for the process variables. Moderate-to-large effect sizes were achieved at six-weeks for functional impairment, anxiety, kinesiophobia, perceived competence, and positive reappraisal. The number needed to treat (NNT) was 3 (95%CI = 1.6-3.2). The nature activities yielded an improvement in affective valence, arousal, dominance, fatigue, pain, stress, and self-effcacy. Kinesiophobia and perceived competence were the mediators that could explain a significant part of the improvements obtained with TAU + NAT-FM treatment. TAU + NAT-FM is an e ective co-adjuvant multicomponent treatment for improving FM-related symptoms.
Note: Reproducció del document publicat a:
It is part of: Journal of Clinical Medicine, 2020, vol. 9, num. 10, p. 1-24
Related resource:
ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (Mètodes d'Investigació i Diagnòstic en Educació)

Files in This Item:
File Description SizeFormat 
704751.pdf1.37 MBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons