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limitations of sample representation. Finally, the inclusion of sociodemographic variables (age), other clinical aspects (nonpharmacological aids), and social factors would have contributed to a more complete understanding of FM impact. For future research, it may be of great interest to conduct longitudinal studies that allow a more precise exploration of the temporal links between pain, sleep and psychopathology. It would also be relevant to examine these links by considering psychopathology in terms of clinical diagnosis. The replicability of the moderating role of psychopathology should be analyzed in other chronic pain and healthy samples. Further, given the connection between trauma and FM (Miró et al., 2020), it may be key to explore if psychopathology is a dysfunctional response pattern associated with FM or with a highly stressful event that precedes FM, and how this sequence interact with sleep over time. Finally, it may be important to examine whether FM patients with high comorbidity of insomnia and psychopathology respond better to tailored version of CBT/MABI. In conclusion, FM patients show clinical levels of psychopathology that interact with sleep problems, exacerbating the deterioration of daily functioning. Psychopathological sphere is proposed as an important target for FM management. Acknowledgements This study was fi nancially supported by the Spanish Ministry of Economy and Competitiveness (ref. PSI2014-58379-P). References Adams, L. M., & Turk, D. C. (2018). Central sensitization and the biopsychosocial approach to understanding pain. Journal of Applied Biobehavioral Research. (2013). ModGraph-I. A programme to compute cell means for the graphical display of moderational analyses: The internet version. https://psychology.victoria.ac.nz/modgraph/ Joustra, M. L., Zijlema, W. L., Rosmalen, J. G., & Janssens, K. A. (2018). Physical activity and sleep in chronic fatigue syndrome and fi bromyalgia syndrome: Associations with symptom severity in the general population cohort lifelines. Pain Research and Management, 5801510. https://doi. org/10.1155/2018/5801510 Keller, D., de Gracia, M., & Cladellas, R. (2011). Subtypes of patients with fi bromyalgia, psychopathological characteristics and quality of life. Actas Españolas de Psiquiatría, 39(5), 273-279. Kempke, S., Van Houdenhove, Individualized, Assessment-Based Manual Therapy to Reduce Chronic Pain and Increase Function: Case Study of a Patient with Fibromyalgia and Diabetes Thuy Bowyer1*, Leena S Hiremath2 , Jennifer R Larson3 , Deborah M Grzybowski4 , Ann Scheck McAlearney5 and Brian L Bowyer6 1 M. T. Wellness Clinic, USA 2 Department of Obstetrics and Gynecology, The Ohio State University, USA 3 Department of Biological and Environmental Sciences, Capital University, USA 4 Department of Chemical and Biomolecular Engineering, The Ohio State University, USA 5 Department of Family Medicine, The Ohio State University, USA 6 Department of Physical Medicine and Rehabilitation, The Ohio State University, USA *Corresponding author: Thuy Bowyer, CMRMT, LMT, BS, M. T. Wellness Clinic, Inc., 1151 Bethel Road, Suite 302, Columbus, Ohio 43220, USA, Tel: 614-273-0810, Fax: 614-273-0173 Abstract Fibromyalgia is a medical condition characterized by chronic pain that is attributed to an imbalance in neurotransmitter function. It is now estimated to affect more than 10 million adults in the U.S. and 0.2-6.6% of the general population worldwide. Current treatment options include both pharmacological and nonpharmacological interventions, with massage therapy and physical therapy predominant among nonpharmacological approaches. We conducted a case study of a novel treatment modality, Medical Restorative Massage Therapy (MRMT®), which includes a detailed patient assessment and individualized treatment to address chronic pain. In this case, MRMT® was used over a 6-month period to assess and treat a female patient with fibromyalgia and diabetes. Assessments included patient perceptions of pain, therapist assessments of pain, and patient and therapist assessments of function. We found
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