Effect of Physiotherapy Protocol in Treatment of Depression: Longitudinal Study

Study Overview
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Brief Summary
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The purpose of his study is to investigate the effect of physiotherapy protocol in management of depression in patients with fibromyalgia and in patients with psychogenic depression.

Detailed Description
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This study will investigate the effect of physiotherapy protocol in management of depression in patients with fibromyalgia and in patients with psychogenic depression.

Official Title
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Effect of Physiotherapy Protocol in Treatment of Depression: Longitudinal Study

Conditions
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Fibromyalgia, Depression

Intervention / Treatment
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* Other: Physiotherapy protocol
* Drug: Selective serotonin reuptake inhibitors (SSRI)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fibromyalgia patients will be included if they meet the diagnosis of FM according to the American College Rheumatology (ACR), diagnosed with depression and referred by a physician. Patients diagnosed with mild and moderate forms of major depression. Their ages range from 20- 60 years old. Patients willing and able to participate in a physiotherapy program and capable of doing physical exercise on their own. Exclusion Criteria: severe spinal injuries severe musculoskeletal abnormalities inflammatory rheumatic diseases respiratory or cardiac pathologies Any vestibular, visual or neurological dysfunction affecting balance. History of suicidal attempts Severe depression Suffering from severe somatic or psychiatric disorders.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with fibromyalgia and depression (1)<br>Patients in this group will receive physiotherapy protocol and medications. | Other: Physiotherapy protocol<br>* the physiotherapy protocol which will include: 4. Exercise in the form of: d. Breathing exercise e. Aerobic exercise (walking on treadmill with a speed of 3 miles per hour and 0% inclination) f. Bridging exercise 5. Manual techniques in the form of: Suboccipital release Diaphragm release Clavi-pectoral myofascial release 6. Home Routine c. Hot tub bath for 30 minutes d. Breathing exercise<br>Drug: Selective serotonin reuptake inhibitors (SSRI)<br>* Selective serotonin reuptake inhibitors (SSRIs)<br>|
| Active Comparator: Patients with fibromyalgia and depression (2)<br>Patients in this group will receive medications only. | Drug: Selective serotonin reuptake inhibitors (SSRI)<br>* Selective serotonin reuptake inhibitors (SSRIs)<br>|
| Experimental: Patients with depression only (1)<br>Patients in this group will receive physiotherapy protocol and medications. | Other: Physiotherapy protocol<br>* the physiotherapy protocol which will include: 4. Exercise in the form of: d. Breathing exercise e. Aerobic exercise (walking on treadmill with a speed of 3 miles per hour and 0% inclination) f. Bridging exercise 5. Manual techniques in the form of: Suboccipital release Diaphragm release Clavi-pectoral myofascial release 6. Home Routine c. Hot tub bath for 30 minutes d. Breathing exercise<br>Drug: Selective serotonin reuptake inhibitors (SSRI)<br>* Selective serotonin reuptake inhibitors (SSRIs)<br>|
| Active Comparator: Patients with depression only (2)<br>Patients in this group will receive medications only. | Drug: Selective serotonin reuptake inhibitors (SSRI)<br>* Selective serotonin reuptake inhibitors (SSRIs)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessing the change in severity of respondents' depression | Assessment will be done by using Arabic version of Beck Depression Inventory (BDI) which is designed to rate the severity of respondents' depression in the weeks preceding questionnaire completion. Each of the 21 questions presents four different statements and asks respondents to select the option that best represents them. Statements refer to depressive states in varying degrees of severity (from I do not feel sad to I am so sad or unhappy that I can't stand it), and this is reflected in the scoring process which assigns higher values to responses indicating more acute symptoms of depression. The total score can range from 0 to 63 points, with a total score of 0-9 points indicating minimal depression, 10-18 points mild, 19-29 points moderate, and 30-63 points severe depression. | at baseline, after 2 weeks of intervention, after 4 weeks of intervention and after one month and two months of end of treatment period |