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Physiotherapie, medizinische Trainingstherapie und physikalische Therapie beim Fibromyalgiesyndrom

Physiotherapy, exercise and strength training and physical therapies in the treatment of fibromyalgia syndrome

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Zusammenfassung

Hintergrund

Eine interdisziplinäre Leitlinie auf S3-Niveau 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 Physiotherapie, medizinische Trainingstherapie sowie physikalischen Therapie des FMS wurde unter Benutzung der Cochrane Collaboration Reviews (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 wurde die Empfehlungsgraduierung der nationalen Versorgungsleitlinien verwendet. Die Erstellung der Empfehlungen erfolgte in einem mehrstufigen nominalen Gruppenprozess.

Ergebnisse

Aerobes Ausdauertraining erhielt den Empfehlungsgrad A und die zeitlich befristete Verwendung von Ganzkörperwärmetherapie und Balneo- bzw. Spatherapie den Empfehlungsgrad B.

Schlussfolgerung

Die Aussagekraft der meisten Studien zu verschiedenen Verfahren der Physiotherapie, medizinischen Trainingstherapie und physikalischen Therapie ist durch die kurze Studiendauer (durchschnittliche Studiendauer 6–12 Wochen) und kleinen Fallzahlen in den meisten Studien eingeschränkt.

Abstract

Background

A guideline for the treatment and diagnostic procedures for 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 physiotherapy, exercise and strength training as well as physical therapies was performed in the Cochrane Collaboration Reviews (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

Aerobic exercise training is strongly recommended (grade A) and the temporary use of whole body hyperthermia, balneotherapy and spa therapy is recommended (grade B).

Conclusion

The significance which can be assigned to most of the studies on the various procedures for therapy is restricted due to short study duration (mean 6–12 weeks) and small sample sizes.

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Authors and Affiliations

  1. Sektion Schmerztherapie, Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstraße 200, 69118, Heidelberg, Deutschland

    M. Schiltenwolf

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

    W. Häuser

  3. Deutsche Fibromyalgie Vereinigung, Seckach, Deutschland

    E. Felde & M. Settan

  4. Praxis für Physiotherapie, Köln, Köln, Deutschland

    C. Flügge

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

    R. Häfner

  6. Humanwissenschaftliches Zentrum, Bad Tölz, Ludwig-Maximilians-Universität München, Bad Tölz, Deutschland

    M. Offenbächer

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  1. M. Schiltenwolf
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Schiltenwolf, M., Häuser, W., Felde, E. et al. Physiotherapie, medizinische Trainingstherapie und physikalische Therapie beim Fibromyalgiesyndrom. Schmerz 22, 303–312 (2008). https://doi.org/10.1007/s00482-008-0675-3

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