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Fibromyalgia Exercise Treatment Guide

This document discusses exercises for treating fibromyalgia syndrome. It summarizes the results of a systematic review of 34 randomized controlled trials examining the effects of aerobic, strength, and flexibility exercises on fibromyalgia. The review found moderate evidence that aerobic exercise improves global well-being and physical function, and may help with pain and tender points. Strength training had limited evidence of helping with pain, global well-being, physical function, tender points, and depression. There was insufficient evidence on the effects of flexibility exercises alone. The document recommends aerobic exercise 3 times per week at a moderate intensity for at least 20 minutes.

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584 views21 pages

Fibromyalgia Exercise Treatment Guide

This document discusses exercises for treating fibromyalgia syndrome. It summarizes the results of a systematic review of 34 randomized controlled trials examining the effects of aerobic, strength, and flexibility exercises on fibromyalgia. The review found moderate evidence that aerobic exercise improves global well-being and physical function, and may help with pain and tender points. Strength training had limited evidence of helping with pain, global well-being, physical function, tender points, and depression. There was insufficient evidence on the effects of flexibility exercises alone. The document recommends aerobic exercise 3 times per week at a moderate intensity for at least 20 minutes.

Uploaded by

doomed4eva
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd

EXERCISES FOR

TREATING
FIBROMYALGIA
SYNDROME
Ms. Sweeta Priyadarshini
Physical Therapy Intern
Christian Medical College
 Cochrane Database of Systematic
Reviews 2007

 Busch AJ, Barber KA, Overend TJ, Peloso


PMJ, Schachter CL
 Chronic widespread pain illness
 Muscular Rheumatism/Fibrositis
 2% of the general population
 F:M :: 9:1 (ACR)
 20-50 yrs
ETIOLOGY
 Genetic Predisposition
 Stress-induced
 Sleep disturbance
 Hormonal: reduction in
dopamine/serotonin/HGH
 Co-morbidity
CLASSIFICATION
 Primary
 Secondary: Physical injury, Surgery ,
Hepatitis
FEATURES:
 Pain, fatigue
 Tender points
 Headaches; TMJ/
Facial pain
 Paraesthesias
 Sleep disturbances
 Brain fog/Fibrofog:
cognitive dysfunction
 Depression
OTHER SYMPTOMS:
 Irritable bowel syndrome
 Restless leg syndrome
 Temperature sensitivity
 GI complaints

 Skin Complaints
 Chest Symptoms
 Inco-ordination/
Imbalance
 Dysmenorrhea
Dx – ACR CRITERIA 1990
 Chronic widespread pain for at least 3
months

 Pain in all 4 quadrants of the body; At least


one point in each quadrant

 Pain on digital palpation with a 4-kg force in


11/18 tender points
MANAGEMENT
 Pharmaceutical:
- Analgesics
- Dopamine, serotonin
- Anti-depression, anti-seizure drugs
- Muscle relaxants
- CNS stimulants
 Non-drug Rx:
- Psychological/ behavioural therapy
OBJECTIVE
 Effect of exercise training including
-Cardiorespiratory (aerobic)
-Muscle strengthening,
-and/or Flexibility exercise on:

 Global wellbeing,
 Selected signs and symptoms, and
 Physical function in individuals with FMS
METHOD
 34 RCTs; 2276 subjects(1264)

 Inclusion criteria: ACR

 Exclusion criteria: medical conditions C/I


exs.
PRIMARY OUTCOME MEASURES
1. Pain
2. Global well-being: Fibromyalgia Impact
Questionnaire (FIQ)
3. Physical function:
-Aerobic: 6MWT, Ergometer
-Strength: grip, hip/knee extension strength
-Flexibility: sit and reach test
4.Tender points: Dolorimetry, TP count

 SECONDARY OUTCOMES

5. Depression: Beck Depression Inventory

6. Fatigue and sleep: FIQ fatigue scale and sleep


VAS
ACSM GUIDELINES 2006
AEROBIC TRAINING ×6wks
 F: 3/week
 I: 40% HRR (min-max: 40-85%) or 64%
predicted MHR (min-max: 64-94%)
 T: at least 20 mins duration
 T: use of major muscle groups
 Walking, cycling, swimming
MUSCLE STRENGTHENING
 F: 2-3 days per week
 I: RM of each exercise
 T: min. of 1 set of 8-12 reps
 T: any type of strengthening exercise that
can be progressed over time
 Hip extn/abd/add.; Knee extn./flx.;

Upper limbs
FLEXIBILITY TRAINING
 F: twice a week
 I: to a position of mild discomfort
 T: 3-4 reps for each stretch ×10-30 secs
 T: static stretching, AROM, neck and
extremity stretches
RESULTS
AEROBIC ONLY:
 Positive effect : global well being and
physical function
 Insignificant on: pain, TP
 Conflicting: depression and fatigue

STRENGTH TRAINING:
 Limited evidence
FLEXIBILITY ONLY:
 Limited
 No effect on TP or depression

MIXED:
-inadequate number of studies
IMPLICATIONS FOR PRACTICE
 Moderate quality evidence (aerobic)
- global outcome measures
- physical function
- possibly pain and tender points

 Limited evidence (strength)


-pain, global wellbeing, physical function, TP and
depression

 Insufficient evidence on effects of flexibility exercise

EXERCISES FOR TREATING FIBROMYALGIA SYNDROME Ms. Sweeta Priyadarshini Physical Therapy Intern Christian Medical Colleg
Cochrane Database of Systematic Reviews 2007 Busch AJ, Barber KA, Overend TJ, Peloso PMJ, Schachter CL
Chronic widespread pain illness Muscular Rheumatism/Fibrositis 2% of the general population F:M :: 9:1 (ACR) 20-50 y
ETIOLOGY Genetic Predisposition Stress-induced Sleep disturbance Hormonal: reduction in dopamine/serotonin/HGH Co-m
CLASSIFICATION Primary Secondary: Physical injury, Surgery , Hepatitis
FEATURES: Pain, fatigue Tender points Headaches; TMJ/ Facial pain Paraesthesias Sleep disturbances Brain fog/Fibr
OTHER SYMPTOMS: Irritable bowel syndrome Restless leg syndrome Temperature sensitivity GI complaints Skin Complaint
Dx – ACR CRITERIA 1990 Chronic widespread pain for at least 3 months Pain in all 4 quadrants of the body; At least o
MANAGEMENT Pharmaceutical: - Analgesics - Dopamine, serotonin - Anti-depression, anti-seizure drugs - Muscle relaxants -

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