The Importance of Daily Activity for Reducing Fibromyalgia Symptoms: A Retrospective "Real World" Data Comparison of two Multimodal Treatment Programs

Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVE

Fibromyalgia is a condition characterised by disabling levels of pain of varying intensity. Aerobic exercise may play a role in reducing pain in these patients. The aim of this review is to assess the dose of aerobic exercise needed, based on the frequency, intensity, type, time, volume and progression (FITT-VP) model, to obtain clinically relevant reductions in pain.

DATABASES AND DATA TREATMENT

A systematic review and meta-analysis of randomised clinical trials was conducted in the Web of Science (WoS), PEDro, PubMed and Scopus databases, the search having been conducted between July and October of 2023. Risk of bias was assessed with the Cochrane Risk of Bias assessment tool 2.

RESULTS

Seventeen studies were included. The risk of bias varied, with six studies showing low risk; five, some concerns; and six, high risk. Aerobic exercise interventions were analysed using the FITT-VP model. Frequency ranged from 1 to 10 times per week, intensity varied from light to vigorous, and the types of exercise included music-based exercise, interval training, pool-based exercise, stationary cycling, swimming and walking. The intervention durations ranged from 3 to 24 weeks, with session lengths ranging from 10 to 45 min. Most of the studies presented significant differences, favouring aerobic exercise (MD -0.49; CI [-0.90, -0.08; p = 0.02]), with moderate to low heterogeneity in subgroup analyses.

CONCLUSIONS

The study findings underscore the efficacy of aerobic exercise in alleviating pain among fibromyalgia patients, advocating for tailored exercise dosing to optimise adherence and outcomes.

SIGNIFICANCE STATEMENT

Individuals with fibromyalgia should engage in aerobic exercises two to three times weekly, for twenty-five to forty minutes in each session, aiming for more than a hundred minutes per week. They should start at low intensity, gradually increasing to higher intensities over six to twelve weeks, for optimal pain management. Exercise types should be selected in collaboration with the patient and based on personal preferences and accessibility, such as walking, and swimming, to ensure long-term adherence to the regimen.

Effect of Aerobic Exercises on Lung Function in Women With Fibromyalgia: A Randomized Controlled Trial

BACKGROUND

Aerobic exercises (AEs) have gained much interest in managing fibromyalgia (FM). This trial aimed to find out how AEs affect women with FM in terms of lung function, chest expansion, dyspnea, exercise capacity, and quality of life.

METHODS

Eighty FM-diagnosed women were allocated randomly into 2 equal-sized groups. For 12 weeks, the AEs group did moderate-intensity aerobic cycling and diaphragmatic breathing exercises while the control group did just diaphragmatic breathing exercises. Outcome measures included forced vital capacity, forced expiratory volume in the first second, and total lung capacity for lung function; upper and lower chest expansions; Medical Research Council dyspnea scale for dyspnea; maximal oxygen consumption for exercise capacity; and physical component score and mental component score components of the 12-item Short Form Health Survey for quality of life.

RESULTS

By study completion, all outcomes improved significantly in the AEs and control groups (P < .05). Compared with the group of control, the AEs group revealed more substantial increases in forced vital capacity (9.51% vs 4.95%, P = .04), forced expiratory volume in the first second (8.72% vs 4.54%, P = .03), total lung capacity (11.02% vs 5.39%, P = .001), upper chest expansion (21.22% vs 10.03%, P = .02), lower chest expansion (31.35% vs 11.2%, P = .01), maximal oxygen consumption (55.89% vs 36.94%, P = .03), physical component score (18.8% vs 10.9%, P = .001), and mental component score (25.67% vs 15.26%, P = .02) accompanied with greater declines in Medical Research Council dyspnea scale scores (37.71% vs 19.45%, P = .03).

CONCLUSIONS

In FM women, moderate AEs could improve lung function, chest expansion, dyspnea, exercise capacity, and quality of life.

Whole-Body Cryostimulation in Fibromyalgia: A Scoping Review

Currently, all available therapies for the control and management of fibromyalgia (FM) are mostly focused on relieving patients’ symptoms and improving their quality of life. The purpose of this review is to provide an up-to-date overview of the evidence supporting the beneficial effects of whole-body cryostimulation (WBC) in patients with FM and evidence-based guidance on the possible adjuvant use of WBC in the treatment of FM. We searched the most recent literature by retrieving 10 eligible studies, 4 of which were abstracts only, from a total of 263 records. Thermal stress caused by cryostimulation induces an analgesic effect, improving pain, redox balance, and inflammatory symptoms in an exercise-mimicking fashion. In addition, it reduces the feeling of fatigue, improves mood, and reduces mental health deterioration with positive consequences on depressive states and improved sleep quality. Although the studies included in this review are not of sufficient quality and quantity to draw definitive conclusions about the effectiveness of WBC in FM, initial evidence indicates WBC as a promising add-on option in the multidisciplinary treatment of FM, due to its rapid action and high patients’ compliance. The application of WBC protocols has the potential to expand therapeutic options for the treatment of FM and related disorders; however, larger, high-quality primary studies are still needed.