Efficacy of Cognitive Behaviour Therapy in Fibromyalgia as compared with Myofascial Release Technique

Abstract

BACKGROUND: Fibromyalgia (FM) is a nonspecific rheumatologic disorder, characterized by widespread pain present for 3 months or more and acute response to digital palpation in at least 11 of 18 tender points resulting in stiffness, fatigue, depression, anxiety and sleep disturbances affecting 2% of the population with a female-to-male ratio of approximately 9:1.The conventional treatment such as LASER, Biofeedback, Transcutaneous Electrical Muscle Stimulator (TENS), Thermotherapy and Ultrasound along with Myofascial Release techniques (MFR) are helpful in reducing the symptoms of FM. The programs of physical training, relaxation techniques, self-assertion, anxiety management, emotional awareness courses and education programs are being associated with pharmacological treatment for FM that help patients in understanding the illness and learn to live with it. A multidisciplinary healthcare approach is required to address the multidimensional nature of FMS. METHOD: 22 patients consisting of 3 males and 19 females were selected for the randomized control trial and were divided into two groups by using simple randomization method. Group A (N=11) received MFR technique along with conventional physiotherapy (hot fomentation, ultrasound and TENS) and group B (N=11) received Cognitive Behaviour Therapy (CBT) in adjunct to MFR technique and conventional physiotherapy. Primary outcome measure Fibromyalgia Impact Questionnaire (FIQR) and Secondary outcome measure Depression Anxiety and Stress Questionnaire (DASS), Epworth Sleepiness Scale (ESS), Visual Analogue Scale (VAS) and Functional Independence Measure (FIM) were recorded on 1st, 15th and 30th day. RESULTS: Results of the present study indicate that statistically there is no difference in the efficacy of CBT along with MFR and conventional therapy and the MFR along with conventional therapy for the treatment of FM symptoms of pain, depression, anxiety, stress, sleepiness and hampered quality of life. However, both the treatments have shown good prognosis. The Researcher found that the patients under group B who were administered CBT has shown significant effects in reducing FM symptoms and maintaining them for longer duration of time as compared with the patients under group. Hence, it is reliable method for reducing the features of FMS. KEY WORDS: Fibromyalgia, Cognitive Behaviour Therapy, Myofascial Release, Conventional therapy.