Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial.

BACKGROUND: Exercise therapy is an effective component of fibromyalgia (FM) treatment. However, it is important to know the effects and specificities of the different types of exercise: muscle stretching and resistance training. AIM: To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients. DESIGN: Randomized controlled trial. SETTING: Physical therapy service, FM outpatient clinic. POPULATION: Forty-four women with FM (79 screened). METHODS: Patients were randomly allocated into a stretching group (N.=14), resistance group (N.=16), and control group (N.=14). Pain was assessed using the visual analog scale, pain threshold using a Fischer dolorimeter, FM symptoms using the Fibromyalgia Impact Questionnaire (FIQ), and quality of life using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The three intervention groups continued with usual medical treatment. In addition, the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks. RESULTS: After treatment, the stretching group showed the highest SF-36 physical functioning score (P=0.01) and the lowest bodily pain score (P=0.01). The resistance group had the lowest FIQ depression score (P=0.02). The control group had the highest score for FIQ morning tiredness and stiffness, and the lowest score for SF-36 vitality. In clinical analyses, the stretching group had significant improvement in quality of life for all SF-36 domains, and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning, vitality, social function, emotional role, and mental health. CONCLUSIONS: Muscle stretching exercise was the most effective modality in improving quality of life, especially with regard to physical functioning and pain, and resistance training was the most effective modality in reducing depression. CLINICAL REHABILITATION IMPACT: The trial included a control group and two intervention groups, both of which received exercise programs created specifically for patients with FM. In clinical practice, we suggest including both modalities in an exercise therapy program for FM.

Fibromyalgia: is there association between balance and pain? a pilot study / Fibromialgia: existe associação entre equilíbrio e dor? um estudo piloto / Fibromialgia: ¿hay una asociación entre el equilibrio y el dolor? un estudio piloto

Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group...

O estudo das quedas e déficit de equilíbrio tem privilegiado os idosos e pessoas portadoras de dor musculoesquelética. Apesar de a fibromialgia apresentar fatores intrínsecos que podem estar associados às quedas (dor, depressão, fadiga), poucos tem estudado equilíbrio e quedas nesta síndrome. O objetivo deste estudo foi verificar a associação entre equilíbrio, autoconfiança no equilíbrio e dor em mulheres com e sem fibromialgia e verificar a associação entre as escalas: escala de equilíbrio de Berg e Activities-specific Balance Confidence scale (escala ABC). Participaram do estudo 48 mulheres entre 40-59 anos, sendo 22 com fibromialgia (GF) e 26 assintomáticas que constituíram o grupo controle (GC). O equilíbrio foi avaliado através da "Berg Balance Scale" (escala Berg), a auto confiança no equilíbrio pela "Activities-specific Balance Confidence scale" (escala ABC) e a dor pela Escala Visual Analógica (EVA). A média dos escores para dor, escala de Berg e ABC foram respectivamente 5,4 cm (DP 2,6), 55 (IQ 54-56) e 54.6 (DP 26,6) para o grupo Fibromialgia e zero cm, 56 (IQ 55-56) e 89.4 (DP 14,4) respectivamente para o grupo Controle. Os resultados das escalas de equilíbrio mostraram diferença estatisticamente significativa entre os grupos (p=0,000 para Berg e 0,009 para escala ABC) com valores menores para o grupo Fibromialgia. Houve correlação negativa entre dor e escala de Berg (r=-0,48, p=0,020) e escala ABC (rs=-0,56, p=0,006) no grupo Fibromialgia. Houve correlação entre as escalas somente no GF (rs=0,55, p=0,007). Existe associação entre falta de equilíbrio e dor e entre falta de equilíbrio e auto confiança no equilíbrio em mulheres com fibromialgia. Existe uma associação entre as escalas no grupo Fibromialgia...

El estudio de las caídas y déficit de equilibrio ha privilegiado a los mayores y las personas portadoras de dolor musculoesquelético. Aunque la fibromialgia presente factores intrínsecos que pueden estar asociados con las caídas (el dolor, la depresión, la fatiga), pocos han estudiado el equilibrio y la caída en este síndrome. El objetivo de este estudio fue verificar la asociación entre el equilibriol, la autoconfianza en el equilibrio y el dolor en mujeres con y sin fibromialgia y verificar la asociación entre las escalas: de equilibrio de Berg y la Activities-specific Balance Confidence scale (escala ABC). Participaron del estudio 48 mujeres con edades entre 40-59 años, siendo 22 con fibromialgia (GF) y 26 asintomáticas que constituyeron el grupo de control (GC). Se ha evaluado el equilibrio a través de la "Berg Balance Scale" (escala de Berg), la autoconfianza en el equilibrio por la "Activities-specific Balance Confidence scale (escala ABC)" y el dolor por la Escala Visual Analógica (EVA). El promedio de las puntuaciones de dolor, escala Berg y ABC fueron respectivamente 5.4cm (DE 2.6), 55 (IQ 54-56) y 54.6 (DE 26.6) para el grupo Fibromialgia y cero cm, 56 (IQ 55-56 ) y 89.4 (DE 14.4 ) respectivamente para el grupo de control. Los resultados de las escalas de equilibrio mostraron diferencia estadísticamente significativa entre los grupos (p = 0. 000 para Berg y 0. 009 para la escala ABC) con valores menores para el grupo Fibromialgia. Hubo una correlación negativa entre el dolor y la escala de Berg (rs=-0,48, p=0,020) y la escala ABC (rs=-0,56, p=0,006) en el grupo Fibromialgia. Hubo una correlación entre las escalas sólo en el GF (rs=0.55, p=0,007). Existe una asociación entre la falta de equilibrio y el dolor y entre la falta de equilibrio y autoconfianza en el equilibrio en mujeres con fibromialgia. Existe una asociación entre las escalas del grupo Fibromialgia...