• Susmita Kashikar-Zuck, Matthew S Briggs, Sharon Bout-Tabaku, Mark Connelly, Morgan Daffin, Jessica Guite, Richard Ittenbach, Deirdre E Logan, Anne M Lynch-Jordan, Gregory D Myer, Sylvia Ounpuu, James Peugh, Kenneth Schikler, Dai Sugimoto, Jennifer N Stinson, Tracy V Ting, Staci Thomas, Sara E Williams, William Zempsky, and Childhood Arthritis and Rheumatology Research Alliance (CARRA) Pain Workgroup Investigators.
• Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: susmita.kashikar-zuck@cchmc.org.
• Contemp Clin Trials. 2021 Apr 1; 103: 106321.

ObjectiveJuvenile-onset fibromyalgia (JFM) is a chronic debilitating pain condition that negatively impacts physical, social and academic functioning. Cognitive-behavioral therapy (CBT) is beneficial in reducing functional disability among adolescents with JFM but has only a modest impact on pain reduction and does not improve physical exercise participation. This randomized controlled trial (RCT) aims to test whether a novel intervention that combines CBT with specialized neuromuscular exercise training (the Fibromyalgia Integrative Training program for Teens "FIT Teens") is superior to CBT alone or a graded aerobic exercise (GAE) program.Design/MethodsThis 3-arm multi-site RCT will examine the efficacy of the FIT Teens intervention in reducing functional disability (primary outcome) and pain intensity (secondary outcome), relative to CBT or GAE. All interventions are 8-weeks (16 sessions) in duration and are delivered in small groups of 4-6 adolescents with JFM. A total of 420 participants are anticipated to be enrolled across seven sites with approximately equal allocation to each treatment arm. Functional disability and average pain intensity in the past week will be assessed at baseline, post-treatment and at 3-, 6-, 9- and 12-month follow-up. The 3-month follow-up is the primary endpoint to evaluate treatment efficacy; longitudinal assessments will determine maintenance of treatment gains. Changes in coping, fear of movement, biomechanical changes and physical fitness will also be evaluated.ConclusionsThis multi-site RCT is designed to evaluate whether the combined FIT Teens intervention will have significantly greater effects on disability and pain reduction than CBT or GAE alone for youth with JFM. Clinical trials.gov registration: NCT03268421.Copyright © 2021 Elsevier Inc. All rights reserved.

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