Rheumatology International

, Volume 29, Issue 2, pp 147–152 | Cite as

Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool

  • Sandra Cristina de Andrade
  • Ranulfo Fiel Pereira Pessoa de Carvalho
  • Aluízio Silvio Soares
  • Rodrigo Pegado de Abreu Freitas
  • Luís Marcos de Medeiros Guerra
  • Maria José Vilar
Original Article

Abstract

The aim of this study was to evaluate the effectiveness of aerobic exercise in water pool compared with aerobic exercise performed in sea by women with fibromyalgia (FM). A total of 46 patients were randomly allocated into two groups: pool group (23 patients) and sea group (23 patients) that performed the same aerobic exercise program. Patients were evaluated baseline and after 12 weeks using: VAS, number of tender points, FIQ, SF-36, PSQI, and BDI. Both groups improved significantly in post-treatment for all the evaluated variables. There were no significant differences between two groups, except for BDI (F = 2.418, < 0.0001). Aerobic exercise program performed in water (pool or sea) was effective for patients with FM. However, sea water exercises have been shown to bring more advantages related to emotional aspects. Then, exercise performed sea water (thalassotherapy) is an option for effective treatment with low cost for patients with FM.

Keywords

Fibromyalgia Aerobic exercise Hydrotherapy Thalassotherapy 

References

  1. 1.
    Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (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.
    Martinez JE, Ferraz MB, Sato EI, Atra E (1995) Fibromyalgia versus rheumatoid arthritis: a longitudinal comparison of the quality of life. J Rheumatol 22:270–274PubMedGoogle Scholar
  3. 3.
    Mannerkorpi K, Burckhardt CS, Bjelle A (1994) Physical performance characteristics of women with fibromyalgia. Arthritis Care Res 7:123–129PubMedCrossRefGoogle Scholar
  4. 4.
    Penrod JR, Bernatsky S, Adam V, Baron M, Dayan N, Dobkin PL (2004) Health services costs and their determinants in women with fibromyalgia. J Rheumatol 31:1391–1398PubMedGoogle Scholar
  5. 5.
    Burchardt CS, Bjelle A (1994) Education programmes for fibromyalgia patients: description and evaluation. Baillieres Clin Rheumatol 8:935–956CrossRefGoogle Scholar
  6. 6.
    Bennet RM (1996) Multidisciplinary group programs to treat fibromyalgia patients. Rheum Dis Clin North Am 22:351–367CrossRefGoogle Scholar
  7. 7.
    Sprott H (2003) What can rehabilitation interventions achieve in patients with primary fibromyalgia? Curr Opin Rheumatol 15:145–150PubMedCrossRefGoogle Scholar
  8. 8.
    Valim V, Oliveira L, Suda A, Silva L, de Assis M, Neto T, Feldman D, Natour J (2003) Aerobic fitness effects in fibromyalgia. J Rheumatol 30:1060–1069PubMedGoogle Scholar
  9. 9.
    Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL (2007) Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 17(4):CD003786Google Scholar
  10. 10.
    Assis MR, Silva LE, Alves AM, Pessanha AP, Valim V, Feldman D, Neto TL, Natour J (2006) A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum 55:57–65PubMedCrossRefGoogle Scholar
  11. 11.
    Munguía-Izquierdo D, Legaz-Arrese A (2007) Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol 25:823–830PubMedGoogle Scholar
  12. 12.
    Franke A, Reiner L, Resch KL (2007) Long-term benefit of radon spa therapy in the rehabilitation of rheumatoid arthritis: a randomised, double-blinded trial. Rheumatol Int 27:703–713PubMedCrossRefGoogle Scholar
  13. 13.
    Altan L, Bingol U, Aslan M, Yurtkuran M (2006) The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 35:283–289PubMedCrossRefGoogle Scholar
  14. 14.
    Elkayam O, Ophir J, Brener S, Paran D, Wigler I, Efron D, Even-Paz Z, Politi Y, Yaron M (2000) Immediate and delayed effects of treatment at the Dead Sea in patients with psoriatic arthritis. Rheumatol Int 19:77–82PubMedCrossRefGoogle Scholar
  15. 15.
    Evcik D, Kavuncu V, Yeter A, Yigit I (2007) The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine 74:60–65PubMedCrossRefGoogle Scholar
  16. 16.
    Constant F, Guillemin F, Collin JF, Boulangé M (1998) Use of spa therapy to improve the quality of life of chronic low back pain patients. Med Care 36:1309–1314PubMedCrossRefGoogle Scholar
  17. 17.
    Sukenik S, Baradin R, Codish C, Neumann L, Flusser D, Abu-Shakra M, Buskila D (2001) Balneotherapy at the Dead Sea area for patients with psoriatic arthritis and concomitant fibromyalgia. Isr Med Assoc J 3:147–150PubMedGoogle Scholar
