1. Evidenced-Based Interventions for Preventing Further Limitations in Occupational Performance in Individuals with Fibromyalgia Vision in Action Conference Spalding University January 24, 2014 Brittany Hebert, OTS

2. What is Fibromyalgia? Unclear epidemiology Widespread muscle joint pain Fatigue and sleep disturbances Psychosocial factors ▫Depression ▫Anxiety

3. Why Do We Care? Second to osteoarthritis, fibromyalgia is the most common musculoskeletal condition.

4. Why Do We Care? Exercise, relaxation, and stress-reduction techniques may help to control symptoms.

5. Why Do We Care? Fibromyalgia can impact occupational performance. Consider this scenario: Wife and mother of three with fibromyalgia Decreased mobility and endurance Increased pain, trigger points, limited ROM Lack of sleep and anxiety

6. PICO Question What are the most effective interventions to prevent future limitations in occupational performance for individuals with fibromyalgia?

7. About the Research Mostly Randomized Controlled Trials (Level I), included a Pre-Post Test Study (Level III) Research is scarce in OT journals ▫American Journal of Physical Medicine and Rehabilitation ▫Journal of Rehabilitation Medicine ▫Clinical Rehabilitation Studies are from 2006-2012

8. Things to Consider Majority of studies are dominated by female participants ▫Why? Most commonly used outcome measure ▫FIQ  Links to OT  ADL/IADL completion

9. Fibromyalgia Impact Questionnaire

10. What the Research Says… Physical Aspects ▫Interventions focusing on a variety of exercises and specific techniques (i.e. yoga) coupled with educational programs showed statistically significant improvements for multiple outcomes.  Pain score/ pain catastophizing  Fibromyalgia impact score  Lowered number of tender points  ROM (lumbar extension, cervical flexion, cervical rotation, cervical side bending)  6 Minute Walk Test

11. What the Research Says… Psychosocial Aspects ▫Interventions focusing on patients’ thinking, self- efficacy, and individualized goal setting showed statistically significant improvements for multiple outcomes.  Depression  Emotional distress  Participation in daily occupations  Overall quality of life

12. What the Research Says… Psychosocial Aspects ▫Interventions focusing on a variety of exercises showed statistically significant improvements for multiple outcomes.  Depression  Sleep quality  Fatigue  Mental health  Overall quality of life

13. Implications for OT We can have a positive impact on quality of life and occupational performance through non- pharmacological interventions. Generalizable across a wide variety of settings Addresses multiple client factors Allows for collaboration with other disciplines

14. Thank you for your time!