Estudo randomizado e controlado de uma intervenção terapêutica grupal em pacientes com síndrome fibromiálgica

Objetivo: Avaliar a eficácia de um programa interdisciplinar semanal (PIS) composto de atividades educativas, terapias físicas, alongamento, ergonomia, orientações posturais combinado com estratégias cognitivas e comportamentais e abordagens de aspectos psicossociais e ocupacionais, a fim de determinar se esta intervenção seria efetiva em curto e médio prazos para melhora dos sintomas destes pacientes. Casuística e métodos: Trata-se de um estudo unicêntrico, randomizado, simples cego e controlado com amostra de um grupo-teste (T), com diagnóstico de SFM (n = 12), e de um grupo-controle (C) submetido a interconsulta na Clínica da Dor (n = 15). Os instrumentos utilizados em dois momentos distintos foram: Questionário de Impacto de Fibromialgia (FIQ), Escala Visual Analógica (EVA) e Protocolo Pós-Sono (PSI). Para avaliar a qualidade de vida, foi utilizado o Questionário SF-12. Resultados: Na amostra dos dois grupos houve predomínio do gênero feminino, média de idade de 42,5±9,8 anos, 43% casados e média de escolaridade de 8,3±4,5 anos. Foi relatado um tempo médio de dor de 4,2 anos e uma média de dois anos para o diagnóstico de SFM no grupo T. Houve diferença estatística entre os grupos, em relação à eficácia pós-intervenção do PIS, em quase todos os desfechos analisados. Conclusão: Verificou-se que o programa interdisciplinar semanal (PIS) contribuiu para melhora da qualidade de vida dos pacientes fibromiálgicos

EFFECTIVENESS OF AN INTERDISCIPLINARY PROGRAM IN PATIENTS WITH FAILED BACK SURGERY SYNDROME

ABSTRACT Objective: To evaluate the results of an interdisciplinary program administered to patients with failed back surgery syndrome, aiming at functional improvement, modulation of pain, reduction of anxiety symptoms and depression, and improvement of quality of life. Method: This is a non-randomized prospective study with a sample of patients with failed back surgery pain syndrome diagnosed with persistent or recurrent pain after surgery to the lumbar spine (laminectomy and arthrodesis) referred to liaison in the Pain Clinic (n= 26). The instruments used were Brief Pain Inventory, Roland-Morris Questionnaire and Beck Anxiety and Depression Inventories. The generic WHOQOL-bref13 questionnaire was used to evaluate the quality of life and the fear of moving was assessed by the Tampa Scale for Kinesiophobia. Results: There was a predominance of females, the mean age was 42.3 ± 5.8 years, 43% were married and average schooling was 7 ± 4.5 years. The mean time of pain reported was 8 ± 6.8 months in addition to high levels of anxiety, depression and kinesiophobia. After the intervention, there was a significant improvement in the perception of quality of life and of all parameters evaluated (p<0.05), with functional gains as well as decreased pain threshold. Conclusion: The interdisciplinary intervention in patients with failed back surgery syndrome provides better functional performance, decreases the intensity of pain, anxiety and depression symptoms, and improves quality of life. The inclusion of this intervention associated with drug therapy may the patient develop an active and independent lifestyle