  18. 18.
    Evcik D, Kizilay B, Gökçen E (2002) The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 22:56–59PubMedCrossRefGoogle Scholar
  19. 19.
    Neumann L, Sukenik S, Bolotin A, Abu-Shakara M, Amir M, Flusser D, Buskila D (2001) The effect of balneotherapy at the Dead Sea on the quality of life of patients with fibromyalgia syndrome. Clin Rheumatol 20:15–19PubMedCrossRefGoogle Scholar
  20. 20.
    Ardiç F, Ozgen M, Aybek H, Simin Rota, Çubukçu D, Gökgöz A (2007) Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int 27:441–446PubMedCrossRefGoogle Scholar
  21. 21.
    Ortiz MR (2004) Origenges y fundamentos de la talassoterapia. Revista de la Facultad de Ciencias de la Salud 2:1–12Google Scholar
  22. 22.
    Zijlstra TR, van de Laar MA, Bernelot Moens HJ, Taal E, Zakraoui L, Rasker JJ (2005) Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life. Rheumatology (Oxford) 44:539–546CrossRefGoogle Scholar
  23. 23.
    American College of Sports Medicine Position Stand (1998) The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30:975–991CrossRefGoogle Scholar
  24. 24.
    Fisher AA (1986) Pressure threshold meter: its use for quantification of tender spots. Arch Phys Med Rehabil 67:836–838Google Scholar
  25. 25.
    Marques AP, Santos AMB, Assumpção A, Matsutani LA, Lage LV, Pereira CAB (2006) Validação da Versão Brasileira do Fibromyalgia Impact Questionnaire (FIQ). Rev Bras Reumatol 46:24–31 in PortugueseGoogle Scholar
  26. 26.
    Burckhardt CS, Clark SR, Bennett RM (1991) The Fibromyalgia Impact Questionnaire: development and validation. J Rheumatol 18:728–733PubMedGoogle Scholar
  27. 27.
    Ware JE Jr, 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
  28. 28.
    Ciconelli RM, Ferraz MB, Santos W, Meinao I, Quaresma MR (1999) Brazilian–Portuguese version of the SF-36: a reliable and valid quality of life outcome measure. Rev Bras Rheumatol 39:143–150 in PortugueseGoogle Scholar
  29. 29.
    Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213PubMedCrossRefGoogle Scholar
  30. 30.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedGoogle Scholar
  31. 31.
    Gorenstein C, Andrade L (1996) Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res 29:453–457PubMedGoogle Scholar
  32. 32.
    Fitzcharles M, Esdaile JM (1997) Nonphysician practitioner treatments and fibromyalgia syndrome. J Rheumatol 24:937–940PubMedGoogle Scholar
  33. 33.
    Pioro-Boisset M, Esdaile JM, Fitzcharles MA (1996) Alternative medicine use in fibromyalgia syndrome. Arthritis Care Res 9:13–17PubMedCrossRefGoogle Scholar
  34. 34.
    Gowans SE, de Hueck 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 Rheum 45:519–529PubMedCrossRefGoogle Scholar
  35. 35.
    Mannerkorpi K, Burckhardt CS, Bjelle A (2002) Pool exercise combined with an education program for patients with fibromyalgia syndrome. A prospective randomised study. Scand J Rheumatol 31:306–310PubMedCrossRefGoogle Scholar
  36. 36.
    Jentoft ES, Kvalvik AG, Mengshoel AM (2001) Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain. Arthritis Rheum 45:42–47PubMedCrossRefGoogle Scholar
  37. 37.
    Cedraschi C, Desmeules J, Rapiti E, Baumgartner E, Cohen P, Finckh A, Allaz AF, Vischer TL (2004) Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management. Ann Rheum Dis 63:290–296PubMedCrossRefGoogle Scholar
  38. 38.
    Schmidt KL (1995) Scientific basis of spa treatment in rheumatic diseases. Rheumatol Eur 24:136–140Google Scholar
  39. 39.
    Preisinger E, Quittan M (1994) Thermo- and hydrotherapy. Wien Med Wochenschr 144:520–526PubMedGoogle Scholar
  40. 40.
    Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94:149–158PubMedCrossRefGoogle Scholar
  41. 41.
    Altan L, Bingöl U, Aykaç M, Koç Z, Yurtkuran M (2004) Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int 24:272–277PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Sandra Cristina de Andrade
    • 1
    • 2
  • Ranulfo Fiel Pereira Pessoa de Carvalho
    • 1
  • Aluízio Silvio Soares
    • 1
  • Rodrigo Pegado de Abreu Freitas
    • 1
  • Luís Marcos de Medeiros Guerra
    • 1
  • Maria José Vilar
    • 1
  1. 1.Division of Rheumatology, Department of Clinical Medicine, Postgraduate Program in Health SciencesFederal University of Rio Grande do NorteNatalBrazil
  2. 2.Departamento de FisioterapiaUniversidade PotiguarNatalBrazil

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