Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review.

BACKGROUND: This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being. METHODS: A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes. RESULTS: We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life. CONCLUSION: Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected. REGISTRATION: The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172).

Whole-Body Vibration Training on Oxidative Stress Markers, Irisin Levels, and Body Composition in Women with Fibromyalgia: A Randomized Controlled Trial.

(1) Background: Mitochondrial dysfunction and redox imbalance seem to be involved in fibromyalgia (FM) pathogenesis. The results of our previous studies suggest that whole-body vibration training (WBVT) would improve redox status markers, increase blood irisin levels, and ameliorate the body composition of women with FM. (2) Objective: The current study aimed to investigate WBVT on oxidative stress markers, plasma irisin levels, and body composition in women with FM. (3) Methods: Forty women with FM were randomized into WBVT or untrained (UN) groups. Before and after 6 weeks of WBVT, body composition was assessed by dual-energy radiological absorptiometry (DXA), and inflammatory marker activities were measured by enzymatic assay. (4) Results: Body composition, blood irisin levels, and oxidative stress markers were similar between UN and WBVT groups before the intervention. After 6 weeks of intervention, the WBVT group presented higher irisin levels (WBVT: 316.98 ± 109.24 mg·dL³, WBVT: 477.61 ± 267.92 mg·dL³, p = 0.01) and lower TBARS levels (UN: 0.39 ± 0.02 nmol MDA/mg protein, WBVT: 0.24 ± 0.06 nmol MDA/mg protein, p = 0.001) and visceral adipose tissue mass (UN: 1.37 ± 0.49 kg, WBVT: 0.69 ± 0.54 kg, p = 0.001) compared to the UN group. (5) Conclusions: Six weeks of WBVT improves blood redox status markers, increases irisin levels, and reduces visceral adipose tissue mass, favoring less cell damage and more outstanding oxidative balance in women with FM.

Supervised and Non-Supervised Exercise Programs for the Management of Cancer-Related Fatigue in Women with Breast Cancer: A Systematic Review and Meta-Analysis.

Physical exercise is considered to be a non-pharmacological strategy for reducing symptoms of cancer-related fatigue (CRF) in women with breast cancer (BC). This systematic review and meta-analysis aims to assess the effects of non-supervised exercise programs in comparison with the effects of supervised exercise interventions for CRF in BC patients. Randomized controlled trials that investigated the effect of exercise on CRF in women were searched for until 29 June 2022. Inclusion criteria comprised women diagnosed with BC; exercise-based interventions; trials comparing at least one exercise group vs. a control group; trials that assessed exercise effects on CRF. Thirty-one studies met the inclusion criteria (n = 2964). Both non-supervised and supervised exercise programs significantly reduced CRF (standard mean difference (SMD) = −0.46, confidence interval (CI) = (−0.64, −0.28), p < 0.0001 and SMD = −0.74, CI = (−0.99, −0.48), p < 0.0001, respectively), without statistical difference (p = 0.09). However, a short-term training program subgroup analyses showed significant differences between supervised and non-supervised training programs (p = 0.01), showing that supervised training programs have a greater effect (SMD = −1.33, CI = (−1.92, −0.73), p < 0.0001) than non-supervised ones (SMD = −0.44, CI = (−0.78, −0.11), p = 0.009). Both supervised and non-supervised exercise programs may reduce CRF in BC patients; however, in the short-term, supervised exercise may have a greater effect on CRF in BC patients.

Oxidative Stress Biomarkers and Quality of Life Are Contributing Factors of Muscle Pain and Lean Body Mass in Patients with Fibromyalgia.

(1) The evidence points to an increase in oxygen reactive species as one of the possible causes of fibromyalgia (FM). In addition, it is plausible that an imbalance in redox markers can be associated with pain amplification and dynapenia in FM patients. The aim of our study was to investigate possible factors associated with muscle pain and lean body mass in FM patients. (2) Methods: This was a quantitative, exploratory and cross-sectional study of 47 patients with FM (53.45 + 7.32 years). We evaluated self-perceptions of muscle pain, lean body mass, body composition, quality of life, sleep quality, depression index, muscle performance and oxidative stress biomarkers. (3) Results: We observed that lower blood levels of antioxidants and poor quality of life explained 21% of the greater muscle pain. In addition, high blood levels of oxidative stress, worse muscle performance and poor quality of life explained 27% of the lower lean mass in patients with FM. (4) Conclusions: Larger amounts of lipid peroxidation and reductions in antioxidant levels, in addition to lower muscle performance and poor life quality, are possible independent contributors to greater muscle pain and lower lean body mass in FM patients.

Fibromyalgia in social media: content and quality of the information analysis of videos on the YouTube platform.

To evaluate the fibromyalgia (FM) content in YouTube videos and verify if American College of Rheumatology (ACR) guidelines are being met. The videos were searched with the keyword "Fibromyalgia." Two independent researchers evaluated and coded specific characteristics of the videos. The popularity of the videos, the presentation properties, and content related to FM according to the ACR criteria were analyzed. Of the 200 videos included, the majority were presented by health professionals, 61.5%. Most videos covered more than one subject, 38.5%. The videos presented by health professionals were the most viewed. Following the ACR guidelines, 38% defined FM, 24% described the etiology, 19.5% described the diagnostic criteria and 52% presented recommended management strategies. The results indicate that users mainly watch videos published by health professionals. Most of the published videos do not follow the information recommended by the ACR guidelines. Therefore, videos should be interpreted with caution, not being the most appropriate resource for health education for patients with FM. Most of the videos published on YouTube about FM do not meet the ACR guidelines for FM.

Efficacy of Whole-Body Vibration Training on Brain-Derived Neurotrophic Factor, Clinical and Functional Outcomes, and Quality of Life in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial.

This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels (p=0.045), a higher number of repetitions on the STS test (p=0.011), and increased walking distance on the 6MWT (p=0.010), compared to CG. Moreover, there was a reduction in the scores of the FIQ (p=0.001), the PSQI (p=0.001), the BDI (p=0.017), and pain assessed using VAS (p=0.008) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).

COVID-19 Lockdown and the Behavior Change on Physical Exercise, Pain and Psychological Well-Being: An International Multicentric Study.

OBJECTIVE: To evaluate the impact of the COVID-19 pandemic and the following lockdown on physical exercise (PEx) practice, pain, and psychological well-being. METHODS: A cross-sectional multicentric study was performed using a nonrandom convenience sampling from the general population (≥18 years-old) of 6 countries (Brazil, Italy, France, Portugal, Germany, and Spain) adopting social isolation (SI). The validated self-administered online survey (PEF-COVID19) was used. The tests T-test and Chi-square with Bonferroni correction were used for statistical analysis and a multivariate logistic regression model (p ˂ 0.05). RESULTS: We included 3194 replies and ~80% of the respondents were in SI. Brazilian sample was highly influenced by the pandemic considering PEx practice and habits, pain, anxiety, and stress (p ˂ 0.05). Among the European countries, Italy presented the major changes. The model to predict the non-practice of PEx during SI showed that the variables countries, smoking, SI, and PEx level were significant predictors (p ˂ 0.001). CONCLUSION: The pandemic changed the PEx practice and habits, and the psychological well-being of populations in different manners. Countries, smoking, SI, and PEx level were predictors for the non-practice of PEx. Public health strategies are suggested to avoid sedentary lifestyles and quality of life decrease.

Effectiveness of Exercise on Fatigue and Sleep Quality in Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Trials.

OBJECTIVES: To determine the effects of exercise on fatigue and sleep quality in fibromyalgia (primary aim) and to identify which type of exercise is the most effective in achieving these outcomes (secondary aim). DATA SOURCES: PubMed and Web of Science were searched from inception until October 18, 2018. STUDY SELECTION: Eligible studies contained information on population (fibromyalgia), intervention (exercise), and outcomes (fatigue or sleep). Randomized controlled trials (RCT) testing the effectiveness of exercise compared with usual care and randomized trials (RT) comparing the effectiveness of 2 different exercise interventions were included for the primary and secondary aims of the present review, respectively. Two independent researchers performed the search, screening, and final eligibility of the articles. Of 696 studies identified, 17 RCTs (n=1003) were included for fatigue and 12 RCTs (n=731) for sleep. Furthermore, 21 RTs compared the effectiveness of different exercise interventions (n=1254). DATA EXTRACTION: Two independent researchers extracted the key information from each eligible study. DATA SYNTHESIS: Separate random-effect meta-analyses were performed to examine the effects from RCTs and from RTs (primary and secondary aims). Standardized mean differences (SMD) effect sizes were calculated using Hedges' adjusted g. Effect sizes of 0.2, 0.4, and 0.8 were considered small, moderate, and large. Compared with usual care, exercise had moderate effects on fatigue and a small effect on sleep quality (SMD, -0.47; 95% confidence interval [CI], -0.67 to -0.27; P<.001 and SMD, -0.17; 95% CI, -0.32 to -0.01; P=.04). RTs in which fatigue was the primary outcome were the most beneficial for lowering fatigue. Additionally, meditative exercise programs were the most effective for improving sleep quality. CONCLUSIONS: Exercise is moderately effective for lowering fatigue and has small effects on enhancing sleep quality in fibromyalgia. Meditative exercise programs may be considered for improving sleep quality in fibromyalgia.

Whole-Body Vibration for Individuals with Reconstructed Anterior Cruciate Ligament: A Systematic Review.

BACKGROUND: ACL ruptures are a prevalent condition, affecting daily living activities, associated with high financial burden. OBJECTIVE: To assess the effect of whole-body vibration (WBV) in the rehabilitation of patients with reconstructed anterior cruciate ligament. Methodology. An electronic search in Pubmed, Scopus, Web of Science, and PEDro databases was conducted and randomized controlled trials (RCTs) in humans that analysed the effects of WBV in patients with ACL injury subjected to reconstruction surgery, published in English, Portuguese, Spanish, Italian, or French were included. Records were identified through database search and reference screening by two reviewers, which independently examined titles and abstracts and irrelevant studies were excluded based in eligibility criteria. Relevant full texts were analysed for eligibility, and all relevant studies were included in the systematic review. RESULTS: Ten studies were included in the systematic review with a mean methodological quality score of 6. Results demonstrate positive effects of WBV in relevant outcomes such as knee function, electromyographic activity, balance, and muscle strength. CONCLUSIONS: WBV demonstrated a positive effect in strength, balance, electromyographic activity, and knee function.

Depression symptoms are associated with key health outcomes in women with fibromyalgia: a cross-sectional study.

AIM: To analyze the association between depression severity and other fibromyalgia- (FM) related symptoms such as pain, fatigue, sleep problems, severity of the disease, activity pattern, functional capacity and quality of life. METHOD: The sample included 105 Spanish women with FM. Quality of life was assessed by means of the EQ-5D and symptom severity by the Fibromyalgia Impact Questionnaire. Pain, fatigue and unrestful sleep problems were assessed using 0-10 Visual Analog Scales. Activity patterns were determined by using the International Physical Activity Questionnaire while a battery of standardized field-based functional capacity tests was used to assess cardiorespiratory fitness, muscular strength, flexibility, agility and static and dynamic balance. Depression level was assessed and categorized according to the Beck Depression Inventory. RESULTS: Sixty-two percent of the participants were depressed. Depressed patients exhibited higher pain, fatigue level, sleep problems and severity of the symptoms, reduced levels of lower limb strength and physical activity time and worse quality of life when compared with non-depressed patients (P < 0.05). A negative relationship was found between total minutes of physical activity (P = 0.001) and caloric expenditure (P = 0.026), lower flexibility (P = 0.005), hand grip strength (P = 0.026) and lower limb strength (P < 0.001). A positive relationship was detected between depression and total sitting time (P = 0.018). These results were maintained when correlations were adjusted for body mass index. CONCLUSIONS: Depressed women with FM exhibited higher symptom severity and reported worse physical fitness and quality of life than their non-depressed peers.

The role of daily physical activity and nutritional status on bone turnover in cystic fibrosis: a cross-sectional study.

BACKGROUND: Nutritional status and daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF). OBJECTIVE: To evaluate the relationship between nutritional status, daily physical activity and bone turnover in cystic fibrosis patients. METHOD: A cross-sectional study of adolescent and adult patients diagnosed with clinically stable cystic fibrosis was conducted. Total body, femoral neck, and lumbar spine bone mineral density (BMD) were determined by dual energy X-ray absorptiometry and bone metabolism markers ALP, P1NP, PICP, and ß-CrossLaps. PA monitoring was assessed for 5 consecutive days using a portable device. Exercise capacity was also determined. Serum 25-hydroxyvitamin D and vitamin K were also determined in all participants. RESULTS: Fifty patients (median age: 24.4 years; range: 16-46) were included. BMI had positive correlation with all BMD parameters, with Spearman's coefficients ranging from 0.31 to 0.47. Total hip bone mineral density and femoral neck BMD had positive correlation with the daily time spent on moderate PA (>4.8 metabolic equivalent-minutes/day; r=0.74, p<0.001 and r=0.72 p<0.001 respectively), daily time spent on vigorous PA (>7.2 metabolic equivalent-minutes/day; r=0.45 p<0.001), body mass index (r=0.44, p=0.001), and muscle mass in limbs (r=0.41, p=0.004). Levels of carboxy-terminal propeptide of type 1 collagen were positively associated with the daily time spent on moderate (r=0.33 p=0.023) and vigorous PA (r=0.53, p<0.001). CONCLUSIONS: BMI and the daily time spent on moderate PA were found to be correlated with femoral neck BMD in CF patients. The association between daily PA and biochemical markers of bone formation suggests that the level of daily PA may be linked to bone health in this patient group. Further research is needed to confirm these findings.

The role of daily physical activity and nutritional status on bone turnover in cystic fibrosis: a cross-sectional study

ABSTRACT Background Nutritional status and daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF). Objective To evaluate the relationship between nutritional status, daily physical activity and bone turnover in cystic fibrosis patients. Method A cross-sectional study of adolescent and adult patients diagnosed with clinically stable cystic fibrosis was conducted. Total body, femoral neck, and lumbar spine bone mineral density (BMD) were determined by dual energy X-ray absorptiometry and bone metabolism markers ALP, P1NP, PICP, and ß-CrossLaps. PA monitoring was assessed for 5 consecutive days using a portable device. Exercise capacity was also determined. Serum 25-hydroxyvitamin D and vitamin K were also determined in all participants. Results Fifty patients (median age: 24.4 years; range: 16-46) were included. BMI had positive correlation with all BMD parameters, with Spearman’s coefficients ranging from 0.31 to 0.47. Total hip bone mineral density and femoral neck BMD had positive correlation with the daily time spent on moderate PA (>4.8 metabolic equivalent-minutes/day; r=0.74, p<0.001 and r=0.72 p<0.001 respectively), daily time spent on vigorous PA (>7.2 metabolic equivalent-minutes/day; r=0.45 p<0.001), body mass index (r=0.44, p=0.001), and muscle mass in limbs (r=0.41, p=0.004). Levels of carboxy-terminal propeptide of type 1 collagen were positively associated with the daily time spent on moderate (r=0.33 p=0.023) and vigorous PA (r=0.53, p<0.001). Conclusions BMI and the daily time spent on moderate PA were found to be correlated with femoral neck BMD in CF patients. The association between daily PA and biochemical markers of bone formation suggests that the level of daily PA may be linked to bone health in this patient group. Further research is needed to confirm these findings.

Vagal modulation and symptomatology following a 6-month aerobic exercise program for women with fibromyalgia.

OBJECTIVES: To examine the effects of a supervised aerobic exercise programme on heart rate variability (HRV) parameters and symptom severity in women with fibromyalgia (FM). METHODS: Thirty-two women with FM were randomly allocated to one of two groups: aerobic exercise (AE) or usual care control for 24 weeks. Women allocated to AE performed two aerobic exercise sessions per week of 45-60 min duration including 15-20 min of steady-state aerobic exercise at 60-65% of predicted maximum heart rate (HRmax) and 15 min of interval training at 75-80% HRmax (six repetitions of 1.5 min, with 1 min interpolated rest intervals). Cardiac autonomic modulation was assessed using power spectral analysis of HRV. Symptom severity was assessed by a 10 cm visual analogue scale (VAS) for pain, sleep disturbances, stiffness, anxiety and depression. RESULTS: After 24 weeks, the women in the exercise group showed an increase (4.8 ± 0.2 to 5.2 ± 0.2) in total power (LnTP, p<0.001), low frequency power (LnLF, p<0.01), high frequency power (LnHF, p<0.001), and the root-mean-square of successive R-R intervals (rMSSD, p<0.001). In addition, significant group-by-time interaction effects were observed for LnHF (p=0.036) and LnLF/HF (p=0.014). Improvements in anxiety and depression were also observed in AE versus control patients. CONCLUSIONS: These results show that a programme of aerobic exercise training induced changes in cardiac autonomic nervous system modulation in FM and that these changes in HRV parameters were accompanied by changes in anxiety and depression.

Influência do nível de atividade física sobre a aptidão física e qualidade de vida relacionada à saúde em idosos portadores ou não de diabetes mellitus tipo 2 / Influence of physical activity level on physical fitness and health-related quality of life in elderly with and without type 2 diabetes mellitus / Influencia del nivel de actividades físicas sobre la aptitud física y la calidad de vida, vinculada a la salud, en ancianos portadores o no de diabetes mellitus tipo 2

INTRODUÇÃO: O exercício físico é considerado um dos componentes para melhoria das condições de saúde em diabéticos tipo 2. Além disso, alguns estudos têm sugerido que níveis mais elevados de aptidão física também podem melhorar a qualidade de vida relacionada à saúde (QVRS). No entanto, não existem estudos publicados que sejam especificamente concebidos para examinar esta relação. OBJETIVO: O objetivo do presente estudo foi avaliar o efeito do nível de atividade física sobre a aptidão física e QVRS e determinar se existem diferenças quando indivíduos com e sem diabetes mellitus tipo 2 são comparados. MÉTODO: Cinquenta e quatro participantes com diabetes tipo 2 e 54 participantes pareados por idade sem diabetes foram voluntários para participar deste estudo. A aptidão física (teste de levantar da cadeira de 30 segundos, teste de caminhada de seis minutos e teste de sentar e alcançar) e QVRS (VC-36) foram avaliadas. RESULTADOS: Os participantes com diabetes tipo 2 apresentaram menores escores médios para o teste de sentar e alcançar e uma maior pontuação em relação ao escore do componente mental do que os controles. Quando os dois grupos foram classificados quanto ao nível de atividade física, foram encontradas diferenças significativas em relação a função social, saúde mental, saúde geral e vitalidade, entre os pacientes insuficiente e minimamente ativos. CONCLUSÃO: Os participantes com maiores níveis de prática de atividade física também relataram melhor aptidão física, a qual, juntamente com as melhorias na QVRS, pode ter implicações clínicas na prevenção e tratamento do diabetes mellitus tipo 2.

INTRODUCTION: Physical exercise is considered to improve different health outcomes in type 2 diabetic patients. In addition, a few studies have suggested that higher levels of fitness might also enhance health-related quality of life (HRQoL). However, there are no published studies that were specifically designed to examine this relationship. OBJECTIVE: The aim of the current study was to assess the effect of physical activity level on physical fitness and HRQoL and determine whether differences existed when comparing people with and without type 2 diabetes mellitus. METHODS: Fifty-four participants with type 2 diabetes and 54 age-matched participants without diabetes volunteered to participate in this study. Physical fitness (30-second chair stand test, six-min walk test and sit-and-reach test) and HRQoL (36-item Short Form Health Survey) were assessed. RESULTS: Participants with type 2 diabetes had lower mean scores for sit and reach and higher mental component score than control participants. When both groups were categorized regarding their level of physical activity significant differences were found in relation to social function, mental health, general health and vitality between poorly and minimally active patients. CONCLUSIONS: Participants with the greater levels of physical activity also reported better physical fitness which together with the improvement in HRQoL may have clinical implications in the prevention and treatment of type 2 diabetes mellitus.

INTRODUCCIÓN: Los ejercicios físicos son considerados como siendo uno de los componentes para la mejoría de las condiciones de salud en diabéticos tipo 2. Además de eso, algunos estudios han sugerido que niveles más altos de aptitud física también pueden mejorar la calidad de vida relacionada con la salud (CVRS). No obstante, no hay estudios publicados que hayan sido planeados, específicamente, para examinar esta relación. OBJETIVO: El objetivo de este estudio fue evaluar el efecto del nivel de actividades físicas sobre la aptitud física y la CVRS, y determinar si hay diferencias cuando se comparan individuos con y sin diabetes mellitus tipo 2. MÉTODO: Cincuenta y cuatro participantes, con diabetes tipo 2, y 54 participantes, de edades comparables, sin diabetes, fueron voluntarios a fin de participar en este estudio. La aptitud física (prueba de 30 segundos para levantarse de la silla, prueba de caminata de seis minutos y prueba de sentarse y alcanzar algo) y la CVRS (VC-36) fueron evaluadas. RESULTADOS: Los participantes con diabetes tipo 2 presentaron menores puntuaciones en promedio para la prueba de sentarse y alcanzar algo, y una puntuación más alta en componente mental en comparación con los participantes de control. Cuando los dos grupos fueron clasificados con respecto al nivel de actividades físicas, se encontraron diferencias significativas con referencia a función social, salud mental, salud general y vitalidad, entre los pacientes insuficiente y mínimamente activos. CONCLUSIÓN: Los participantes con niveles más altos de prácticas de actividades físicas también mostraron mejor aptitud física, la cual, conjuntamente con las mejorías en la CVRS, puede tener implicaciones clínicas para la prevención y el tratamiento de la diabetes mellitus tipo 2.

Changes in body balance and functional performance following whole-body vibration training in patients with fibromyalgia syndrome: a randomized controlled trial.

OBJECTIVE: To determine whether an 8-week exercise programme supplemented with whole-body vibration improves body balance and dynamic strength in women with fibromyalgia. DESIGN: Randomized controlled trial. PATIENTS: Forty-six participants diagnosed with fibromyalgia. METHODS: Participants were randomly assigned to: (i) an exercise training group with whole-body vibration (n = 15), which performed twice-weekly exercise sessions (aerobic exercise, strengthening and flexibility) combined with 3 whole-body vibration training sessions a week (bilateral squats: 6-9 sets of 30 s with 45-s recovery between sets; and unilateral squat: 4-7 sets of 30 s, 30 Hz-4 mm); (ii) an exercise group (n = 15) with the same combined exercise therapy; and (iii) a usual-care control group (n = 16). RESULTS: Statistically significant improvements in the Medio-Lateral Stability Index and Medio-Lateral Mean Deflection with open eyes were found in the whole-body vibration exercise group compared with the control group. Non-significant effects were found for lower-limb physical function. CONCLUSION: The results show that a traditional exercise programme, supplemented with whole-body vibration training, improved balance in women with fibromyalgia. This may represent a key factor for falls prevention in this patient group.

Effects of exercise training and detraining in patients with fibromyalgia syndrome: a 3-yr longitudinal study.

OBJECTIVE: This study aimed to evaluate the immediate effects of a 6-mo combined exercise program on quality-of-life, physical function, depression, and aerobic capacity in women with fibromyalgia syndrome and to determine the impact of repeated delivery of the intervention. DESIGN: Forty-one women with fibromyalgia were randomly assigned to a training group (EG; n = 21) and a control group (CG; n = 20). Quality-of-life and physical function were assessed using the 36-item Short-Form Health Survey (SF-36) and the Fibromyalgia Impact Questionnaire, and depression was measured using the Beck Depression Inventory. Physical fitness was measured using the 6-min Walk Test. Outcomes were assessed at baseline and after each 6-mo intervention, which was delivered over 30 mos (6 mos of training and 6 mos of detraining). RESULTS: After a 6-mo combined exercise program, there was a significant improvement in the Fibromyalgia Impact Questionnaire (P < 0.0005) for the training group over the control group. Repeated-measures analysis of variance across all time points demonstrated significant main effects for time for the Fibromyalgia Impact Questionnaire, SF-36, Beck Depression Inventory and the 6-min Walk Test, but there were no between-group interaction effects. For the EG, there were significant within-group changes in the Fibromyalgia Impact Questionnaire, SF-36, and Beck Depression Inventory at the final time point; however, there were no within-group changes for the control group. Improvement achieved for the training group were maintained during the detraining period. CONCLUSIONS: A long-term exercise program can produce immediate improvements in key health domains in women with fibromyalgia. The benefits achieved with regular training can be maintained for 30 mos. The lack of difference between groups over time may be caused by attrition and consequent lack of power at the final time point.

Effect of whole-body vibration exercise on balance in women with fibromyalgia syndrome: a randomized controlled trial.

OBJECTIVES: This study evaluated the effectiveness of a 6-week "usual care" exercise program supplemented with whole-body vibration (WBV) to improve balance and strength in women with fibromyalgia (FM). DESIGN: This was a randomized controlled study. SETTINGS: The setting was a physical therapy department in an academic setting. SUBJECTS: The subjects were 30 postmenopausal women with FM (age: 59±7.90 years). INTERVENTIONS: Subjects were randomized into one of two groups: an experimental group (EG: n=15), which combined exercise training (2 days a week) with 3 days of WBV, and a control group (CG: n=15), who performed the same exercise training program (2 days a week) but without WBV. OUTCOME MEASURES: Balance and muscle strength were measured at baseline and after the 6-week intervention. RESULTS: Significant differences were found (p<0.05) between the study groups for the Medio-Lateral Stability Index (MLSI), when patients were assessed with their eyes open and closed. The effect size of the improvement was large with eyes closed (R2=0.260) and moderate when the eyes were open (R2=0.047). However, no significant differences were found (p>0.05) between the study groups for other outcomes. CONCLUSIONS: Women with FM may increase their MLSI by engaging in a 6-week traditional exercise program with supplementary WBV. This may have implications for falls prevention in this patient group.

Effects of a prolonged exercise program on key health outcomes in women with fibromyalgia: a randomized controlled trial.

OBJECTIVE: To assess the impact of a long-term exercise programme vs usual care on perceived health status, functional capacity and depression in patients with fibromyalgia. DESIGN: Randomized controlled trial. SUBJECTS: Forty-two women with fibromyalgia were allocated randomly to 1 of 2 groups: an experimental group that carried out aerobic, strength and flexibility exercises for 24 weeks and a usual care control group. METHODS: Health status and functional capacity were evaluated using the Fibromyalgia Impact Questionnaire and the Short Form Health Survey 36. Depression was evaluated with the Beck Depression Inventory. RESULTS: Significant improvements were observed in health status and functional capacity for the exercise group over the control group. The magnitude of the effect size of these improvements, expressed as Cohen's d, was medium. The effect size (95% confidence interval) for the Fibromyalgia Impact Questionnaire was 0.58 (-14.12, -2.35), for the Short Form Health Survey 36. global score 0.54 (1.28, 14.52), and in the mental health domain of the Short Form Health Survey 36. 0.51 (1.20, 16.26). There was a large effect size in vitality. All the aforementioned improvements can be considered as clinically important changes. CONCLUSION: Results confirm that a long-term combination of aerobic exercise, strengthening and flexibility improves psychological health status and health-related quality of life in patients with fibromyalgia.

Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial.

OBJECTIVE: To investigate the effects of supervised aerobic exercise (AE) and a combined program of supervised aerobic, muscle strengthening, and flexibility exercises (combined exercise [CE]) on important health outcomes in women with fibromyalgia syndrome (FMS). DESIGN: Randomized controlled trial. SETTING: Community-based supervised intervention. PARTICIPANTS: Women (N=64) with a diagnosis of FMS according to the American College of Rheumatology criteria. INTERVENTION: Participants were randomly allocated to 1 of 3 groups: supervised AE, supervised CE, or usual-care control. Exercise sessions were performed twice weekly (45-60min/session) for 24 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were the 36-Item Short-Form Health Survey, Beck Depression Inventory (BDI), aerobic capacity (6-minute walk test), hand-grip strength, and range of motion in the shoulders and hips. RESULTS: Compliance with both interventions was excellent, with women in the exercise groups attending more than 85% of sessions. A 14% to 15% improvement from baseline in total FIQ score was observed in the exercise groups (P≤.02) and was accompanied by decreases in BDI scores of 8.5 (P<.001) and 6.4 (P<.001) points in the AE and CE groups, respectively. Relative to nonexercising controls, CE evoked improvements in the SF-36 Physical Functioning (P=.003) and Bodily Pain (P=.003) domains and was more effective than AE for evoking improvements in the Vitality (P=.002) and Mental Health (P=.04) domains. Greater improvements also were observed in shoulder/hip range of motion and handgrip strength in the CE group. CONCLUSION: Given the equivalent time commitment required for AE and CE, our results suggest that women with FMS can gain additional health benefits by engaging in a similar volume of CE.