Operant Learning Versus Energy Conservation Activity Pacing Treatments in a Sample of Patients With Fibromyalgia Syndrome: A Pilot Randomized Controlled Trial - 22/03/19
, Mark P. Jensen §, Manfred Harth *, Patricia Morley-Forster ¶, Warren R. Nielson *, ‡, #Abstract |
This study's aim was to assess the efficacy of 2 forms of activity pacing in patients with fibromyalgia syndrome (FMS). Treatment-related changes in activity management patterns were also examined. Patients with FMS (n = 178) were randomly assigned to an operant learning (OL; delayed [n = 36] or immediate [n = 54] groups) or an energy conservation (EC; delayed [n = 35] or immediate [n = 53] groups) treatment condition. Of these, 32 OL and 37 EC patients completed treatment. Forty-three patients were allocated to the delayed treatment condition (control group). Repeated measures analyses of variance were used to examine the effects of OL and EC treatments on primary (average pain and usual fatigue), secondary (pain and fatigue interference, physical and psychological function, sleep quality, depressive symptoms, and anxiety symptoms), and tertiary (pain-related activity patterns) outcomes. Neither treatment was effective in reducing average pain or usual fatigue symptoms. Relative to EC, OL patients showed greater improvements in depressive symptoms, whereas nonsignificant trends (P values ranging between .05 and .06) were observed for pain interference, fatigue interference, and psychological function. Both treatments were associated with improvements in sleep quality and physical function, increases in pacing, and decreases in overdoing activity patterns. Reductions in activity avoidance were only found in OL. These findings suggest that OL may be more beneficial than EC and that it could potentially be viewed as an effective stand-alone activity pacing treatment for patients with FMS. Research to determine the extent to which these preliminary findings replicate is warranted.
Perspective |
This article examines the efficacy of 2 forms of activity pacing in patients with fibromyalgia syndrome. The results suggest the possibility that operant learning may be more beneficial than energy conservation and could potentially be viewed as an effective stand-alone activity pacing treatment for patients with fibromyalgia syndrome.
Le texte complet de cet article est disponible en PDF.Key words : Activity pacing, fibromyalgia syndrome, pain intensity, psychological function, physical function
Plan
| All authors reviewed and provided comments on drafts and subsequent revisions of this article and approved the final version for submission and publication. W.R.N. was responsible for initially defining the research questions and research objectives. M.R. developed the study protocol and treatment manuals, participated in the design of the analyses, provided input in the data analysis plan, conducted part of the statistical analyses, and prepared the first draft of the manuscript; M.P.J., M.H., P.M.-F., and W.R.N. provided input into the research protocol, the data analysis plan, and feedback on multiple drafts of the manuscript. |
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| Financial support for this project included a bequest from the estate of Mrs. Beryl Ivey to Dr. Warren R. Nielson and an Earl Russell Trainee Grant from Western University, London, Ontario to Dr. Mélanie Racine. |
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| The authors have no conflicts of interest to declare. |
Vol 20 - N° 4
P. 420-439 - avril 2019 Retour au numéro
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