Kinesiophobia, adherence to treatment, pain and quality of life in fibromyalgia syndrome patients

BACKGROUND AND OBJECTIVES: Fibromyalgia syndrome is characterized by diffuse and chronic musculoskeletal pain, which is difficult to handle and negatively affects patients' quality of life. This study aimed at measuring fear of movement, adherence to treatment and at evaluating health-related quality of life of fibromyalgia syndrome patients.METHODS: This is a prospective study in convenience sample made up of individuals with fibromyalgia syndrome and treated in a Pain Outpatient Clinic. Tools used were: identification protocol, Fibromyalgia Impact Questionnaire, generic quality of life questionnaire World Health Organization's Quality of Life Instrument, visual analog scale, Tampa Scale for Kinesiophobia and treatment adherence measurement. Participated in the study 65 individuals being 35 with fibromyalgia syndrome called test group and 30 without diagnostic of musculoskeletal and neurological systems diseases called control group.RESULTS: The test group had predominance of females, mean age of 42.5±4.3 years, 53% were married and mean education was 9±2.5 years. Mean pain duration was 3.5±1.2 years and mean of two years for fibromyalgia syndrome diagnostic. There has been poorer quality of life, more severe pain and acknowledgment of the importance of physical activities, in spite of referring fear. In addition, adherence to pharmacological treatment was lower than that observed in the control group.CONCLUSION: Fibromyalgia patients had more severe pain, more fear of movement and poorer quality of life in physical an social domains. Adherence to treatment level was medium and there has been decreased functional capacity.

背景与目的：纤维肌痛综合征（fibromyalgia syndrome）以弥漫性慢性肌肉骨骼疼痛为核心临床特征，此类疼痛管控难度大，且会对患者的生活质量造成负面影响。本研究旨在量化纤维肌痛综合征患者的运动恐惧程度、治疗依从性，并评估其健康相关生活质量。
方法：本研究为一项基于便利抽样样本的前瞻性研究，研究对象为在疼痛门诊接受治疗的纤维肌痛综合征患者。本研究采用的评估工具包括：人口学信息登记表、纤维肌痛影响问卷（Fibromyalgia Impact Questionnaire）、普适性生活质量问卷——世界卫生组织生活质量测定量表（World Health Organization's Quality of Life Instrument）、视觉模拟评分法（visual analog scale）、坦帕运动恐惧症量表（Tampa Scale for Kinesiophobia）以及治疗依从性评估工具。本研究共纳入65名受试者，其中35名确诊纤维肌痛综合征的患者作为试验组，剩余30名无肌肉骨骼及神经系统疾病诊断史的个体作为对照组。
结果：试验组以女性群体为主，平均年龄为42.5±4.3岁，53%的受试者处于已婚状态，平均受教育年限为9±2.5年。受试者的疼痛平均病程为3.5±1.2年，纤维肌痛综合征确诊平均时长为2年。尽管存在运动恐惧心理，但试验组人群的生活质量较差、疼痛程度更为严重，且均认可体力活动的重要性。此外，试验组的药物治疗依从性显著低于对照组。
结论：纤维肌痛综合征患者的疼痛程度更剧烈、运动恐惧程度更高，且在生理及社会领域的生活质量显著更差。其治疗依从性处于中等水平，且存在躯体功能能力下降的情况。