Rheumatology International

, Volume 28, Issue 6, pp 527–532 | Cite as

Effects of muscle strengthening versus aerobic exercise program in fibromyalgia

  • Çiğdem Bircan
  • Seide Alev Karasel
  • Berrin Akgün
  • Özlem El
  • Serap Alper
Original Article


The purpose of this study was to compare the effects of aerobic training with a muscle-strengthening program in patients with fibromyalgia. Thirty women with fibromyalgia were randomized to either an aerobic exercise (AE) program or a strengthening exercise (SE) program for 8 weeks. Outcome measures included the intensity of fibromyalgia-related symptoms, tender point count, fitness (6-min walk distance), hospital anxiety and depression (HAD) scale, and short-form health survey (SF-36). There were significant improvements in both groups regarding pain, sleep, fatigue, tender point count, and fitness after treatment. HAD-depression scores improved significantly in both groups while no significant change occurred in HAD-anxiety scores. Bodily pain subscale of SF-36 and physical component summary improved significantly in the AE group, whereas seven subscales of SF-36, physical component summary, and mental component summary improved significantly in the SE group. When the groups were compared after treatment, there were no significant differences in pain, sleep, fatigue, tender point count, fitness, HAD scores, and SF-36 scores. AE and SE are similarly effective at improving symptoms, tender point count, fitness, depression, and quality of life in fibromyalgia.


