Juvenile Fibromyalgia Improves with Physical, Occupational, and PsychotherapySeptember 22, 2015
The Neurology Advisor take:
While adults with fibromyalgia tend to be less physically active and more sedentary because of pain, rigorous physical and occupational therapy (PT/OT), in combination with psychotherapy, may help relieve fibromyalgia symptoms in children. More importantly, these results may be achieved without the help of medications.
David D. Sherry, MD, of the Children’s Hospital- Philadelphia, and colleagues studied the effects of an intensive PT/OT and psychotherapy program on 64 children with fibromyalgia (median age, 16 years; 95% Caucasian; 94% female; median duration of symptoms, 21 months). The participants were treated with five to six hours of intensive PT/OT daily and at least four hours of psychotherapy on a weekly basis, during which all medications for fibromyalgia were discontinued.
From the beginning to the end of the program, mean pain score decreased from 66 of 100 to 25 of 100 (P= .001). At one-year follow-up, 33% reported no pain. Measures of functions on the Bruininks-Oseretsky Test of Motor Performance, Second Edition improved significantly during the program and remained at that level or continued to improve during follow-up. Mean Bruce Treadmill protocol went from 588 seconds to 801 seconds (P<.001) and dropped to 750 seconds during follow-up, however the score is within the 90th percentile for age and sex. Pain Stages of Change Questionairre, adolescent version subset scores, Pediatric Quality of Life Inventory scores, and Teen Report total scores improved significantly during the program and remained stable or improved further at the one-year mark.
David D. Sherry, MD, of the Children's Hospital- Philadelphia, and colleagues assessed the short-term and 1-year outcomes of children with fibromyalgia treated with intensive physical and occupational therapy (PT/OT) and psychotherapy.
Children with fibromyalgia seen at a tertiary care hospital were treated with 5-6 hours of intensive PT/OT daily and at least 4 hours of psychosocial services weekly. All medications used for fibromyalgia were discontinued. Children underwent standardized testing, including a visual analog scale for pain; the Bruininks-Oseretsky Test of Motor Performance, Second Edition; the Bruce treadmill protocol; the Functional Disability Inventory; the Pain Stages of Change Questionnaire, adolescent version; and the Pediatric Quality of Life Inventory, and Teen Report.