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Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials.

Abstract

OBJECTIVE

To systematically review the efficacy of multicomponent treatment of fibromyalgia syndrome (FMS).

METHODS

We screened Medline, PsychINFO, Scopus, and the Cochrane Library (through December 2007), as well as reference sections of original studies, reviews, and evidence-based guidelines. Randomized controlled trials (RCTs) on the multicomponent treatment (at least 1 educational or other psychological therapy with at least 1 exercise therapy) of FMS were analyzed.

RESULTS

We included 9 (of 14) RCTs with 1,119 subjects (median treatment time 24 hours) in the meta-analysis. Effects were summarized using standardized mean differences (SMDs) or weighted mean differences (WMDs). There was strong evidence that multicomponent treatment reduces pain (SMD -0.37; 95% confidence interval [95% CI] -0.62, -0.13), fatigue (WMD -0.85; 95% CI -1.50, -0.20), depressive symptoms (SMD -0.67; 95% CI -1.08, -0.26), and limitations to health-related quality of life (HRQOL) (SMD -0.59; 95% CI -0.90, -0.27) and improves self-efficacy pain (SMD 0.54; 95% CI 0.26, 0.82) and physical fitness (SMD 0.30; 95% CI 0.02, 0.57) at posttreatment. There was no evidence of its efficacy on pain, fatigue, sleep disturbances, depressive symptoms, HRQOL, or self-efficacy pain in the long term. There was strong evidence that positive effects on physical fitness (SMD 0.30; 95% CI 0.09, 0.51) can be maintained in the long term (median followup 7 months).

CONCLUSIONS

There is strong evidence that multicomponent treatment has beneficial short-term effects on the key symptoms of FMS. Strategies to maintain the benefits of multicomponent treatment in the long term need to be developed.

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  • Authors+Show Affiliations

    ,

    Klinikum Saarbrücken, Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de

    , , ,

    Source

    Arthritis and rheumatism 61:2 2009 Feb 15 pg 216-24

    MeSH

    Adult
    Combined Modality Therapy
    Female
    Fibromyalgia
    Humans
    Male
    Middle Aged
    Randomized Controlled Trials as Topic
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19177530

    Citation

    Häuser, Winfried, et al. "Efficacy of Multicomponent Treatment in Fibromyalgia Syndrome: a Meta-analysis of Randomized Controlled Clinical Trials." Arthritis and Rheumatism, vol. 61, no. 2, 2009, pp. 216-24.
    Häuser W, Bernardy K, Arnold B, et al. Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. Arthritis Rheum. 2009;61(2):216-24.
    Häuser, W., Bernardy, K., Arnold, B., Offenbächer, M., & Schiltenwolf, M. (2009). Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. Arthritis and Rheumatism, 61(2), pp. 216-24. doi:10.1002/art.24276.
    Häuser W, et al. Efficacy of Multicomponent Treatment in Fibromyalgia Syndrome: a Meta-analysis of Randomized Controlled Clinical Trials. Arthritis Rheum. 2009 Feb 15;61(2):216-24. PubMed PMID: 19177530.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. AU - Häuser,Winfried, AU - Bernardy,Kathrin, AU - Arnold,Bernhard, AU - Offenbächer,Martin, AU - Schiltenwolf,Marcus, PY - 2009/1/30/entrez PY - 2009/1/30/pubmed PY - 2009/4/15/medline SP - 216 EP - 24 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 61 IS - 2 N2 - OBJECTIVE: To systematically review the efficacy of multicomponent treatment of fibromyalgia syndrome (FMS). METHODS: We screened Medline, PsychINFO, Scopus, and the Cochrane Library (through December 2007), as well as reference sections of original studies, reviews, and evidence-based guidelines. Randomized controlled trials (RCTs) on the multicomponent treatment (at least 1 educational or other psychological therapy with at least 1 exercise therapy) of FMS were analyzed. RESULTS: We included 9 (of 14) RCTs with 1,119 subjects (median treatment time 24 hours) in the meta-analysis. Effects were summarized using standardized mean differences (SMDs) or weighted mean differences (WMDs). There was strong evidence that multicomponent treatment reduces pain (SMD -0.37; 95% confidence interval [95% CI] -0.62, -0.13), fatigue (WMD -0.85; 95% CI -1.50, -0.20), depressive symptoms (SMD -0.67; 95% CI -1.08, -0.26), and limitations to health-related quality of life (HRQOL) (SMD -0.59; 95% CI -0.90, -0.27) and improves self-efficacy pain (SMD 0.54; 95% CI 0.26, 0.82) and physical fitness (SMD 0.30; 95% CI 0.02, 0.57) at posttreatment. There was no evidence of its efficacy on pain, fatigue, sleep disturbances, depressive symptoms, HRQOL, or self-efficacy pain in the long term. There was strong evidence that positive effects on physical fitness (SMD 0.30; 95% CI 0.09, 0.51) can be maintained in the long term (median followup 7 months). CONCLUSIONS: There is strong evidence that multicomponent treatment has beneficial short-term effects on the key symptoms of FMS. Strategies to maintain the benefits of multicomponent treatment in the long term need to be developed. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/19177530/full_citation L2 - https://doi.org/10.1002/art.24276 DB - PRIME DP - Unbound Medicine ER -