An exercise program in the treatment of fibromyalgia. Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia: comparison with healthy women Resistance exercise training improves heart rate variability in women with fibromyalgia Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. Effects of T’ai Chi Exercise on Fibromyalgia Symptoms and Health-Related Quality of Life Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review Effectiveness of acupuncture in the treatment of fibromyalgia. Clinically Effective Treatment of Fibromyalgia Pain With High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization. Utilizing exercise to affect the symptomology of fibromyalgia: a pilot study. Feasibility and effectiveness of an aerobic exercise program in children with fibromyalgia: results of a randomized controlled pilot trial. Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia—a randomized controlled trial Meditation awareness training for the treatment of fibromyalgia syndrome: A randomized controlled trial Written pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial. Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial. Effects of resistance training and chiropractic treatment in women with fibromyalgia. Patients with Fibromyalgia Benefit from Aerobic Endurance Exercise Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. A shared decision-making communication training program for physicians treating fibromyalgia patients: effects of a randomized controlled trial. Probiotics for fibromyalgia: study design for a pilot double-blind, randomized controlled trial.
OBJECTIVE To assess the utility of an exercise program , which included aerobic , flexibility and strengthening elements , in the treatment of fibromyalgia ( FM ) . FM is a chronic musculoskeletal condition characterized by diffuse musculoskeletal pain and aching . It has been suggested that aerobic exercise is helpful in its treatment . METHODS We studied 60 patients who met American College of Rheumatology criteria for FM and had no significant comorbidities . Measurements performed on each patient at the pre and post study assessment included the number of tender points ( TP ) , total myalgic scores ( TM ) , aerobic fitness ( AF ) , flexibility and isokinetic strength . After initial evaluation patients were r and omly assigned to either an exercise or a relaxation group . Each group met 3 times per week for 6 weeks for 1 h of supervised exercise or relaxation . All patients data were stored in a computerized data base and statistical analysis was performed on all pre and post study assessment s. RESULTS Thirty-eight patients ( 18 exercise and 20 relaxation ) completed the study . Analysis of our data showed no significant difference between the groups in their pre study assessment . Post study assessment s , however , showed a significant improvement between the exercise and relaxation groups in TP ( p < 0.05 ) , TM ( p < 0.05 ) , and AF ( p < 0.05 ) . Similar improvements were also found when the pre and post study assessment of the exercise group were compared . CONCLUSION Exercise is helpful in the management of FM in the short term . It also shows that FM patients can undertake an exercise program which includes aerobic , flexibility , and strength training exercises without adverse effects . The long term utility of this type of exercise requires further evaluation OBJECTIVE To investigate the effects of 21 weeks ' progressive strength training on neuromuscular function and subjectively perceived symptoms in premenopausal women with fibromyalgia ( FM ) . METHODS Twenty one women with FM were r and omly assigned to experimental ( FMT ) or control ( FMC ) groups . Twelve healthy women served as training controls ( HT ) . The FMT and HT groups carried out progressive strength training twice a week for 21 weeks . The major outcome measures were muscle strength and electromyographic ( EMG ) recordings . Secondary outcome measures were pain , sleep , fatigue , physical function capacity ( Stanford Health Assessment Question naire ) , and mood ( short version of Beck 's depression index ) . RESULTS Female FMT subjects increased their maximal and explosive strength and EMG activity to the same extent as the HT group . Moreover , the progressive strength training showed immediate benefits on subjectively perceived fatigue , depression , and neck pain of training patients with FM . CONCLUSIONS The strength training data indicate comparable trainability of the neuromuscular system of women with FM and healthy women .  