Physical Activity Monitoring in Adolescents With Juvenile Fibromyalgia: Findings From a Clinical Trial of Cognitive-Behavioral Therapy
Physical Activity Monitoring in Adolescents With Juvenile Fibromyalgia: Findings From a Clinical Trial of Cognitive-Behavioral Therapy
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DOI：
10.1002/acr.21849
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发表时间：
2013-03-01
影响因子：
4.7
通讯作者：
Schikler, Kenneth N.
中科院分区：
文献类型：
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作者：
Kashikar-Zuck, Susmita;Flowers, Stacy R.;Schikler, Kenneth N.
目标。青少年纤维肌痛（JFM）是一种慢性肌肉骨骼疼痛状况，与身体功能下降有关。最近的研究表明，认知行为疗法（CBT）对改善青少年JFM的日常功能是有效的。然而，尚不清楚这些改善是否伴随着体力活动水平的增加。我们的目的是分析来自一项随机临床试验的辅助数据，以检验CBT是否与客观测量的身体活动的改善有关，以及活动记录指数是否与jfm青少年自我报告的功能相符。参与者是114名青少年（11-18岁），从符合JFM标准的儿科风湿病诊所招募，并参加了临床试验。受试者被随机（1:1）分配接受CBT或纤维肌痛教育（FE）。参与者佩戴了一个安装在臀部的加速度计一周，作为他们基线和治疗后评估的一部分。最终样本包括68名受试者（94%为女性，平均年龄15.2岁），他们获得了完整的活动记录仪数据。活动描记测量与自我报告的功能改善不一致。虽然与FE相比，CBT组的自我报告功能有所改善，但两组的活动计数、久坐、中度或剧烈活动均未见显著变化。CBT组治疗后峰值明显降低，活动量较轻。活动记录仪监测提供了关于患者预后的独特信息来源。CBT干预与JFM青少年身体活动增加无关，表明CBT联合干预增加身体活动可能会提高治疗效果。
Objective. Juvenile fibromyalgia (JFM) is a chronic musculoskeletal pain condition that is associated with reduced physical function. Recent research has demonstrated that cognitive-behavioral therapy (CBT) is effective in improving daily functioning among adolescents with JFM. However, it is not known whether these improvements were accompanied by increased physical activity levels. Our objective was to analyze secondary data from a randomized clinical trial of CBT to examine whether CBT was associated with improvement in objectively measured physical activity and whether actigraphy indices corresponded with self-reported functioning among adolescents with JFM.Methods. Participants were 114 adolescents (ages 11-18 years) recruited from pediatric rheumatology clinics that met criteria for JFM and were enrolled in a clinical trial. Subjects were randomly (1:1) assigned to receive either CBT or fibromyalgia education (FE). Participants wore a hip-mounted accelerometer for 1 week as part of their baseline and posttreatment assessments.Results. The final sample included 68 subjects (94% female, mean age 15.2 years) for whom complete actigraphy data were obtained. Actigraphy measures were not found to correspond with self-reported improvements in functioning. While self-reported functioning improved in the CBT condition compared to FE, no significant changes were seen in either group for activity counts, sedentary, moderate, or vigorous activity. The CBT group had significantly lower peak and light activity at posttreatment.Conclusion. Actigraphy monitoring provides a unique source of information about patient outcomes. CBT intervention was not associated with increased physical activity in adolescents with JFM, indicating that combining CBT with interventions to increase physical activity may enhance treatment effects.