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Multimodale Therapie des Fibromyalgiesyndroms

Multicomponent therapy for treatment of fibromyalgia syndrome

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Zusammenfassung

Fragestellung

Eine interdisziplinäre Leitlinie zur Diagnostik und Therapie des Fibromyalgiesyndroms (FMS) wurde in Kooperation von 10 medizinischen bzw. psychologischen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen erstellt.

Methodik

Eine Literatursuche über alle kontrollierten Studien zur multimodalen Therapie (MT) des FMS wurde unter Benutzung der Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) und Scopus (1980–12/2006) durchgeführt. Für die Vergabe von Evidenzklassen wurde das System des Oxford Centre for Evidence-Based Medicine verwendet, für die Vergabe von Empfehlungsgraden die Empfehlungsgraduierung der nationalen Versorgungsleitlinien. Die Erstellung der Empfehlungen erfolgte in einem mehrstufigen nominalen Gruppenprozess.

Ergebnisse

Multimodale Therapie ist Wartegruppen bzw. medizinischer Routinebehandlung überlegen (Evidenzgrad Ia) und soll Patienten mit FMS angeboten werden (Empfehlungsgrad A).

Schlussfolgerung

Zukünftige Studien sollten Parameter wie Medikation, Kotherapie und Komorbiditäten berücksichtigen. Auf FMS-Subgruppen zugeschnittene Behandlungsverfahren sollten untersucht werden.

Abstract

Background

A guideline for the treatment of fibromyalgia syndrome (FMS) was developed in cooperation with 10 German medical and psychological associations and 2 patient self-help groups.

Methods

A systematic literature search including all controlled studies evaluating multicomponent therapy (MT) was performed in the Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/2006). Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures to reach a consensus on recommendations were used.

Results

MT is superior to control groups or routine treatment (evidence level 1A) and should be offered to FMS patients (recommendation strength A).

Conclusions

Future studies should consider medication, other co-therapies and comorbidities. MT programs tailored to FMS subgroups should be tested.

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Literatur

  1. Anderson FJ, Winkler AE (2006) Benefits of long-term fibromyalgia syndrome treatment with a multidisciplinary program. J Musculoskeletal Pain 14: 11–25

    Article  Google Scholar 

  2. Angst F, Brioschi R, Chris J et al. (2006) Interdisciplinary rehabilitation in fibromyalgia and chronic back pain: a prospective outcome study. J Pain 7: 807–815

    Article  PubMed  Google Scholar 

  3. Bennett RM, Jones J, Turk DC et al. (2007) An internet survey of 2596 people with fibromyalgia. BMC Musculoskeletal Dis 8: 27

    Article  Google Scholar 

  4. Boenisch A, Ehlebracht-Koenig I (2006) Change in exercise behaviour after medical rehabilitation in patients with spondyloarthritis, arthritis and fibromyalgia. Akt Rheumatol 31: 75–82

    Article  Google Scholar 

  5. Brockow T, Wagner A, Franke A et al. (2007) A randomized controlled trial on the effectiveness of mild water-filtered near infrared whole-body hyperthermia as an adjunct to a standard multimodal rehabilitation in the treatment of fibromyalgia. Clin J Pain 23: 67–75

    Article  PubMed  Google Scholar 

  6. Buckelew SP, Conway R, Parker J et al. (1998) Biofeedback/relaxation training and exercise interventions for fibromyalgia: a prospective trial. Arthritis Care Res 11: 196–209

    Article  PubMed  CAS  Google Scholar 

  7. Burckhardt CS, Mannerkorpi K, Hedenberg L, Bjelle A (1994) A randomized, controlled clinical trial of education and physical training for women with fibromyalgia. J Rheumatol 21: 714–20

    PubMed  CAS  Google Scholar 

  8. Burckhardt CS, Clark C, Bennett RM (2005) Long-term follow-up of fibromyalgia patients who completed a structured treatment program versus patients in routine treatment. J Musculoskeletal Pain 13: 5–14

