title: Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia.
abstract: OBJECTIVE
  Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes.
  
  
  METHODS
  High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models.
  
  
  RESULTS
  The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC.
  
  
  CONCLUSIONS
  A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Centre, The Netherlands. s.vankoulil@mps.umcn.nl
authors.forename: S
authors.initials: S
authors.lastname: van Koulil
authors.forename: W
authors.initials: W
authors.lastname: van Lankveld
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: T
authors.initials: T
authors.lastname: van Helmond
authors.forename: A
authors.initials: A
authors.lastname: Vedder
authors.forename: H
authors.initials: H
authors.lastname: van Hoorn
authors.forename: A R T
authors.initials: AR
authors.lastname: Donders
authors.forename: L
authors.initials: L
authors.lastname: Wirken
authors.forename: H
authors.initials: H
authors.lastname: Cats
authors.forename: P L C M
authors.initials: PL
authors.lastname: van Riel
authors.forename: A W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D016896:Treatment Outcome