People who have fibromyalgia syndrome can suffer from chronic widespread pain creating difficulty with day-to-day tasks that can often be frustrating to the individual.
Despite the general health benefits associated with exercise, people with fibromyalgia syndrome are often reluctant to undertake exercise, as they perceive a risk of exacerbating their symptoms. So what are the best exercise programmes for people with fibromyalgia?
A recent systematic review has evaluated the effect of exercise on aerobic functional capacity in adults with fibromyalgia syndrome.
Here’s what they did
The authors searched 7 electronic databases looking for randomised controlled trials that evaluated the effects of exercise compared with a control on aerobic functional capacity in adults with fibromyalgia syndrome.
Physical exercise included; aerobic, strength, combined, aquatic and multidisciplinary.
Control groups included; no exercise, education or usual care.
Quality of the studies were evaluated using the Physiotherapy Evidence Database scale.
Exercise programmes ranged from 6 to 24 weeks, with 0.5 to 3 sessions per week and session duration ranging from 20 to 60 mins.
Functional aerobic capacity (6-min walk test) was found to improve with aerobic exercise (Effect size (ES)=0.85; 95% CI, 0.57-1.12) and aquatic exercise (ES=0.44; 95% CI, 0.15-0.73),
Strength training and the multidisciplinary programmes were not found to improve function
The authors concluded
Physical exercise (aerobic and aquatic exercise) performed at least 2 times per week and 30-60min per day is effective for increasing functional aerobic capacity in adults with fibromyalgia syndrome.
Aerobic and aquatic exercise is effective for increasing functional aerobic capacity in adults with fibromyalgia.
The Musculoskeletal Elf’s view
Physical exercise has been used as common practice to assist in the improvement of symptoms for people with fibromyalgia. However there is little guidance in clinical guidelines for exercise prescription in this population. This is further complicated as there are many associated symptoms in people with fibromyalgia and many guidelines need to provide generic guidance. This systematic review has provided an important starting point for individuals with fibromyalgia syndrome looking to introduce an exercise routine.
The recommended standard of the American College of Sports Medicine for exercise programmes is 2 sessions of 20 min duration per week. Interestingly all the studies included in this review met this minimum standard.
What do you think?
Do you prescribe exercise for patients with fibromyalgia?
What type of exercise do you find to be the most effective?
How do you determine what intensity to start the patient on, and what progression parameters do you employ?
Send us your views on this blog and become part of the ever expanding Musculoskeletal Elf community. Post your comment below, or get in touch via social media (Facebook, Twitter, LinkedIn, Google+).
I am currently a student researcher at Glasgow Caledonian University. My research area is examining ways to improve the management of patients suffering with fibromyalgia. Prior to this I completed my BSc and MSc at Teesside University in Sports Therapy and Advanced Sports Therapy and Rehabilitation Science respectively. When not in the university I am a full time Sports Therapist I currently own and practice out of Sports Injury Scotland, based within Run4It in Glasgow. Other research interests include running injuries, biomechanical imbalances and strength and conditioning.
Hi I am Tracey Howe. I am a Professor of Rehabilitation Sciences at Glasgow Caledonian University, UK and Deputy Chair of Glasgow City of Science. I am also an editor for the Cochrane Musculoskeletal Review Group and a convenor for the Cochrane Health Care of Older People Field. I am a Trustee of the Picker Institute Europe.
I started my career as a physiotherapist in the National Health Service in England. I have extensive experience of assessing the quality of research in Universities in the UK and internationally. I enjoy strategic visioning, creative problem-solving, and creating vibrant, multi-disciplinary environments, through collaboration, partnerships, and relationships, that empower others to succeed.
I think looking at published trials is one way but we don't know who what or where these trials took place we don't know if their methods are good if the population sample was good it's not hard evidence and that makes it poor science most students tend to do literature reviews at degree level that's fine and that's all this is just a review not really that helpful as it has drawn up a model for people to use
unfortunately the paper doesn’t mention pain scores, and poorly defines what it means by functional aerobic capacity. Included studies varied in their prescription and few recorded adverse effects and adherence, with only one study reporting having to reduce intensity of sessions due to muscle soreness lasting >3days. There needs to be more research into exercise prescription for this complex patient group.
I couldn't agree more. I have had ME and severe but intermittent (but lasting from months to a year) of chronic pain in my soft tissues. I'm up to driving short distances now and walking about 2 miles but I don't puff so I guess it's not aerobic. 2 weeks ago, I was at a spa and after the jacuzzi, steam room and sauna went into the pool to chill. It was so inviting I dove under and floated but using my arms and legs a bit over to the side of the pool and back (I don't mean length). The next day all my body was wracked with pain the severity of which I haven't had for about a year and it returns on mild stretching or walking which were my routine before. Doesn't fibroblasts implicitly mean pain, so isn't this a major shortcoming in the study in terms of relevant outcomes and couldn't the information be used in a misguided way, confirming public and professional misconceptions about these illness. ...All you need is a bit of exercise!
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