Año 2024 / Volumen 31 / Número 2

Revisión

Integrating pain science education in a multicomponent treatment for individuals with fibromyalgia: a practical guide for clinicians
Integrando la educación en ciencia del dolor en un tratamiento multicomponente para personas con fibromialgia: una guía práctica clínica

Rev. Soc. Esp. Dolor. 2024; 31(2): 106-120 / DOI: 10.20986/resed.2025.4157/2024

Mayte Serrat, Estibaliz Royuela, Jo Nijs, Xavier Borràs, Juan V. Luciano, Rubén Nieto, Albert Feliu


RESUMEN

There is a growing body of literature acknowledging the significance of integrating multiple therapeutic components to effectively manage the wide range of symptoms related to fibromyalgia (FM). Empirically supported approaches such as pain science education, therapeutic physical exercise programs, and cognitive behavioural therapy (CBT) have garnered considerable attention. The FIBROWALK program incorporates Pain Science Education (PSE) as its core component. This comprehensive program amalgamates diverse components, including therapeutic physical exercise designed to engage cognitive and emotional targets through dual tasks, and adhering to the transtheoretical model of stages of change. Additionally, it integrates CBT and mindfulness training to enhance self-management strategies by reshaping biased pain cognitions and negative beliefs. The program aims to instigate behavioural change by employing motivational interviewing (MI) as the primary communication style. Its ultimate objective lies in fostering lifestyle changes that ensure the sustainability of benefits, thereby enhancing outcomes with more significant and enduring effects. Multiple randomized clinical trials (RCTs) have assessed the effectiveness of FIBROWALK, consistently revealing moderate-to-large effect sizes across core FM-related outcomes. This article provides a practical guide for clinicians, offering insights into seamlessly integrating PSE within a multicomponent treatment package for individuals with FM.



ABSTRACT

Existe una creciente literatura que reconoce la importancia de integrar múltiples componentes terapéuticos para controlar eficazmente la amplia gama de síntomas relacionados con la fibromialgia (FM). Los enfoques respaldados empíricamente, como la educación en ciencia del dolor (PSE), los programas de ejercicio físico terapéutico y la terapia cognitivo-conductual (TCC), han atraído considerable atención. El programa FIBROWALK incorpora PSE como su componente principal. No obstante, este programa integral amalgama diversos componentes, incluido el ejercicio físico terapéutico diseñado para involucrar objetivos cognitivos y emocionales a través de tareas duales y adhiriéndose al modelo transteórico de etapas de cambio. Además, integra la TCC y el entrenamiento de atención plena para mejorar las estrategias de autocontrol al reestructurar las cogniciones sesgadas sobre el dolor y las creencias negativas. El programa FIBROWALK tiene como objetivo provomer un cambio de comportamiento mediante el empleo de la entrevista motivacional (EM) como estilo de comunicación principal. Su objetivo final radica en fomentar cambios en los estilos de vida que aseguren la sostenibilidad de los beneficios, mejorando así los resultados con efectos más significativos y duraderos. Múltiples ensayos clínicos aleatorizados (ECA) han evaluado la efectividad de FIBROWALK, revelando consistentemente tamaños de efecto de moderados a grandes en los principales resultados relacionados con la FM. Este artículo proporciona una guía práctica para los profesionales sanitarios y ofrece información sobre cómo integrar la PSE dentro de un paquete de tratamiento multicomponente para personas con FM.





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Tablas y Figuras

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Table I

Table II

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Instrucciones para citar

Serrat M, Royuela E, Nijs J, Borràs X, Luciano J, Nieto R, et all. Integrating pain science education in a multicomponent treatment for individuals with fibromyalgia: a practical guide for clinicians . Rev Soc Esp Dolor 2024; 31(2): 106-120 / DOI: 1020986/resed20254157/2024


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Recibido: 18/05/2024

Aceptado: 31/01/2025

Prepublicado: 02/04/2025

Publicado: 04/07/2025

Tiempo de prepublicación: 319 días

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