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PHYSIO  January 2003

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Subject:

Exercise and Fibromyalgia

From:

[log in to unmask]

Reply-To:

- for physiotherapists in education and practice <[log in to unmask]>

Date:

Fri, 31 Jan 2003 14:47:39 EST

Content-Type:

text/plain

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The following studies concluded that exercise can be useful in treating
anyone who suffers from fibromyalgia.

----------------

Prescribed exercise in people with fibromyalgia: parallel group randomised
controlled trial.

Richards SC, Scott DL.

BMJ 2002 Jul 27; 325(7357):185

OBJECTIVES: To evaluate cardiovascular fitness exercise in people with
fibromyalgia.

DESIGN: Randomised controlled trial. Setting: Hospital  rheumatology
outpatients. Group based classes took place at a "healthy living centre."
PARTICIPANTS: 132 patients with fibromyalgia.  INTERVENTIONS: Prescribed
graded aerobic exercise (active treatment) and relaxation and flexibility
(control treatment). MAIN OUTCOME  MEASURES: Participants' self assessment of
improvement, tender point count, impact of condition measured by fibromyalgia
impact questionnaire,  and short form McGill pain questionnaire.

RESULTS: Compared with relaxation exercise led to significantly more
participants rating themselves as  much or very much better at three months:
24/69 (35%) vs 12/67 (18%). Benefits were maintained or improved at one year
follow up, when fewer participants in the exercise group fulfilled the
criteria for fibromyalgia (31/69 vs 44/67). People in the exercise group also
had greater  reductions in tender point counts (4.2 vs 2.0) and in scores on
the fibromyalgia impact questionnaire (4.0 vs 0.6).

CONCLUSIONS:  Prescribed graded aerobic exercise is a simple, cheap,
effective, and potentially widely available treatment for fibromyalgia.

*** You can download the entire article free at:

http://bmj.com/cgi/content/full/325/7357/185

-----------------------

Arthritis Care Res 1999 Apr; 12(2):120-8

A randomized, controlled trial of exercise and education for individuals with
fibromyalgia.

Gowans SE, deHueck A, Voss S, Richardson M.

OBJECTIVE: To evaluate the efficacy of a 6-week exercise and educational
program for patients with fibromyalgia.

METHODS: Forty-one subjects were randomly assigned to the program or served
as waiting list controls. Program outcome was assessed with a 6-minute walk
test, the Fibromyalgia Impact Questionnaire, a Self-Efficacy Scale, and a
"knowledge" questionnaire (based on information provided during the
educational sessions). Waiting list control subjects subsequently completed
the program. Program outcome was reassessed 3 or 6 months post-program.

RESULTS: The program produced significant improvements in 6-minute walk
distance, well-being, fatigue, self-efficacy (for controlling pain and other
symptoms), and knowledge. At followup, immediate gains in walk distance,
well-being, and self-efficacy were maintained, but gains in fatigue and
knowledge were lost.

CONCLUSION: Short-term exercise and educational programs can produce
immediate and sustained benefits for patients with fibromyalgia. The benefits
of our program may be due to exercise or education since both interventions
were given.

----------------

Scand J Rheumatol 1996;25(2):77-86

Effects of aerobic exercise versus stress management treatment in
fibromyalgia. A 4.5 year prospective study.

Wigers SH, Stiles TC, Vogel PA.

Dept of Physical Med and Rehab, University Hospital of Trondheim, Norway.

To determine and compare short- and long-term effects of aerobic exercise
(AE), stress management treatment (SMT), and treatment-as-usual (TAU) in
fibromyalgia, 60 patients were randomized to 14 weeks of treatment by either
AE, SMT or TAU. Outcome measures at baseline, midway through treatment, at
treatment completion, and at 4 year follow up included a patient made drawing
of pain distribution, dolorimetry of tender points, ergometer cycle test,
global subjective improvement, and VAS registrations of: pain, disturbed
sleep, lack of energy, and depression. Both AE and SMT showed positive
short-term effects. AE was the overall most effective treatment, despite
being subject to the most sceptical patient attitude prior to the study. At
follow up, there were no obvious group differences in symptom severity, which
for AE seemed to be due to a considerable compliance problem.

------------------

J Rheumatol 1996 Jun; 23(6): 1050-3

 An exercise program in the treatment of fibromyalgia.

Martin L, Nutting A, MacIntosh BR, Edworthy SM, Butterwick D, Cook J.

Faculty of Medicine, University of Calgary, Alberta, Canada.

OBJECTIVE: To assess the utility of an exercise program, which included
aerobic, flexibility and strengthening elements, in the treatment of
fibromyalgia (FM). FM is a chronic musculoskeletal condition characterized by
diffuse musculoskeletal pain and aching. It has been suggested that  aerobic
exercise is helpful in its treatment.

METHODS: We studied 60 patients who met American College of Rheumatology
criteria for FM and had no significant comorbidities. Measurements performed
on each patient at the pre and poststudy assessment included the number of
tender  points (TP), total myalgic scores (TM), aerobic fitness (AF),
flexibility and isokinetic strength. After initial evaluation patients were
randomly  assigned to either an exercise or a relaxation group. Each group
met 3 times per week for 6 weeks for 1 h of supervised exercise or
relaxation. All  patients data were stored in a computerized database and
statistical analysis was performed on all pre and poststudy assessments.

RESULTS:  Thirty-eight patients (18 exercise and 20 relaxation) completed the
study. Analysis of our data showed no significant difference between the
groups  in their prestudy assessment. Poststudy assessments, however, showed
a significant improvement between the exercise and relaxation groups in TP,
TM, and AF. Similar improvements were also found when the pre and poststudy
assessment of the exercise group  were compared.

CONCLUSION: Exercise is helpful in the management of FM in the short term. It
also shows that FM patients can undertake an  exercise program which includes
aerobic, flexibility, and strength training exercises without adverse
effects. The long term utility of this type of  exercise requires further
evaluation.

-----------------

Dr Mel C Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

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