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|Effects of amitriptyline and cardiovascular fitness training on pain in patients with primary fibromyalgia|
|Isomeri R, Mikkelsson M, Latikka P, Kammonen K|
|Journal of Musculoskeletal Pain 1993;1(3-4):253-260|
|4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
OBJECTIVES: The aim of the study was to compare the value of amitriptyline (AT) and cardiovascular fitness training (CFT) in the treatment of pain in patients with primary fibromyalgia syndrome (PFS). METHODS: A total of 45 patients (39 female, 6 male, mean age 43.7, range 24 to 55 years) with PFS were randomized into three treatment groups: A. 16 patients who received AT 25 mg at 9pm daily; B. 15 patients with heavy CFT; and C. 14 patients who received AT 25 mg at 9pm daily and who had heavy CFT. The duration of treatment was 15 weeks. RESULTS: Pain measured as the pressure pain threshold and tolerance on muscle and bone control points and as the pain threshold on tender points and on a visual analogue scale (VAS) were similar in all three groups at the start of the trial. After 15 weeks all measurements showed less pain experience in patients treated with both AT and CFT (group C) than in patients treated with AT alone (group A). The effect of CFT alone (group B) was better than that of AT alone, but not as good as that of the combination. General pain as measured by VAS only declined in patients treated with both AT and CFT. CONCLUSIONS: A combination of AT and CFT is more effective in the treatment of PFS than either of these alone.