Efetividade de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas com fibromialgia
Resumo
A auto-liberação miofascial pode facilitar a diminuição ou o desaparecimento da dor intensa percebida pelas terminações nervosas localizadas no tecido miofascial. Segundo alguns pesquisadores, a fibromialgia (FM) pode estar diretamente relacionada à teoria da "sensibilização central". O presente estudo tem como objetivo determinar a eficácia da aplicação de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas diagnosticadas com fibromialgia (FM). A amostra foi randomizada para os grupos intervenção (n =33) e controle (n =33). Os sujeitos do grupo de intervenção participaram de um programa de auto- condicionamento miofascial composto por um total de 40 sessões de 50 minutos cada. Medidas de intervenção pré e pós foram tomadas. Os resultados foram obtidos por meio de uma ANOVA 2x2 de medidas repetidas com dois fatores (tempo e grupo). Os resultados mostram que, após o término do programa, os sujeitos do grupo de intervenção obtiveram uma diminuição significativa na dor geral (p <0,01), o nível de depressão (p <0,05), estado de ansiedade (p < 0,01) e traço (p <0,01), assim como em três subescalas relacionadas à qualidade do sono, como a "qualidade subjetiva do sono" (p <0,05), a "eficiência habitual do sono" (p <0,05) e "disfunção diária" (p <0,001). Esses resultados indicam que participar de um programa de auto-condicionamento miofascial regularmente, sob o controle de um profissional de educação física e esportes, pode afetar positivamente os pacientes com FM fisicamente e psicologicamente.
Downloads
Referências
Aguilar-Parra, J. M., Gallego, J., Fernández-Campoy, J. M., Pérez-Gallardo, E. R., Trigueros, R., Alías-García, A., … Cangas, A. J. (2015). Influencia de programas de actividad física en la calidad del sueño de personas mayores de 55 años. Revista de Psicología del Deporte, 24(2), 289-295.
Allen, M. (1983). Activity-generated endorphins: a review of their role in sports science. Canadian Journal of Applied Sport Sciences. Journal Canadien Des Sciences Appliquées Au Sport, 8(3), 115-133.
Alonso-Blanco, C., Fernández-de-las-Peñas, C., Morales-Cabezas, M., Zarco-Moreno, P., Ge, H.-Y., & Florez-García, M. (2011). Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. The Clinical Journal Of Pain, 27(5), 405-413. https://doi.org/10.1097/AJP.0b013e318210110a
Amutio, A., Franco, C., Pérez-Fuentes, M. del C., Gázquez, J. J., & Mercader, I. (2015). Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Frontiers in Psychology, 5. https://doi.org/10.3389/fpsyg.2014.01572
Amutio, A., Franco, C., Sánchez-Sánchez, L. C., Pérez-Fuentes, M. del C., Gázquez-Linares, J. J., Van Gordon, W., & Molero-Jurado, M. del M. (2018). Effects of Mindfulness Training on Sleep Problems in Patients With Fibromyalgia. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01365
Andrade, A., Sieczkowska, S. M., & Vilarino, G. T. (2018). Resistance training improves quality of life and associated factors in patients with fibromyalgia syndrome. PM&R. https://doi.org/10.1016/j.pmrj.2018.09.032
Aparicio, V. A., Ortega, F. B., Carbonell-Baeza, A., Cuevas, A. M., Delgado-Fernández, M., & Ruíz, J. (2013). Anxiety, depression and fibromyalgia pain and severity. Behavioral Psychology / Psicología Conductual: Revista Internacional Clínica y de la Salud, 21(2), 381-392.
Baek, S.-H., Seok, H. Y., Koo, Y. S., & Kim, B.-J. (2016). Lengthened Cutaneous Silent Period in Fibromyalgia Suggesting Central Sensitization as a Pathogenesis. PloS One, 11(2), e0149248. https://doi.org/10.1371/journal.pone.0149248
Bartkowska, W., Samborski, W., & Mojs, E. (2018). Cognitive functions, emotions and personality in woman with fibromyalgia. Anthropologischer Anzeiger; Bericht Uber Die Biologisch-Anthropologische Literatur, 75(4), 271-277. https://doi.org/10.1127/anthranz/2018/0900
Beck, A. T., & Steer, R. A. (1993). BAI: Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.
