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Physical activity monitoring in adolescents with juvenile fibromyalgia: findings from a clinical trial of cognitive-behavioral therapy.
Arthritis Care Res (Hoboken). 2013 Mar; 65(3):398-405.AC

Abstract

OBJECTIVE

Juvenile fibromyalgia (JFM) is a chronic musculoskeletal pain condition that is associated with reduced physical function. Recent research has demonstrated that cognitive-behavioral therapy (CBT) is effective in improving daily functioning among adolescents with JFM. However, it is not known whether these improvements were accompanied by increased physical activity levels. Our objective was to analyze secondary data from a randomized clinical trial of CBT to examine whether CBT was associated with improvement in objectively measured physical activity and whether actigraphy indices corresponded with self-reported functioning among adolescents with JFM.

METHODS

Participants were 114 adolescents (ages 11-18 years) recruited from pediatric rheumatology clinics that met criteria for JFM and were enrolled in a clinical trial. Subjects were randomly (1:1) assigned to receive either CBT or fibromyalgia education (FE). Participants wore a hip-mounted accelerometer for 1 week as part of their baseline and posttreatment assessments.

RESULTS

The final sample included 68 subjects (94% female, mean age 15.2 years) for whom complete actigraphy data were obtained. Actigraphy measures were not found to correspond with self-reported improvements in functioning. While self-reported functioning improved in the CBT condition compared to FE, no significant changes were seen in either group for activity counts, sedentary, moderate, or vigorous activity. The CBT group had significantly lower peak and light activity at posttreatment.

CONCLUSION

Actigraphy monitoring provides a unique source of information about patient outcomes. CBT intervention was not associated with increased physical activity in adolescents with JFM, indicating that combining CBT with interventions to increase physical activity may enhance treatment effects.

Authors+Show Affiliations

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA. Susmita.Kashikar-Zuck@cchmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22972753

Citation

Kashikar-Zuck, Susmita, et al. "Physical Activity Monitoring in Adolescents With Juvenile Fibromyalgia: Findings From a Clinical Trial of Cognitive-behavioral Therapy." Arthritis Care & Research, vol. 65, no. 3, 2013, pp. 398-405.
Kashikar-Zuck S, Flowers SR, Strotman D, et al. Physical activity monitoring in adolescents with juvenile fibromyalgia: findings from a clinical trial of cognitive-behavioral therapy. Arthritis Care Res (Hoboken). 2013;65(3):398-405.
Kashikar-Zuck, S., Flowers, S. R., Strotman, D., Sil, S., Ting, T. V., & Schikler, K. N. (2013). Physical activity monitoring in adolescents with juvenile fibromyalgia: findings from a clinical trial of cognitive-behavioral therapy. Arthritis Care & Research, 65(3), 398-405. https://doi.org/10.1002/acr.21849
Kashikar-Zuck S, et al. Physical Activity Monitoring in Adolescents With Juvenile Fibromyalgia: Findings From a Clinical Trial of Cognitive-behavioral Therapy. Arthritis Care Res (Hoboken). 2013;65(3):398-405. PubMed PMID: 22972753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical activity monitoring in adolescents with juvenile fibromyalgia: findings from a clinical trial of cognitive-behavioral therapy. AU - Kashikar-Zuck,Susmita, AU - Flowers,Stacy R, AU - Strotman,Daniel, AU - Sil,Soumitri, AU - Ting,Tracy V, AU - Schikler,Kenneth N, PY - 2012/01/26/received PY - 2012/08/29/accepted PY - 2012/9/14/entrez PY - 2012/9/14/pubmed PY - 2013/4/19/medline SP - 398 EP - 405 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 65 IS - 3 N2 - OBJECTIVE: Juvenile fibromyalgia (JFM) is a chronic musculoskeletal pain condition that is associated with reduced physical function. Recent research has demonstrated that cognitive-behavioral therapy (CBT) is effective in improving daily functioning among adolescents with JFM. However, it is not known whether these improvements were accompanied by increased physical activity levels. Our objective was to analyze secondary data from a randomized clinical trial of CBT to examine whether CBT was associated with improvement in objectively measured physical activity and whether actigraphy indices corresponded with self-reported functioning among adolescents with JFM. METHODS: Participants were 114 adolescents (ages 11-18 years) recruited from pediatric rheumatology clinics that met criteria for JFM and were enrolled in a clinical trial. Subjects were randomly (1:1) assigned to receive either CBT or fibromyalgia education (FE). Participants wore a hip-mounted accelerometer for 1 week as part of their baseline and posttreatment assessments. RESULTS: The final sample included 68 subjects (94% female, mean age 15.2 years) for whom complete actigraphy data were obtained. Actigraphy measures were not found to correspond with self-reported improvements in functioning. While self-reported functioning improved in the CBT condition compared to FE, no significant changes were seen in either group for activity counts, sedentary, moderate, or vigorous activity. The CBT group had significantly lower peak and light activity at posttreatment. CONCLUSION: Actigraphy monitoring provides a unique source of information about patient outcomes. CBT intervention was not associated with increased physical activity in adolescents with JFM, indicating that combining CBT with interventions to increase physical activity may enhance treatment effects. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/22972753/Physical_activity_monitoring_in_adolescents_with_juvenile_fibromyalgia:_findings_from_a_clinical_trial_of_cognitive_behavioral_therapy_ L2 - https://doi.org/10.1002/acr.21849 DB - PRIME DP - Unbound Medicine ER -