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Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: The FIT Teens Program.
J Pain. 2018 09; 19(9):1049-1062.JP

Abstract

Cognitive-behavioral therapy (CBT) improves coping and daily functioning in adolescents with juvenile fibromyalgia (JFM), but is less effective in reducing pain. This pilot trial evaluated the efficacy of a novel intervention (Fibromyalgia Integrative Training for Teens; FIT Teens) which integrates CBT with specialized neuromuscular exercise training to enhance the effect of treatment on reducing pain and disability. Forty adolescents with JFM (12-18 years) were randomized to CBT-only or FIT Teens. Treatment was conducted in group-based sessions over 8 weeks with assessments at baseline, post-treatment, and 3-month follow-up (primary end point). Primary outcomes were pain intensity and functional disability. Secondary outcomes were depressive symptoms, fear of movement, and pain catastrophizing. Thirty-six participants (mean age=15.33 years; 90% female) completed the program. Intent to treat analysis was conducted to evaluate differences between the FIT Teens and CBT groups from baseline to 3-month follow-up, controlling for baseline group differences. Participants in the FIT Teens group showed significantly greater decreases in pain than the CBT group. FIT Teens participants also showed significant improvements in disability, but did not differ from CBT-only at the 3-month end point. Results provide preliminary evidence that the FIT Teens intervention provides added benefits beyond CBT in the treatment of JFM, particularly in pain reduction.

PERSPECTIVE

Results from this pilot randomized controlled trial of a new combined CBT and specialized neuromuscular exercise intervention (FIT Teens), compared with CBT alone suggested that FIT Teens offers stronger treatment benefits than CBT alone at initial treatment follow-up, especially with respect to the outcome of pain reduction.

Authors+Show Affiliations

Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: Susmita.Kashikar-Zuck@cchmc.org.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Pub Type(s)

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

Language

eng

PubMed ID

29678563

Citation

Kashikar-Zuck, Susmita, et al. "Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: the FIT Teens Program." The Journal of Pain : Official Journal of the American Pain Society, vol. 19, no. 9, 2018, pp. 1049-1062.
Kashikar-Zuck S, Black WR, Pfeiffer M, et al. Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: The FIT Teens Program. J Pain. 2018;19(9):1049-1062.
Kashikar-Zuck, S., Black, W. R., Pfeiffer, M., Peugh, J., Williams, S. E., Ting, T. V., Thomas, S., Kitchen, K., & Myer, G. D. (2018). Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: The FIT Teens Program. The Journal of Pain : Official Journal of the American Pain Society, 19(9), 1049-1062. https://doi.org/10.1016/j.jpain.2018.04.003
Kashikar-Zuck S, et al. Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: the FIT Teens Program. J Pain. 2018;19(9):1049-1062. PubMed PMID: 29678563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pilot Randomized Trial of Integrated Cognitive-Behavioral Therapy and Neuromuscular Training for Juvenile Fibromyalgia: The FIT Teens Program. AU - Kashikar-Zuck,Susmita, AU - Black,William R, AU - Pfeiffer,Megan, AU - Peugh,James, AU - Williams,Sara E, AU - Ting,Tracy V, AU - Thomas,Staci, AU - Kitchen,Katie, AU - Myer,Gregory D, Y1 - 2018/04/17/ PY - 2017/10/03/received PY - 2018/03/26/revised PY - 2018/04/04/accepted PY - 2018/4/22/pubmed PY - 2019/11/9/medline PY - 2018/4/22/entrez KW - Pediatric pain KW - cognitive-behavioral therapy KW - fibromyalgia KW - neuromuscular exercise SP - 1049 EP - 1062 JF - The journal of pain : official journal of the American Pain Society JO - J Pain VL - 19 IS - 9 N2 - : Cognitive-behavioral therapy (CBT) improves coping and daily functioning in adolescents with juvenile fibromyalgia (JFM), but is less effective in reducing pain. This pilot trial evaluated the efficacy of a novel intervention (Fibromyalgia Integrative Training for Teens; FIT Teens) which integrates CBT with specialized neuromuscular exercise training to enhance the effect of treatment on reducing pain and disability. Forty adolescents with JFM (12-18 years) were randomized to CBT-only or FIT Teens. Treatment was conducted in group-based sessions over 8 weeks with assessments at baseline, post-treatment, and 3-month follow-up (primary end point). Primary outcomes were pain intensity and functional disability. Secondary outcomes were depressive symptoms, fear of movement, and pain catastrophizing. Thirty-six participants (mean age=15.33 years; 90% female) completed the program. Intent to treat analysis was conducted to evaluate differences between the FIT Teens and CBT groups from baseline to 3-month follow-up, controlling for baseline group differences. Participants in the FIT Teens group showed significantly greater decreases in pain than the CBT group. FIT Teens participants also showed significant improvements in disability, but did not differ from CBT-only at the 3-month end point. Results provide preliminary evidence that the FIT Teens intervention provides added benefits beyond CBT in the treatment of JFM, particularly in pain reduction. PERSPECTIVE: Results from this pilot randomized controlled trial of a new combined CBT and specialized neuromuscular exercise intervention (FIT Teens), compared with CBT alone suggested that FIT Teens offers stronger treatment benefits than CBT alone at initial treatment follow-up, especially with respect to the outcome of pain reduction. SN - 1528-8447 UR - https://www.unboundmedicine.com/medline/citation/29678563/Pilot_Randomized_Trial_of_Integrated_Cognitive_Behavioral_Therapy_and_Neuromuscular_Training_for_Juvenile_Fibromyalgia:_The_FIT_Teens_Program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-5900(18)30144-5 DB - PRIME DP - Unbound Medicine ER -