Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia, 2021, Haugmark et al

Abstract
Introduction: Non-pharmacological approaches are recommended as first-line treatment for patients with fibromyalgia. This randomised controlled trial investigated the effects of a multicomponent rehabilitation programme for patients with recently diagnosed fibromyalgia in primary and secondary healthcare.

Methods: Patients with widespread pain ≥3 months were referred to rheumatologists for diagnostic clarification and assessment of study eligibility. Inclusion criteria were age 20-50 years, engaged in work or studies at present or during the past 2 years, and fibromyalgia diagnosed according to the American College of Rheumatology 2010 criteria. All eligible patients participated in a short patient education programme before inclusion and randomisation. The multicomponent programme, a 10-session mindfulness-based and acceptance-based group programme followed by 12 weeks of physical activity counselling was evaluated in comparison with treatment as usual, that is, no treatment or any other treatment of their choice. The primary outcome was the Patient Global Impression of Change (PGIC). Secondary outcomes were self-reported pain, fatigue, sleep quality, psychological distress, physical activity, health-related quality of life and work ability at 12-month follow-up.

Results: In total, 170 patients were randomised, 1:1, intervention:control. Overall, the multicomponent rehabilitation programme was not more effective than treatment as usual; 13% in the intervention group and 8% in the control group reported clinically relevant improvement in PGIC (p=0.28). No statistically significant between-group differences were found in any disease-related secondary outcomes. There were significant between-group differences in patient's tendency to be mindful (p=0.016) and perceived benefits of exercise (p=0.033) in favour of the intervention group.

Conclusions: A multicomponent rehabilitation programme combining patient education with a mindfulness-based and acceptance-based group programme followed by physical activity counselling was not more effective than patient education and treatment as usual for patients with recently diagnosed fibromyalgia at 12-month follow-up.

https://bmjopen.bmj.com/content/11/6/e046943.long

 

first honest conclusion i have seen in years if ever when referring to psychobabble therapies .

 

here is a quote from the "discussion section" (PA= physical activity):

"……. it was hypothesised that the lack of effects in patients with FM might have been related to living with distressing symptoms over a long time without receiving any diagnosis. The present study aimed to improve the management of FM by following the EULAR recommendations for management of FM in a Norwegian context. We assumed that offering patients who had been recently diagnosed with FM a mindfulness-based and acceptance-based intervention might help them overcome some of their internal barriers to PA before they attended a PA intervention. However, we found no support for this assumption."

 

Patient selection was a bit skewed : they had to be involved in school or work within the last two years. This means that either they were recently diagnosed or that they are mildly affected.

At least the post testing was done 12 months after the intervention.

 

and this from the discussion section (PA = physical activity):

"There was a high drop-out rate from the PA intervention. Further, studies on how to adapt and tailor PA interventions to patients with FM are needed."

I interpret this as meaning that people dropped out of the study because of the physical activity that was being demanded of them.

 

The mindfulness arm tended to be more mindful.

 

And the types of physical activities offered were painful to individual patients (my experience with generic chronic pain education groups w/exercise therapy thrown in).