Clinical Rheumatology

, 30:1455 | Cite as

A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study

Original Article

Abstract

Evidence-based recommendations support the use of multimodal therapy and hydrotherapy for fibromyalgia syndrome; however, there is little standardisation of such programmes. The aim of the study was to assess the effectiveness of a pool-based exercise using deep water running (DWR) as part of a multimodal physiotherapy programme for patients with fibromyalgia syndrome. For a non-randomised clinical study, 44 patients diagnosed with fibromyalgia were recruited from primary care. Patients in the experimental group received a multimodal programme incorporating pool-based exercise using DWR three times a week for an 8-week period. The control group received a leaflet containing advice and continued with normal activities. Patients were evaluated for physical function (Fibromyalgia Impact Questionnaire, FIQ), pain, general health (Short Form-12 Health Survey) and quality of life (European Quality of Life Scale-5D) pre- and post intervention. Statistically significant results were found for the experimental group for FIQ total score, incorporating physical function, pain, fatigue, stiffness and psychological variables (p < 0.05). Statistically significant differences between the experimental group and control were also found for general health (p < 0.05) and quality of life (p < 0.05). The results of this pilot study and the high level of compliance and adherence and low level of attrition suggest that this multimodal programme incorporating DWR is a safe and effective intervention for fibromyalgia syndrome that is acceptable to patients.

Keywords

Aquatic exercise Deep water running Fibromyalgia Multimodal physiotherapy 

Notes

Disclosures

None.

References

  1. 1.
    Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russel AS, Russell IJ, Winfield JB, Yunus MB (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62(5):600–610CrossRefGoogle Scholar
  2. 2.
    Sim J, Adams N (2002) Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia. Clin J Pain 18:324–336PubMedCrossRefGoogle Scholar
  3. 3.
    Burckhardt CS (2006) Multidisciplinary approaches for management of fibromyalgia. Curr Pharm Des 12:59–66PubMedCrossRefGoogle Scholar
  4. 4.
    Van Koulil S, Effting M, Kraaimaat FW, van Lankveld W, van Helmond T, Cats H, van riel PLCM, de Jong AJL, Haverman JF, Evers AWM (2007) Cognitive–behavioural therapies and exercise programmes for patients with fibromyalgia: state of the art and future directions. Ann Rheum Dis 66:571–581PubMedCrossRefGoogle Scholar
  5. 5.
    Häuser W, Bernardy K, Arnold B, Offenbacher M, Schilternwolf M (2009) Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. Arthritis Rheum 61(2):216–224PubMedCrossRefGoogle Scholar
  6. 6.
    Häuser W, Klose P, Langhorst J, Moradi B, Steinbach M, Schilternwolf M, Busch A (2010) Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther 12(3):R79PubMedCrossRefGoogle Scholar
  7. 7.
    Carville SF, Arendt-Nielsen S, Biddal H et al (2008) EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67:536–541PubMedCrossRefGoogle Scholar
  8. 8.
    National Collaborating Centre for Primary Care (2009) Low back pain. Early management of persistent non-specific low back pain. NICE Clinical Guidelines, No. 88. Royal College of General Practitioners (UK), LondonGoogle Scholar
  9. 9.
    McVeigh JG, McGaughey H, Hall M, Kane P (2008) The effectiveness of hydrotherapy in the management of fibromyalgia syndrome. Rheumatol Int 29:119–130PubMedCrossRefGoogle Scholar
  10. 10.
    Langhorst J, Musial F, Klose P, Hauser W (2009) Efficacy of hydrotherapy in fibromyalgia syndrome—a meta-analysis of randomized controlled trials. J Rheumatol 48:1155–1159CrossRefGoogle Scholar
  11. 11.
    van Tulder Mw, Assendelft WB, Koes BW, Bouter LM (1997) Method guidelines for systematic review in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine 22:2323–2330PubMedCrossRefGoogle Scholar
  12. 12.
    Gusi N, Tomar-Carus P, Hakkinen A, Hakkinen K, Ortega-Alonso A (2006) Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum 55:66–73PubMedCrossRefGoogle Scholar
  13. 13.
    Gowans SE, de Hueck A, Voss S, Richardson M (1999) A randomised controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 12:120–128PubMedCrossRefGoogle Scholar
  14. 14.
    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
  15. 15.
    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 Care Res 45:42–47CrossRefGoogle Scholar
  16. 16.
    Mannerkorpi K, Norderman L, Ericsson A, Arndorw M, GAU study group (2009) Pool exercise for patients with fibromyalgia or chronic widespread pain: a randomized controlled trial and subgroup analyses. J Rehabil Med 41:751–760PubMedCrossRefGoogle Scholar
  17. 17.
    Munguia-Izquierdo D, Legas-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 89:2250–2256PubMedCrossRefGoogle Scholar
  18. 18.
    Assis MR, Silva LE, Alves AMB, Pessanha AP, Feldman VVD et al (2006) A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum 55:57–65PubMedCrossRefGoogle Scholar
  19. 19.
    Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL 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
  20. 20.
    Burckhardt CS, Clark SR, Bennett RM (1991) The Fibromyalgia Impact Questionnaire: development and validation. J Rheumatol 18:728–733PubMedGoogle Scholar
  21. 21.
    Vilagut G, Valderas JM, Ferrer M, Garin O, López-García E, Alonso J (2008) Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components. Med Clin 130(19):726–735CrossRefGoogle Scholar
  22. 22.
    Jia H, Lubetkin EI (2008) Estimating. EuroQol EQ-5D scores from Population Healthy Days data. Med Decis Making 28(4):491–499PubMedCrossRefGoogle Scholar
  23. 23.
    World Health Organization (2002). Innovative care for chronic conditions: building blocks for action. WHO, GenevaGoogle Scholar
  24. 24.
    Cuesta-Vargas A, Garcia-Romero JC, Kuisma R (2009) Maximum and resting heart rate in treadmill and deep-water running in male international volleyball players international. IJARE 3:398–405Google Scholar
  25. 25.
    Fernández-Pastor VJ, Pérez F, García JC, Diego AM, Guirado F, Noguer N (1997) Maintenance of the threshold/maximum heart rate quotient in swimmers. Rev Esp Fisiol 53(3):327–334PubMedGoogle Scholar
  26. 26.
    Hammond A, Freeman K (2006) Community patient education and exercise for people with fibromyalgia: a parallel group randomized controlled trial. Clin Rehabil 20:835–846PubMedGoogle Scholar
  27. 27.
    Burckhardt CS, Mannerkorpi K, Hedenberg L, Bjelle A (1994) A randomised controlled trial of education and physical training for women with fibromyalgia. J Rheumatol 21:714–720PubMedGoogle Scholar
  28. 28.
    King DJ, Wessel J, Bhambhami 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
  29. 29.
    Goldenberg DL, Burckhardt C, Crofford L (2004) Management of fibromyalgia syndrome. JAMA 292:2388–2395PubMedCrossRefGoogle Scholar
  30. 30.
    Haskell WL, Lee I, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434PubMedCrossRefGoogle Scholar
  31. 31.
    Altan L, Bingol U, Aykac M, Koc Z, Yurtkuran M (2004) Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int 24:272–277PubMedCrossRefGoogle Scholar
  32. 32.
    Koltyn KF (2000) Analgesia following exercise. A review. Sports Med 29:85–98PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2011

Authors and Affiliations

  1. 1.Department of Physiotherapy, Faculty of Health ScienceUniversity of MalagaMalagaSpain
  2. 2.School of Health, Community and Education StudiesNorthumbria UniversityNewcastle upon TyneUK

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