EFFECTIVENESS OF CONVENTIONAL PHYSICAL THERAPY INTERVENTIONS WITH AND WITHOUT COGNITIVE BEHAVIOR THERAPY ON PAIN AND QUALITY OF LIFE IN FIBROMYALGIA PATIENT

Background: Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. It significantly impairs quality of life, and its complex pathophysiology involves central sensitization, neurochemical imbalances, and psychological factors. Conventional physical therapy is commonly used for symptom management, but integrating cognitive behavioral therapy (CBT) may enhance treatment outcomes. This study evaluates the effectiveness of physical therapy alone versus a combination of physical therapy and CBT in improving fibromyalgia symptoms and health-related quality of life. Objective: To compare the effectiveness of conventional physical therapy with and without cognitive behavioral therapy in improving fibromyalgia symptoms and quality of life in adults diagnosed with fibromyalgia. Methods: A single-masked randomized clinical trial was conducted at the Physical Therapy Department, Maryam Hospital, Burewala. A total of 66 participants aged 18 to 65 years with a confirmed fibromyalgia diagnosis were randomly assigned to two groups. The intervention group received both physical therapy and CBT, while the control group received only physical therapy. Exclusion criteria included other chronic pain conditions, severe psychiatric disorders, substance abuse, unstable medical conditions, and participation in another clinical trial within the past 30 days. Treatment was provided twice weekly for 12 weeks. Outcomes were measured using the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 (SF-36) at baseline, the 6th week, and the 12th week. Data analysis was performed using SPSS version 24, applying parametric tests with a significance level of p ≤ 0.05. Results: Baseline FIQ scores were comparable between the intervention (69.03 ± 6.34) and control (68.09 ± 5.49) groups (p = 0.523). Post-intervention, the intervention group showed a significant reduction in FIQ scores (18.94 ± 3.68) compared to the control group (48.03 ± 4.60) (p = 0.001). Similarly, pre-intervention SF-36 scores in the intervention (30.27 ± 3.44) and control (31.03 ± 3.34) groups were not significantly different (p = 0.367). However, post-treatment, the intervention group demonstrated a significantly higher improvement (76.33 ± 5.65) than the control group (50.61 ± 2.81) (p = 0.001). Cohen’s d effect sizes for FIQ and SF-36 were 15.13 and 16.47, respectively, indicating a substantial treatment effect. Conclusion: The combination of physical therapy and CBT resulted in significantly greater improvements in fibromyalgia symptoms and quality of life compared to physical therapy alone. The findings support a multidimensional treatment approach, emphasizing the integration of psychological interventions into conventional rehabilitation strategies for fibromyalgia management.