Exercise and Education for Fibromyalgia
Fibromyalgia is characterized by widespread chronic pain and point tenderness and often is accompanied by fatigue, sleep disturbance, depression, cognitive difficulty and exercise intolerance. Although pregabalin (Lyrica) has recently been approved to treat fibromyalgia, drug therapy is often insufficient for people with the disorder. Read more about Lyrica in Arthritis Today.
What Problem Was Studied?
To determine the most effective nonpharmacologic management techniques to accompany medication therapy, a team of Boston researchers from Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital and Harvard Medical School designed a study to evaluate and compare four common self-management interventions. Daniel S. Rooks, ScD – recipient of an Arthritis Foundation Investigator Award – and team measured functional status, symptom severity and self-efficacy before and after the interventions.
Self-efficacy: The belief that one has the ability to manage a situation. Self-efficacy beliefs determine how people feel, think, motivate themselves and behave.
What Was Done in the Study?
A total of 207 women with fibromyalgia were recruited from physician practices and randomly assigned to one of four groups. Group 1 participated in aerobic and flexibility exercises; group 2 participated in strength training, aerobic and flexibility exercises; group 3 attended the Arthritis Foundation Fibromyalgia Self-Help Course (FSHC); and group 4 attended the FSHC and participated in strength training, aerobic and flexibility exercises. Groups 1 and 2 met twice weekly on different days of the week for their exercise classes. Each session involved approximately 60 minutes of activity, and participants were given instructions to perform a third day of exercise on their own. The FSHC group attended the seven-session program; each session lasted approximately two hours and met every-other week. Participants in group 4 exercised with group 2 and attended the FSHC with group 3.
What Were the Study Results?
Of the 207 women recruited, 135 completed the 16-week intervention period and underwent a follow-up assessment. The group that combined the FSHC and the strength training-aerobic-flexibility exercise class demonstrated the greatest increases in outcome scores. The group that attended only the FSHC showed the least improvement. Both of the structured exercise programs improved physical, emotional and social function, key symptoms and self-efficacy in women with fibromyalgia. When the exercise program was combined with self-management education, the benefits were enhanced.
What Does This Mean for People with Fibromyalgia?
The authors conclude in their article published in the Archives of Internal Medicine, “The present study suggests that progressive walking, simple strength training movements, and stretching activities are effective at improving physical, emotional and social function, key symptoms, and self-efficacy in women with fibromyalgia who are being actively treated with medication. Furthermore, the benefits of exercise are enhanced when combined with targeted self-management education.”
Although the Fibromyalgia Self-Help Course is no longer available, the Arthritis Foundation Self-Help Program offers similar education and empowerment training, and has been proven in studies to be effective. It is a group education program designed to complement the care provided by the participants’ health-care team and allows them to share experiences with others. Trained volunteers, many of whom have arthritis or fibromyalgia, lead the courses. To find a course near you, contact your local Arthritis Foundation chapter.
Rooks DS, Gautam S, Romeling M, et al. Group exercise, education, and combination self-management in women with fibromyalgia: A randomized trial. Arch Intern Med 2007;167:2192-2200.
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