    Article  Google Scholar 

  9. Burckhardt CS (2006) Multidisciplinary approaches for management of fibromyalgia. Curr Pharm Des 12: 59–66

    Article  PubMed  CAS  Google Scholar 

  10. Cedraschi C, Desmeules J, Rapiti E et al. (2004) Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management. Ann Rheum Dis 63: 290–296

    Article  PubMed  CAS  Google Scholar 

  11. Deutsches Institut für Medizinische Information und Dokumentation. Operationen- und Prozedurenschlüssel (OPS), Version 2007. http://www.dimdi.de/static/de/klassi/prozeduren/ops301/opshtml2007/fr-ops.htm

  12. Finset A, Wigers SH, Gotestam KG (2004) Depressed mood impedes pain treatment response in patients with fibromyalgia. J Rheumatol 31: 976–980

    PubMed  Google Scholar 

  13. Gowans SE, deHueck A, Voss S, Richardson M (1999) A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 12: 120–128

    Article  PubMed  CAS  Google Scholar 

  14. Gustafsson M, Ekholm J, Broman L (2002) Effects of a multiprofessional rehabilitation program for patients with fibromyalgia syndrome. J Rehabil Med 34: 119–127

    Article  PubMed  Google Scholar 

  15. Guzmán J, Esmail R, Karjalainen K et al. (2004) Multidisciplinary bio-psycho-social rehabilitation for chronic low-back pain (Cochrane Review). The Cochrane Library, issue 4

  16. Häuser W, Wilhelm R, Klein W, Zimmer C (2006) Subjektive Krankheitsattributionen und Inanspruchnahme medizinischer Leistungen von Patienten mit Fibromyalgiesyndrom. Schmerz 20: 119–127

    Article  PubMed  Google Scholar 

  17. Häuser W, Musial F, Kopp I, Bernardy K (2008) Methodische Grundlagen für die Entwicklung der Leitlinienempfehlungen (Methodenreport). Schmerz 22, im Druck

  18. Hammond A, Freeman K (2006) Community patient education and exercise for people with fibromyalgia: a parallel group randomized controlled trial. Clin Rehabil 20: 835–846

    PubMed  Google Scholar 

  19. Jaeckel WH, Traber U, Gerdes N (2004) Inpatient rehabilitation of patients with fibromyalgia: concept and results. Akt Rheumatol 29: 270–275

    Article  Google Scholar 

  20. Keel PJ, Bodoky C, Gerhard U, Muller W (1998) Comparison of integrated group therapy and group relaxation training for fibromyalgia. Clin J Pain 14: 232–238

    Article  PubMed  CAS  Google Scholar 

  21. King SJ, Wessel J, Bhambhani Y et al. (2002) The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol 29: 2620–2627

    PubMed  Google Scholar 

  22. Lemstra M, Olszynski WP (2005) The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: a randomized controlled trial. Clin J Pain 21: 166–174

    Article  PubMed  Google Scholar 

  23. Mannerkorpi K, Nyberg B, Ahlmen M, Ekdahl C (2000) Pool exercise combined with an education program for patients with fibromyalgia syndrome. A prospective, randomized study. J Rheumatol 27: 2473–2481

    PubMed  CAS  Google Scholar 

  24. Mason LW, Goolkasian P, McCain GA (1998) Evaluation of multimodal treatment program for fibromyalgia. J Behav Med 21: 163–178

    Article  PubMed  CAS  Google Scholar 

  25. Müller A, Hartmann M, Eich W (2000) Inanspruchnahme medizinischer Versorgungsleistungen. Untersuchungen bei Patienten mit Fibromyalgiesyndrom. Schmerz 14: 77–83

    Article  PubMed  Google Scholar 

  26. Müller A, Mueller K, Blumenstiel K et al. (2004) The concept of self-efficacy as important predictor of long-term therapeutic success in patients with fibromyalgia. Akt Rheumatol 29: 101–108

