title: Functionally oriented rehabilitation program for patients with fibromyalgia: preliminary results.
abstract: OBJECTIVE
  To evaluate function and disability in patients with fibromyalgia before and after participation in a functionally oriented, multidisciplinary, 8-wk treatment program.
  
  
  METHODS
  A total of 23 patients who met American College of Rheumatology criteria for the diagnosis of fibromyalgia were enrolled in the study. Outcome measures included: range of motion, 6-min walk test, a modified Fibromyalgia Impact Questionnaire, a modified SF-36 Physical Functioning Scale, and the Fibromyalgia Health Assessment Questionnaire. Pretreatment and posttreatment scores were analyzed using paired t tests.
  
  
  RESULTS
  All subjects completed the program, and there were no reported injuries. Three subjects failed to complete the survey instruments at the conclusion of the study. Intention to treat analysis including these subjects was carried out but did not significantly change results. For the remaining subjects (n = 20), a significant improvement was found on the Physical Functioning Scale (P = 0.01). Trends toward improvement on the Fibromyalgia Impact Questionnaire (P = 0.40) and Fibromyalgia Health Assessment Questionnaire (P = 0.14) were seen but did not achieve statistical significance. Range of motion testing revealed significant improvements in lumbar spine extension (P < 0.001), straight-leg raise (P < 0.001), cervical spine flexion (P < 0.01), cervical spine rotation (P < 0.05), and cervical spine side bending (P < 0.05). Distance traveled during the 6-min walk test increased significantly (P < 0.01), whereas perceived exertion as measured by the Borg scale did not change. There were no injuries or other adverse consequences of the program.
  
  
  CONCLUSIONS
  This study utilized multiple functional outcome measures to demonstrate improved function and decreased disability in patients with fibromyalgia. Our patients reported significantly improved physical function after participation in the 8-wk intensive multidisciplinary treatment program. This progressive, functionally based exercise training program was well tolerated by all participants and outlines an effective exercise prescription for patients with fibromyalgia. Fibromyalgia patients in this study responded favorably to a treatment program that focused on function instead of pain.
authors.affiliation: Spinal Cord Injury Unit, West Roxbury Division, VA Boston Health Care System, West Roxbury, Massachusetts 02132, USA.
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Wennemer
authors.forename: Joanne
authors.initials: J
authors.lastname: Borg-Stein
authors.forename: Lorraine
authors.initials: L
authors.lastname: Gomba
authors.forename: Bobbi
authors.initials: B
authors.lastname: Delaney
authors.forename: Astrid
authors.initials: A
authors.lastname: Rothmund
authors.forename: David
authors.initials: D
authors.lastname: Barlow
authors.forename: Gail
authors.initials: G
authors.lastname: Breeze
authors.forename: Anita
authors.initials: A
authors.lastname: Thompson
mesh_terms: D002574:Cervical Vertebrae / Q000503:physiopathology; D006233:Persons with Disabilities / Q000534:rehabilitation; D005081:Exercise Therapy; D005356:Fibromyalgia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000503:physiopathology; D009068:Movement / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology