Improving activities of daily living ability in women with fibromyalgia: An exploratory, quasi-randomized, phase-two study, IMPROvE trial
Cecilie von Bülow , Kirstine Amris , Elisabeth Bandak, Bente Danneskiold-Samsøe, Eva Elisabet Ejlersen Wæhrens
Department of Rheumatology, The Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark. E-mail: Cecilie.firstname.lastname@example.org
Objective: To explore and compare the outcomes of adaptation and physical activity programmes regarding activities of daily living (ADL) ability following interdisciplinary rehabilitation in women with fibromyalgia.
Methods: Participants (n = 85) were quasi-randomized to 16-week adaptation (ADAPT) or physical activity (ACTIVE) programmes following 2-week interdisciplinary rehabilitation. Primary outcomes were ADL motor and ADL process ability, measured with the Assessment of Motor and Process Skills (AMPS) at 4-week follow-up. Data were analysed per protocol.
Results: Participants (ADAPT, n = 21; ACTIVE, n = 27) did not differ from withdrawers (n = 37). Improvements in ADL ability in the ADAPT (ADL motor mean change = 0.43 logits (95% confidence interval (95% CI) = 0.31–0.56); ADL process mean change = 0.34 logits (95% CI = 0.17–0.52)) and ACTIVE (ADL motor mean change = 0.33 logits (95% CI = 0.22–0.43); ADL process mean change = 0.25 logits (95% CI = 0.12–0.38)) groups were statistically significant, with no differences between groups. Responder analyses revealed that 63% of all participants obtained clinically relevant improvements in ADL motor ability and 48% in ADL process ability.
Conclusion: Although limited by a large drop-out, this exploratory study showed that both adaptation and physical activity programmes following interdisciplinary rehabilitation improved ADL ability in the majority of participants. ADL ability outcomes were independent of group allocation (ADAPT vs ACTIVE), suggesting efficacy of both programmes.
Woman with fibromyalgia can improve their ability to perform tasks related to daily life
Fibromyalgia often cause severe problems in performance of tasks related to daily living (also termed ADL tasks). In this study we investigated if two therapeutic programmes (compensatory focused and physical activity focused, respectively) following a two-week interdisciplinary rehabilitation programme would influence ADL ability among women with fibromyalgia. While the compensatory programme focused on teaching participants to use adaptation strategies to compensate for ADL task performance problems, the physical activity programme focused on teaching strategies to increase physical activity in everyday life. The results showed that both compensatory and physical activity programmes following interdisciplinary rehabilitation improved performance of ADL tasks indicated by decreased effort, increased efficiency, safety and independence. However, the study results pointed towards higher responder rate in participants attending the compensatory programme.
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