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Cited by 59Fibromyalgia and Chronic Fatigue Syndrome ResearchPediatric Pain Management TechniquesMusculoskeletal pain and rehabilitation

Pilot randomized trial of integrated cognitive-behavioral therapy and neuromuscular training for juvenile fibromyalgia: the FIT teens program

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Kashikar-Zuck, Susmita, Black, William R., Pfeiffer, Megan, Peugh, James, Williams, Sara E., Ting, Tracy V., Thomas, Staci, Kitchen, Katie +1 more·2018·The Journal of Pain
DOI 10.1016/j.jpain.2018.04.003PMC PMC6119635
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Abstract

Cognitive-behavioral therapy (CBT) improves coping and daily functioning in adolescents with juvenile fibromyalgia (JFM), but is less effective in reducing pain. This pilot trial evaluated the efficacy of a novel intervention (Fibromyalgia Integrative Training for Teens; FIT Teens) which integrates CBT with specialized neuromuscular exercise training to enhance the effect of treatment on reducing pain and disability. Forty adolescents with JFM (12-18 years) were randomized to CBT-only or FIT Teens. Treatment was conducted in group-based sessions over 8 weeks with assessments at baseline, post-treatment, and 3-month follow-up (primary end point). Primary outcomes were pain intensity and functional disability. Secondary outcomes were depressive symptoms, fear of movement, and pain catastrophizing. Thirty-six participants (mean age=15.33 years; 90% female) completed the program. Intent to treat analysis was conducted to evaluate differences between the FIT Teens and CBT groups from baseline to 3-month follow-up, controlling for baseline group differences. Participants in the FIT Teens group showed significantly greater decreases in pain than the CBT group. FIT Teens participants also showed significant improvements in disability, but did not differ from CBT-only at the 3-month end point. Results provide preliminary evidence that the FIT Teens intervention provides added benefits beyond CBT in the treatment of JFM, particularly in pain reduction.Perspective Results from this pilot randomized controlled trial of a new combined CBT and specialized neuromuscular exercise intervention (FIT Teens), compared with CBT alone suggested that FIT Teens offers stronger treatment benefits than CBT alone at initial treatment follow-up, especially with respect to the outcome of pain reduction.

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  • The positive outcome for MPM contributes to a critical and growing evidence base supporting CBT and PT for pain treatment in youth.

    “The positive outcome for MPM in this trial contributes to a critical and growing evidence base supporting CBT and PT for pain treatment in youth[27; 31; 63; 64].”

    From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [27]

  • The findings lend further support for combined approaches, such as programs that integrate CBT and neuromuscular training for adolescents with fibromyalgia.

    “It also lends further support for combined approaches, such as programs that integrate CBT and neuromuscular training for adolescents with fibromyalgia[27].”

    From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [27]

  • FIT Teens provides additional benefits above and beyond CBT for children and adolescents with fibromyalgia.

    “suggesting that FIT Teens provides additional benefits above and beyond CBT for children and adolescents with fibromyalgia.”

    From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [49]

  • Over the last several years, effort has been made to develop interdisciplinary outpatient treatments, such as FIT Teens, 2B Active, and GET Living, and preliminary outcomes are promising.

    “Over the last several years, effort has been made to develop interdisciplinary outpatient treatments, such as FIT Teens [49], 2B Active [51], and GET Living (NCT: 03699007), and preliminary outcomes are promising [51].”

    From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [49]

  • FIT Teens combines cognitive-behavioral interventions with neuromuscular exercise training.

    “Fibromyalgia Integrative Training for Teens (FIT Teens) combines cognitive-behavioral interventions with neuromuscular exercise training [49].”

    From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [49]

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Authors
Kashikar-Zuck, S., Black, W. R., Pfeiffer, M., Peugh, J., Williams, S. E., Ting, T. V., Thomas, S., Kitchen, K., & Myer, G. D.
Affiliations
Cincinnati Children's Hospital Medical Center (US)
ORCID
Venue
The Journal of Pain
Publisher
Elsevier BV
Published
2018-09
Volume
19
Issue
9
Pages
1049-1062
ISSN
1526-5900 (ISSN-L)
DOI
10.1016/j.jpain.2018.04.003
PMC
PMC6119635
OpenAlex
W2800682112
Cited by
59
References
43
Citations by year
2026: 5 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 12 · 2021: 9 · 2020: 4 · 2019: 5 · 2018: 1
FWCI
3.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (R21AR063412, K24AR056687)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
juvenile fibromyalgia, cognitive behavioral therapy, neuromuscular training, integrated treatment, pain intensity, functional disability, adolescents, depressive symptoms, kinesiophobia, pain catastrophizing, group intervention
MeSH terms
Adolescent, Combined Modality Therapy, Exercise Therapy, Female, Fibromyalgia, Humans, Male, Pilot Projects, Cognitive Behavioral Therapy, Treatment Outcome

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