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NCT Number: NCT07733739

Mandala Coloring for Pain, Fatigue, and Sleep in Patients With Fibromyalgia

Fibromyalgia is a chronic condition commonly associated with widespread pain, fatigue, and poor sleep quality. This randomized controlled study aims to determine whether mandala coloring, when added to routine treatment, improves pain, fatigue, and sleep quality in adults with fibromyalgia.

A total of 60 eligible participants will be randomly assigned in a 1:1 ratio to either a mandala coloring group or a control group. Participants in the mandala coloring group will complete eight 60-minute coloring sessions over four weeks, with two sessions per week, while continuing their routine treatment. Participants in the control group will continue their routine treatment without taking part in a structured coloring activity.

Pain, fatigue, and sleep quality will be assessed at the beginning of the study and at the end of the fourth week. Changes in these outcomes will be compared between the two groups.

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Key information

Conditions

Fibromyalgia Muscular Diseases Musculoskeletal Diseases Nervous System Diseases Neuromuscular Diseases Rheumatic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Artvin State Hospital

Artvin, Turkey (Türkiye)

Location status: Recruiting

About this study

This is a single-center, two-arm, parallel-group randomized controlled trial designed to evaluate the effects of mandala coloring on pain, fatigue, and sleep quality in adults with fibromyalgia. The study will be conducted in the Physical Medicine and Rehabilitation Outpatient Clinic of Artvin State Hospital.

Sixty participants who meet the eligibility criteria will be enrolled. Following the baseline assessment, participants will be randomly assigned in a 1:1 ratio to the mandala coloring group or the control group using a simple randomization method.

Participants assigned to the intervention group will receive colored pencils and a coloring booklet containing mandala patterns. They will complete eight supervised mandala coloring sessions over four weeks. The sessions will be conducted twice weekly, and each session will last approximately 60 minutes. Participants will continue receiving their routine treatment throughout the study.

Participants assigned to the control group will continue their routine treatment and will not participate in any structured mandala coloring activity during the four-week study period.

Outcome assessments will be performed at baseline and at the end of week 4. Pain intensity will be assessed using the Visual Analog Scale for Pain, fatigue will be assessed using the Fatigue Severity Scale, and sleep quality will be assessed using the Pittsburgh Sleep Quality Index. Changes in outcome scores will be compared within and between the study groups.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Aged 18 years or older
  • Diagnosed with fibromyalgia
  • Pain intensity score of 5 or higher on the Visual Analog Scale
  • Fatigue Severity Scale score of 4 or higher
  • Pittsburgh Sleep Quality Index global score of 5 or higher
  • Able to communicate and complete the study assessments
  • No physical limitation preventing mandala coloring
  • Willing to participate and provide written informed consent

Exclusion criteria

  • Presence of a communication problem that prevents participation or completion of the assessments
  • Presence of a physical limitation that prevents mandala coloring
  • Refusal to participate or provide written informed consent

Treatment and study plan

Mandala Coloring

Behavioral

Participants will complete eight supervised mandala coloring sessions over four weeks. Sessions will be conducted twice weekly, and each session will last 60 minutes. Participants will use colored pencils and a coloring booklet containing mandala patterns while continuing their routine treatment.

Primary outcomes

  1. Change From Baseline in Pain Intensity Assessed by the Visual Analog Scale at Week 4

    Time frame: Baseline and end of week 4

    Pain intensity will be assessed using a 10-cm Visual Analog Scale, ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. The outcome will be evaluated as the change in the Visual Analog Scale score from baseline to the end of week 4.

Secondary outcomes

  1. Change From Baseline in Fatigue Severity Assessed by the Fatigue Severity Scale at Week 4

    Time frame: Baseline and end of week 4

    Fatigue will be assessed using the nine-item Fatigue Severity Scale. Each item is scored from 1 (strongly disagree) to 7 (strongly agree), and the total score is calculated as the mean of the nine items. Scores range from 1 to 7, with higher scores indic

  2. Change From Baseline in Sleep Quality Assessed by the Pittsburgh Sleep Quality Index at Week 4

    Time frame: Baseline and end of week 4

    Sleep quality will be assessed using the Pittsburgh Sleep Quality Index. The global score ranges from 0 to 21, with higher scores indicating poorer sleep quality. A global score of 5 or higher indicates poor sleep quality. The outcome will be evaluated as the change in the global score from baseline to the end of week 4.

Interested in participating?

Recruiting

Interested in participating?

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Sponsors and collaborators

Lead sponsor

Artvin Coruh University

Other

Registry information

Official study title

The Effect of Mandala Coloring on Pain, Fatigue, and Sleep Quality in Patients With Fibromyalgia

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jul 29, 2026
Registry last updated
Sep 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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