Lifestyle Redesign® Intervention for Psychological Well-Being and Function in People With Fibromyalgia:A Retrospective Cohort Study 2022 Shomer & Roll

Abstract

Importance: Fibromyalgia is a complex chronic pain condition for which effective nonpharmacological treatment interventions are lacking.

Objective: To explore the effects of an occupational therapy intervention for fibromyalgia on client-reported outcomes of pain interference, self-efficacy, mood, and function.

Design: Retrospective cohort study using a chart review method.

Setting: Outpatient clinic.

Participants: Twenty-one adults with fibromyalgia (M age = 54 yr).

Intervention: A 10-wk occupational therapy group intervention using a Lifestyle Redesign® (LRD) approach.

Outcomes and Measures: The Brief Pain Inventory, Pain Self-Efficacy Scale, Beck Depression Inventory (BDI), and the Fibromyalgia Impact Questionnaire (FIQ) or the Revised Fibromyalgia Impact Questionnaire were administered at the first and last sessions of the program.

Results: Between 2015 and 2018, 37 clients entered the program, and 21 completed it. Changes in group averages exceeded the minimal clinically important difference for the BDI and the FIQ. Eighty-one percent of clients who completed the program had a clinically significant improvement on one or more of the outcome measures.

Conclusions and Relevance: The findings demonstrate the potential benefit of occupational therapy as a complementary approach to pharmacological treatment for people with fibromyalgia. Preliminary evidence suggests that a 10-wk occupational therapy group intervention using an LRD approach may reduce symptoms of depression and decrease the impact on daily function for people with fibromyalgia.

What This Article Adds: Occupational therapy should be considered as a nonpharmacological intervention for adults with fibromyalgia to improve psychological well-being and function.

Paywall, https://research.aota.org/ajot/arti...tyle-RedesignR-Intervention-for-Psychological

 

My thoughts too

 

There is simply no other context where professionals are involved and the denominator used to calculate the effect of something will be anything but the original number, this is cherry-picking. It makes no sense to calculate the effect of something based on such arbitrary criteria. The people who did not complete the treatment made a statement about its usefulness. This is a fantasy result.

I know this is commonplace in evidence-based medicine. And it's exactly why this discipline is so FUBAR. If it's so standard for large numbers of people to drop out of those trials, then it means this type of trial is garbage. If they can't figure out how to recruit people who will stick with a treatment they have major problems to solve before they can start making any claims. Especially as there is never an actual examination of why people dropped out, which is the big tell that the fantasy is a choice.

Basically, forcing researchers to use the original denominator would require them to actually make an effort to retain the participants. If they can't figure that out that's on them, the original denominator should still be used as it's the only representative way to calculate this. It's absurd that this has been going on for so long.

 

How would OT improve on the usual chronic pain classes I wonder. Maybe they would emphasis pacing, using joint-sparing devices. Who knows.

Or it's another entrepreneurial venture (hence the trademark) destined to cost the US more than it already spends on health care. I'm trying to stay optimistic; yet, self-management by trial and error, over time, seems to be the best path forward for me w/FM. Maybe for the newly diagnosed it may help.