title: Long-term efficacy of therapy in patients with fibromyalgia: a physical exercise-based program and a cognitive-behavioral approach.
abstract: OBJECTIVE
  To analyze the long-term efficacy of 2 interventions for female fibromyalgia (FM) patients: 1) cognitive-behavioral therapy (CBT), and 2) a physical exercise (PE)-based strategy.
  
  
  METHODS
  We conducted a prospective, long-term, randomized, parallel clinical trial. The outcome variables are physical activity, aerobic capacity, and results of the Fibromyalgia Impact Questionnaire (FIQ), Short Form 36, Beck Anxiety and Depression Inventory, Chronic Pain Self-Efficacy Scale, and Chronic Pain Coping Inventory. All were measured at baseline, posttreatment, 6 months, and 1 year. The duration of both treatments was 8 weeks.
  
  
  RESULTS
  Some items of the FIQ and some strategies to cope with pain improved significantly in both groups after treatment. All variables measuring functional capacity improved significantly in the PE group, whereas only physical activity of the vertebral column improved in the CBT group. There were no differences in anxiety, depression, and self efficacy after treatment in either group. After 1 year of followup, most of the parameters had returned to baseline values in both groups. However, in the PE group, functional capacity remained significantly better.
  
  
  CONCLUSIONS
  PE and CBT improve clinical manifestations in FM patients only for short periods of time. Improvement in self efficacy and physical fitness are not associated with improvement in clinical manifestations.
authors.affiliation: Instituto Provincial de Rehabilitación, Hospital Universitario Gregorio Marañón, Madrid, Spain. javierrivera@ser.es
authors.forename: Javier Rivera
authors.initials: JR
authors.lastname: Redondo
authors.forename: Carmen Moratalla
authors.initials: CM
authors.lastname: Justo
authors.forename: Francisca Valdepeñas
authors.initials: FV
authors.lastname: Moraleda
authors.forename: Yolanda García
authors.initials: YG
authors.lastname: Velayos
authors.forename: José Juan Osés
authors.initials: JJ
authors.lastname: Puche
authors.forename: Julio Ruiz
authors.initials: JR
authors.lastname: Zubero
authors.forename: Teresa González
authors.initials: TG
authors.lastname: Hernández
authors.forename: Loreto Carmona
authors.initials: LC
authors.lastname: Ortells
authors.forename: Miguel Angel Vallejo
authors.initials: MA
authors.lastname: Pareja
mesh_terms: D015928:Cognitive Behavioral Therapy; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D005356:Fibromyalgia / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008609:Mental Status Schedule; D010809:Physical Fitness; D011446:Prospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome