Management of patients with fibromyalgia using biofeedback: a randomized control trial. Written pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial. Phytothermotherapy: a possible complementary therapy for fibromyalgia patients. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Neurotherapy of fibromyalgia? Patients with Fibromyalgia Benefit from Aerobic Endurance Exercise Research to Encourage Exercise for Fibromyalgia (REEF): Use of Motivational Interviewing, Outcomes From a Randomized-controlled Trial Patients with fibromyalgia display less functional connectivity in the brain’s pain inhibitory network Multidisciplinary treatment of fibromyalgia: does cognitive behavior therapy increase the response to treatment? The efficacy of the Rességuier method in the treatment of fibromyalgia syndrome: a randomized controlled trial. Changes associated with a quota-based approach on a walking program for individuals with fibromyalgia. Internet-enhanced management of fibromyalgia: A randomized controlled trial Predicting high physical function in people with fibromyalgia. Integrating Virtual Reality With Activity Management for the Treatment of Fibromyalgia: Acceptability and Preliminary Efficacy Responsiveness of fibromyalgia clinical trial outcome measures. Low-frequency Pulsed Electromagnetic Field Therapy in Fibromyalgia: A Randomized, Double-blind, Sham-controlled Clinical Study A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study
OBJECTIVE Fibromyalgia syndrome ( FMS ) is a chronic rheumatological condition which could be characterized by generalized pain and fatigue . Cognitive and behavioral therapy has been found to be a suitable technique in the management of FMS . This study intends to evaluate the efficacy of electromyography ( EMG ) biofeedback to reduce pain in patients with FMS . MATERIAL S AND METHODS A r and omized controlled trial involving two groups of FMS patients , one receiving EMG biofeedback and the other a sham biofeedback  , was carried out . The assessment tools included in the study were fibromyalgia impact question naire ( FIQ ) , visual analogue scale ( VAS ) , six-minute walk test ( SMWT ) and number of tender points ; and tenderness of each tender point was done for both the groups . STATISTICS A Student 's ' t ' test was used to study the test for significance . RESULTS After using biofeedback , the mean VAS scores and the mean number of tender points were found to be 3 out of 10 and 6 out of 18 respectively . Subjective analysis from both groups showed improvement in physical and psychological realms . Statistical significance . CONCLUSION Biofeedback as a treatment modality reduces pain in patients with FMS , along with improvements in FIQ , SMWT and the number of tender points Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients . This study aim ed at examining whether written education about pain neuroscience improves illness perceptions , catastrophizing , and health status in patients with fibromyalgia . A double-blind , multicenter r and omized controlled clinical trial with 6-month follow-up was conducted . Patients with FM ( n = 114 ) that consented to participate were r and omly allocated to receive either written pain neuroscience education or written relaxation training . Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties ; the relaxation group received a booklet with relaxation education and a telephone call . The revised illness perception question naire , Pain Catastrophizing Scale , and fibromyalgia impact question naire were used as outcome measures . Both patients and assessors were blinded . Repeated- measures analyses with last observation carried forward principle were performed . Cohen 's d effect sizes ( ES ) were calculated for all within-group changes and between-group differences . The results reveal that written pain neuroscience education does not change the impact of FM on daily life , catastrophizing , or perceived symptoms of patients with FM . Compared with written relaxation training , written pain neuroscience education  improved beliefs in a chronic timeline of FM ( P = 0.03 ; ES = 0.50 ) , but it does not impact upon other domains of illness perceptions . Compared with written relaxation training , written pain neuroscience education slightly improved illness perceptions of patients with FM , but it did not impart clinical ly meaningful effects on pain , catastrophizing , or the impact of FM on daily life . Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM OBJECTIVE It is a traditional practice in the Alpine region of Trentino and Alto Adige ( Italy ) to use phytothermotherapeutic treatment with fermenting grass ( " hay baths " ) for rheumatic diseases . However , despite its long history and popularity , a clinical validation of the efficacy and tolerability of the treatment has yet to be found in current literature . Fibromyalgia syndrome ( FMS ) is characterised by generalised musculoskeletal pain , high tender point counts , sleep disturbance , fatigue , headaches , irritable bowel syndrome , frequent psychological distress and depressed mood . There is no st and ard therapy regime for FMS and the variety of medical treatments used have given limited benefits . The aim of this study was to assess the efficacy and tolerability of a cycle of phytothermotherapy through a single-blind , controlled , r and omised trial , in patients with primary FMS . METHODS Fifty-six patients with primary FMS according to the ACR criteria were r and omly allocated to two groups : 30 were su bmi tted to phytothermotherapy at the thermal resort of Garniga Terme ( Trento , Italy ) and the other 26 were considered as controls . All patients were evaluated by FIQ , Tender Points Count , HAQ and AIMS 1 at baseline , after 10 days , then after 12 and 24 weeks . RESULTS Patients su bmi tted to phytothermotherapy showed visible and significant improvement of all evaluation parameters at the end of the treatment , which persisted during the follow-up period . No significant difference was found in the control group . Regarding the tolerability , none of the patients presented side effects . CONCLUSIONS Our results suggest the efficacy and the tolerability of phytothermotherapy in patients with primary FMS OBJECTIVE To examine prospect ively the accuracy of an initial diagnosis for fibromyalgia ( FM ) . METHODS All patients newly referred for rheumatology consultation in a 6-month period were evaluated prospect ively for either a preceding , current or subsequent diagnosis of FM . Clinical characteristics , previous and subsequent management and health care utilization were assessed . The final diagnosis at 6 months was verified and accuracy regarding the diagnosis of FM was assessed . RESULTS Seventy six ( 12 % ) of all new patients were either referred with a question of FM or finally diagnosed with FM . At the final evaluation the accuracy of the diagnosis regarding FM by either the referring physician or by the rheumatologist at the time of the initial visit was correct in 34 % of patients . The FM group in comparison with those with some other rheumatological diagnosis had more tender points ( 12.5 vs 4 ) and were more fatigued . In contrast , prolonged early morning stiffness and limitation of lumbar spinal mobility in more than one plane was more common in the non-FM group . CONCLUSION There is a disturbing inaccuracy , mostly observed to be overdiagnosis , in the diagnosis of FM by referring physicians . This finding may help explain the current high reported rates of FM and caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain OBJECTIVE To evaluate the efficacy of a novel variant of electroencephalograph biofeedback , the Low Energy Neurofeedback System ( LENS ) , that utilizes minute pulses of electromagnetic stimulation to change brainwave activity for the amelioration of fibromyalgia ( FM ) symptoms . DESIGN R and omized , double-blind , placebo-controlled clinical trial . SETTING Tertiary referral academic medical center , outpatient . PATIENTS Thirty-four patients diagnosed with FM according to 1990 American College of Rheumatology classification criteria . INTERVENTIONS Active or sham LENS , depending on r and omization , for 22 treatment sessions . OUTCOME MEASURES Primary outcome measure was the Fibromyalgia Impact Question naire total score . Secondary outcome measures included number of tender points ( TPs ) and pressure required to elicit TPs on physical examination , quantitative sensory testing heat pain threshold , and self-reported cognitive dysfunction , fatigue , sleep problems , global psychological distress , and depression obtained at baseline , immediate post-treatment , and 3- and 6-month follow-up . RESULTS Participants who received the active or sham interventions improved ( Ps < 0.05 ) on the primary and a variety of secondary outcome measures , without statistically significant between group differences in evidence at post-treatment or 3- or 6-month follow-up . Individual session self-reported ratings of specific symptoms ( cognitive dysfunction , fatigue , pain , and sleep , and overall activity level ) over the course of the 22 intervention sessions indicated significant linear trends for improvement for the active intervention condition only ( Ps < 0.05 ) . CONCLUSION LENS can not be recommended as a single modality treatment for FM . However , further study is warranted to investigate the potential of LENS to interact synergistically with other pharmacologic and nonpharmacologic therapies for improving symptoms in FM Abstract : Fibromyalgia ( FM ) is a disorder characterised by diffuse widespread musculoskeletal aching and stiffness and multiple tender points [ 1 ] . Its pathophysiology is poorly understood . The influence of aerobic endurance exercise on pain in patients with FM was investigated . Twenty-seven patients ( 25 female , 2 male ) participated in a controlled clinical study and performed 12 weeks of jogging , walking , cycling or swimming following a given schedule .  