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Benefits of Long-term Fibromyalgia Syndrome Treatment with a Multidisciplinary Program.

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Journal: Journal of Musculoskeletal Pain. Vol. 14(4) 2006:11-24 [Abstract/article is in online prepublication first draft version only, as of October 11, 2006. Copies of final article will be available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH, E-mail docdelivery@haworthpress.com, and Website http://www.jmp.haworthpress.com] Authors and Affiliations: Anne E. Winkler, Department of Rheumatology, St. John’s Physicians & Clinics, Springfield, Missouri; and Frances J. Anderson, Hammons Heart Institute, St. John’s Regional Health Center, Springfield. Missouri. Address correspondence to Dr. Fran Anderson [E-mail: fanderson@ sprg.mercy.net] DOI: 10.1300/J094v14n04_03

Objectives: To systematically assess the effectiveness of a combination of pharmacologic and nonpharmacologic long-term treatment interventions for the Fibromyalgia Syndrome [FMS].

Methods: Participants involved in an outpatient, one year, multidisciplinary treatment program within a health care setting were studied. After being screened for eligibility, participants in the treatment sample took part in combined standard pharmacologic treatment and non-pharmacologic treatment [including cognitive behavioral therapy/psychoeducational classes, exercise, massage, auricular therapy, microcurrent therapy, and nutritional counseling] in a case controlled manner. A control sample received standard medical care in a rheumatologist’s office. Pre- versus post-treatment outcome variables of psychological symptoms and personality features, as measured by the Multiaxial Diagnostic Inventory–Revised, overall impact of FMS as measured by the Fibromyalgia Impact Questionnaire, overall health status as measured by the Short Form-36, pain and anxiety as measured by visual analog scales, and tender points were assessed for treatment study participants. Data was concurrently collected for the control sample on 26 of the 39 treatment variables, including the Multiaxial Diagnostic Inventory–Revised and the Fibromyalgia Impact Questionnaire.

Results: Seventy-eight participants took part in the combined pharmacologic and non-pharmacologic treatment. The control sample consisted of 20 eligible participants. Using a quasi-experimental design, the results from a series of 2 [Group] x 2 [Test] one-way analysis of variance tests with repeated measures showed a significant decrease in pre- versus post-treatment measures of function, chronic depression, general anxiety, somatization, pain, anxiety, and tender points for the treatment group. A significant increase in Short Form-36 scores indicated a patient’s perceived overall better health. No significant changes were revealed with the control group.

Conclusions: These findings suggested the possible value of a long-term, multidisciplinary treatment program in alleviating FMS physical and psychological symptoms.

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