title: Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial.
abstract: OBJECTIVE
  Regular exercise is associated with important benefits in patients with fibromyalgia (FM). Unfortunately, long-term maintenance of exercise after a structured program is rare. The present study tested the efficacy of Motivational Interviewing (MI) to promote exercise and improve symptoms in patients with FM.
  
  
  METHODS
  A total of 216 patients with FM were randomized to 6 MI sessions (n=107) or an equal number of FM self-management lessons (education control/EC, n=109). Co-primary endpoints were an increase of 30 minutes in moderate-vigorous physical activity and improvement in the Fibromyalgia Impact Questionnaire (FIQ)-Physical Impairment score, assessed at pretreatment, posttreatment, and 3-month and 6-month follow-up. Secondary outcomes included clinically meaningful improvements in FIQ score, pain severity ratings, and a 6-minute walk test.
  
  
  RESULTS
  There were no significant treatment group differences in either co-primary endpoint at 6-month follow-up. However, more MI participants than controls exhibited meaningful improvements in FIQ score at 6-month follow-up (62.9% vs. 49.5%, P=0.06). Compared with EC participants, MI participants also displayed a larger increment in their 6-minute walk test (43.9 vs. 24.8 m, P=0.03). In addition, MI was superior to EC in increasing the number of hours of physical activity immediately postintervention and in reducing pain severity both immediately after the intervention and at 3-month follow-up.
  
  
  CONCLUSIONS
  Despite a lack of benefits on long-term outcome, MI seems to have short-term benefits with respect to self-report physical activity and clinical outcomes. This is the first study in FM that explicitly addresses exercise maintenance as a primary aim.
authors.affiliation: Department of Medicine, Division of Rheumatology, Indiana University, Indianapolis, IN 46202, USA. dang@iupui.edu
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Ang
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Kaleth
authors.forename: Silvia
authors.initials: S
authors.lastname: Bigatti
authors.forename: Steven A
authors.initials: SA
authors.lastname: Mazzuca
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.forename: Janna
authors.initials: J
authors.lastname: Hilligoss
authors.forename: James
authors.initials: J
authors.lastname: Slaven
authors.forename: Chandan
authors.initials: C
authors.lastname: Saha
mesh_terms: D000328:Adult; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D012106:Research; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome