Skip to main content

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

Rheumatology International volume 29, pages 147–152 (2008)Cite this 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, P < 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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  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 33:160–172

    Article  PubMed  CAS  Google Scholar 

  2. Martinez JE, Ferraz MB, Sato EI, Atra E (1995) Fibromyalgia versus rheumatoid arthritis: a longitudinal comparison of the quality of life. J Rheumatol 22:270–274

    PubMed  CAS  Google Scholar 

  3. Mannerkorpi K, Burckhardt CS, Bjelle A (1994) Physical performance characteristics of women with fibromyalgia. Arthritis Care Res 7:123–129

    Article  PubMed  CAS  Google Scholar 

  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 31:1391–1398

    PubMed  Google Scholar 

  5. Burchardt CS, Bjelle A (1994) Education programmes for fibromyalgia patients: description and evaluation. Baillieres Clin Rheumatol 8:935–956

    Article  Google Scholar 

  6. Bennet RM (1996) Multidisciplinary group programs to treat fibromyalgia patients. Rheum Dis Clin North Am 22:351–367

    Article  Google Scholar 

  7. Sprott H (2003) What can rehabilitation interventions achieve in patients with primary fibromyalgia? Curr Opin Rheumatol 15:145–150

    Article  PubMed  Google Scholar 

  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 30:1060–1069

    PubMed  Google Scholar 

  9. Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL (2007) Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 17(4):CD003786

    Google Scholar 

  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 55:57–65

    Article  PubMed  Google Scholar 

  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 25:823–830

    PubMed  Google Scholar 

  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 27:703–713

    Article  PubMed  Google Scholar 

  13. Altan L, Bingol U, Aslan M, Yurtkuran M (2006) The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 35:283–289

    Article  PubMed  CAS  Google Scholar 

  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 19:77–82

    Article  PubMed  CAS  Google Scholar 

  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 74:60–65

    Article  PubMed  Google Scholar 

  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 36:1309–1314

    Article  PubMed  CAS  Google Scholar 

  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 3:147–150

    PubMed  CAS  Google Scholar 

  18. Evcik D, Kizilay B, Gökçen E (2002) The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 22:56–59

    Article  PubMed  Google Scholar 

  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 20:15–19

    Article  PubMed  CAS  Google Scholar 

  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 27:441–446

    Article  PubMed  CAS  Google Scholar 

  21. Ortiz MR (2004) Origenges y fundamentos de la talassoterapia. Revista de la Facultad de Ciencias de la Salud 2:1–12

  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) 44:539–546

    Article  CAS  Google Scholar 

  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 30:975–991

    Article  Google Scholar 

  24. Fisher AA (1986) Pressure threshold meter: its use for quantification of tender spots. Arch Phys Med Rehabil 67:836–838

    Google Scholar 

  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 Portuguese

    Google Scholar 

  26. Burckhardt CS, Clark SR, Bennett RM (1991) The Fibromyalgia Impact Questionnaire: development and validation. J Rheumatol 18:728–733

    PubMed  CAS  Google Scholar 

  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 30:473–483

    Article  PubMed  Google Scholar 

  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 Portuguese

    Google Scholar 

  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 28:193–213

    Article  PubMed  CAS  Google Scholar 

  30. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  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 29:453–457

    PubMed  CAS  Google Scholar 

  32. Fitzcharles M, Esdaile JM (1997) Nonphysician practitioner treatments and fibromyalgia syndrome. J Rheumatol 24:937–940

    PubMed  CAS  Google Scholar 

  33. Pioro-Boisset M, Esdaile JM, Fitzcharles MA (1996) Alternative medicine use in fibromyalgia syndrome. Arthritis Care Res 9:13–17

    Article  PubMed  CAS  Google Scholar 

  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 45:519–529

    Article  PubMed  CAS  Google Scholar 

  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 31:306–310

    Article  PubMed  Google Scholar 

  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 45:42–47

    Article  PubMed  CAS  Google Scholar 

  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 63:290–296

    Article  PubMed  CAS  Google Scholar 

  38. Schmidt KL (1995) Scientific basis of spa treatment in rheumatic diseases. Rheumatol Eur 24:136–140

    Google Scholar 

  39. Preisinger E, Quittan M (1994) Thermo- and hydrotherapy. Wien Med Wochenschr 144:520–526

    PubMed  CAS  Google Scholar 

  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 94:149–158

    Article  PubMed  CAS  Google Scholar 

  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 24:272–277

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Clinical Medicine, Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, RN, Brazil

    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

  2. Departamento de Fisioterapia, Universidade Potiguar, Rua São Cristóvão 3831, Apto 101, Lagoa Nova, Natal, RN, 59056-290, Brazil

    Sandra Cristina de Andrade

Authors
  1. Sandra Cristina de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ranulfo Fiel Pereira Pessoa de Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aluízio Silvio Soares
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rodrigo Pegado de Abreu Freitas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luís Marcos de Medeiros Guerra
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria José Vilar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandra Cristina de Andrade.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

de Andrade, S.C., de Carvalho, R.F.P.P., Soares, A.S. et al. Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool. Rheumatol Int 29, 147–152 (2008). https://doi.org/10.1007/s00296-008-0644-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-008-0644-2

Keywords

  • Fibromyalgia
  • Aerobic exercise
  • Hydrotherapy
  • Thalassotherapy