Strength training and aerobic exercise have beneficial effects on pain in adults with fibromyalgia. However, the equivalence of strengthening and aerobic exercise has not been reported. The primary aim of this randomized equivalence trial involving patients with fibromyalgia admitted to an interdisciplinary pain treatment program was to test the hypothesis that strengthening (n=36) and aerobic (n=36) exercise have equivalent effects (95% confidence interval within an equivalence margin ± 8) on pain, as measured by the pain severity subscale of the Multidimensional Pain Inventory. Secondary aims included determining the effects of strengthening and aerobic exercise on peak Vo(2) uptake, leg strength, and pressure pain thresholds. In an intent-to-treat analysis, the mean (± standard deviation) pain severity scores for the strength and aerobic groups at study completion were 34.4 ± 11.5 and 37.6 ± 11.9, respectively. The group difference was -3.2 (95% confidence interval, -8.7 to 2.3), which was within the equivalence margin of Δ8. Significant improvements in pain severity (P<.001), peak Vo(2) (P<.001), strength (P<.001), and pain thresholds (P<.001) were observed from baseline to week 3 in the intent-to-treat analysis; however, patients in the aerobic group (mean change 2.0 ± 2.6 mL/kg/min) experienced greater gains (P<.013) in peak Vo(2) compared to the strength group (mean change 0.4 ± 2.6 mL/kg/min). Knowledge of the equivalence and physiological effects of exercise have important clinical implications that could allow practitioners to target exercise recommendations on the basis of comorbid medical conditions or patient preference for a particular type of exercise. This study found that strength and aerobic exercise had equivalent effects on reducing pain severity among patients with fibromyalgia.

In this series of patients undergoing multidisciplinary treatment for chronic pain, immediate treatment effects for a variety of outcome measures were similar or significantly better in smokers compared with nonsmokers.

Patients with longstanding CPRP on chronic opioid therapy, who choose to participate in interdisciplinary rehabilitation that incorporates opioid withdrawal, can experience significant and sustained improvement in pain severity and functioning.

BACKGROUNDThe relation between undergoing a single computed tomography (CT) screening for lung carcinoma and the potential long‐term impact on smoking status has been equivocal. Perhaps, recommendations from multiple cancer screenings may promote smoking abstinence among individuals at high risk for lung carcinoma.METHODSThe current longitudinal study comprised 926 current smokers and 594 former smokers who participated in 3 annual follow‐up low‐dose, fast spiral chest CT scan screenings for lung carcinoma. Baseline demographic, pulmonary function, smoking history variables, and previous abnormal findings were evaluated as predictors of self‐reported point prevalence smoking abstinence.RESULTSAmong current smokers at baseline, abstinence from smoking during the 3‐year follow‐up was associated with older age, worse baseline pulmonary function, and abnormal CT finding the previous year requiring interim follow‐up. Of participants who received abnormal screens each of the previous 3 years, 41.9% reported smoking abstinence compared with 28.0% with 2 abnormal screens, 24.2% with 1 abnormal screen, and 19.8% with no abnormal screens. Among former smokers, abstinence from smoking was associated with a longer duration of abstinence before the baseline visit.CONCLUSIONSSmokers with abnormal CT findings from multiple CT screens were more likely to be abstinent from smoking at the 3‐year follow‐up. Multiple low‐dose, fast spiral chest CT scan screenings for lung carcinoma may represent teachable moments and opportunities to enhance motivation for smoking abstinence. Further research is needed to continue to investigate how annual screening may enhance motivation for health behavior change. Cancer 2005. © 2005 American Cancer Society.

For patients completing a pain rehabilitation program, most were able to eliminate opioid use, regardless of smoking status. However, significantly more smokers did not complete treatment. The most frequent reasons for program noncompletion included discrepant expectations of treatment, acute illness, and psychosocial stressors.