A 12-week multicomponent therapy in fibromyalgia improves health but not in concomitant moderate depression, an exploratory pilot study

Abstract

Objectives: Literature suggests that graded and multicomponent therapy improves outcomes in fibromyalgia, but there is no conclusive evidence in which combination to be used. This study focused on the effect of a multicomponent therapy in fibromyalgia when a combination of exercise therapy and cognitive behavioural therapy was applied. Additionally, predictors for dropping out were explored as research reports high dropout rates.

Methods: Participants received graded multicomponent therapy for 12 weeks, twice a week during two hours every session by an occupational therapist, a physiotherapist, and a psychologist. Following outcome measures were assessed at baseline, weeks 6 and 12: Fibromyalgia Impact Questionnaire, Tampa scale for kinesiophobia, the Beck Depression Index, the Pain Coping Inventory (PCI), pain at the tenderpoints, grip strength, the 6-min walking test (6MWT), and cycling test.

Results: In total, 64 fibromyalgia patients were screened and included. The dropout rate was 28%. A per-protocol analysis revealed significant improvement at week 6 for the Beck Depression Index, pain at the tenderpoints and the 6MWT. At week 12, the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Index (BDI), Pain PCI, pain at the tenderpoints, grip strength, and 6MWT improved significantly. The dropout analysis showed an association in participants with a moderate BDI score at baseline.

Conclusions: A 12-week multicomponent therapy for fibromyalgia, well described and gradually applied, showed improvement in health-related outcome. According to our results, we recommend to exclude patients with a moderate-to-severe depression at onset before starting a multicomponent therapy protocol.

Implications for rehabilitation

• Multicomponent therapy for fibromyalgia is beneficial on different health outcomes.

• Moderate depression at onset should be exclusion criteria for starting with multicomponent therapy in patients with fibromyalgia.

• This multicomponent therapy protocol is ready to be implemented at daily practice.

Keywords:

• Fibromyalgia
• cognitive therapy
• physical therapy modalities
• depression
• occupational therapy

Acknowledgements

We are grateful to all patients who participated at the study.

Disclosure statement

No conflicts of interest were presented.