Twelve sedentary FM patients ( 11 female , 1 male ) served as controls . Before and after training both the study and the control groups were evaluated spiroergometrically .  Tender point pain was quantified by dolorimetry . The painful body surface was estimated by a pain body diagram , and its intensity by a visual analogue scale and a ranking scale . Patients trained for an average of 25 min two to three times a week , with an average intensity of 50 % of maximal oxygen uptake ( VO2max ) . Unlike the control group , the training group exhibited a decrease in heart rate and VO2 and an increase in respiratory quotient during submaximal workload . Maximal performance capacity and VO2max remained unchanged , whereas the wattpulse ( watt/heart rate ) improved at maximal workload . Pain parameters remained unchanged in the control group , but in the training group the mean number of positive tender points ( 15.4/12.7 ) , the mean pain threshold of the gluteal tender point ( 2.89 kp/3.50 kp ) and the painful body surface ( 18%/15 % body surface ) decreased significantly . Subjective general pain condition deteriorated in two patients but improved in 17 . Our results suggest a positive effect of aerobic endurance exercise on fitness and well-being in patients with FM Objectives : Regular exercise is associated with important benefits in patients with fibromyalgia ( FM ) . Unfortunately , long-term maintenance of exercise after a structured program is rare . The present study tested the efficacy of Motivational Interviewing ( MI ) to promote exercise and improve symptoms in patients with FM . Methods : A total of 216 patients with FM were r and omized to 6 MI sessions ( n=107 ) or an equal number of FM self-management lessons ( education control/EC , n=109 ) . Co- primary endpoints were an increase of 30 minutes in moderate-vigorous physical activity and improvement in the Fibromyalgia Impact Question naire (FIQ)-Physical Impairment score , assessed at pretreatment , posttreatment , and 3-month and 6-month follow-up . Secondary outcomes included clinical ly meaningful improvements in FIQ score , pain severity ratings , and a 6-minute walk test . Results : There were no significant treatment group differences in either co- primary endpoint at 6-month follow-up . However , more MI participants than controls exhibited meaningful improvements in FIQ score at 6-month follow-up ( 62.9 % vs. 49.5 % , P=0.06 ) . Compared with EC participants , MI participants also displayed a larger increment in their 6-minute walk test ( 43.9 vs. 24.8 m , P=0.03 ) . In addition , MI was superior to EC in increasing the number of hours of physical activity immediately postintervention and in reducing pain severity both immediately after the intervention and at 3-month follow-up . Conclusions : Despite a lack of benefits on long-term outcome , MI seems to have short-term benefits with respect to self-report physical activity and clinical outcomes . This is the first study in FM that explicitly addresses exercise maintenance as a primary aim . Clinical Trial Registration : NCT00573612 Background There is evidence for augmented processing of pain and impaired endogenous pain inhibition in Fibromyalgia syndrome ( FM ) . In order to fully underst and the mechanisms involved in FM pathology , there is a need for closer investigation of endogenous pain modulation . In the present study , we compared the functional connectivity of the descending pain inhibitory network in age-matched FM patients and healthy controls (HC).We performed functional magnetic resonance imaging ( fMRI ) in 42 subjects ; 14 healthy and 28 age-matched FM patients ( 2 patients per HC ) , during r and omly presented , subjectively calibrated pressure pain stimuli . A seed-based functional connectivity analysis of brain activity was performed . The seed coordinates were based on the findings from our previous study , comparing the fMRI signal during calibrated pressure pain in FM and HC : the rostral anterior cingulate cortex ( rACC ) and thalamus . Results FM patients required significantly less pressure ( kPa ) to reach calibrated pain at 50 mm on a 0–100 visual analogue scale ( p < .001 , two-tailed ) . During fMRI scanning , the rACC displayed significantly higher connectivity to the amygdala , hippocampus , and brainstem in healthy controls , compared to FM patients . There were no regions where FM patients showed higher rACC connectivity . Thalamus showed significantly higher connectivity to the orbitofrontal cortex in healthy controls but no regions showed higher thalamic connectivity in FM patients . Conclusion Patients with FM displayed less connectivity within the brain ’s pain inhibitory network during calibrated pressure pain , compared to healthy controls . The present study provides brain-imaging evidence on how brain regions involved in homeostatic control of pain are less connected in FM patients . It is possible that the dysfunction of the descending pain modulatory network plays an important role in maintenance of FM pain and our results may translate into clinical implication s by using the functional connectivity of the pain modulatory network as an objective measure of pain dysregulation OBJECTIVE Multidisciplinary treatments ( MTs ) are usually recommended for reducing fibromyalgia ( FM ) symptoms and include physical exercise , drug management , education , and cognitive behavior therapy ( CBT ) . However , there is no evidence that CBT adds efficacy to the other therapeutic components . This r and omized controlled trial analyzed the response of FM patients to two MTs , with and without CBT , according to the presence of concurrent symptoms . METHODS Eighty-three women with FM were r and omly assigned to MT or combined MT and CBT . The MT included medical intervention , physical training , education , and discussion of the syndrome . The CBT focused on coping with stress , modifying lifestyles , and changing pain behaviors . Demographic and clinical data , information regarding tender points , and question naire responses about functional capability [ Fibromyalgia Impact Question naire ( FIQ ) ] , health status [ 36-item Short Form Health Survey ( SF-36 ) ] , and mental health [ Symptom Checklist-90-Revised ( SCL-90-R ) ] were obtained at the beginning , at the end of the 15-week treatment , and at 6-month follow-up . Subgroups are identified in relation to treatment response . RESULTS Sixty-six women ( 80 % ) completed treatment . Although the variance of the total sample had changed at posttreatment ( F=2.67 , P=.031 ) , there was no significant effect for the TimexTreatment interaction ( F=1.65 , P=.16 ) . Univariate tests detected a significant fall in the FIQ score . The subgroup of patients with fatigue showed a better response with MT+CBT than with MT . At 6-month follow-up , the statistical differences had been maintained . Intention-to-treat analysis ratified these results . CONCLUSIONS MT improves functional capability and reduces symptom impact . CBT increases mildly the effect of MT in patients with fatigue OBJECTIVES In fibromyalgia syndrome ( FMS ) defined rehabilitation guidelines are yet to be vali date d. Our aim is to evaluate the efficacy of the Rességuier method ( RM ) in FMS . METHODS Forty-one patients were r and omly assigned to Interventional ( 22 pts ) and Observational ( 19 pts ) Group ( IG and OG ) . The study lasted 8 months . Patients were assessed at baseline ( T0 ) after a 2-month rehabilitation ( T1 ) and at a 6-month follow-up ( T2 ) ( only IG ) with SF-36 Physical ( PSI ) and Mental Synthetic Index ( MSI ) , Regional Pain Scale ( RPS ) , Fibromyalgia Impact Question naire ( FIQ ) , Number Rating Scales 0 - 10 to measure pain , movement quality , sleep , relax ability , analgesics number/per week . OG patients maintained their lifestyle for the duration of the study . RM aims to obtain patient awareness and control of bodily perceptions , thus reaching a modulation of responses to pain . Therapist controls patient attention and perception by verbal and manual contacts and leads them to perform bodily and respiratory active and conscious movements . RESULTS In IG , at T1 all items were improved : PSI and MSI ( p<0.001 and = 0.001 ) , FIQ ( p<0.0001 ) , RPS ( p<0.001 ) , pain ( p<0.0001 ) , movement quality ( p=0.001 ) , relax ability ( p<0.0001 ) , sleep ( p<0.001 ) ; analgesics number/per week was reduced ( p<0.001 ) . All results obtained at T1 , except FIQ , were maintained at T2 . In OG at T1 versus T0 , no difference in any of the assessed parameters was observed . CONCLUSION In FMS patients , the rehabilitation with RM  improves HRQoL , FMS-related disability and perceived pain , thus reducing the assumption of analgesics STUDY DESIGN Single-subject , multiple-baseline design across 3 subjects . OBJECTIVE To investigate the use of a quota-based approach to prescribing a walking program for individuals with fibromyalgia ( FM ) . BACKGROUND Exercise has been found to be beneficial for individuals with FM . What has not been determined is the best way to implement an exercise program that does not increase FM symptoms . METHODS AND MEASURES Three women with FM were r and omly assigned a baseline period of 5 , 6 , or 7 weeks , which served as the control phase , followed by an intervention period consisting of an 8-week walking program . The walking program progression was prescribed using a quota-based approach . Weekly outcome measures were the Fibromyalgia Impact Question naire ( FIQ ) , Arthritis Self-Efficacy Scale ( ASES ) , and SF-36v2 ( acute ) . A 6-minute walk test was recorded twice : at the start of the baseline phase ( after a trial phase ) and at the end of the intervention phase . RESULTS Subjects 1 and 3 had a significant decrease in the symptoms associated with FM during the intervention phase ( FIQ , P<.05 ) , but no significant increase in self-efficacy ( ASES ) . They increased their walking distances used for exercise by 640 and 480 m , respectively . Subject 2 had no significant improvements in her symptoms of FM . Despite a significant decrease in ASES ( P<.05 ) , walking distance used for exercise by subject 2 increased by 2080 m. Six-minute walk test distances increased 76 , 32 , and 106 m for subjects 1 , 2 , and 3 , respectively . CONCLUSIONS Prescribing a walking program using a quota-based exercise prescription result ed in increasing the distance walked for 3 subjects . It also decreased symptoms associated with FM in 2 of the 3 subjects , but did not increase self-efficacy & NA ; Both pharmacological and non‐pharmacological interventions have demonstrated efficacy in the management of fibromyalgia ( FM ) .  Non‐pharmacological interventions however are far less likely to be used in clinical setting s , in part due to limited access . This manuscript presents the findings of a r and omized controlled trail of an Internet‐based exercise and behavioral self‐management program for FM design ed for use in the context of a routine clinical care . 118 individuals with FM were r and omly assigned to either ( a ) st and ard care or ( b ) st and ard care plus access to a Web‐Enhanced Behavioral Self‐Management program ( WEB‐SM ) grounded in cognitive and behavioral pain management principles . Individuals were assessed at baseline and again at 6 months for primary endpoints : reduction of pain and an improvement in physical functioning . Secondary outcomes included fatigue , sleep , anxiety and depressive symptoms , and a patient global impression of improvement . Individuals assigned to the WEB‐SM condition reported significantly greater improvement in pain , physical functioning , and overall global improvement . Exercise and relaxation techniques were the most commonly used skills throughout the 6 month period . A no‐contact , Internet‐based , self‐management intervention demonstrated efficacy on key outcomes for FM . While not everyone is expected to benefit from this approach , this study demonstrated that non‐pharmacological interventions can be efficiently integrated into routine clinical practice with positive outcomes PURPOSE The purpose of this study was to investigate predictors of high physical function in people with fibromyalgia ( FM ) . DESIGN Cross-sectional descriptive , correlational study of 2,580 persons with FM who responded to an online survey during fall 2005 . METHODS The survey indicated self-reported physical activity levels , functional abilities , symptoms , health care costs , employment status , work productivity , self management strategies . It had adequate validity and reliability . A significant binary logistic regression model of predictors of physical function ( individual factors , symptoms , self management strategies ) was vali date d using backwards logistic regression . FINDINGS Significant explanatory variables of high physical function were : men , greater education , younger age , lower intensity fatigue , spasticity , and balance problems , not using prescription pain medications , using aerobic or strength training exercise , and not using relaxation methods . CONCLUSIONS People with FM suffer from multiple symptoms and use many modalities to control symptoms to remain functional . Given knowledge of predictors of physical function in FM , health care providers might be able to develop strategies to promote better functioning . Prospect i ve trials are needed to track the natural course of study variables , measuring their effect on function , and to test effects of interventions to maximize function Objectives : Cognitive-behavioral therapies ( CBT ) for fibromyalgia syndrome ( FMS ) are important interventions in the management of this condition . Empirical evidence reports that although the results are promising , further research is needed to respond more appropriately to these patients . This study focuses on exploring the use of Virtual Reality ( VR ) as an adjunct to the activity management component . The aim of this study is to present the results of a small-sized r and omized controlled trial to test the preliminary efficacy and acceptability of this component . Material s and Methods : The final sample was composed of 61 women diagnosed with FMS according to the American College of Rheumatology . The sample was r and omly allocated to 2 conditions : VR treatment and treatment as usual . Results : Participants in the VR condition achieved significant improvements in the primary outcome : disability measured with the FIQ . The improvement was also significant in secondary outcomes , such as perceived quality of life and some of the coping strategies included in the Chronic Pain Coping Inventory : task persistence and exercise . There were no differences in other secondary outcome measures like pain intensity and interference and depression . Participants reported high satisfaction with the VR component . Discussion : The effects were related to the psychological aspects targeted in the treatment . The component was well accepted by FMS patients referred from a public hospital . These findings show that the VR component could be useful in the CBT treatment of FMS and encourage us to continue exploring the use of integrating