Rheumatology International

, Volume 30, Issue 9, pp 1143–1150

Aerobic exercise in fibromyalgia: a practical review

Review

Abstract

The objective of the study was to determine the current evidence to support guidelines for aerobic exercise (AE) and fibromyalgia (FM) in practice, and to outline specific research needs in these areas. Data sources consisted of a PubMed search, 2007 Cochrane Data Base Systematic review, 2008 Ottawa panel evidence-based clinical practice guidelines, as well as additional references found from the initial search. Study selection included randomized clinical trials that compared an aerobic-only exercise intervention (land or pool based) with an untreated control, a non-exercise intervention or other exercise programs in patients responding to the 1990 American College of Rheumatology criteria for FM. The following outcome data were obtained: pain, tender points, perceived improvement in FM symptoms such as the Fibromyalgia Impact Questionnaire total score (FIQ), physical function, depression (e.g., Beck Depression Inventory, FIQ subscale for depression), fatigue and sleep were extracted from 19 clinical trials that considered the effects of aerobic-only exercise in FM patients. Data synthesis shows that there is moderate evidence of important benefit of aerobic-only exercise in FM on physical function and possibly on tender points and pain. It appears to be sufficient evidence to support the practice of AE as a part of the multidisciplinary management of FM. However, future studies must be more adequately sized, homogeneously assessed, and monitored for adherence, to draw definitive conclusions.

Keywords

Fibromyalgia Aerobic exercise Clinical trials Review article 

References

  1. 1.
    Montoya P, Sitges C, Garcia-Herrera M et al (2006) Reduced brain habituation to somatosensory stimulation in patient with fibromyalgia. Arthritis Rheum 54:1995–2003CrossRefPubMedGoogle Scholar
  2. 2.
    Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172CrossRefPubMedGoogle Scholar
  3. 3.
    McNally JD, Matheson DA, Bakowsky VS (2006) The epidemiology of self-reported fibromyalgia in Canada. Chronic Dis Can 27:9–16PubMedGoogle Scholar
  4. 4.
    Hawley DJ, Wolfe F (1991) Pain, disability, and pain/disability relationships in seven rheumatic disorders: a study of 1522 patients. J Rheumatol 18:1552–1557PubMedGoogle Scholar
  5. 5.
    Carville SF, Arendt-Nielsen S, Bliddal H et al (2008) Eular evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67:536–541CrossRefPubMedGoogle Scholar
  6. 6.
    Staud R, Robinson ME, Price DD (2005) Isometric exercise has opposite effects on central pain mechanisms in fibromyalgia patients compared to normal controls. Pain 118:176–184CrossRefPubMedGoogle Scholar
  7. 7.
    Valkeinen H, Häkkinen A, Alen M, Hannonen P, Kukkonen-Harjula K, Häkkinen K (2008) Physical fitness in postmenopausal women with fibromyalgia. Int J Sports Med 29:408–413CrossRefPubMedGoogle Scholar
  8. 8.
    Jones J, Rutledge DN, Jones KD, Matallana L, Rooks DS (2008) Self-assessed physical function levels of women with fibromyalgia: a national survey. Womens Health Issues 18:406–412CrossRefPubMedGoogle Scholar
  9. 9.
    Etnier JL, Karper WB, Gapin JI, Barella LA, Chang YK, Murphy KJ (2009) Exercise, fibromyalgia and fibrofog: a pilot study. J Phys Act Health 6:239–246PubMedGoogle Scholar
  10. 10.
    Jones KD, Adams D, Winters-Stone K, Burckhardt CS (2006) A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988–2005). Health Qual Life Outcomes 4:67CrossRefPubMedGoogle Scholar
  11. 11.
    Mannerkorpi K (2007) Non-pharmacological treatment of chronic widespread musculoskeletal pain. Best Pract Res Clin Rheumatol 21:513–534CrossRefPubMedGoogle Scholar
  12. 12.
    Van Koulil S, Effting M, Kraaimaat FW et al (2007) Cognitive-behavioural therapies and exercise programmes for patients with fibromyalgia: state of the art and future directions. Ann Rheum Dis 66:571–581CrossRefPubMedGoogle Scholar
  13. 13.
    Gowans SE, deHueck A (2007) Pool exercise for individuals with fibromyalgia. Curr Opin Rheumatol 19:168–173CrossRefPubMedGoogle Scholar
  14. 14.
    Rooks DS (2008) Talking to patients with fibromyalgia about physical activity and exercise. Curr Opin Rheumatol 20:208–212CrossRefPubMedGoogle Scholar
  15. 15.
    Bush AJ, Barber KA, Overend TJ, Peloso PM, Schachter CM (2007) Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 4:CD003786Google Scholar
  16. 16.
    Brosseau L, Wells GA, Tugwell P et al (2008) Ottawa panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: part 1. Phys Ther 88:857–871PubMedGoogle Scholar
  17. 17.
    McCain GA, Bell DA, Mai FM, Halliday PD (1988) A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum 31:1135–1141CrossRefPubMedGoogle Scholar
  18. 18.
    Richards SC, Scott DL (2002) Prescribed exercise in people with fibromyalgia: parallel group randomised controlled trial. BMJ 325:185CrossRefPubMedGoogle Scholar
  19. 19.
    Valim V, Oliveira L, Suda A et al (2003) Aerobic fitness effects in fibromyalgia. J Rheumatol 30:1060–1069PubMedGoogle Scholar
  20. 20.
    Bircan C, Karasel SA, Akgün B, El O, Alper S (2008) Effects of muscle strengthening versus aerobic exercise program in fibromyalgia. Rheumatol Int 28:527–532CrossRefPubMedGoogle Scholar
  21. 21.
    Mengshoel AM, Komnaes HB, Forre O (1992) The effects of 20 weeks of physical fitness training in female patients with fibromyalgia. Clin Exp Rheumatol 10:345–349PubMedGoogle Scholar
  22. 22.
    Wigers SH, Stiles TC, Vogel PA (1996) Effects of aerobic exercise versus stress management treatment in fibromyalgia. A 4.5 year prospective study. Scand J Rheumatol 25:77–86CrossRefPubMedGoogle Scholar
  23. 23.
    Verstappen FTJ, van Santen-Hoeuftt HMS, Bolwijn PH, van der Linden S, Kuipers H (1997) Effects of a group activity program for fibromyalgia patients on physical fitness and well being. J Musculoskelet Pain 5:17–28CrossRefGoogle Scholar
  24. 24.
    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 Rheum 45:519–529CrossRefPubMedGoogle Scholar
  25. 25.
    van Santen M, Bolwijn P, Verstappen F et al (2002) A randomized clinical trial comparing fitness and biofeedback training versus basic treatment in patients with fibromyalgia. J Rheumatol 29:575–581PubMedGoogle Scholar
  26. 26.
    King SJ, Wessel J, Bhambhani Y, Sholter D, Maksymowych W (2002) The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol 29:2620–2627PubMedGoogle Scholar
  27. 27.
    Schachter CL, Busch AJ, Peloso PM, Sheppard MS (2003) Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther 83:340–358PubMedGoogle Scholar
  28. 28.
    Da Costa D, Abrahamowicz M, Lowensteyn I et al (2005) A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia. Rheumatology 44:1422–1427CrossRefPubMedGoogle Scholar
  29. 29.
    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 45:42–47CrossRefPubMedGoogle Scholar
  30. 30.
    Altan L, Bingöl U, Aykaç M, Koç Z, Yurtkuran M (2004) Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int 24:272–277CrossRefPubMedGoogle Scholar
  31. 31.
    Cedraschi C, Desmeules J, Rapiti E et al (2004) Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management. Ann Rheum Dis 63:290–296CrossRefPubMedGoogle Scholar
  32. 32.
    Tomas-Carus P, Häkkinen A, Gusi N, Leal A, Häkkinen K, Ortega-Alonso A (2007) Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc 39:1044–1050CrossRefPubMedGoogle Scholar
  33. 33.
    Tomas-Carus P, Gusi N, Hâkkinen A, Häkkinen K, Leal A, Ortega-Alonso A (2008) Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial. J Rehabil Med 40:248–252CrossRefPubMedGoogle Scholar
  34. 34.
    de Andrade SC, de Carvalho RFPP, Soares AS, de Abreu Freitas RP, de Medeiros Guerra LM, Vilar MJ (2008) Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool. Rheumatol Int 29:147–152CrossRefPubMedGoogle Scholar
  35. 35.
    Van Tulder MW, Furlan A, Bombardier C, Bouter L (2003) Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Spine 28:1290–1299CrossRefPubMedGoogle Scholar
  36. 36.
    Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12CrossRefPubMedGoogle Scholar
  37. 37.
    American College of Sports Medecine (2006) ACSM’s guidelines for exercise testing and prescription, 7th edn. Lippincott, Williams & Wilkins, BaltimoreGoogle Scholar
  38. 38.
    Dobkin PL, Abrahamowicz M, Fitzcharles MA, Dritsa M, Da Costa D (2005) Maintenance of exercise in women with fibromyalgia. Arthritis Rheum 53:724–731CrossRefPubMedGoogle Scholar
  39. 39.
    Munguia-Izquierdo D, Legaz-Arrese A (2008) Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil 89:2250–2257CrossRefPubMedGoogle Scholar
  40. 40.
    Jones K, Hoffman J. Functional fitness. http://www.myalgia.com/exercise

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Lapeyronie HospitalCHRU MontpellierFrance

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