A 12-week multicomponent therapy in fibromyalgia improves health but not in concomitant moderate depression, an exploratory pilot study.

Objectives: Literature suggests that graded and multicomponent therapy improves outcomes in fibromyalgia, but there is no conclusive evidence in which combination to be used. This study focused on the effect of a multicomponent therapy in fibromyalgia when a combination of exercise therapy and cognitive behavioural therapy was applied. Additionally, predictors for dropping out were explored as research reports high dropout rates.Methods: Participants received graded multicomponent therapy for 12 weeks, twice a week during two hours every session by an occupational therapist, a physiotherapist, and a psychologist. Following outcome measures were assessed at baseline, weeks 6 and 12: Fibromyalgia Impact Questionnaire, Tampa scale for kinesiophobia, the Beck Depression Index, the Pain Coping Inventory (PCI), pain at the tenderpoints, grip strength, the 6-min walking test (6MWT), and cycling test.Results: In total, 64 fibromyalgia patients were screened and included. The dropout rate was 28%. A per-protocol analysis revealed significant improvement at week 6 for the Beck Depression Index, pain at the tenderpoints and the 6MWT. At week 12, the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Index (BDI), Pain PCI, pain at the tenderpoints, grip strength, and 6MWT improved significantly. The dropout analysis showed an association in participants with a moderate BDI score at baseline.Conclusions: A 12-week multicomponent therapy for fibromyalgia, well described and gradually applied, showed improvement in health-related outcome. According to our results, we recommend to exclude patients with a moderate-to-severe depression at onset before starting a multicomponent therapy protocol.Implications for rehabilitationMulticomponent therapy for fibromyalgia is beneficial on different health outcomes.Moderate depression at onset should be exclusion criteria for starting with multicomponent therapy in patients with fibromyalgia.This multicomponent therapy protocol is ready to be implemented at daily practice.

Practice, Knowledge and Needs of Occupational Therapy Practitioners Providing Services to Parents with Physical Impairments: A Pilot Study.

This survey study describes practice patterns, knowledge, skills, resources, and needs of occupational therapy practitioners providing services to parents with physical impairments. Participants (n = 51) primarily worked in outpatient rehabilitation (30%), inpatient rehabilitation (21%), and acute care (15%) settings. Participants reported evaluating and providing interventions for nine role-focused parenting activities. All participants agreed addressing the instrumental activities of daily living (IADL) of parenting should be part of occupational therapy practice. Adaptive equipment and techniques were utilized to increase participation of parents with physical impairments in child rearing. Lack of resources for childcare equipment and need for more training were barriers. Ninety-eight percent of participants agreed advancing the role of occupational therapy for parents with physical impairments is needed.

Computerized platform posturography for children: test-retest reliability of the sensory test of the VSR System.

The purpose of this study was to examine the consistency of scores from typically developing children on the sensory test of the NeuroCom International VSR System. Participants included 18 children between five and nine years of age. Postural sway was measured using the VSR System, a computerized platform posturography assessment tool. The sensory test protocol examines the relative contributions of the visual, somatosensory, and vestibular systems to maintain postural stability by systematically manipulating the availability and accuracy of sensory inputs. Test-retest intraclass correlation coefficients for all four sensory conditions ranged from .76 to .83.