Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Juvenile Fibromyalgia: Responsiveness of Tools, Greatest Areas of Impairment, and Impact of an Aerobic Exercise Program.

Luca2,  Nadia J. C., Feldman3,  Brian M., Tshantshapanyan4,  Larisa, Abrahamyan4,  Lusine, Stephens4,  Samantha, Bradley4,  Nicolette, Schneiderman4,  Jane

Bloorview Kids Rehab, Bloorview Research Institute
Hospital for Sick Children, Toronto, ON, Canada
The Hospital for Sick Children, Toronto, ON, Canada
The Hospital for Sick Children

Background:

Patients with juvenile fibromyalgia (FM) have generalized MSK pain, fatigue, and poor sleep, as well as high rates of school absence and functional disability.

Objectives:

This study determines which areas of functioning are most impaired in children with FM, as well as the effect of an aerobic exercise program on ability to do specific activities. Also, the responsiveness of various evaluation tools in juvenile FM was evaluated.

Methods:

FM patients aged 8–18 were asked to complete the FM Impact Questionnaire and Functional Status and Symptom Questionnaire (FSSQ), as well as other questionnaires, while participating in a randomized, 12-week trial of either aerobic exercise or control (qigong). Data were collected before and after the intervention. A repeated measures analysis of variance was used to compare the rates of change in ability between the groups after the exercise intervention.

Results:

Thirty patients participated in the study, and 24 patients completed the program (12 in aerobic and 12 in qigong group). At baseline, a minority of patients reported difficulties with daily function (homework 11%, chores 23%) and social function (31%); whereas, on average, 56% reported difficulty with physical function. Specific activities associated with great difficulty or inability included playing sports after school (43%), running long distances (35%), and participating in gym class (25%). The most prominent symptom during physical activities was pain. Subjects also reported difficulty with waking up for school and attending overnight camp (37% and 26% respectively), mostly due to fatigue and sleep difficulties.

After the exercise intervention, subjects in both groups showed improvement in function. However, when compared with subjects in the qigong group, those in the aerobic group demonstrated a significantly greater improvement in ability to run long distances (P=0.023), attend school every day (P=0.036), and complete homework (P=0.003).

Greatest responsiveness, as measured by effect size, was associated with PedsQLpain2, HR QOL, C-HAQ (total score), and the FSSQ questionnaires.

Conclusions:

Juvenile FM causes significant difficulties in function, mostly seen in physical activities and activities affected by poor sleep. Daily and social activities tend to be relatively spared. The most prominent symptoms experienced are pain, fatigue and sleep difficulties. Aerobic exercise was found to have greatest impact in improving physical and daily functions but, in our sample, did not affect social function. The FSSQ, as well as other evaluation tools for juvenile FM, has a strong responsiveness.

To cite this abstract, please use the following information:
Luca, Nadia J. C., Feldman, Brian M., Tshantshapanyan, Larisa, Abrahamyan, Lusine, Stephens, Samantha, Bradley, Nicolette, et al; Juvenile Fibromyalgia: Responsiveness of Tools, Greatest Areas of Impairment, and Impact of an Aerobic Exercise Program. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1681
DOI: 10.1002/art.29446

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