Strong evidence was found for interventions categorized for this review as  cognitive – behavioral interventions ; relaxation and stress management ; emotional disclosure ; physical activity ;  and  multidisciplinary interventions for improving daily living , pain , depressive symptoms , and fatigue .
There was limited to no evidence for self-management , and few interventions result ed in better sleep .
Although the evidence supports interventions within the scope of occupational therapy practice for people with fibromyalgia , few interventions were occupation based
This systematic review addresses the effectiveness of occupational therapy – related interventions for adults with fibromyalgia .
Combining Cognitive-Behavioral Therapy and Milnacipran for Fibromyalgia: A Feasibility Randomized-controlled Trial
Objectives : To evaluate the feasibility of a r and omized-controlled trial and to obtain estimates of the effects of combined cognitive-behavioral therapy ( CBT ) and milnacipran for the treatment of fibromyalgia . Methods : Fifty-eight patients with fibromyalgia were r and omized to 1 of the 3 treatment arms : ( 1 ) combination therapy ( n=20 ) ; ( 2 ) milnacipran+education ( n=19 ) ; and ( 3 ) placebo+CBT ( n=19 ) . Patients received either milnacipran ( 100 mg/d ) or placebo . Patients also received 8 sessions of phone-delivered CBT or educational instructions , but only from baseline to week 9 . Assessment s were conducted at baseline , week 9 , and 21 . The primary endpoints were baseline to week 21 changes in weekly average pain intensity and physical function ( SF-36 physical function scale ) . Results : Compared with milnacipran , combination therapy demonstrated a moderate effect on improving SF-36 physical function ( SE=9.42 [ 5.48 ] , P=0.09 , effect size=0.60 ) and in reducing weekly average pain intensity ( mean difference [SE]=−1.18 [ 0.62 ] , P=0.07 , effect size=0.67 ) . Compared with milnacipran , CBT had a moderate to large effect in improving SF-36 physical function ( mean difference [SE]=11.0 [ 5.66 ] , P=0.06 , effect size=0.70 ) . Despite the presence of concomitant central ly acting therapies , dropout rate was lower than anticipated ( 15 % at week 21 ) . Importantly , at least 6 out of the 8 phone-based therapy sessions were successfully completed by 89 % of the patients ; and adherence to the treatment protocol s was > 95 % . Conclusions : In this pilot study , a therapeutic approach that combines phone-based CBT and milnacipran was feasible and acceptable . Moreover , the preliminary data supports conducting a fully powered r and omized-controlled trial . Clinical Trial Registration : NCT01038323
Strong evidence was found for interventions categorized for this review as  cognitive – behavioral interventions ; relaxation and stress management ; emotional disclosure ; physical activity ;  and  multidisciplinary interventions for improving daily living , pain , depressive symptoms , and fatigue .
There was limited to no evidence for self-management , and few interventions result ed in better sleep .
Although the evidence supports interventions within the scope of occupational therapy practice for people with fibromyalgia , few interventions were occupation based
This systematic review addresses the effectiveness of occupational therapy – related interventions for adults with fibromyalgia .