Exercise on prescription in new clinical trial
May 2007Patients from Macclesfield in Cheshire suffering from chronic pain are to be offered free exercise on prescription at their local gyms as part of a major new clinical trial aimed at developing more effective ways of reducing their painful symptoms.
Two hundred and fifty people suffering from chronic widespread pain, which currently affects ten per cent of the population and is extremely difficult to treat, will also be offered cognitive behavioural therapy (CBT) over the phone by trained therapists. CBT is a psychological method of helping people managing their pain by identifying and evaluating thoughts and behaviour.
Patients aged between 25 and 60 from a number of GP practices in Macclesfield in Cheshire will be recruited onto the trial, which is being run at the Universities of Manchester and Aberdeen funded by a three-year £600,000 grant from the Arthritis Research Campaign (arc). Macclesfield has been chosen as researchers have a good relationship with local GPs, and have worked with them on previous studies.
Pain
Chronic widespread pain is the main symptom of fibromyalgia, which also causes tenderness around the body, extreme fatigue and sleep disturbance.“Chronic widespread pain is one of the most common reasons for referral from the GP to the rheumatologist,” explained lead investigator in Manchester Deborah Symmons, Professor of Rheumatology and Musculoskeletal Epidemiology at the arc epidemiology unit at the University of Manchester, one of a large team of doctors, physiotherapists and statisticians from Manchester and Aberdeen, which is also recruiting a similar number of patients
“Symptoms tend to be permanent, and GPs and rheumatologists struggle to manage and treat it. We think there is a real need to tackle this problem and to evaluate various types of treatment at primary care level that are potentially available to a large number of patients, and inexpensive to provide.”
Trials
Patients will be split into groups; one group doing exercise, a second receiving CBT, and a third group a combination of both. Their progress will be measured against another group who will be given the “usual care” from their GP, which may be painkillers.Patients taking part in the exercise arm of the trial will be expected to attend the gym at least twice a week for up to nine months and will be assigned their own personal trainer to develop an exercise plan aimed at improving aerobic fitness by using a treadmill, exercise bike, rowing machine or cross-trainer. They will also be encouraged to try strength and flexibility training as well.
Those receiving CBT will have an initial hour-long assessment over the phone by a trained therapist, followed by seven weekly half hourly sessions and two further sessions at three months and six months. The therapy is being delivered over the phone as there is a shortage of trained therapists to undertake face-to-face work.
Before recruitment can start the team will survey 40,000 patients from GP practices in Macclesfield and Aberdeen to identify people with the condition, who will then be assessed for eligibility.
