Fibromyalgia (FMS), defined as the presence of both chronic widespread pain and the finding of 11/18 tender points on examination, affects 2% of the general population. Drug therapy for FMS is largely symptomatic as there is not yet a complete understanding of the pathogenesis of the disease. In the past 17 years, supervised aerobic exercise has emerged as an important treatment modality to improve pain, aerobic capacity, function and well-being. Individuals who are able to adhere to exercise almost always maintain the symptomatic benefits of exercise. Unfortunately, the rate of exercise adherence six months after the completion of a well-structured supervised exercise program is disappointingly low. Furthermore, although the efficacy of supervised aerobic exercise in the research setting is well documented, the applicability of such intervention in the clinic setting is doubtful. Therefore, we propose to conduct the Research to Encourage Exercise for Fibromyalgia (REEF), a randomized attention-controlled trial whose primary Aim is to evaluate the efficacy of telephone-delivered motivational interviewing (Ml) to encourage exercise, in improving exercise adherence and self-report physical function (co-primary outcome measures) for FMS patients. REEF will enroll 200 FMS patients, randomizing them to either the Ml group or the attention-control (AC) group. Participants from each group will receive a total of six telephone calls within a 12-week period. Prior to the phone calls, participants from both groups will receive an individualized exercise prescription and two supervised exercise training sessions to get them started on an exercise program. All subjects will undergo comprehensive outcome assessment at baseline, week 12, week 24 and week 36. The secondary Aim of this application is to determine the mediators between Ml and improvement in self-report physical function. The proposed research is significant because our focus is the promotion of adherence to an exercise program, of adequate intensity, in order to maximize functioning and well-being for patients with FMS. The use of a predominantly home-based exercise program and telephone-delivered Ml by a trained licensed practice nurse (LPN) could potentially make the proposed intervention more accessible to the greater majority of FMS patients. Furthermore, if proven efficacious, Ml could readily be applied to other chronically painful conditions (e.g. chronic back pain). ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
1R01AR054324-01A1
Application #
7305648
Study Section
Special Emphasis Panel (ZRG1-CFS-E (01))
Program Officer
Serrate-Sztein, Susana
Project Start
2007-09-01
Project End
2011-08-31
Budget Start
2007-09-01
Budget End
2008-08-31
Support Year
1
Fiscal Year
2007
Total Cost
$493,750
Indirect Cost
Name
Indiana University-Purdue University at Indianapolis
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
603007902
City
Indianapolis
State
IN
Country
United States
Zip Code
46202
Kaleth, Anthony S; Slaven, James E; Ang, Dennis C (2018) Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia. Clin J Pain 34:76-81
Kim, Sunghye; Slaven, James E; Ang, Dennis C (2017) Sustained Benefits of Exercise-based Motivational Interviewing, but Only among Nonusers of Opioids in Patients with Fibromyalgia. J Rheumatol 44:505-511
Steiner, Jennifer L; Bigatti, Silvia M; Slaven, James E et al. (2017) The Complex Relationship between Pain Intensity and Physical Functioning in Fibromyalgia: The Mediating Role of Depression. J Appl Biobehav Res 22:
Kaleth, Anthony S; Slaven, James E; Ang, Dennis C (2016) Determining the Minimal Clinically Important Difference for 6-Minute Walk Distance in Fibromyalgia. Am J Phys Med Rehabil 95:738-45
Steiner, Jennifer L; Bigatti, Silvia M; Ang, Dennis C (2015) Trajectory of change in pain, depression, and physical functioning after physical activity adoption in fibromyalgia. J Health Psychol 20:931-41
Kaleth, Anthony S; Slaven, James E; Ang, Dennis C (2014) Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia? Arthritis Care Res (Hoboken) 66:1887-94
Kaleth, Anthony S; Saha, Chandan K; Jensen, Mark P et al. (2013) Effect of moderate to vigorous physical activity on long-term clinical outcomes and pain severity in fibromyalgia. Arthritis Care Res (Hoboken) 65:1211-8
Ang, Dennis C; Kaleth, Anthony S; Bigatti, Silvia et al. (2013) Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial. Clin J Pain 29:296-304
Ang, Dennis C; Kaleth, Anthony S; Bigatti, Silvia et al. (2011) Research to Encourage Exercise for Fibromyalgia (REEF): use of motivational interviewing design and method. Contemp Clin Trials 32:59-68