Progressive strength training can safely be used in the treatment of FM to decrease the impact of the syndrome on the neuromuscular system , perceived symptoms , and functional capacity . These results confirm the opinion that FM syndrome has a central rather than a peripheral or muscular basis Fibromyalgia ( FM ) is characterized by generalized muscle pain , low muscle strength and autonomic dysfunction . Heart rate ( HR ) variability ( HRV ) is reduced in individuals with FM increasing their risk for cardiovascular morbidity and mortality . We tested the hypothesis that resistance exercise training ( RET ) improves HRV , baroreflex sensitivity ( BRS ) and muscle strength in women with FM . Women with FM ( n = 10 ) and healthy controls ( n = 9 ) , aged 27–60 years , were compared at baseline . Only women with FM underwent supervised RET 2 days per week for 16 weeks . Baseline and post‐training measurements included HRV and spontaneous baroreflex sensitivity ( BRS , alpha index ) from continuous electrocardiogram and blood pressure ( BP ) recorded with finger plethysmography during 5 min in the supine position . RR interval , total power , log transformed ( Ln ) squared root of the st and ard deviation of RR interval ( RMSSD ) , low‐frequency power and BRS were lower ( P<0·05 ) , and HR and pulse pressure were higher ( P<0·05 ) in women with FM than in healthy controls . After RET , mean ( SEM ) total power increased ( 387 ± 170 ms2 , P<0·05 ) , RMSSD increased ( 0·18 ± 0·08 Ln ms , P<0·05 ) and Ln of high‐frequency power increased ( 0·54 ± 0·27 Ln ms2 , P = 0·08 ) in women with FM . Upper and lower body muscle strength increased by 63 % and 49 % ( P<0·001 ) , and pain perception decreased by 39 % in women with FM . There were no changes in BRS , HR and BP after RET . Our study demonstrates that RET  improves total power , cardiac parasympathetic tone , pain perception and muscle strength in women with FM who had autonomic dysfunction before the exercise programme OBJECTIVE To examine the effectiveness of concurrent strength and endurance training on muscle strength , aerobic and functional performance , and symptoms in postmenopausal women with fibromyalgia ( FM ) . DESIGN R and omized controlled trial . SETTING Local gym and university research laboratory . PARTICIPANTS Twenty-six women with FM . INTERVENTION Progressive and supervised 21-week concurrent strength and endurance training . MAIN OUTCOME MEASURES Muscle strength of leg extensors , upper extremities , and trunk ; peak oxygen uptake ( Vo(2)peak ) , maximal workload ( Wmax ) , and work time ; 10-m walking and 10-step stair-climbing time and self-reported functional capacity ( Health Assessment Question naire ) ; and symptoms of FM . RESULTS After concurrent strength and endurance training , the groups differed significantly in Wmax ( P=.001 ) , work time ( P=.001 ) , concentric leg extension force ( P=.043 ) , walking ( P=.001 ) and stair-climbing ( P<.001 ) time , and fatigue ( P=.038 ) . The training led to an increase of 10 % ( P=.004 ) in Wmax and 13 % ( P=.004 ) in work time on the bicycle but no change in Vo(2)peak . CONCLUSIONS Concurrent strength and endurance training in low to moderate volume improves the muscle strength of leg extensors , Wmax , work time , and functional performance as well as perceived symptoms , fatigue in particular . Concurrent strength and endurance training is beneficial to postmenopausal women with FM without adversities , but more extensive studies are needed to confirm the results Osteopathic physicians caring for patients with fibromyalgia syndrome ( FM ) often use osteopathic manipulative treatment ( OMT ) in conjunction with other forms of st and ard medical care . Despite a growing body of evidence on the efficacy of manual therapy for the treatment of selected acute musculoskeletal conditions , the role of OMT in treating patients with chronic conditions such as FM remains largely unknown . Twenty-four female patients meeting American College of Rheumatology criteria for FM were r and omly assigned to one of four treatment groups : ( 1 ) manipulation group , ( 2 ) manipulation and teaching group , ( 3 ) moist heat group , and ( 4 ) control group , which received no additional treatment other than current medication . Participants ' pain perceptions were assessed by use of pain thresholds measured at each of 10 bilateral tender points using a 9-kg dolorimeter , the Chronic Pain Experience Inventory , and the Present Pain Intensity Rating Scale . Patients ' affective response to treatment was assessed using the Self-Evaluation Question naire . Activities of daily living were assessed using the Stanford Arthritis Center Disability and Discomfort Scales : Health Assessment Question naire . Depression was assessed using the Center for Epidemiological Studies Depression Scale . Significant findings between the four treatment groups on measures of pain threshold , perceived pain , attitude toward treatment , activities of daily living , and perceived functional ability were found . All of these findings favored use of OMT . This study found OMT combined with st and ard medical care was more efficacious in treating FM than st and ard care alone . These findings need to be replicated to determine if cost savings are incurred when treatments for FM incorporate nonpharmacologic approaches such as OMT Background Fibromyalgia ( FM ) , one of the most common musculoskeletal disorders , is associated with high levels of impaired health and inadequate or limited symptom relief . The cause of this complex syndrome is unknown , and there is no known cure . Numerous research results indicate that a combination of physical exercise and mind-body therapy is effective in symptom management .  T’ai Chi , an ancient Chinese exercise , combines physical exercise with mind-body therapy . Purpose To investigate the effects of T’ai Chi exercise on FM symptoms and health-related quality of life . Design Pilot study , one group pre-to-post posttest design . Methods Participants with FM ( n = 39 ) formed a single group for 6 weeks of 1-hour , twice weekly T’ai Chi exercise classes .  