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Improving physical functional status in patients with fibromyalgia: a brief cognitive behavioral intervention
Williams DA, Cary MA, Groner KH, Chaplin W, Glazer LJ, Rodriguez AM, Clauw DJ
The Journal of Rheumatology 2002 Jun;29(6):1280-1286
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; 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: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Sustained improvement in physical functional status was the primary goal of a brief, 6 session cognitive behavioral therapy (CBT) protocol for fibromyalgia (FM). assigned to either (1) standard medical care that included pharmacological management of symptoms and suggestions for aerobic fitness, or (2) the same standard medical treatment plus 6 sessions of CBT aimed at improving physical functioning. Outcome measures included the Medical Outcome Study Short Form-36 Physical Component Score and McGill ratings of pain. Outcomes were treated dichotomously using a preestablished criterion for clinically significant success based upon the reliability of change index from baseline to one year posttreatment. to achieve clinically meaningful levels of longterm improvement in physical functioning, whereas only 12% of the patients receiving standard care achieved the same level of improvement. There were no lasting differences on pain ratings between groups. among the most difficult outcomes to obtain in studies of FM, These data suggest that the inclusion of CBT to a standard medical regimen for FM can favorably influence physical functioning in a subset of patients.

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