Therapeutic Neuroscience Education in Fibromyalgia: a Randomized Controlled Trial

Abstract

Objective To investigate additive effect of Therapeutic Neuroscience Education (TNE) to pilates exercises in female patients with fibromyalgia (FM). Method 25 female patients FM included in the study. They randomly separated into two groups. There were 11 patients in the intervention group and 14 patients in the control group. Pilates exercises and TNE were applied in the intervention group, and only pilates exercises were applied in the control group. Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA), Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), Fibromyalgia Impact Questionnare (FIQ), Symptom Severity Scale (SSS), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Biopsychosocial Questionnaire (BETY-BQ) and pressure algometer was used for evaluation. Results After the treatment, control group improved in the "visuomotor construction" and "thinking operations"cognitive areas andtotal score of DLOTCA, BPI-pain severity score, VAS, FIQ, SSS, PCS-magnification, and only left medial knee mean score of pressure pain thresholds (p<0.05). Intervention group improved in the "thinking operations" cognitive area and total score of DLOTCA, BPI-pain severity score, BPI-pain interference score, VAS, WPI, FIQ, SSS, TSK, BETY-BQ and all pressure pain thresholds (excluding left trapezius) (p<0.05). In the comparison of delta values, the intervention group improved more in WPI, FIQ, right trapezius mean score and left trapezius, right quadriceps femoris, right-left medial knee maximum and mean scores of pressure pain thresholds (p<0.05). Conclusion TNE increased the effectiveness of pilates exercises on pain, functional status and pressure pain thresholds in patients with FM.