Janet L. Poole, Patricia Siegel; Effectiveness of Occupational Therapy Interventions for Adults With Fibromyalgia: A Systematic Review. Am J Occup Ther 2016;71(1):7101180040. https://doi.org/10.5014/ajot.2017.023192
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© 2021 American Occupational Therapy Association
OBJECTIVE. This systematic review addresses the effectiveness of occupational therapy–related interventions for adults with fibromyalgia.
METHOD. We examined the literature published between January 2000 and June 2014. A total of 322 abstracts from five databases were reviewed. Forty-two Level I studies met the inclusion criteria. Studies were evaluated primarily with regard to the following outcomes: daily activities, pain, depressive symptoms, fatigue, and sleep.
RESULTS. Strong evidence was found for interventions categorized for this review as cognitive–behavioral interventions; relaxation and stress management; emotional disclosure; physical activity; and multidisciplinary interventions for improving daily living, pain, depressive symptoms, and fatigue. There was limited to no evidence for self-management, and few interventions resulted in better sleep.
CONCLUSION. Although the evidence supports interventions within the scope of occupational therapy practice for people with fibromyalgia, few interventions were occupation based.
People with FM should be encouraged to engage in a combination of strength and aerobic exercises to improve global well-being, decrease pain and tender points, and improve symptoms such as depression.
Traditional strengthening programs are safe to perform, but Tai Chi, yoga, and Pilates are also effective for pain reduction and improved function.
Aquatic exercise appears to have an effect on pain, and clients who prefer a water-based exercise should be encouraged to participate.
Psychoeducational interventions seem to be less effective, but multidisciplinary interventions appear to improve function, pain, and depressive symptoms. Occupational therapy practitioners could develop and lead comprehensive multidisciplinary programs in centers serving people with FM.
Cognitive–behavioral interventions seem to have a small benefit for pain and function.
Self-management programs do not appear to be effective. Slight benefits were seen for guided imagery and mindfulness interventions and emotional disclosure, but the improvements generally were not maintained long term.
In view of the evidence for physical activity interventions, researchers could investigate the effectiveness of interventions modeled after the Lifestyle Redesign intervention to promote participation in physical activities (Clark et al., 2015).
Occupational therapy researchers could also investigate the effectiveness of psychoeducational interventions specifically designed to address client-identified goals.
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