Beltrán-Carrillo, V. J., Tortosa-Martínez, J., Jennings, G., & Sánchez, E. S. (2013). Contributions of a Group-Based Exercise Program for Coping with Fibromyalgia: A Qualitative Study Giving Voice to Female Patients. Women & Health, 53(6), 612-629. https://doi.org/10.1080/03630242.2013.819399
Branco, J. C., Bannwarth, B., Failde, I., Abello Carbonell, J., Blotman, F., Spaeth, M., … Matucci-Cerinic, M. (2010). Prevalence of fibromyalgia: a survey in five European countries. Seminars in Arthritis and Rheumatism, 39(6), 448-453. https://doi.org/10.1016/j.semarthrit.2008.12.003
Cabo-Meseguer, A., Cerda-Olmedo, G., & Luis Trillo-Mata, J. (2017). Fibromyalgia: Prevalence, epidemiologic profiles and economic costs. Medicina Clinica, 149(10), 441-448. https://doi.org/10.1016/j.medcli.2017.06.008
Cao, T. V., Hicks, M. R., Zein-Hammoud, M., & Standley, P. R. (2015). Duration and magnitude of myofascial release in 3-dimensional bioengineered tendons: effects on wound healing. The Journal Of The American Osteopathic Association, 115(2), 72-82. https://doi.org/10.7556/jaoa.2015.018
Castro-Sánchez, A. M., Garcia-Lopez, H., Fernandez-Sanchez, M., Perez-Marmol, J. M., Aguilar-Ferrandiz, M. E., Luque-Suarez, A., & Mataran-Penarrocha, G. A. (2019). Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Disability and rehabilitation, 41(19), 2235-2246. https://doi.org/10.1080/09638288.2018.1461259
Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J. M., & Moreno-Lorenzo, C. (2011). Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety, Quality of Sleep, Depression, and Quality of Life in Patients with Fibromyalgia. Evidence-Based Complementary and Alternative Medicine: eCAM, 2011, 561753. https://doi.org/10.1155/2011/561753
Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Arroyo-Morales, M., Saavedra-Hernández, M., Fernández-Sola, C., & Moreno-Lorenzo, C. (2011). Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial. Clinical Rehabilitation, 25(9), 800-813. https://doi.org/10.1177/0269215511399476
Ceca, D., Elvira, L., Guzmán, J. F., & Pablos, A. (2017). Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized controlled trial. The Journal of Sports Medicine and Physical Fitness, 57(7-8), 993-1002. https://doi.org/10.23736/S0022-4707.17.07025-6
Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. International Journal of Sports Physical Therapy, 10(6), 827-838.
Chesterton, L. S., Sim, J., Wright, C. C., & Foster, N. E. (2007). Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. The Clinical Journal of Pain, 23(9), 760-766. https://doi.org/10.1097/AJP.0b013e318154b6ae
Chica, A., González-Guirval, F., Reigal, R. E., Carranque, G., & Hernández-Mendo, A. (2019). Efectos de un programa de danza española en mujeres con fibromialgia. Cuadernos de Psicología del Deporte, 19(2), 52-63.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hilldale, NJ: L. Erlbaum Associates.
Córdoba-Torrecilla, S., Aparicio, V. A., Soriano-Maldonado, A., Estévez-López, F., Segura-Jiménez, V., Álvarez-Gallardo, I., … Delgado-Fernández, M. (2015). Physical fitness is associated with anxiety levels in women with fibromyalgia: The al-ándalus project. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 25(4), 1053-1058. https://doi.org/10.1007/s11136-015-1128-y
Crofford, L. J. (2016). Fibromyalgia. In G. S. Firestein, R. Budd, S. E. Gabriel, I. B. McInnes, & J. R. O’Dell (Eds.), Kelley and Firestein’s Textbook of Rheumatology (pp. 768-782). Philadelphia, PA: Elsevier Health Sciences.