    Article  Google Scholar 

  27. Nielson WR, Jensen M (2004) Relationship between changes in coping and treatment outcome in patients with Fibromyalgia Syndrome. Pain 109: 233–241

    Article  PubMed  Google Scholar 

  28. Skouen JS, Grasdal A, Haldorsen EM (2006) Return to work after comparing outpatient multidisciplinary treatment programs versus treatment in general practice for patients with chronic widespread pain. Eur J Pain 10: 145–152

    Article  PubMed  Google Scholar 

  29. Solomon DH, Warsi A, Brown-Stevenson T et al. (2002) Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. J Rheumatol 29: 362–368

    PubMed  Google Scholar 

  30. Turk DC, Okifuji A, Sinclair JD, Starz TW (1998) Differential responses by psychosocial subgroups of fibromyalgia syndrome patients to an interdisciplinary treatment. Arthritis Care Res 11: 397–404

    Article  PubMed  CAS  Google Scholar 

  31. Worrel LM, Krahn LE, Sletten CD, Pond GR (2001) Treating fibromyalgia with a brief interdisciplinary program: initial outcomes and predictors of response. Mayo Clin Proc 76: 384–390

    Article  PubMed  CAS  Google Scholar 

  32. Zijlstra TR, van de Laar MA, Bernelot Moens HJ et al. (2005) Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life. Rheumatology (Oxford) 44: 539–546

    Google Scholar 

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Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Abteilung für Schmerztherapie, Klinikum Dachau, Krankenhausstr. 15, 85221, Dachau, Deutschland

    B. Arnold

  2. Zentrum für Schmerztherapie, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland

    W. Häuser

  3. Medizinische Fakultät der Universitätskliniken des Saarlandes und Fachklinik für Psychosomatische Medizin, Bliestal-Kliniken, Blieskastel, Blieskastel, Deutschland

    K. Bernardy

  4. Rheumaklinik Bad Nenndorf, Bad Nenndorf, Deutschland

    W. Brückle

  5. Klinikum und Fibromyalgie-Zentrum Bad Bocklet, Bad Bocklet, Deutschland

    E. Friedel

  6. Medizinische Fakultät der Universitätsklinken des Saarlandes und Fachklinik für Psychosomatische Medizin, Bliestal-Kliniken, Blieskastel, Blieskastel, Deutschland

    V. Köllner

  7. Praxis für Anästhesiologie - Spezielle Schmerztherapie - Psychotherapie, Zweibrücken, Zweibrücken, Deutschland

    H. Kühn-Becker

  8. Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen, Garmisch-Partenkirchen, Deutschland

    M. Richter

  9. Klinik und Poliklinik für Physikalische Medizin und Rehabilitation, Ludwig-Maximilians-Universität München, München, Deutschland

    M. Weigl

  10. Praxisklinik, Mannheim, Mannheim, Deutschland

    T. Weiss

  11. GRP - Generation Research Program, Humanwissenschaftliches Zentrum, Bad Tölz, Ludwig-Maximilians-Universität München, Bad Tölz, Deutschland

    M. Offenbächer

Authors
  1. B. Arnold
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  2. W. Häuser
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  3. K. Bernardy
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  4. W. Brückle
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  5. E. Friedel
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  6. V. Köllner
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  7. H. Kühn-Becker
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  8. M. Richter
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  9. M. Weigl
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  10. T. Weiss
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  11. M. Offenbächer
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Corresponding author

Correspondence to B. Arnold.

Additional information

Die Mitgliedschaften der Autoren in Fachgesellschaften sind in Infobox 1 aufgelistet.

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Arnold, B., Häuser, W., Bernardy, K. et al. Multimodale Therapie des Fibromyalgiesyndroms. Schmerz 22, 334–338 (2008). https://doi.org/10.1007/s00482-008-0678-0

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