Fibromyalgia Aerobic exercise Strengthening exercise 


  1. 1.
    Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds WJ, Romano TJ, Russel IJ, Sheon RP (1990) The American college of rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172PubMedCrossRefGoogle Scholar
  2. 2.
    Wolfe F, Ross K, Andersen J, Russe U (1995) Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheum 22:151–156PubMedGoogle Scholar
  3. 3.
    Staud R (2004) Fibromyalgia pain: do we know the source? Curr Opin Rheumatol 16:157–163PubMedCrossRefGoogle Scholar
  4. 4.
    Goldenberg DL, Burckhardt C, Crofford L (2004) Management of fibromyalgia syndrome. JAMA 292:2388–2395PubMedCrossRefGoogle Scholar
  5. 5.
    Busch AJ, Barber KAR, Overend TJ, Peloso PMJ, Schachter CL (2002) Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev (Issue 2):CD003786Google Scholar
  6. 6.
    Bennett RM, Clark S, Goldberg L, Nelson D, Bonafede RP, Porter J, Specht D (1989) Aerobic fitness patients with fibrositis: a controlled study of respiratory gas exchange and 133 Xenon clearance from exercising muscle. Arthritis Rheum 32:454–460PubMedCrossRefGoogle Scholar
  7. 7.
    Mannerkorpi K, Burckhardt CS, Bjelle A (1994) Physical performance characteristics of women with fibromyalgia. Arthritis Care Res 3:123–129CrossRefGoogle Scholar
  8. 8.
    Maquet D, Croisier J, Renard C, Crielaard J (2002) Muscle performance in patients with fibromyalgia. Joint Bone Spine 69:293–299PubMedCrossRefGoogle Scholar
  9. 9.
    Valim V, Oliveira L, Suda A, Silva L, deAssis M, Neto TB, Feldman D, Natour J (2003) Aerobic fitness effects in fibromyalgia. J Rheumatol 30:1060–1069PubMedGoogle Scholar
  10. 10.
    Richards SCM, Scott DL (2002) Prescribed exercise in people with fibromyalgia: parallel group randomized controlled trial. BMJ 325:185–187PubMedCrossRefGoogle Scholar
  11. 11.
    Gowans SE, deHueck A, Voss S, Silaj A, Abbey SE, Reynolds WJ (2001) Effect of a randomized, controlled trial of exercise on mood and physical function in individuals with fibromyalgia. Arthritis Care Res 45:519–529CrossRefGoogle Scholar
  12. 12.
    Wigers GH, Stiles TC, Vogel PA (1996) Effects of aerobic exercise versus stress management treatment in fibromyalgia: a 4.5-year prospective study. Scand J Rheumatol 25:77–86PubMedCrossRefGoogle Scholar
  13. 13.
    Burckhardt CS, Mannerkorpi K, Hedenberg L, Bjelle A (1994) A randomized, controlled clinical trial of education and physical training for women with fibromyalgia. J Rheumatol 21:714–720PubMedGoogle Scholar
  14. 14.
    Kingsley JD, Panton LB, Toole T, Sirithienthad P, Mathis R, McMillan V (2005) The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia. Arch Phys Med Rehabil 86:1713–1721PubMedCrossRefGoogle Scholar
  15. 15.
    Valkeinen H, Alen M, Hannonen P, Hakkinen A, Airaksinen O, Hakkinen K (2004) Changes in knee extension and flexion force, EMG and functional capacity during strength training in older females with fibromyalgia and healthy controls. Rheumatology 43:225–228PubMedCrossRefGoogle Scholar
  16. 16.
    Jones KD, Burckhardt CS, Clark SR, Bennett RM, Potempa KM (2002) A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol 29:1041–1048PubMedGoogle Scholar
  17. 17.
    Hakkinen A, Hakkinen K, Hannonen P, Alen M (2001) Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia: comparison with healthy women. Ann Rheum Dis 60:21–26PubMedCrossRefGoogle Scholar
  18. 18.
    Hannonen P, Rahkila P, Kallinen M, Alen M (1995) Effects of prolonged aerobic vs muscle strength training programs on fibromyalgia. J Musculoskelet Pain 3(Suppl 1):34Google Scholar
  19. 19.
    King S, Wessel J, Bhambhani Y, Maikala R, Sholter D, Maksymowych W (1999) Validity and reliability of the six minute walk in persons with fibromyalgia. J Rheumatol 26: 2233–2237PubMedGoogle Scholar
  20. 20.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRefGoogle Scholar
  21. 21.
    Aydemir Ö, Güvenir T, Küey L, Kültür S (1997) Hastane Anksiyete ve Depresyon Ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 8:280–287Google Scholar
  22. 22.
    Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRefGoogle Scholar
  23. 23.
    Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A (1999) Kısa form 36 (KF-36)’nın Türkçe versiyonun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 12:102–106Google Scholar
  24. 24.
    Gowans SE, deHueck A, Voss S, Richardson M (1999) A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 12:120–128PubMedCrossRefGoogle Scholar
  25. 25.
    Rooks DS, Silverman CB, Kantrowitz FG (2002) The effects of progressive strength training and aerobic exercise on muscle strength and cardiovascular fitness in women with fibromyalgia: a pilot study. Arthritis Rheum 47:22–28PubMedCrossRefGoogle Scholar
  26. 26.
    North TC, McCullagh P, Tran VZ (1990) Effect of exercise on depression. Exerc Sport Sci Rev 18:379–415PubMedCrossRefGoogle Scholar
  27. 27.
    Petruzzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazar W (1991) A meta-analysis on the anxiety-reducing effects of acute and chronic exercise: outcomes and mechanisms. Sports Med 11:143–182PubMedCrossRefGoogle Scholar
  28. 28.
    Dunn AL, Trivedi MH, O’Neal HA (2001) Physical activity dose-response effects on outcomes of depression and anxiety. Med Sci Sports Exerc 33(6 Suppl):S587–S597PubMedGoogle Scholar
  29. 29.
    Mannerkorpi K, Nyberg B, Ahlmen M, Ekdahl C (2000) Pool exercise combined with an education program for patients with fibromyalgia syndrome. A prospective, randomized study. J Rheumatol 27:2473–2481PubMedGoogle Scholar
  30. 30.
    Mannerkorpi K, Gard G (2003) Physiotherapy group treatment for patients with fibromyalgia: an embodied learning process. Disabil Rehabil 25:1372–1380PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Çiğdem Bircan
    • 1
  • Seide Alev Karasel
    • 1
  • Berrin Akgün
    • 1
  • Özlem El
    • 1
  • Serap Alper
    • 1
  1. 1.Department of Physical Medicine and Rehabilitation, Faculty of MedicineDokuz Eylül UniversityİzmirTurkey

Personalised recommendations