Ekici, G., Bakar, Y., Akbayrak, T., & Yuksel, I. (2009). Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. Journal Of Manipulative And Physiological Therapeutics, 32(2), 127-133. https://doi.org/10.1016/j.jmpt.2008.12.001
Fernandes, G., Jennings, F., Nery, M. V., Pirozzi-Buosi, A. L., & Natour, J. (2016). Swimming Improves Pain and Functional Capacity of Patients With Fibromyalgia: A Randomized Controlled Trial. Archives Of Physical Medicine And Rehabilitation, 97(8), 1269-1275. https://doi.org/10.1016/j.apmr.2016.01.026
Ge, H.-Y., Wang, Y., Fernandez-de-las-Penas, C., Graven-Nielsen, T., Danneskiold-Samsoe, B., & Arendt-Nielsen, L. (2011). Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients. Arthritis Research & Therapy, 13(2), R48. https://doi.org/10.1186/ar3289
González, J., Ortín, F. J., & Bonillo, J. A. (2011). Actividad física, asistencia psicológica y niveles de ansiedad y depresión en mujeres con fibromialgia: Un estudio descriptivo. Cuadernos de Psicología del Deporte, 11(1), 59-66.
Homann, D., Stefanello, J. M. F., Góes, S. M., Breda, C. A., Paiva, E. dos S., & Leite, N. (2012). Stress perception and depressive symptoms: functionality and impact on the quality of life of women with fibromyalgia. Revista Brasileira De Reumatologia, 52(3), 319-330.
Jensen, M. P., & Karoly, P. (2001). Self-report scales and procedures for assessing pain in adults. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 15-34). New York, NY: Guilford Press.
Jiménez-Genchi, A., Monteverde-Maldonado, E., Nenclares-Portocarrero, A., Esquivel-Adame, G., & de la Vega-Pacheco, A. (2008). [Reliability and factorial analysis of the Spanish version of the Pittsburg Sleep Quality Index among psychiatric patients]. Gaceta médica de México, 144(6), 491-496.
Kelley, G. A., Kelley, K. S., & Hootman, J. M. (2015). Effects of exercise on depression in adults with arthritis: a systematic review with meta-analysis of randomized controlled trials. Arthritis Research & Therapy, 17, 21-21. https://doi.org/10.1186/s13075-015-0533-5
Knight, T., Schaefer, C., Chandran, A., Zlateva, G., Winkelmann, A., & Perrot, S. (2013). Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States. Clinicoeconomics And Outcomes Research: CEOR, 5, 171-180. https://doi.org/10.2147/CEOR.S41111
Liptan, G. L. (2010). Fascia: A missing link in our understanding of the pathology of fibromyalgia. Journal of bodywork and movement therapies, 14(1), 3-12. https://doi.org/10.1016/j.jbmt.2009.08.003
Liptan, G., Mist, S., Wright, C., Arzt, A., & Jones, K. D. (2013). A pilot study of myofascial release therapy compared to Swedish massage in Fibromyalgia. Journal of bodywork and movement therapies, 17(3), 365-370. https://doi.org/10.1016/j.jbmt.2012.11.010
Mas, A. J., Carmona, L., Valverde, M., Ribas, B., & EPISER Study Group. (2008). Prevalence and impact of fibromyalgia on function and quality of life in individuals from the general population: results from a nationwide study in Spain. Clinical and Experimental Rheumatology, 26(4), 519-526.
Moya-Albiol, L., & Salvador, A. (2001). Efectos del ejercicio físico agudo sobre la respuesta psicofisiológica al estrés: papel modulador de la condición física. Revista de Psicología del Deporte, 10(1), 35-48.
