Rehabilitation approaches in fibromyalgia.
OBJECTIVE
This paper provides an overview of the evidence for the principal approaches taken to the rehabilitation of patients with fibromyalgia (FM): exercise, psychologically-based approaches, multimodal approaches, self-management approaches, and complementary and alternative therapies.


METHODS
A review of current published evidence.


RESULTS
Owing to factors such as methodological shortcomings of existing studies, and the lack of evidence on individual modalities, it is difficult to draw definitive conclusions as to which is the most appropriate rehabilitation approach in FM. However, there is growing evidence for the role of exercise training, and clear indications that if appropriately prescribed, this can be undertaken without adverse effects. Similarly, psychologically-based interventions such as cognitive-behavioural therapy have received some support from the literature. Evidence for other interventions is more equivocal.


CONCLUSIONS
It appears that a combination of interventions, in a multimodal approach (e.g., exercises combined with education and psychologically-based interventions) is the most promising means of managing patients with FM.
Adams
Nicola
N
Centre for Research in Health Care, Liverpool John Moores University, Great Crosshall Street, Liverpool, UK. j.sim@keele.ac.uk
Sim
Julius
J
D001676:Biofeedback, Psychology / Q000379:methods*; D000529:Complementary Therapies; D004576:Electromyography; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005356:Fibromyalgia / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D006113:United Kingdom