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Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia.
Arthritis Care Res (Hoboken). 2017 03; 69(3):413-420.AC

Abstract

OBJECTIVE

Cognitive-behavioral therapy (CBT) is effective in reducing disability among youth with juvenile fibromyalgia (FM); however, engagement in moderate to vigorous physical activity remains poor, even after CBT. The purpose of this study was to evaluate the feasibility and preliminary outcomes of an innovative program combining CBT with specialized neuromuscular exercise: the Fibromyalgia Integrative Training for Teens (FIT Teens) program.

METHODS

Adolescents with juvenile FM (n = 22, all female, ages 12-18 years) from 2 urban children's hospitals participated in the 8-week FIT Teens intervention. Participants completed measures of pain intensity, functional disability, depressive symptoms, pain catastrophizing, fear of movement, and readiness to change at baseline and after the intervention.

RESULTS

The feasibility of the intervention across 2 sites was documented, including high retention rates (80%). Participants showed significant decreases in functional disability (P < 0.05), depression (P < 0.001), fear of movement (P < 0.01), and pain catastrophizing (P < 0.001) from pre- to postintervention. Results of the readiness to change measure indicated a significant decrease in precontemplation (P < 0.01) and increase in action/maintenance scores (P < 0.001). All results demonstrated medium to large effect sizes.

CONCLUSION

Adolescents with juvenile FM reported significant improvements in physical function and reduced fear of movement following the intervention. Improvement in physical function was achieved in a shorter time frame than in a prior trial of CBT without an exercise component. Further work is needed to compare the FIT Teens program with existing approaches and determine whether objective changes in exercise participation are achieved.

Authors+Show Affiliations

DePaul University, Chicago, Illinois.Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.Connecticut Children's Medical Center, Hartford.Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, University of Pennsylvania, Philadelphia, and The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.Emory University School of Medicine, Children's Healthcare of Atlanta, and Aflac Cancer and Blood Disorders Center, Atlanta, Georgia.Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.Connecticut Children's Medical Center, Hartford.Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

27331358

Citation

Tran, Susan T., et al. "Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia." Arthritis Care & Research, vol. 69, no. 3, 2017, pp. 413-420.
Tran ST, Guite JW, Pantaleao A, et al. Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia. Arthritis Care Res (Hoboken). 2017;69(3):413-420.
Tran, S. T., Guite, J. W., Pantaleao, A., Pfeiffer, M., Myer, G. D., Sil, S., Thomas, S. M., Ting, T. V., Williams, S. E., Edelheit, B., Ounpuu, S., Rodriguez-MacClintic, J., Zemel, L., Zempsky, W., & Kashikar-Zuck, S. (2017). Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia. Arthritis Care & Research, 69(3), 413-420. https://doi.org/10.1002/acr.22946
Tran ST, et al. Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia. Arthritis Care Res (Hoboken). 2017;69(3):413-420. PubMed PMID: 27331358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia. AU - Tran,Susan T, AU - Guite,Jessica W, AU - Pantaleao,Ashley, AU - Pfeiffer,Megan, AU - Myer,Gregory D, AU - Sil,Soumitri, AU - Thomas,Staci M, AU - Ting,Tracy V, AU - Williams,Sara E, AU - Edelheit,Barbara, AU - Ounpuu,Sylvia, AU - Rodriguez-MacClintic,Jennifer, AU - Zemel,Lawrence, AU - Zempsky,William, AU - Kashikar-Zuck,Susmita, PY - 2016/03/30/received PY - 2016/05/13/revised PY - 2016/05/31/accepted PY - 2016/6/23/pubmed PY - 2017/7/14/medline PY - 2016/6/23/entrez SP - 413 EP - 420 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 69 IS - 3 N2 - OBJECTIVE: Cognitive-behavioral therapy (CBT) is effective in reducing disability among youth with juvenile fibromyalgia (FM); however, engagement in moderate to vigorous physical activity remains poor, even after CBT. The purpose of this study was to evaluate the feasibility and preliminary outcomes of an innovative program combining CBT with specialized neuromuscular exercise: the Fibromyalgia Integrative Training for Teens (FIT Teens) program. METHODS: Adolescents with juvenile FM (n = 22, all female, ages 12-18 years) from 2 urban children's hospitals participated in the 8-week FIT Teens intervention. Participants completed measures of pain intensity, functional disability, depressive symptoms, pain catastrophizing, fear of movement, and readiness to change at baseline and after the intervention. RESULTS: The feasibility of the intervention across 2 sites was documented, including high retention rates (80%). Participants showed significant decreases in functional disability (P < 0.05), depression (P < 0.001), fear of movement (P < 0.01), and pain catastrophizing (P < 0.001) from pre- to postintervention. Results of the readiness to change measure indicated a significant decrease in precontemplation (P < 0.01) and increase in action/maintenance scores (P < 0.001). All results demonstrated medium to large effect sizes. CONCLUSION: Adolescents with juvenile FM reported significant improvements in physical function and reduced fear of movement following the intervention. Improvement in physical function was achieved in a shorter time frame than in a prior trial of CBT without an exercise component. Further work is needed to compare the FIT Teens program with existing approaches and determine whether objective changes in exercise participation are achieved. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/27331358/Preliminary_Outcomes_of_a_Cross_Site_Cognitive_Behavioral_and_Neuromuscular_Integrative_Training_Intervention_for_Juvenile_Fibromyalgia_ L2 - https://doi.org/10.1002/acr.22946 DB - PRIME DP - Unbound Medicine ER -