Tailoring pain neuroscience education and exercise programme for people with fibromyalgia who also have cognitive deficits: a case series

Purpose: The purpose of this case series was to describe the outcomes of a tailored pain neuroscience education (PNE) and individualised exercise programme for people with fibromyalgia (FM) who also have cognitive deficits. Materials and methods: Nine FM patients with memory and concentration problems underwent a six-week programme consisting of six PNE sessions followed by six sessions of individualised exercise. Participants were assessed at the baseline, 3 and 6 weeks, and at 3 and 6 months follow-ups. Outcomes measures included the Tampa Scale of Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), the Numerical Pain Rating Scale (NPRS), the Fibromyalgia Impact Questionnaire-Revised (FIQ-R) and the Patient Global Improvement of Change Scale (PGIC). Results: At six weeks, all patients decreased their scores on the TSK, PCS, NPRS and FIQ-R and reported a moderate to considerable improvement in their perception of overall change. At the six-month follow-up, improvements in pain intensity, pain catastrophizing, kinesiophobia and perception of overall change, appeared clinically meaningful for the majority of the participants. Conclusions: This study's findings demonstrate an example of how cognitive characteristics can be considered in the intervention of FM patients in order to optimise their results and encourage the need for a further randomised control trial.