Interdisciplinary treatment for fibromyalgia (FM) syndrome: clinical & statistical significance

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OBJECTIVES: The primary purposes of the study were to:

evaluate the treatment efficacy of an outpatient,

interdisciplinary treatment program for fibromyalgia syndrome

(FMS); examine whether treatment gains would be sustained for

6 months following the treatment; assess whether improvements

were clinically significant; and delineate the factors

associated with clinically significant improvement in pain


METHODS: Sixty-seven FMS patients completed a 4-week

outpatient program consisting of medical, physical,

psychologic, and occupational therapies. Six-month followup

data were available for 66% of treated patients.


Comparisons between pretreatment and posttreatment measures

revealed significant improvements in pain severity, life

interference, sense of control, affective distress,

depression, perceived physical impairment, fatigue, and

anxiety; however, there was no improvement in interpersonal

relationships or general activities. Clinically significant

improvement in pain severity, using the Reliable Change Index,

was obtained by 42% of the sample and was predicted by the

pretreatment levels of depression, activity, perceived

disability, solicitous responses of significant others, and

idiopathic onset. Pretreatment level of pain severity was not

a significant predictor of the degree of pain improvement.

Comparisons among pretreatment, posttreatment, and 6-month

followup data revealed that the patients maintained treatment

gains in pain, life interference, sense of control, affective

distress, and depression. However, the quadratic polynomial

analysis revealed that relapse occurred in the subjective

rating of fatigue.

CONCLUSIONS: The results suggest that,

overall, an outpatient interdisciplinary treatment program was

effective in reducing many FMS symptoms. Treatment gains

tended to be maintained for at least 6 months. However, there

were large individual differences in response to treatment.

These results suggest that identification of subgroups of FMS

patients and their specific clinical characteristics may be

useful for maximizing treatment efficacy.

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