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      Knowledge, Awareness, and Perceptions of the Diagnosis and Management of Fibromyalgia Among Physical Therapists in Saudi Arabia: A Cross-Sectional Survey


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          To explore awareness of the diagnostic criteria and management of fibromyalgia (FM) among physical therapists practicing in Saudi Arabia.


          A cross-sectional survey was distributed electronically among musculoskeletal physical therapists. It was designed based on the research literature relevant to FM and reviewed by two rheumatologists for accuracy and comprehension. The survey included two sections: participants’ demographic information and questions related to FM. The data were described using absolute and relative frequencies.


          A total of 234 physical therapists accepted the invitation to participate in the study, and 52 were excluded for not satisfying the inclusion criteria or not completing the survey. Responses were received from March to May 2020; only 118 (65%) respondents completed the FM section. The average age of the participants was 31.2 (SD=6.9) years, and 36% were females. Eighty percent reported seeing fewer than five patients with FM in the past year; 51% acquired FM-related knowledge through self-learning; half reported having little to no confidence in their FM assessments and management; and less than 20% were familiar with common diagnostic criteria and management guidelines for FM.


          Participating physical therapists showed little awareness of or confidence in the assessment and management of patients with FM; moreover, their awareness was not supported by their adherence to recent FM guidelines. Despite the common practice of referring patients with FM for physical therapy, there are many misconceptions about FM. This study highlights the need for educational programs to provide up-to-date evidence in undergraduate and postgraduate education.

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          Most cited references26

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          The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.

          To develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in primary and specialty care and that do not require a tender point examination, and to provide a severity scale for characteristic fibromyalgia symptoms. We performed a multicenter study of 829 previously diagnosed fibromyalgia patients and controls using physician physical and interview examinations, including a widespread pain index (WPI), a measure of the number of painful body regions. Random forest and recursive partitioning analyses were used to guide the development of a case definition of fibromyalgia, to develop criteria, and to construct a symptom severity (SS) scale. Approximately 25% of fibromyalgia patients did not satisfy the American College of Rheumatology (ACR) 1990 classification criteria at the time of the study. The most important diagnostic variables were WPI and categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and number of somatic symptoms. The categorical scales were summed to create an SS scale. We combined the SS scale and the WPI to recommend a new case definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS > or =9). This simple clinical case definition of fibromyalgia correctly classifies 88.1% of cases classified by the ACR classification criteria, and does not require a physical or tender point examination. The SS scale enables assessment of fibromyalgia symptom severity in persons with current or previous fibromyalgia, and in those to whom the criteria have not been applied. It will be especially useful in the longitudinal evaluation of patients with marked symptom variability.
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            Fibromyalgia: a clinical review.

            Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.
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              The american college of rheumatology 1990 criteria for the classification of fibromyalgia


                Author and article information

                Open Access Rheumatol
                Open Access Rheumatol
                Open Access Rheumatology : Research and Reviews
                30 November 2020
                : 12
                : 293-301
                [1 ]College of Applied Medical Sciences, Health Rehabilitation Sciences, King Saud University , Riyadh, Saudi Arabia
                [2 ]Department of Health and Rehabilitation Science, Sattam Bin Abdulaziz University , Al-Kharj, Saudi Arabia
                [3 ]Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, UT, USA
                Author notes
                Correspondence: Faris Alodiabi College of Applied Medical Sciences, Health Rehabilitation Sciences, King Saud University , 22480, Riyadh11495, Kingdom of Saudi ArabiaTel +966 14676176Fax +966 14676162 Email falodaibi@KSU.EDU.SA
                © 2020 Alodiabi et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 5, Tables: 2, References: 26, Pages: 9
                Funded by: the Deanship of Scientific Research at Prince Sattam Bin AbdulAziz University;
                This project was supported by the Deanship of Scientific Research at Prince Sattam Bin AbdulAziz University under the research project number 2019/01/13,195.
                Original Research

                fibromyalgia,physical therapy,awareness,knowledge,saudi arabia


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