New Juvenile Fibromyalgia Program May Help Improve Movement in Teens

New Juvenile Fibromyalgia Program May Help Improve Movement in Teens

A pilot study from DePaul University researchers suggests that a program combining well-established techniques of cognitive behavioral therapy (CBT) and specialized neuromuscular exercises can improve movement confidence and engagement in physical exercise in adolescents with juvenile fibromyalgia (JFM).

JFM occurs in 2 to 6 percent of children, primarily in adolescent girls, and is characterized by chronic widespread musculoskeletal pain associated with significant physical and emotional impairment.

Physical exercise is strongly recommended for the management of musculoskeletal pain in JFM patients, but traditional exercise programs such as aerobic or resistance training often include difficult or uncomfortable exercises that patients fear will worsen pain.

Indeed, juvenile fibromyalgia adolescents have poor biomechanics that may increase the risk of injury during certain exercises which, combined with the fear of pain, often lead to a lack of confidence in one’s ability and sedentarism, reinforcing disability and pain.

Susan T. Tran, PhD, and her colleagues published their preliminary results in a study titled “A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia” in the journal Pediatric Rheumatology.

“The results showed that mechanics of walking gait and functional performance appeared to improve after treatment. (…) hip abduction strength and dynamic postural control also demonstrated improvements,” the authors wrote in their report.

The program – dubbed Fibromyalgia Integrative Training for Teens (FIT Teens) – followed 11  female JFM adolescents (ages 12-18) for eight weeks in twice-weekly, 90-minute small-group sessions, but patients were also assigned exercises to be performed twice over the weekend at home.

Half the session was dedicated to cognitive behavioral therapy techniques to enhance psychological confidence in engaging in physical exercise including pain education, relaxation skills, distraction, and modification of negative thoughts about pain.

The other half was devoted to neuromuscular training targeting basic functional skills including gait, posture, balance, and movement mechanics. The exercises were tailored to be well tolerated by JFM patients, and the participants were allowed to adapt to the exercises before advancing in the training. There was no control group.

Based on the study’s results, the team believes this two-step program can help obtain a safer and more stable execution of functional tasks of daily living, such as sit-to-standing, walking, and stair climbing, while minimizing risk of overexertion, stress, injury, and/or pain in individuals with chronic pain.

Studies with larger patient groups and longer time duration are now required to test whether these improvements are indeed attributable to the FIT Teen program and whether they can translate into long-lasting changes in functional movement.

Still, the authors believe this preliminary study “may offer enhanced capabilities to better design intervention protocols specifically targeting biomechanical deficits in patients with musculoskeletal pain for optimal outcomes.”

2 comments

  1. MK says:

    The reason that patients fear exercise will worsen their pain, is that exercise DOES worsen their pain. Fibromyalgia patients typically show abnormal results on the “2 day exercise test” demonstrating that their bodies DO NOT RECOVER from exercise the way that a normal person’s body does. Prescribing exercise for such a patient without addressing this fundamental problem, is cruel and dangerous. Exercise is NOT a first line treatment for fibromyalgia. Excercise is an absolutely essential part of basic health, of course, AFTER the underlying problem has been addressed. Exercise is a lifestyle, not a medical prescription.

    What kids need from their doctor is a treatment to address their underlying physical illness. As the parent of a child with fibromyalgia, I have found that the underlying problem is best addressed through very targeted nutritional supplementation, preferably tailored to their personal genetics. Many of these kids, for instance, have the MTHFR mutation, and other mutations that need to be addressed. For instance, through consumer genetics testing, I found my child has a genetic mutation interfering with the processing of vitamin A. Kids with these types of genetic mutations need specific “active” forms of certain vitamins. Asking one of these kids to exercise without addressing their physical disease is simply cruel. B-vitamins, megadoses of magnesium, malic acid, metafolin and methyl B12, fish oil, and many other supplements can help a child to reach a state where exercise can be helpful, but it is absolutely critical to help the child’s body recover and gain the strength necessary to exercise, before demanding that the child exercise.

    Do anyone really think these kids don’t want to get up and run and jump and play like a typical child? The reason they don’t exercise more is because they are listening to their bodies. It is time that the medical community should start listening to these patients.

    They need real help, not just advice to exercise more!!

    When is the medical community going to buy a vowel, and get a clue?!

    • Jara Halfen says:

      Hi MK,
      I liked the ideas in this article about combing exercise and cognitive support, but I completely agree with your comments as well. My 14 year old daughter wants nothing more than to attend a regular school, play volleyball and live like a normal teenage girl. We have had continuing difficulty in getting anyone, including the medical community, to really help or find ways to help her live with this condition. I am thankful about your suggestion of consumer genetic testing and will pursue that as a way to gain more information about what is happening with my child. I feel your frustration completely. Thank you.

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