Functional Exercise Training Reduced Pain in People With Fibromyalgia

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Functional exercise training was more effective at reducing pain and improving quality of life than stretching exercises in patients with fibromyalgia (FM).¹

“The aim of functional training is to optimize the skills of an individual regarding the performance of a particular task. Functional exercise protocols have been used to enhance athletic performance and diminish the incidence of injuries, improve functioning in older people regarding the performance of activities of daily living and contribute to the rehabilitation of patients with chronic musculoskeletal diseases. However, the literature offers no studies involving functional exercises for individuals with FM,” lead investigator Giovana Fernandes, Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil, and colleagueswrote.¹

Fernandes and colleagues conducted a study including 82 women with FM randomized into 2 groups, 1 performing functional exercises in 45-minute sessions twice per week for 14 weeks and the second performing stretching exercises with the same duration and frequency. The study measured visual analog scale for widespread pain, Fibromyalgia Impact Questionnaire (FIQ) for health-related quality of life, Timed Up and Go test for functional performance, one-repetition maximum for muscle strength, Sit and Reach test on Wells bench for flexibility, Berg Balance Scale for balance, and SF-36 for general quality of life.

The investigators found that after 14 weeks, the function exercise group had a statistically significant reduction in pain (interaction P = .002), improvement in health-related quality of life as measured by FIQ (interaction P < .001), and improvement in general health state domain of SF-36 (interaction P = .043) compared to the stretching exercise group. The investigators did not find any significant differences in functional capacity, muscle strength, flexibility or balance improvements between the functional exercise and the stretching exercise groups.

“This study showed that the functional exercise training program used was capable of diminishing pain and improving quality of life related to the disease in individuals with FM after seven weeks and these benefits were maintained for up to 12 weeks after the end of the intervention. However, the benefits did not persist for up to 24 weeks after the intervention, which underscores the need to continue the exercises. The reduction in pain through functional exercise training is the most important finding of this study, as pain is the major symptom in FM,” Fernandes and colleagues concluded.¹

Other recent research aimed at reducing FM pain found that digital acceptance and commitment therapy (ACT), a form of cognitive behavioral therapy (CBT), was safe and helped manage FM. in adult patients when compared with digital symptom tracking.²

At 12 weeks, 99 (71%) ACT participants reported improvement on patient global impression of change compared with 30 (22%) active control participants, a 48·4% proportional difference (95% CI, 37·9–58·9; P<.0001). The digital ACT group demonstrated superiority over the active control group on FIQ total score, Patient-Reported Outcomes Measurement Information System (PROMIS) scores, weekly pain intensity, and weekly pain interference.²

REFERENCES
1. Fernandes, G., Nery, M., Meireles, S.M. et al. A functional exercise program improves pain and health related quality of life in patients with fibromyalgia: a randomized controlled trial. Adv Rheumatol 64, 81 (2024). https://doi.org/10.1186/s42358-024-00422-7

2. Gendreau RM, McCracken LM, Williams DA, et al. Self-guided digital behavioural therapy versus active control for fibromyalgia (PROSPER-FM): a phase 3, multicentre, randomised controlled trial. Lancet. 2024; 404(10450): 364-374. doi: 10.1016/S0140-6736(24)00909-7