published in May by Alan and Kathleen Light at the University of Utah.
Initially the investigators expected that separating the CFS group by
the presence (or absence) of FM would provide meaningful subgrouping
data, but this did not turn out to be the case. However, the FM-only
group had distinctive results compared to the CFS/CFS+FM and the
controls.Using a bike egometer they found that =93The very modest level
of exercise for 25 minutes caused post-exertional malaise lasting 48
hours in all CFS and FM patient groups, but not controls.=94 More
information about that study can be found here:
http://www.research1st.com/2011/06/02/exercise-challenge-reveals-potential-=
cfs-biomarkers/
The results of the Light study might help explain the high drop out
rates experienced in this study.
As noted previously, cognitive behavioral therapy can be effective in
helping patients cope with severe pain and fatigue, but the results
are more likely because secondary issues are addressed rather than the
actual cause of the condition.
Ann Rheum Dis. 2011 Sep 16. [Epub ahead of print]
Tailored cognitive-behavioural therapy and exercise training improves
the physical fitness of patients with fibromyalgia.
van Koulil S, van Lankveld W, Kraaimaat FW, van Helmond T, Vedder A,
van Hoorn H, Donders AR, Wirken L, Cats H, van Riel PL, Evers AW.
1Department of Medical Psychology, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands.
Abstract
OBJECTIVES:
Patients with fibromyalgia have diminished levels of physical fitness,
which may lead to functional disability and exacerbating complaints.
Multidisciplinary treatment comprising cognitive-behavioural therapy
(CBT) and exercise training has been shown to be effective in
improving physical fitness. However, due to the high drop-out rates
and large variability in patients' functioning, it was proposed that a
tailored treatment approach might yield more promising treatment
outcomes.
METHODS:
High-risk fibromyalgia patients were randomly assigned to a waiting
list control group (WLC) or a treatment condition (TC), with the
treatment consisting of 16 twice-weekly sessions of CBT and exercise
training tailored to the patient's cognitive-behavioural pattern.
Physical fitness was assessed with two physical tests before and 3
months after treatment and at corresponding intervals in the WLC.
Treatment effects were evaluated using linear mixed models.
RESULTS:
The level of physical fitness had improved significantly in the TC
compared with the WLC. Attrition rates were low, effect sizes large
and reliable change indices indicated a clinically relevant
improvement among the TC.
CONCLUSIONS:
A tailored multidisciplinary treatment approach for fibromyalgia
consisting of CBT and exercise training is well tolerated, yields
clinically relevant changes, and appears a promising approach to
improve patients' physical fitness.
ClinicalTrials.gov ID NCT00268606.
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