One-year efficacy of a 3-week intensive multidisciplinary non-pharmacological treatment program for fibromyalgia patients

2009 
Objective The aim of the present study was to investigate the long-term efficacy of a 3-week intensive residential multidisciplinary non-pharmacological treatment program (including individually prescribed and monitored aerobic exercise and cognitive behavioural therapy) on fibromyalgia symptoms and aerobic fitness. Methods Twenty-five women with fibromyalgia participated in six experimental sessions (pre-admission, immediately before and immediately after the treatment, and to 2, 5 and 12 months afterwards) in which they underwent clinical, psychophysical and psychological examinations: pain intensity (VAS), pain area (percentage of total body surface), deep pressure pain threshold at 18 tender point sites measured with a pressure algometer, an incremental step test with blood lactate determination and calculation of the individual intensity of exercise corresponding to 2 mM of lactate concentration (W 2 , index of aerobic fitness). Depression and coping were evaluated with the Center for Epidemiologic Studies Depression Scale (CES-D) and Brief Pain Coping Inventory (BPCI), respectively. Results Pain intensity, pain area and number of positive tender points were significantly reduced up to 12 months, while deep pressure pain threshold and W 2 increased. CES-D score decreased until two months. Among the 18 items of the BCPI, only item 3 ("physical exercise/stretching") changed significantly, increasing until 12 months. Conclusion In fibromyalgia patients, whose symptoms before treatment were constant, a 3-week intensive residential multidisciplinary treatment program showed one-year efficacy in improving pain and aerobic fitness. The acquisition of physical exercise as a coping strategy for chronic pain acceptance could explain the long-term effects of our brief treatment.
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