Murillo-García, Á., Villafaina, S., Adsuar, J. C., Gusi, N., & Collado-Mateo, D. (2018). Effects of Dance on Pain in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis. Evidence-Based Complementary And Alternative Medicine: Ecam, 2018, 8709748-8709748. https://doi.org/10.1155/2018/8709748
Rivera, J., Rejas, J., Esteve-Vives, J., & Vallejo, M. A. (2009). Resource utilisation and health care costs in patients diagnosed with fibromyalgia in Spain. Clinical And Experimental Rheumatology, 27(5 Suppl 56), S39-S45.
Sanz, J., & Vázquez, C. (1988). Fiabilidad, validez y datos normativos del inventario para la depresión de Beck. Psicothema, 10(2), 303-318.
Sañudo, B., Carrasco, L., de Hoyo, M., Figueroa, A., & Saxton, J. M. (2015). Vagal modulation and symptomatology following a 6-month aerobic exercise program for women with fibromyalgia. Clinical And Experimental Rheumatology, 33(1 Suppl 88), S41-S45.
Segura-Jiménez, V., Álvarez-Gallardo, I. C., Carbonell-Baeza, A., Aparicio, V. A., Ortega, F. B., Casimiro, A. J., & Delgado-Fernández, M. (2015). Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: the al-Ándalus project. Seminars In Arthritis And Rheumatism, 44(5), 563-570. https://doi.org/10.1016/j.semarthrit.2014.09.010
Sevimli, D., Kozanoglu, E., Guzel, R., & Doganay, A. (2015). The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome. Journal Of Physical Therapy Science, 27(6), 1781-1786. https://doi.org/10.1589/jpts.27.1781
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (2008). STAI, Cuestionario de Ansiedad Estado-Rasgo. TEA Ediciones, S.A.
Steiner, J. L., Bigatti, S. M., & Ang, D. C. (2015). Trajectory of change in pain, depression, and physical functioning after physical activity adoption in fibromyalgia. Journal of Health Psychology, 20(7), 931-941. https://doi.org/10.1177/1359105313504234
Terzi, H., Terzi, R., & Kale, A. (2015). The relationship between fibromyalgia and pressure pain threshold in patients with dyspareunia. Pain Research & Management, 20(3), 137-140. https://doi.org/10.1155/2015/302404
Toprak-Celenay, S., Anaforoglu-Kulunkoglu, B., Yasa, M. E., Sahbaz-Pirincci, C., Un Yildirim, N., Kucuksahin, O., … Akkus, S. (2017). A comparison of the effects of exercises plus connective tissue massage to exercises alone in women with fibromyalgia syndrome: a randomized controlled trial. Rheumatology International, 37(11), 1799-1806. https://doi.org/10.1007/s00296-017-3805-3
Uçar, M., Sarp, Ü., Karaaslan, Ö., Gül, A. I., Tanik, N., & Arik, H. O. (2015). Health anxiety and depression in patients with fibromyalgia syndrome. The Journal Of International Medical Research, 43(5), 679-685. https://doi.org/10.1177/0300060515587578
Van den Berg, F. (2013). Extracellular matrix. In Fascia: The Tensional Network of the Human Body (pp. 165-170). London, UK: Elsevier Health Sciences. https://doi.org/10.1016/B978-0-7020-3425-1.00058-1
Wiewelhove, T., Doeweling, A., Schneider, C., Hottenrott, L., Meyer, T., Kellmann, M., … Ferrauti, A. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in Physiology, 10, 376. https://doi.org/10.3389/fphys.2019.00376
Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., … et. al. (1990). The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis And Rheumatism, 33(2), 160-172. https://doi.org/10.1002/art.1780330203
Wolfe, F., Clauw, D. J., Fitzcharles, M.-A., Goldenberg, D. L., Häuser, W., Katz, R. S., … Winfield, J. B. (2011). Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. The Journal Of Rheumatology, 38(6), 1113-1122. https://doi.org/10.3899/jrheum.100594
Yuan, S. L. K., Matsutani, L. A., & Marques, A. P. (2015). Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis. Manual Therapy, 20(2), 257-264. https://doi.org/10.1016/j.math.2014.09.003
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica. Color RoMEO: verde.