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

Abstract

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 (W2, 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 W2 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.