Telerehabilitation proposal of mind-body technique for physical and psychological outcomes in patients with fibromyalgia, 2022, Teresa Paolucci et al

Fibromyalgia (FM) syndrome is characterized by the close correlation of chronic widespread pain and other non-pain related symptoms. Aim of this study was to investigate whether telerehabilitation that provides physical and psychological support services of the mind-body techniques can affect the clinical profile and pain relief of FM patients.

The study included twenty-eight female FM patients, mean aged 56.61 ± 8.56 years. All patients underwent a rehabilitation treatment (8 sessions, 1/week, 1 h/each) through Zoom platform, with the following principles of rehabilitation treatment: Anchoring to a positive emotion; listen and perceive your “own” body; conscious breathing; improve interoceptive awareness; relax.

All patients then underwent clinical assessment of the physical distress and fear of movement for the Numeric Rating Scale (NRS); the Fatigue Assessment Scale (FAS); the Fear Avoidance Belief Questionnaire (FABQ); with measures of physical and mental disability for the Fibromyalgia Impact Questionnaire (FIQ); the 12-Items Short Form Survey; the Resilience Scale for Adults and the Coping Strategies Questionnaire-Revised. The evaluations were performed at T0 (baseline), T1 (after 8 weeks of treatment), and T2 (after 1 month of follow-up).

The main finding was that telerehabilitation reduced physical and mental distress, fear, and disability (p < 0.001). Resilience and coping ability were less affected by the rehabilitative treatment. Our attempt of mind-body technique telerehabilitation has shown good results in the improvement of painful symptoms and quality of life for the FM patients but showed fewer positive impacts for the resilience and coping abilities aspects.

https://www.frontiersin.org/articles/10.3389/fphys.2022.917956/full

 

This is simply way too high on the woo index, there is a strong selection to anyone who would participate in such a "study". It's basically spiritualism or something like that, most people would pretty much laugh at being asked to participate in this.

What this all shows is that those questionnaires are essentially useless, easy to manipulate and simply unreliable. Especially when they are so poorly selected, the medical equivalent of "when have you stopped beating your wife?" journalism.

 

This is a proposal so no control group. Seems everyone's pet PT technique thrown at the n=28 FM patients with only a numeric rating of pain at >3 (0-10 scale). That isn't the norm in studies; most require a 6 for pain on a 0-10 scale.

Invasive or useful, is the use of color as an 'emotional anchor'.

The fact that someone is paying attention to the subjects, their pain, and understanding their illness while speaking soothingly to them, instructing them in relaxation or very mild exercises, and having a participatory telephone session with all the MDs, PTs---all this would result in good P-values, or improvements pre- vs post- intervention.

I'm pretty sure the super placebo effect of expectation of improvement is at play here. No long-term follow-up re: improvement persisted at six months out.

For this to help long-term, the researcher-clinicians would have to change their 'pet' strategies. Say, from using colors to animals (anyone for a boa constrictor?). And what is listening to your 'own' body. Is there someone else's?

Could be that the attitude of the researchers is that the person with FM is clueless or hasn't tried all sorts of techniques and methods (largely without success in moderately severe cases) to quell their nervous system's ramping up of pain and other sensory signals.

At least the proposal/intervention was relatively entertaining to read.