title: Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia.
abstract: Cognitive-behavioral therapy (CBT) is effective in reducing disability among youth with juvenile fibromyalgia (FM); however, engagement in moderate to vigorous physical activity remains poor, even after CBT. The purpose of this study was to evaluate the feasibility and preliminary outcomes of an innovative program combining CBT with specialized neuromuscular exercise: the Fibromyalgia Integrative Training for Teens (FIT Teens) program.
  
  
  
  Adolescents with juvenile FM (n = 22, all female, ages 12-18 years) from 2 urban children's hospitals participated in the 8-week FIT Teens intervention. Participants completed measures of pain intensity, functional disability, depressive symptoms, pain catastrophizing, fear of movement, and readiness to change at baseline and after the intervention.
  
  
  
  The feasibility of the intervention across 2 sites was documented, including high retention rates (80%). Participants showed significant decreases in functional disability (P < 0.05), depression (P < 0.001), fear of movement (P < 0.01), and pain catastrophizing (P < 0.001) from pre- to postintervention. Results of the readiness to change measure indicated a significant decrease in precontemplation (P < 0.01) and increase in action/maintenance scores (P < 0.001). All results demonstrated medium to large effect sizes.
  
  
  
  Adolescents with juvenile FM reported significant improvements in physical function and reduced fear of movement following the intervention. Improvement in physical function was achieved in a shorter time frame than in a prior trial of CBT without an exercise component. Further work is needed to compare the FIT Teens program with existing approaches and determine whether objective changes in exercise participation are achieved.
authors.affiliation: DePaul University, Chicago, Illinois.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Tran
authors.affiliation: Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.
authors.forename: Jessica W
authors.initials: JW
authors.lastname: Guite
authors.affiliation: Connecticut Children's Medical Center, Hartford.
authors.forename: Ashley
authors.initials: A
authors.lastname: Pantaleao
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Megan
authors.initials: M
authors.lastname: Pfeiffer
authors.affiliation: University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, University of Pennsylvania, Philadelphia, and The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Myer
authors.affiliation: Emory University School of Medicine, Children's Healthcare of Atlanta, and Aflac Cancer and Blood Disorders Center, Atlanta, Georgia.
authors.forename: Soumitri
authors.initials: S
authors.lastname: Sil
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Staci M
authors.initials: SM
authors.lastname: Thomas
authors.affiliation: University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Tracy V
authors.initials: TV
authors.lastname: Ting
authors.affiliation: University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Williams
authors.affiliation: Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.
authors.forename: Barbara
authors.initials: B
authors.lastname: Edelheit
authors.affiliation: Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Ounpuu
authors.affiliation: Connecticut Children's Medical Center, Hartford.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rodriguez-MacClintic
authors.affiliation: Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Zemel
authors.affiliation: Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford.
authors.forename: William
authors.initials: W
authors.lastname: Zempsky
authors.affiliation: University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017668:Age of Onset; D058443:Catastrophization / Q000523:psychology; D002648:Child; D002652:Child Behavior; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005239:Fear; D005240:Feasibility Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006776:Hospitals, Pediatric; D006786:Hospitals, Urban; D006801:Humans; D010147:Pain Measurement; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States