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

July 24, 2026 updated by: EMRE ERKAL, Artvin Coruh University

The Effect of Mandala Coloring on Pain, Fatigue, and Sleep Quality 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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mandala Coloring Group
Participants will complete eight supervised mandala coloring sessions over four weeks, with two 60-minute sessions per week. Colored pencils and a coloring booklet containing mandala patterns will be provided. Participants will continue receiving their routine treatment throughout the study.
Other: Mandala Coloring
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.
No Intervention: Control Group
Participants will continue receiving their routine treatment for four weeks and will not participate in any structured mandala coloring activity during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
Baseline and end of week 4

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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
Baseline and end of week 4
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.
Baseline and end of week 4

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Artvin Coruh University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

August 17, 2027

Study Completion (Estimated)

August 17, 2027

Study Registration Dates

First Submitted

July 24, 2026

First Submitted That Met QC Criteria

July 24, 2026

First Posted (Actual)

July 29, 2026

Study Record Updates

Last Update Posted (Actual)

July 29, 2026

Last Update Submitted That Met QC Criteria

July 24, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ACU-FM-MANDALA-2026

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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