Tailored cognitive-behavioral therapy and exercise training for high-risk patients with fibromyalgia
Abstract
OBJECTIVE: The treatment of patients with fibromyalgia (FM), a high-prevalence chronic pain condition with a high impact on both patients and society, poses a great challenge to clinicians due to a lack of effective treatments. In view of the large individual variability in outcome, selecting patients at risk of long-term dysfunction and offering tailored treatment may be promising for beneficial treatment effects. METHODS: High-risk patients were selected and classified into 2 groups (pain-persistence and pain-avoidance groups) and subsequently randomized in groups to either a treatment condition (TC) or a waiting list control condition (WLC). Treatment consisted of 16 sessions of cognitive-behavioral therapy (CBT) and exercise training in groups, tailored to the patient's specific cognitive-behavioral pattern, delivered within 10 weeks. Physical and psychological functioning and impact of FM were assessed at baseline, posttreatment, and 6-month followup. Treatment effects were evaluated using a linear mixed model. RESULTS: The treatment effects were significant for all primary outcomes, showing significant differences in physical (pain, fatigue, and functional disability) and psychological (negative mood and anxiety) functioning, and impact of FM for the TC in comparison with the WLC. Effect sizes in the TC were overall large, and reliable change indices indicated a clinically relevant improvement among the TC. CONCLUSION: The presented results demonstrate for the first time that tailored CBT and exercise training for high-risk patients with FM is effective in improving short- and long-term physical and psychological functioning, indicating that tailoring treatment is likely to promote beneficial outcomes in FM and reduce the burden for patients and society.
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In Analysis 2.5, removal of the single study Van Koulil 2010 reduced heterogeneity from 57% to 35%, without affecting the overall result (SMD -0.17, 95% CI -0.30 to -0.03).
“In Analysis 2.5, removal of the single study (Van Koulil 2010) reduced heterogeneity from 57% to 35%, without aFecting the overall result (SMD -0.17 (95% CI -0.30 to -0.03)).”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Van Koulil 2010
In Analysis 4.3, removal of Van Koulil 2010 reduced heterogeneity to 9% but produced a non-significant result in place of the just significant one (Z = 1.57, P > 0.05).
“and reduced it to 9% (Analysis 4.3) but also produced a non-significant result in place of the just significant one: Z was 1.57, P > 0.05.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Van Koulil 2010
In Analysis 4.2, removal of a single study (Van Koulil 2010) reduced heterogeneity to 0% without changing the non-significant result.
“In Analysis 4.2 and Analysis 4.3, removal of a single study (Van Koulil 2010) reduced heterogeneity to 0% but without changing the non-significant result (Analysis 4.2)”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Van Koulil 2010
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- Authors
- van Koulil, S., van Lankveld, W., Kraaimaat, F. W., van Helmond, T., Vedder, A., van Hoorn, H., Donders, R., de Jong, A. J. L., Haverman, J. F., Korff, K., van Riel, P. L. C. M., Cats, H. A., & Evers, A. W. M.
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2010-06-02
- Volume
- 62
- Issue
- 10
- Pages
- 1377-1385
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- OpenAlex
- W2161952759
- Cited by
- 152
- References
- 39
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 8 · 2018: 7 · 2017: 13 · 2016: 7 · 2015: 13 · 2014: 8 · 2013: 11 · 2012: 17
- FWCI
- 9.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Radboud Universiteit
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Keywords
- fibromyalgia, cognitive behavioral therapy, exercise training, tailored treatment, high-risk patients, pain persistence, pain avoidance, chronic pain, fatigue, functional disability, anxiety, negative mood, psychological functioning, physical function
- MeSH terms
- Adult, Exercise Therapy, Female, Fibromyalgia, Follow-Up Studies, Humans, Male, Middle Aged, Pain Measurement, Risk Factors, Cognitive Behavioral Therapy
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