Aerobic Telerehabilitation Program did not Significantly Improve Disease Activity in Women With Fibromyalgia

A telerehabilitation (TR) program focused on utilizing aerobic exercises did not effectively improve pain intensity, physical function, strength, or quality of life in women with fibromyalgia (FM) at 6 months of follow-up, according to a study published in Biomedicines.¹

“The lockdown and restrictions to prevent the spread of COVID-19 have resulted in negative effects by limiting non-pharmacological conservative treatments in patients with chronic diseases such as FM,” investigators explained. “For this reason, the design of therapeutic interventions without the risk of viral infection has become necessary to improve the functional capacity of and decrease symptoms in patients with FM.”

During a single-blind, randomized clinical trial, conducted between May 2020 and January 2021, adult patients (aged between 30 and 75 years) were randomized 1:1 into the TR group (n = 17) or the control group (n = 17). Those placed in the TR cohort performed 30 exercise sessions over 15 weeks, which were guided by video and adjusted via videocalls. Sessions lasted 50 minutes and included a warm-up, exercise portion, and cool down.

Investigators measured pain intensity, the primary outcome, using the visual analogue scale (VAS). Physical function, isometric strength, quality of life, and fibromyalgia impact were evaluated at baseline and at the 6-month mark. FM impacted was assessed using the Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQ-R), physical function was measured using Timed Up and Go (TUG), an Arm Curl Test (ACT), the 6-Minute Walk Test (6MWT), and the Chair Stand Test (30-s CST). Quality of life was determined using the Spanish version of the Health Assessment Questionnaire (HAQ) and elbow and knee isometric strength was assessed using the Layfayette Instrument model 01165 manual dynamometer.

Demographics and clinical characteristics were similar among both groups. Seven participants dropped out of the study the intervention and follow-up periods.

No statistically significant between-group differences in variables were observed in any outcome at the 6-month follow-up mark (P >0.05) and the effect sizes were small. In the within-group analysis of the TR cohort, a statistically significant decrease in pain intensity and FM impact was observed (P=0.034; d = 0.7 and P= 0.010; d = 0.7, respectively). Further, improvements in physical function and an increase in isometric strength were reported, as well as an improvement in quality of life at the 6-month follow-up (P= 0.015; d = 0.5).

The limitations of the study included the small sample size, which may have hindered the detection of between-group differences for specific variables, inclusion of female participants exclusively, and that investigators did not incorporate an additional intervention to the control group.

“Despite of certain authors concluding a positive effect in terms of the aerobic training, it is necessary to consider several factors, such as the attendance rate and the mean values for symptoms and physical function, that the sample presented at the beginning of the study,” investigators concluded. “The results of this study demonstrate that a TR-based approach on exercise offered a similar therapeutic effect compared to the control group in all outcome measures at 6 months in women with FM.”

Reference:

Hernando-Garijo I, Medrano-de-la-Fuente R, Jiménez-Del-Barrio S, et al. Effects of a Telerehabilitation Program in Women with Fibromyalgia at 6-Month Follow-Up: Secondary Analysis of a Randomized Clinical Trial. Biomedicines. 2022;10(12):3024. Published 2022 Nov 23. doi:10.3390/biomedicines10123024