Fibromyalgia Exercise

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Fibromyalgia exercise has been proven as one of the most effective means of treating fibromyalgia. Among the best fibromyalgia exercise options are aerobic exercise, strength training and water based exercise. Aerobic exercise refers to any activity that utilizes large muscle groups in a continuous and rhythmic manner. On a basic level, aerobic exercise is defined by its ability to keep both heart rate and respiration (breathing) rates elevated for a continuous period of time. Examples of aerobic exercise include running (jogging), swimming, cycling, and walking. In addition, aerobic exercise can be done using various types of fitness equipment, including treadmills, elliptical machines, and stationary bicycles. Obviously, activities such as running, cycling, and brisk walking may present problems for fibromyalgia patients due to the risk of exacerbating preexisting symptoms. Therefore, when determining what type of aerobic exercise to include in a fibromyalgia treatment program, it is important to select an exercise that can be done easily and can be tailored to individual patient characteristics. Above all, patients should be sure to “start low and go slow” (Jones 2011), gradually increasing their intensity and frequency of exercise as their level of fitness improves, and decreasing as needed to adjust to changing symptoms. Examples of “fibro-friendly” aerobic exercises include water-based activities, light to moderate walking, and stationary cycling.

Research Regarding Fibromyalgia Exercise

A recent comprehensive review of studies involving the use of various exercise regimens in fibromyalgia management found that both water-based and land-based aerobic exercises were comparable in their ability to improve aerobic conditions, overall functioning, reduce pain, and improve depression (Cazzola et al., 2010). A similar review also found that both land- and water-based aerobic exercises could effectively improve pain, fatigue, depression, and quality of life, as well as overall physical fitness levels. Furthermore, the researchers recommended that an acceptable aerobic exercise program for fibromyalgia patients should consist of low- to moderate-intensity land- or water-based aerobic exercises, performed two to three times a week for a minimum of four weeks (Hauser et al., 2010). Other reviews have also reached similar conclusions with regard to aerobic exercise (Thomas & Blotman, 2010; Busch et al., 2007). Furthermore, studies have also shown that aerobic exercise programs for fibromyalgia patients may continue to provide symptom relief for up to one year after completion (Gowans et al., 2004). In addition, aerobic exercise programs have also been shown to be useful and well-tolerated among children with fibromyalgia; however, research in this field is limited and requires additional studies to confirm (Stephens et al., 2008).

The specific type of exercise, aerobic or otherwise, that is most effective at improving fibromyalgia symptoms has yet to be determined. A small randomized-controlled trial (considered the “gold-standard” for research study design) investigated the effects of aerobic exercise, as well as aerobic exercise combined with strength and flexibility training, on various health outcomes in female fibromyalgia patients. Those who participated in the aerobic exercise only group performed supervised walking, jogging, and various aerobic dancing moves, whereas those who were assigned to the other group performed the same exercises in addition to various strength training and flexibility training exercises. At the end of the study, the researchers found that those in the aerobic exercise only group experienced improvements in functioning, depression, and various other measurements; however, similar and more significant gains were experienced by those women who also completed strength training and flexibility training. As such, the authors concluded that a combination of aerobic, strength, and flexibility exercises may provide greater overall health benefits to women with fibromyalgia than mere aerobic exercise alone (Sanudo et al., 2010). Other studies have found strength training and aerobic exercise to be equally effective at improving certain symptoms of fibromyalgia, including tender point count, fitness, depression, and quality of life (Bircan et al., 2008). One particular land-based form of aerobic exercise, Nordic walking, has been demonstrated to be safe and effective at improving many symptoms of fibromyalgia (Jones 2011). Nordic walking is a mode of high-intensity outdoor walking that utilizes poles to help an individual walk. Several studies have found that Nordic walking is well-tolerated among women with fibromyalgia, and can help increase physical fitness levels and improve fibromyalgia-related quality of life (Mannerkorpi et al., 2010).

Despite the documented usefulness of exercise as part of a comprehensive fibromyalgia treatment plan, a recent review of the medical records for 122 newly-diagnosed fibromyalgia patients found that only 47% (52 patients) received the recommendation to incorporate exercise into their comprehensive treatment plans. The most frequently recommend method of exercise was water-based, followed by a combination of water-based and aerobic exercises. Among those patients who did not receive the recommendation to adopt an exercise program, only three had a documented condition or injury that would have contraindicated the use of exercise. Although this study was small and limited to patients seen in a single rheumatology clinic, the researchers suggest that their finding point to the increased need for patient education regarding the importance of exercise in treating fibromyalgia (Wilson et al. 2012).

The bottom line relative to Fibromyalgia and exercise, including aerobic exercise, is quite simple. Research almost universally suggests that an effective Fibromyalgia treatment program will feature exercise as a primary component. When you combine the research data relative to obesity  the need to incorporate exercise into a Fibromyalgia treatment regimen is even more clear. If you are fighting Fibromyalgia, you need to be exercising regularly and focusing on improving overall fitness levels.

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References

1.        Wilson B, Spencer H, Kortebein P. Exercise recommendations in patients with newly diagnosed fibromyalgia. PM R. 2012;4(4):252-5.

2.        Jones KD. Nordic walking in fibromyalgia: a means of promoting fitness that is easy for busy clinicians to recommend. Arthritis Res Ther. 2011;13(1):103.

3.        Mannerkorpi K, Nordeman L, Cider A, Jonsson G. Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther. 2010;12:R189.

4.        Cazzola M, Atzeni F, Salaffi F, Stisi S, Cassisi G, Sarzi-Puttini P. Which kind of exercise is best in fibromyalgia therapeutic programmes? A practical review. Clin Exp Rheumatol. 2010;28(6 Suppl 63):S117-124.

5.        Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-1843.

6.        Häuser W, Klose P, Langhorst J, Moradi B, Steinbach M, Schiltenwolf M, Busch A. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2010;12(3):R79.

7.        Thomas EN, Blotman F. Aerobic exercise in fibromyalgia: a practical review. Rheumatol Int. 2010;30(9):1143-5110.

8.        Stephens S, Feldman BM, Bradley N, Schneiderman J, Wright V, Singh-Grewal D, Lefebvre A, Benseler SM, Cameron B, Laxer R, O’Brien C, Schneider R, Silverman E, Spiegel L, Stinson J, Tyrrell PN, Whitney K, Tse SM. Feasibility and effectiveness of an aerobic exercise program in children with fibromyalgia: results of a randomized controlled pilot trial. Arthritis Rheum. 2008;59(10):1399-1406.

9.        Bircan C, Karasel SA, Akgün B, El O, Alper S. Effects of muscle strengthening versus aerobic exercise program in fibromyalgia. Rheumatol Int. 2008;28(6):527-32.

10.     Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev. 2007;(4):CD003786.

Gowans SE, Dehueck A, Voss S, Silaj A, Abbey SE. Six-month and one-year followup of 23 weeks of aerobic exercise for individuals with fibromyalgia. Arthritis Rheum. 2004;51(6):890-898.

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