Elsevier

The Journal of Pediatrics

Volume 167, Issue 3, September 2015, Pages 731-737
The Journal of Pediatrics

Original Article
The Treatment of Juvenile Fibromyalgia with an Intensive Physical and Psychosocial Program

https://doi.org/10.1016/j.jpeds.2015.06.036Get rights and content
Under a Creative Commons license
open access

Objective

To assess the short-term and 1-year outcomes of children with fibromyalgia treated with intensive physical and occupational therapy (PT/OT) and psychotherapy.

Study design

Children with fibromyalgia seen at a tertiary care hospital were treated with 5-6 hours of intensive PT/OT daily and at least 4 hours of psychosocial services weekly. All medications used for fibromyalgia were discontinued. Children underwent standardized testing, including a visual analog scale for pain; the Bruininks-Oseretsky Test of Motor Performance, Second Edition; the Bruce treadmill protocol; the Functional Disability Inventory; the Pain Stages of Change Questionnaire, adolescent version; and the Pediatric Quality of Life Inventory, Teen Report, at 3 time points: at program entry, at the end of the intensive program, and 1 year after the end of the program.

Results

Sixty-four children (median age, 16 years; 95% Caucasian; 94% female; median duration of symptoms, 21 months) were studied. The mean pain score decreased significantly from program entry to the end of the program (from 66 of 100 to 25 of 100; P = .001). At the 1-year follow-up, 33% reported no pain. All measures of function on the Bruininks-Oseretsky Test of Motor Performance, Second Edition improved significantly and remained at that level or continued to improve over the subsequent year. The mean Bruce treadmill protocol time first increased from 588 seconds to 801 seconds (P < .001) and then dropped to 750 seconds (P = .005), which is at the 90th percentile for age and sex. All Pain Stages of Change Questionnaire, adolescent version subset scores improved significantly initially and were stable or improved at 1 year, as did the Pediatric Quality of Life Inventory, Teen Report total score.

Conclusion

Children with fibromyalgia can be successfully treated without medications with a very intensive PT/OT and psychotherapy program. They have significantly improved pain and function by subject report and objective measures of function.

BOT-2
Bruininks-Oseretsky Test of Motor Performance, Second Edition
FDI
Functional Disability Inventory
PedsQL
Pediatric Quality of Life Inventory
PSOCQ-A
Pain Stages of Change Questionnaire, adolescent version
PT/OT
Physical and occupational therapy
VAS
Visual analog scale

Cited by (0)

Funded by The Children's Hospital of Philadelphia and the Snider Family. The authors declare no conflicts of interest.