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Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia, 2021, Haugmark et al

Discussion in 'Fibromyalgia and Connective Tissue Disorders' started by voner, Jul 1, 2021.

  1. voner

    voner Senior Member (Voting Rights)

    Messages:
    111
    Abstract
    Introduction: Non-pharmacological approaches are recommended as first-line treatment for patients with fibromyalgia. This randomised controlled trial investigated the effects of a multicomponent rehabilitation programme for patients with recently diagnosed fibromyalgia in primary and secondary healthcare.

    Methods: Patients with widespread pain ≥3 months were referred to rheumatologists for diagnostic clarification and assessment of study eligibility. Inclusion criteria were age 20-50 years, engaged in work or studies at present or during the past 2 years, and fibromyalgia diagnosed according to the American College of Rheumatology 2010 criteria. All eligible patients participated in a short patient education programme before inclusion and randomisation. The multicomponent programme, a 10-session mindfulness-based and acceptance-based group programme followed by 12 weeks of physical activity counselling was evaluated in comparison with treatment as usual, that is, no treatment or any other treatment of their choice. The primary outcome was the Patient Global Impression of Change (PGIC). Secondary outcomes were self-reported pain, fatigue, sleep quality, psychological distress, physical activity, health-related quality of life and work ability at 12-month follow-up.

    Results: In total, 170 patients were randomised, 1:1, intervention:control. Overall, the multicomponent rehabilitation programme was not more effective than treatment as usual; 13% in the intervention group and 8% in the control group reported clinically relevant improvement in PGIC (p=0.28). No statistically significant between-group differences were found in any disease-related secondary outcomes. There were significant between-group differences in patient's tendency to be mindful (p=0.016) and perceived benefits of exercise (p=0.033) in favour of the intervention group.

    Conclusions: A multicomponent rehabilitation programme combining patient education with a mindfulness-based and acceptance-based group programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-up.

    https://bmjopen.bmj.com/content/11/6/e046943.long
     
  2. alktipping

    alktipping Senior Member (Voting Rights)

    Messages:
    963
    first honest conclusion i have seen in years if ever when referring to psychobabble therapies .
     
    Michelle, inox, Nightsong and 12 others like this.
  3. voner

    voner Senior Member (Voting Rights)

    Messages:
    111
    here is a quote from the "discussion section" (PA= physical activity):

    "……. it was hypothesised that the lack of effects in patients with FM might have been related to living with distressing symptoms over a long time without receiving any diagnosis. The present study aimed to improve the management of FM by following the EULAR recommendations for management of FM in a Norwegian context. We assumed that offering patients who had been recently diagnosed with FM a mindfulness-based and acceptance-based intervention might help them overcome some of their internal barriers to PA before they attended a PA intervention. However, we found no support for this assumption."
     
    Michelle, inox, alktipping and 9 others like this.
  4. shak8

    shak8 Senior Member (Voting Rights)

    Messages:
    1,163
    Location:
    Northen California
    Patient selection was a bit skewed : they had to be involved in school or work within the last two years. This means that either they were recently diagnosed or that they are mildly affected.

    At least the post testing was done 12 months after the intervention.
     
  5. voner

    voner Senior Member (Voting Rights)

    Messages:
    111
    and this from the discussion section (PA = physical activity):

    "There was a high drop-out rate from the PA intervention. Further, studies on how to adapt and tailor PA interventions to patients with FM are needed."

    I interpret this as meaning that people dropped out of the study because of the physical activity that was being demanded of them.
     
    Michelle, inox, alktipping and 7 others like this.
  6. Hutan

    Hutan Moderator Staff Member

    Messages:
    16,598
    Location:
    New Zealand
    I often include researchers names in posts, to acknowledge their role in producing a poor piece of research. In this case, I think it's worth congratulating these authors - they reported what they found in the abstract, with no spin. The outcomes were patient-reported and largely subjective, but the period of followup (12 months) was good. It will be interesting to read the study detail.

    I think this is an important study for fibromyalgia treatment.

    A Norwegian study:
    1. Trond Haugmark1,2,
    2. Kåre Birger Hagen1,3,
    3. Sella Aarrestad Provan1,
    4. Geir Smedslund1,3,
    5. Heidi A Zangi1,4
    1. Division of Rheumatology and Research, Diakonhjemmet Hospital, Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway
    2. Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
    3. Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
    4. Faculty of Health, VID Specialized University, Oslo, Norway
     
    Michelle, inox, alktipping and 10 others like this.
  7. InitialConditions

    InitialConditions Senior Member (Voting Rights)

    Messages:
    834
    Location:
    North-West England
    The mindfulness arm tended to be more mindful. :alien:
     
    Michelle, inox, alktipping and 6 others like this.
  8. shak8

    shak8 Senior Member (Voting Rights)

    Messages:
    1,163
    Location:
    Northen California
    And the types of physical activities offered were painful to individual patients (my experience with generic chronic pain education groups w/exercise therapy thrown in).
     
    Michelle, inox, alktipping and 2 others like this.

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