Mind-Body Therapy Plus Exercise Counters Fibromyalgia

12/12/2000 11:30:31 AM
By David Loshak

Mind-body therapy to treat fibromyalgia syndrome is more effective for some
clinical outcomes than waiting list/treatment as usual or placebo.

According to a new comprehensive review of the literature, the results of
mind-body therapies are largely inconclusive when compared to active
treatments except when combined with exercise of moderate or high intensity.

To assess the effectiveness of mind-body therapy for fibromyalgia syndrome,
researchers used methods recommended by the Cochrane Collaboration to make a
systematic review of randomised and quasi-randomised controlled trials.

They searched nine electronic databases, 69 conference proceedings and
several citation lists for relevant trials in any language. A total of 13
eligible trials involving 802 subjects were scored for methodological
quality and information on major outcomes was gathered.

A statistical pooling was not possible because data reporting was
insufficient. Researchers therefore performed a best-evidence synthesis.
Seven of the 13 trials received a high methodological score.

Compared to waiting list/treatment as usual, there was strong evidence that
mind-body therapy was more effective for self-efficacy. There was limited
evidence for quality of life and inconclusive evidence for all other

There was limited evidence, also, that mind-body therapy was more effective
than placebo for pain and global improvement.
The evidence was inconclusive that mind-body therapy was more effective than
physiotherapy, psychotherapy or education/attention control for all

The trials showed strong evidence that moderate and high intensity exercise
was more effective than mind-body therapy for pain and function, but only
moderate evidence that mind-body therapy plus exercise was more effective
than waiting list/treatment as usual for self-efficacy and quality of life.

The evidence that mind-body therapy plus exercise was more effective than
education/attention control was limited and for other outcomes inconclusive.
The evidence for mind-body therapy plus exercise versus other active
treatments was also inconclusive for all outcomes.

Long-term within-groups results showed the greatest benefit for mind-body
therapy plus exercise.

The investigators said that future research should focus on the synergistic
effects of mind-body therapy plus exercise and/or antidepressants.

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