Group treatment of fibromyalgia (FM): a 6 month outpatient program

OBJECTIVE: To evaluate the impact of a 6 month group therapy

program on the treatment of patients with fibromyalgia (FM).

Since FM is a common problem in rheumatology practice, a

program was designed to treat patients in a group setting

using allied health professionals.

METHODS: The FM group (15

to 25 patients) met once a week for 6 months. The average

session lasted 90 min and consisted of formal lectures, group

sessions emphasizing behavior modification, stress reduction

techniques, strategies to improve fitness and flexibility and

support sessions for spouses/significant others. The 2 major

outcome measures were the fibromyalgia impact questionnaire

(FIQ) and the total tender point score. Secondary outcome

measures were the quality of life scale, questionnaires to

assess coping strategies and attitudes to illness, an index of

aerobic conditioning, flexibility, distance walked in 6 min.,

Beck depression and Beck anxiety questionnaires. Patients

were followed 2 years and compared to a group of patients

outside the program.

RESULTS: Between 1989 and 1993 170

patients were evaluated and 104 patients completed the

program. At the end of the 6 months 73 (70%) of patients had

<11 tender points and FIQ improved 25%. Having a pain profile

on MMPI or having major depression, did not predict poorer

outcome. Thirty-three patients followed for 2 years after the

program continue to show improvement. A control group of 29

patients who never entered the program showed no significant


CONCLUSION: The group treatment of patients with

FM in an outpatient setting shows promise; a more formal

controlled study is needed to confirm this impression.

MCM: Utilized a program of formal lectures, group sessions

emphasizing behavioral modification, stress reduction,

strategies to improve fitness and flexibility, and support

sessions for spouses/sign. others. Measured outcomes with

Fibromyalgia Impact Questionnaire, total tender points, and

others. Of 107 pts completing the program over 6 months,

significant improvment seen in number of tender points and


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