Six- and 24-month follow-up of pool exercise therapy and education for patients with fibromyalgia.
ABSTRACT To follow patients with fibromyalgia six and 24 months after they finished a six-month treatment programme. The programme comprised pool exercise therapy, adjusted to the patients' limitations, and education based on their health problems.
Twenty-six patients were examined six and 24 months after the completion of the treatment programme with the Fibromyalgia Impact Questionnaire (FIQ), SF-36, the 6-minute walk test, and the Grippit measure. The values obtained at the follow-up examinations were compared with the baseline and post-treatment values.
As compared with baseline, symptom severity (FIQ, SF-36), physical function (FIQ, SF-36, 6-minute walk test) and quality of life (SF-36) still showed improvements six months after the completion of treatment (p <0.05). Pain (FIQ, SF-36), fatigue (FIQ, SF-36), walking ability, and social function (SF-36) still showed improvements 2 years after the completion of the programme as compared with the baseline values (p < 0.05). No significant changes were found for these variables, when the values obtained at the two follow-up examinations were compared with those of the post-treatment examination.
Improvements in symptom severity, physical function and social function were still found six and 24 months after the completed treatment programme.
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ABSTRACT: A preliminary challenge in learning the art of psychotherapy is mastering how to choose appropriate patients. This skill goes far beyond performing a symptom inventory and matching up those results to a diagnosis. A psychodynamic evaluation explores various innate characteristics that predict a patient's ability to participate fully in and benefit greatly from this mode of therapy. Ignoring this critical first step in the process may create unnecessary stumbling blocks in the road of treatment. In this article, we will use a case example to illustrate some of the consequences a poor fit bears for both the patient and the therapist; in addition, we will review the desired traits that support a patient's suitability for psychodynamic psychotherapy.Psychiatry 11/2006; 3(11):44-50.
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ABSTRACT: To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life (HRQoL) among patients with fibromyalgia (FM), and to identify variables that were predictors of improvement in HRQoL. In a randomized controlled clinical trial carried out on an outpatient basis in a hospital pain management unit, 153 patients with FM were randomly allocated to an experimental group (EG) or a control group (CG). Participants completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6 months after the intervention. The EG received an interdisciplinary treatment (12 sessions for 6 weeks) which consisted of coordinated psychological, medical, educational, and physiotherapeutic interventions while the CG received standard-of-care pharmacologic treatment. Descriptive statistics, ANOVA, Chi square and Fisher tests and generalized linear models were used for data analysis. Six months after the intervention, statistically significant improvements in HRQoL were observed in physical functioning (P = 0.01), pain (P = 0.03) and total FIQ score (P = 0.04) in the EG compared to the CG. The number of physical illnesses was identified as a predictor for improvement. This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM. The number of physical illnesses was identified as a predictor of that improvement.Pain Practice 11/2013; · 2.61 Impact Factor
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ABSTRACT: This paper is a review article that collects and synthesizes up-to-date information about the complex etiological theories and treatment regimens associated with Fibromyalgia. The authors have written the paper in an evidence-based model in order to show the reader where adequate data exist in regards to these pharmacological, psychological, and physical strategies. A thorough MEDLINE search was utilized to collect many papers dedicated to this topic spanning 1970-2005. Measurements: The relevant papers were divided, based upon intervention used for the treatment of FM (pharmacological vs. non-pharmacological). They were also divided based on their scientific merit; randomized controlled trials were given the most evidence-based weight and the case studies the least. Results: The authors first review current epidemiologic and etiologic theories regarding fibromyalgia. A formal literature review is next presented to allow the reader to understand the evidence base that supports treatment of this disorder. In conclusion, a commentary regarding the treatment of this disorder in psychiatric practice occurs where pharmacodynamics and management strategy is discussed. Conclusion: There is much literature available regarding treatment of fibromyalgia. This complex illness has reasonable controlled studies for monotherapy treatments; however, multimodal treatments are the usual norm.Psychiatry 04/2006; 3(4):44-60.