FM symptoms and health-related quality of life were measured before and after exercise . Findings Twenty-one participants completed at least 10 of the 12 exercise sessions . Although the dropout rate was higher than expected , measurements on both the Fibromyalgia Impact Question naire ( FIQ ) ( Buckhardt , Clark , & Bennett , 1991 ) and the Short Form-36 ( SF-36 ) ( Ware & Sherbourne , 1992 ) revealed statistically significant improvement in symptom management and health-related quality of life . Implication s for Nursing Research Knowledge of interventions to enhance health for the patient with musculoskeletal problems is a National Association of Orthopaedic Nurses priority . T’ai Chi is potentially beneficial to patients with FM . Further research is needed to support evidence -based practice Aim Previous systematic review s have found hydrotherapy to be an effective management strategy for  fibromyalgia syndrome ( FMS ) .  The aim of this systematic review was to summarize the components of hydrotherapy programs used in r and omized controlled trials . Method A systematic review of r and omized controlled trials was conducted . Only trials that have reported significant FMS-related outcomes were included . Data relating to the components of hydrotherapy programs ( exercise type , duration , frequency and intensity , environmental factors , and service delivery ) were analyzed . Results Eleven r and omized controlled trials were included in this review . Overall , the quality of trials was good . Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component . Great variability was noted in both the environmental components of hydrotherapy programs and service delivery . Conclusions Aerobic exercise , warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes . Treatment duration of 60 minutes , frequency of three sessions per week and an intensity equivalent to 60%–80 % maximum heart rate were the most commonly reported exercise components . Exercise appears to be the most important component of an effective hydrotherapy program for FMS , particularly when considering mental health-related outcomes CONTEXT Fibromyalgia syndrome ( FMS ) is a prevalent musculoskeletal disorder associated with pain , mood state alteration , and disability . A structured and effective treatment plan for palliative care has not been established . The genesis of FMS is not clear . FMS occurs primarily in adult women . DESIGN Using a quasi-experimental clinical design and following the criteria of the American College of Rheumatology ( ACR ) , for FMS , 21 participants completed the study . The mean age was 53.6 years . The data were collected at baseline and at 1 and 2 months . Acupuncture treatments included 17 points for FMS symptoms , and 8 outcome measures were collected . RESULTS The Fibromyalgia Impact Question naire ( FIQ ) showed significant differences at 1 and 2 months . For the SF-12 , 3 subscales showed significant differences between baseline and 2 months . Four of 6 items were significantly changed . The mean number of general health symptoms was significantly decreased by 2 months . For the Catastrophe Index , significant differences were found for baseline vs 2 months . Pain threshold scores were significantly different at end of treatment for 5 bilateral tender points . There was significant improvement in Beck Depression items for both 1- and 2-month periods . In a multivariate regression model , 5 covariates were included -- age , number of weeks in treatment , number of doctors treating , number of general symptoms , and baseline FIQ score . The results indicated significant age effect . This analysis showed that the higher the FIQ score , the more positive the change experienced by study participants . Number of weeks in treatment , number of doctors who treated , and total number of general health symptoms did not have a significant effect on outcomes . CONCLUSIONS Significant improvement was experienced by participants at 8 weeks of treatment . Acupuncture treatment as delivered was effective at reducing FMS symptoms in this outcome study UNLABELLED Despite promising preliminary results in treating fibromyalgia ( FM ) pain , no neuromodulation technique has been adopted in clinical practice because of limited efficacy , low response rate , or poor tolerability . This phase II open-label trial aims to define a methodology for a clinical ly effective treatment of pain in FM by establishing treatment protocol s and screening procedures to maximize efficacy and response rate . High-definition transcranial direct current stimulation ( HD-tDCS ) provides targeted subthreshold brain stimulation , combining tolerability with specificity . We aim ed to establish the number of HD-tDCS sessions required to achieve a 50 % FM pain reduction , and to characterize the biometrics of the response , including brain network activation pain scores of contact heat-evoked potentials . We report a clinical ly significant benefit of a 50 % pain reduction in half ( n = 7 ) of the patients ( N = 14 ) , with