Effectiveness of two video-based multicomponent treatments for fibromyalgia: The added value of cognitive restructuring and mindfulness in a three-arm randomised controlled trial

Mayte Serrat; Klara Albajes; Jaime Navarrete; Miriam Almirall; Enrique Lluch Girbés; Randy Neblett; Juan V Luciano; Jenny Moix; Albert Feliu-Soler

doi:10.1016/j.brat.2022.104188

Effectiveness of two video-based multicomponent treatments for fibromyalgia: The added value of cognitive restructuring and mindfulness in a three-arm randomised controlled trial

Behav Res Ther. 2022 Nov:158:104188. doi: 10.1016/j.brat.2022.104188. Epub 2022 Sep 8.

Authors

Mayte Serrat¹, Klara Albajes², Jaime Navarrete³, Miriam Almirall⁴, Enrique Lluch Girbés⁵, Randy Neblett⁶, Juan V Luciano⁷, Jenny Moix⁸, Albert Feliu-Soler⁹

Affiliations

¹ Unitat d'Expertesa en Síndromes de Sensibilització Central, Servei de Reumatologia, Vall d'Hebron Hospital, 08035, Barcelona, Spain; Escoles Universitàries Gimbernat, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain. Electronic address: mserrat@vhebron.net.
² Department of Basics, Developmental and Educational Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain. Electronic address: k.albajes.eizaguirre@gmail.com.
³ Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain; Psychological Research in Fibromyalgia and Chronic Pain (AGORA Research Group), Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain. Electronic address: jaime.navarrete@sjd.es.
⁴ Unitat d'Expertesa en Síndromes de Sensibilització Central, Servei de Reumatologia, Vall d'Hebron Hospital, 08035, Barcelona, Spain. Electronic address: malmirall@vhebron.net.
⁵ Department of Physiotherapy, Universitat de València, Valencia, Spain. Electronic address: enrique.lluch@uv.es.
⁶ PRIDE Research Foundation, Dallas, TX, USA. Electronic address: RandyNeblett@pridedallas.com.
⁷ Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain; Psychological Research in Fibromyalgia and Chronic Pain (AGORA Research Group), Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Department of Clinical and Health Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain. Electronic address: juanvicente.luciano@uab.cat.
⁸ Department of Basics, Developmental and Educational Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain. Electronic address: jenny.moix@uab.cat.
⁹ Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain; Psychological Research in Fibromyalgia and Chronic Pain (AGORA Research Group), Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Department of Clinical and Health Psychology, Faculty of Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain. Electronic address: albert.feliu@uab.cat.

PMID: 36116229
DOI: 10.1016/j.brat.2022.104188

Abstract

Background/objectives: The aim of this study was to examine the effectiveness of two video-based multicomponent programs (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only. We posit that FIBROWALK, due to inclusion of specific psychological ingredients (cognitive restructuring and mindfulness), can produce additional clinical benefits when compared to TAU or MPP alone.

Methods: A total of 330 patients with FM were recruited and randomly allocated (1:1:1) to TAU only, TAU + FIBROWALK, or TAU + MPP. FIBROWALK and MPP consisted of weekly videos on pain neuroscience education, therapeutic exercise and self-management patient education, but only the FIBROWALK intervention provided cognitive restructuring and mindfulness. Both programs were structurally equivalent. Between-group differences in functional impairment, pain, kinesiophobia, anxious-depressive symptoms and physical functioning were evaluated at post-treatment following Intention-To-Treat and complete-case approaches.

Results: Compared to TAU only, individuals in the FIBROWALK arm showed larger improvements in all clinical outcomes; similarly, participants in the MPP program also showed greater improvements in functional impairment, perceived pain, kinesiophobia, depressive symptoms compared to TAU only. The FIBROWALK intervention showed superior effects in improving pain, anxiety and depressive symptoms and physical functioning compared to MPP.

Conclusions: This RCT supports the short-term effectiveness of the video-based multicomponent programs FIBROWALK and MPP for FM and provides evidence that cognitive-behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs.

Trial registration number: NCT04571528.

Keywords: Cognitive behaviour therapy; Fibromyalgia; Mindfulness; Pain neuroscience education; Therapeutic exercise; Virtual multicomponent treatment.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
Cognitive Restructuring
Fibromyalgia* / psychology
Fibromyalgia* / therapy
Humans
Mindfulness* / methods
Pain
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT04571528