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|Research to Encourage Exercise for Fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial|
|Ang DC, Kaleth AS, Bigatti S, Mazzuca SA, Jensen MP, Hilligoss J, Slaven J, Saha C|
|The Clinical Journal of Pain 2013 Apr;29(4):296-304|
|7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; 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: Regular exercise is associated with important benefits in patients with fibromyalgia (FM). Unfortunately, long-term maintenance of exercise after a structured program is rare. The present study tested the efficacy of motivational interviewing (MI) to promote exercise and improve symptoms in patients with FM. METHODS: A total of 216 patients with FM were randomized to 6 MI sessions (n = 107) or an equal number of FM self-management lessons (education control/EC, n = 109). Co-primary endpoints were an increase of 30 minutes in moderate-vigorous physical activity and improvement in the Fibromyalgia Impact Questionnaire (FIQ)-Physical Impairment score, assessed at pretreatment, posttreatment, and 3-month and 6-month follow-up. Secondary outcomes included clinically meaningful improvements in FIQ score, pain severity ratings, and a 6-minute walk test. RESULTS: There were no significant treatment group differences in either co-primary endpoint at 6-month follow-up. However, more MI participants than controls exhibited meaningful improvements in FIQ score at 6-month follow-up (62.9% versus 49.5%, p = 0.06). Compared with EC participants, MI participants also displayed a larger increment in their 6-minute walk test (43.9 versus 24.8 m, p = 0.03). In addition, MI was superior to EC in increasing the number of hours of physical activity immediately postintervention and in reducing pain severity both immediately after the intervention and at 3-month follow-up. CONCLUSIONS: Despite a lack of benefits on long-term outcome, MI seems to have short-term benefits with respect to self-report physical activity and clinical outcomes. This is the first study in FM that explicitly addresses exercise maintenance as a primary aim. CLINICAL TRIAL REGISTRATION: NCT00573612.