EXPLORING THE ROLE OF PERIPHERAL MECHANISMS: AN EVALUATION OF A THEORY BASED APPROACH FOR REDUCING SYMPTOMS OF FIBROMYALGIA
This mixed method study presented an integrative approach for the treatment of fibromyalgia, the rationale that justifies the approach, and an evaluation of two integrated components of this protocol designed to mitigate symptoms of fibromyalgia. Considering this to be a theory-based evaluation study it was imperative to make explicit the connection of rationale to intervention. The roles of peripheral mechanisms and trauma were examined and shown paramount to this study. The protocol was initially developed clinically to address each of these influences.
To elicit clinical change for the six female participants diagnosed with fibromyalgia, the six week protocol intervention consisted of two components: 12 sessions of the Medical Massage modality and 6 precise, gentle movement classes. The Medical Massage component was selected for consistency to address dystrophic pathological changes and resulting ischemia. The focus of the Gentle Movement class was to restructure cortical maps, release trauma, and alter the pathological progression.
The Revised Fibromyalgia Impact Questionnaire (FIQR) and the Brief Pain Inventory (BPI) were used pre and post study to obtain quantitative data. The patient global impression of change (PGIC) rating at the completion of the trial allowed the participants to evaluate overall improvement in pain. An intake interview, journals, progress reports, and an exit interview were used to gather qualitative data and to explore and understand each individual outcome.
Statistically significant results were supported by qualitative data as all six participants reported decreases in the symptoms of diffuse, chronic pain; hyperalgesia; hyperesthesia; fatigue; sleep disturbance; depression; and other co-morbid conditions.
The intervention in this study targeted progressive changes in the soft tissues that influence adaptations in the central nervous system (CNS) of patients with fibromyalgia. The consistent reductions in pain and other symptoms in the 6 participants support approaches that address the peripheral mechanisms and trauma in understanding and treating fibromyalgia. The results of this study suggest that further research is needed with larger samples, to further establish the efficacy of this theory based approach.
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