Mind-body therapies for the treatment of fibromyalgia. A systematic

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Mind-body therapies for the treatment of fibromyalgia. A systematic

review.

J Rheumatol 2000 Dec;27(12):2911-8

Hadhazy VA, Ezzo J, Creamer P, Berman BM

Complementary Medicine Program, University of land School of

Medicine, Baltimore, USA.

PMID: 11128685, UI: 21011301

OBJECTIVE: To assess the effectiveness of mind-body therapy (MBT) for

fibromyalgia syndrome (FM) by systematically reviewing

randomized/quasirandomized controlled trials using methods recommended by

the Cochrane Collaboration.

METHODS: Nine electronic databases, 69 conference proceedings, and several

citation lists were searched for relevant trials in any language.

Eligible trials were scored for methodological quality using a validated

instrument. Information on major outcomes was extracted. Insufficient

data reporting prevented statistical pooling, therefore a best-evidence

synthesis was performed.

RESULTS: Thirteen trials involving 802 subjects were included. Seven

trials received a high methodological score. Compared to waiting

list/treatment as usual, there is strong evidence that MBT is more

effective for self-efficacy, limited evidence for quality of life,

inconclusive evidence for all other outcomes. There is limited evidence

that MBT is more effective than placebo (for pain and global

improvement); inconclusive evidence that MBT is more effective than

physiotherapy, psychotherapy, or education/attention control for all

outcomes; strong evidence that moderate/high intensity exercise is more

effective than MBT (for pain and function). There is moderate evidence

that MBT plus exercise (MBT+E) is more effective than waiting

list/treatment as usual (for self-efficacy and quality of life); limited

evidence that MBT+E is more effective than education/attention control;

inconclusive for other outcomes. There is inconclusive evidence for MBT+E

vs other active treatments for all outcomes. Longterm within-groups

results show greatest benefit for MBT+E.

CONCLUSION: MBT is more effective for some clinical outcomes compared to

waiting list/treatment as usual or placebo. Compared to active

treatments, results are largely inconclusive, except for moderate/high

intensity exercise, where results favor the latter. Further research

needs to focus on the synergistic effects of MBT plus exercise and/or

plus antidepressants.