VR with CBT interventions for the treatment of FMS OBJECTIVE To assess the responsiveness of the Fibromyalgia Impact Question naire ( FIQ ) , patient ratings of pain intensity , number of tender points , and total tender point pain intensity score to perceived changes in clinical status in patients with fibromyalgia ( FM ) . METHODS Using data from a r and omized  placebo controlled study evaluating efficacy of magnetic therapy in patients with FM , the ability of primary outcomes to detect clinical ly meaningful changes over a 6 month period was assessed by : ( 1 ) degree of association between outcome change scores and patient global ratings of symptom change ( Spearman rank-order correlations ) ; ( 2 ) ability of these scores to discriminate among groups of patients whose perceived health status had changed to varying degrees ( ANOVA ) ; ( 3 ) ability of these scores , individually and jointly , to discriminate between patients who had reported improvement and those who did not ( logistic regression ) ; ( 4 ) effect size , st and ardized response mean , and Guyatt 's statistic were calculated to quantify responsiveness . RESULTS Correlations showed the outcome measures were moderately responsive to perceived symptomatic change . For FIQ , pain intensity ratings and number of tender points , differences in change scores between globally improved and unchanged groups and between globally improved and worsened groups were significant ; for total tender point pain intensity , the globally improved differed from worsened group . FIQ outperformed the other measures in discriminating between patients who reported improvement from those who did not . Summary statistics were consistent with discriminatory analyses , indicating the measures were sensitive to improvement , but relatively unresponsive to decline . CONCLUSION The FIQ was the most responsive measure to perceived clinical improvement and we recommend its inclusion as a primary endpoint in FM clinical trials Objective To evaluate the clinical effectiveness of low-frequency pulsed electromagnetic field ( PEMF ) therapy for women with fibromyalgia ( FM ) . Methods Fifty-six women with FM , aged 18 to 60 years , were r and omly assigned to either PEMF or sham therapy . Both the PEMF group ( n=28 ) and the sham group ( n=28 ) participated in therapy , 30 minutes per session , twice a day for 3 weeks . Treatment outcomes were assessed by the fibromyalgia Impact question naire ( FIQ ) , visual analog scale ( VAS ) , patient global assessment of response to therapy , Beck Depression Inventory ( BDI ) , and Short-Form 36 health survey ( SF-36 ) , after treatment ( at 4 wk ) and follow-up ( at 12 wk ) . Results The PEMF group showed significant improvements in FIQ , VAS pain , BDI score , and SF-36 scale in all domains at the end of therapy . These improvements in FIQ , VAS pain , and SF-36 pain score during follow-up . The sham group also showed improvement were maintained on all outcome measures except total FIQ scores after treatment . At 12 weeks follow-up , only improvements in the BDI and SF-36 scores were present in the sham group . Conclusion Low-frequency PEMF therapy might improve function , pain , fatigue , and global status in FM patients Evidence -based recommendations support the use of multimodal therapy and hydrotherapy for fibromyalgia syndrome ; however , there is little st and ardisation of such programmes . The aim of the study was to assess the effectiveness of a pool-based exercise using deep water running ( DWR ) as part of a multimodal physiotherapy programme for patients with fibromyalgia syndrome . For a non-r and omised clinical study , 44 patients diagnosed with fibromyalgia were recruited from primary care . Patients in the experimental group received a multimodal programme incorporating pool-based exercise using DWR three times a week for an 8-week period . The control group received a leaflet containing advice and continued with normal activities . Patients were evaluated for physical function ( Fibromyalgia Impact Question naire , FIQ ) , pain , general health ( Short Form-12 Health Survey ) and quality of life ( European Quality of Life Scale-5D ) pre- and post intervention . Statistically significant results were found for the experimental group for FIQ total score , incorporating physical function , pain , fatigue , stiffness and psychological variables ( p < 0.05 ) . Statistically significant differences between the experimental group and control were also found for general health ( p < 0.05 ) and quality of life ( p < 0.05 ) . The results of this pilot study and the high level of compliance and adherence and low level of attrition suggest that this multimodal programme incorporating DWR is a safe and effective intervention for fibromyalgia syndrome that is acceptable to patients
Invariably , their results suggested that homoeopathy was better than the control interventions in alleviating the symptoms of FM .
Homoeopathy is often advocated for fibromyalgia ( FM ) and many FM patients use it .