IMPROVING THE ABILITY TO PERFORM ACTIVITIES OF DAILY LIVING IN WOMEN LIVING WITH FIBROMYALGI: AN EXPLORATORY, QUASI-RANDOMISED CONTROLLED, PHASE-TWO STUDY

Background: Interventions improving the ability to perform activities of daily living (ADL) in fibromyalgia are sparse and trials rarely include occupational therapy despite the professions´ core focus on improving ADL... [ view full abstract ]

Background:
Interventions improving the ability to perform activities of daily living (ADL) in fibromyalgia are sparse and trials rarely include occupational therapy despite the professions´ core focus on improving ADL ability. The objective of this study was to investigate the outcomes of interdisciplinary rehabilitation followed by an additional occupational therapy adaptational program (ADAPT) and a physical activity program (ACTIVE).
Methods:
Women (n=85) with fibromyalgia, were consecutively enrolled from the first phase of the IMPROvE study into two-week interdisciplinary rehabilitation, and quasi-randomized to additional 16-week ADAPT/ACTIVE programs. Participants in the ADAPT program were taught to use adaptational strategies e.g. assistive devices and modifications of the environments. Participants in the ACTIVE program were taught pacing strategies and strategies to overcome training barriers. Primary outcome was observed ADL ability at four-week follow-up, assessed with the Assessment of Motor and Process Skills (AMPS).
Results:
Participants (n=48) included in per protocol analysis did not differ from withdrawers (n=37) at baseline. Improvements in ADL motor and ADL process ability in the ADAPT and ACTIVE groups were statistically significant and independent of group allocation (ADAPT vs. ACTIVE) (figure 1). Responder analyses revealed that 63% of the participants obtained clinically relevant improvements in ADL motor ability and 48% in ADL process ability.
Conclusion:
Women with fibromyalgia can improve their ADL ability through adaptational or physical activity programs as indicated by observable decreased effort, increased efficiency, safety and independence during performance of ADL tasks.
Application to Practice:
Occupational therapists can implement adaptational programs to improve ADL ability in fibromyalgia.