Effects of Mobilization and Perceptive Rehabilitation on Patients With Fibromyalgia Syndrome
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      The aim of our study is to determine and compare the effects of perceptive rehabilitation
      against other mobilization techniques on the treatment of fibromyalgia symptoms and
      disability. Participants in this study will be randomly assigned to three separate groups
      using a random allocation software program, the three groups receiving either perceptive
      rehabilitation (PR-group), mobilization techniques (Mob-group), or neither (the control
      group, C-group).
    

Detailed description: 
      Fibromyalgia is considered to be a chronic, widespread musculoskeletal pain syndrome. Its
      most common symptoms are fatigue, anxiety, depression, and lack of concentration. These
      symptoms may lead to a decrease in the amount of physical activity that a sufferer can
      accomplish. Neck and back pain will also increase as the sedentary behaviour becomes the norm
      (Talotta et al., 2017). The best overall way of managing fibromyalgia is still under
      discussion, but according to the literature, symptoms are best managed by physiotherapy
      (García, Nicolás, and Hernández, 2016). Different programs can also be tailored to individual
      fibromyalgia sufferers with the aim of reducing pain (e.g. heat agents, electrotherapy,
      postural exercises, aerobic exercise, aqua-therapy and manual treatment).

      However, according to Bronfort et al. (2010), there is insufficient evidence supporting the
      effectiveness of manual therapy as a treatment for fibromyalgia. According to Reis et al.
      (2014), a single thoracic mobilization session was able to improve short-term heart-rate
      variability, although the pain was not affected by the intervention.

      Paolucci et al. (2016) used a new rehabilitation tool to treat pain with an increased
      reliance on proprioception. Practically, the tool consisted of cones made from a latex
      material which were placed under the patient's back during treatment sessions. These cones
      were intended to improve tactile response and proprioception, the so-called perceptual
      surface. According to this study, the tool was able to decrease pain and help to improve
      function. However, it is important to understand the tool's effect on long-term
      rehabilitation and compare it with other treatment methods. The aim of our study is to
      determine and compare the effects of perceptive rehabilitation and mobilization techniques on
      disability and fibromyalgia symptoms.

      Our study will include 90 participants, with 30 participants in each group. The PR-group and
      the Mob-group will receive treatments twice per week for eight weeks, a total of 16 sessions;
      there will be no intervention in the C-group. Another physiotherapist will assess each group
      before and after all the sessions. The study will be single blind. Follow-up assessments will
      be three and six months after the last session.
    

Intervention name(s): Perceptive Rehabilitation; Mobilisation Techniques
Intervention type(s): Other; Other
Intervention description(s): In each session, over one hundred cones will be placed on a rigid wooden base using elastic strips. The patient will be asked to lie down supine on the material. Patients weigh will create pressure and reaction force to his/her body. Treatments will be 2 times a week till 8 weeks.
The therapist will ask the patient firstly to breathe normally and feel the pressure. The patient will then perform breathing exercises and active exercises (including stretching, warming up, and cooling down) under supervision. During the session, the therapist will ask about the pressure of the cones and will correct the patient's posture. At the end of each session, the therapist will photograph the patient's back with the aim of documenting the pressure and hyperaemic areas.; A certified physiotherapist will perform mobilisation techniques. All participants in this group will receive treatment protocol according to the list on below. Treatments will be 2 times a week till 8 weeks.
For this treatment, the participant should lie on a bed and change their position according to the technique (supine, position or side-lying). Also, the therapist will be changing her position according to the technique. All technique will be on the range of motion limit. For releasing techniques the therapist will apply three-dimensional pressures till 3-5 minutes, with the feeling of relaxing therapist will change the limit for the next point.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: proprioception; manual therapies; pain; health status; posture; sleep; fatigue; depression