responders and nonresponders alike benefiting from a cumulative effect of treatment , reflected in significant pain reduction ( P = .035 ) as well as improved quality of life ( P = .001 ) over time . We also report an aggregate 6-week response rate of 50 % of patients and estimate 15 as the median number of HD-tDCS sessions to reach clinical ly meaningful outcomes . The methodology for a pivotal FM neuromodulation clinical trial with individualized treatment is thus supported . ONLINE REGISTRATION Registered in Clinical trials.gov under registry number NCT01842009 . PERSPECTIVE In this article , an optimized protocol for the treatment of fibromyalgia pain with targeted subthreshold brain stimulation using high-definition transcranial direct current stimulation is outlined UNLABELLED Fibromyalgia ( FM ) , a rheumatological disorder of unknown origin , is characterized by both physical and psychological symptoms . Although inconclusive results have been reported for most treatment modalities , exercise appears to have universal support for decreasing the myriad of symptoms associated with FM . Weaknesses in the literature , however , prevent conclusive statements regarding exercise prescription and concomitant impact on FM symptomology . PURPOSE The current pilot study attempted to examine the effect of a 24-wk walking program at predetermined intensities on FM . METHODS Initial design was a r and omized control trial with  high- and low-intensity exercise groups  , and a control group . Subsequent nonr and omized control trials were based on actual exercise behavior . RESULTS No differences between initial groups were identified . By collapsing groups , heart rate ( HR ) decreased ( P < 0.05 ) weeks 0 - 12 . Functional impairments were reduced 54 % weeks 0 - 24 , with exercise having a large impact ( omega2 = 0.30 ) on this decrease . By reassigning groups , impact of FM on current health status decreased in the low-intensity group ( P < 0.05 ) and increased in the high-intensity group ( P < 0.02 ) weeks 0 - 24 . Omega squared indicated strong influence of exercise on pain ( omega2 = 0.51 ) , with greater pain in the high-intensity group . CONCLUSIONS A larger number of subjects and direct supervision of the training program to increase compliance is necessary to clarify the effects of a walking program on the manifestations of FM . Results indicate that intensity of the walking program is an important consideration . Individuals with FM can adhere to low-intensity walking programs two to three times per week , possibly reducing FM impact on daily activities OBJECTIVE To determine the feasibility of conducting a r and omized controlled trial of a 12-week exercise intervention in children with fibromyalgia ( FM ) and to explore the effectiveness of aerobic exercise on physical fitness , function , pain , FM symptoms , and quality of life ( QOL ) . METHODS FM patients ages 8 - 18 years were r and omized to a 12-week exercise intervention of either aerobics or qigong . Both groups participated in 3 weekly training sessions . Program adherence and safety were monitored at each session . Data were collected at 3 testing sessions , 2 prior to and 1 after the intervention , and included FM symptoms , function , pain , QOL , and fitness measures . RESULTS Thirty patients participated in the trial . Twenty-four patients completed the program ; 4 patients dropped out prior to training and 2 dropped out of the aerobics program . Better adherence was reported in the aerobics group than in the qigong group ( 67 % versus 61 % ) . Significant improvements in physical function , functional capacity , QOL , and fatigue were observed in the aerobics group . Anaerobic function , tender point count , pain , and symptom severity improved similarly in both groups . CONCLUSION It is feasible to conduct an exercise intervention trial in children with FM . Children with FM tolerate moderate-intensity exercise without exacerbation of their disease . Significant improvements in physical function , FM symptoms , QOL , and pain were demonstrated in both exercise groups ; the aerobics group performed better in several measures compared with the qigong group . Future studies may need larger sample sizes to confirm clinical improvement and to detect differences in fitness in childhood FM To assess the effects of medicinal plants ( MPs ) or related natural products ( RNPs ) on fibromyalgia ( FM ) patients , we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight r and omized placebo-controlled trials ( RCTs ) involving 475 patients . The method ological quality of all studies included was determined according to JADAD and “ Risk of Bias ” with the criteria in the Cochrane H and book for Systematic Review s of Interventions 5.1.0 . Evidence suggests significant benefits of MP or RNP in sleep disruption , pain , depression , joint stiffness , anxiety , physical function , and quality of life . Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo ; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP , thus suggesting effective alternative therapies in the treatment of pain with minimized side effects Introduction Fibromyalgia ( FM ) is characterized by persistent widespread pain , increased pain sensitivity and tenderness . Muscle strength in women with FM is reduced compared to healthy women . The aim of this study was to examine the effects of a progressive resistance exercise program on muscle strength , health status , and current pain intensity in women with FM . Methods A total of 130 women with FM ( age 22–64 years , symptom duration 0–35 years ) were included in this assessor-blinded r and omized controlled multi-center trial examining the effects of progressive resistance group exercise compared with an active control group . A person-centred model of exercise was used to support the participants ’ self-confidence for management of exercise because of known risks of activity-induced pain in FM . The intervention was performed twice a week for 15 weeks and was supervised by experienced physiotherapists . Primary outcome measure was isometric knee-extension force ( Steve Strong ® ) , secondary outcome measures were health status ( FIQ total score ) , current pain intensity ( VAS ) , 6MWT , isometric elbow-flexion force , h and -grip force , health related quality of life , pain disability , pain acceptance , fear avoidance beliefs , and patient global impression of change ( PGIC ) . Outcomes were assessed at baseline and immediately after the intervention . Long-term follow up comprised the self-reported question naires only and was conducted after 13–18 months . Between-group and within-group differences were calculated using non-parametric statistics . Results Significant improvements were found for isometric knee-extension force ( p = 0.010 ) , health status ( p = 0.038 ) , current pain intensity ( p = 0.033 ) , 6MWT ( p = 0.003 ) , isometric elbow flexion force ( p = 0.02 ) , pain disability ( p = 0.005 ) , and pain acceptance ( p = 0.043 ) in the resistance exercise group ( n = 56 ) when compared to the control group ( n = 49 ) . PGIC differed significantly ( p = 0.001 ) in favor of the resistance exercise group at post-treatment examinations . No significant differences between the resistance exercise group and the active control group were found regarding change in self-reported question naires from baseline to 13–18 months . Conclusions Person-centered progressive resistance exercise was found to be a feasible mode of exercise for women with FM , improving muscle strength , health status , and current pain intensity when assessed immediately after the intervention . Trial registration Clinical Trials.gov identification number : NCT01226784 , Oct 21 , 2010 OBJECTIVES The purpose of this study was to conduct the first r and omized controlled trial ( RCT ) to evaluate the effectiveness of a second-generation mindfulness-based intervention ( SG-MBI ) for treating fibromyalgia syndrome ( FMS ) . Compared to first-generation mindfulness-based interventions , SG-MBIs are more acknowledging of the spiritual aspect of mindfulness . DESIGN A RCT employing intent-to-treat analysis . METHODS Adults with FMS received an 8-week SG-MBI known as meditation awareness training ( MAT ; n = 74 ) or an  active control intervention known as cognitive behaviour theory for groups ( n = 74 ) . Assessment s were performed at pre- , post- , and 6-month follow-up phases . RESULTS Meditation awareness training participants demonstrated significant and sustained improvements over control group participants in FMS symptomatology , pain perception , sleep quality , psychological distress , non-attachment ( to self , symptoms , and environment ) , and civic engagement . A mediation analysis found that ( 1 ) civic engagement partially mediated treatment effects for all outcome variables , ( 2 ) non-attachment partially mediated treatment effects for psychological distress and sleep quality , and ( 3 ) non-attachment almost fully mediated treatment effects for FMS symptomatology and pain perception . Average daily time spent in meditation was found to be a significant predictor of changes in all outcome variables . CONCLUSIONS Meditation awareness training may be a suitable treatment for adults with FMS and appears to ameliorate FMS symptomatology and pain perception by reducing attachment to self . Statement of contribution What is already known on this subject ? Design ing interventions to treat fibromyalgia syndrome ( FMS ) continues to be a challenge . There is growing interest into the applications of mindfulness-based interventions for treating FMS . Second-generation mindfulness-based interventions ( SG-MBIs ) are a key new direction in mindfulness research . What does this study add ? Meditation awareness training - an SG-MBI - result ed in significant reductions in FMS symptomatology . SG-MBIs recognize the spiritual aspect of mindfulness and may have a role in the treatment of FMS Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients . This study aim ed at examining whether written education about pain neuroscience improves illness perceptions , catastrophizing , and health status in patients with fibromyalgia . A double-blind , multicenter r and omized controlled clinical trial with 6-month follow-up was conducted . Patients with FM ( n = 114 ) that consented to participate were r and omly allocated to receive either written pain neuroscience education or written relaxation training . Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties ; the relaxation group received a booklet with relaxation education and a telephone call . The revised illness perception question naire , Pain Catastrophizing Scale , and fibromyalgia impact question naire were used as outcome measures . Both patients and assessors were blinded . Repeated- measures analyses with last observation carried forward principle were performed . Cohen 's d effect sizes ( ES ) were calculated for all within-group changes and between-group differences . The results reveal that written pain neuroscience education does not change the impact of FM on daily life , catastrophizing , or perceived symptoms of patients with FM . Compared with written relaxation training , written pain neuroscience education  improved beliefs in a chronic timeline of FM ( P = 0.03 ; ES = 0.50 ) , but it does not impact upon other domains of illness perceptions . Compared with written relaxation training , written pain neuroscience education slightly improved illness perceptions of patients with FM , but it did not impart clinical ly meaningful effects on pain , catastrophizing , or the impact of FM on daily life . Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM BACKGROUND Exercise therapy is an effective component of fibromyalgia ( FM ) treatment . However , it is important to know the effects and specificities of the different types of exercise : muscle stretching and resistance training . AIM To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients . DESIGN R and omized controlled trial . SETTING Physical therapy service , FM outpatient clinic . POPULATION Forty-four women with FM ( 79 screened ) . METHODS Patients were r and omly allocated into a stretching group ( N.=14 ) , resistance group ( N.=16 ) , and control group ( N.=14 ) . Pain was assessed using the visual analog scale , pain threshold using a Fischer dolorimeter , FM symptoms using the Fibromyalgia Impact Question naire ( FIQ ) , and quality of life using the Medical Outcomes Study 36-item Short-Form Health Survey ( SF-36 ) . The three intervention groups continued with usual medical treatment . In addition , the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks . RESULTS After treatment , the stretching group showed the highest SF-36 physical functioning score ( P=0.01 ) and the lowest bodily pain score ( P=0.01 ) . The resistance group had the lowest FIQ depression score ( P=0.02 ) . The control group had the highest score for FIQ morning tiredness and stiffness , and the lowest score for SF-36 vitality . In clinical analyses , the stretching group had significant improvement in quality of life for all SF-36 domains , and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning , vitality , social function , emotional role , and mental health . CONCLUSIONS Muscle stretching exercise was the most effective modality in improving quality of life , especially with regard to physical functioning and pain , and resistance training was the most effective modality in reducing depression . CLINICAL REHABILITATION IMPACT The trial included a control group and two intervention groups , both of which received exercise programs created specifically for patients with FM . In clinical practice , we suggest including both modalities in an exercise therapy program for FM OBJECTIVE The objective of this study was to evaluate resistance training ( RES ) and RES combined with chiropractic treatment ( RES-C ) on fibromyalgia ( FM ) impact and functionality in women with FM . DESIGN The design of the study was a r and omized control trial . SETTING Testing and training were completed at the university and chiropractic treatment was completed at chiropractic clinics . PARTICIPANTS Participants ( 48 + /- 9 years ; mean + /- st and ard deviation ) were r and omly assigned to RES ( n = 10 ) or RES-C ( n = 11 ) . INTERVENTION Both groups completed 16 weeks of RES consisting of 10 exercises performed two times per week . RES-C received RES plus chiropractic treatment two times per week . OUTCOME MEASURES Strength was assessed using one repetition maximum for the chest press and leg extension . FM impact was measured using the FM impact question naire , myalgic score , and the number of active tender points . Functionality was assessed using the 10-item Continuous Scale Physical Functional Performance test . Analyses of variance with repeated measures compared groups before and after the intervention . RESULTS Six ( 6 ) participants discontinued the study : 5 from  RES  and 1 from RES-C.  Adherence to training was significantly higher in RES-C ( 92.0 + /- 7.5 % ) than in RES ( 82.8 + /- 7.5 % ) . Both groups increased ( p < or = 0.05 ) upper and lower body strength . There were similar improvements in FM impact in both groups . There were no group interactions for the functionality measures . Both groups improved in the strength domains ; however , only RES-C significantly improved in the pre- to postfunctional domains of flexibility , balance and coordination , and endurance . CONCLUSIONS In women with FM , resistance training improves strength , FM impact , and strength domains of functionality . The addition of chiropractic treatment improved adherence and dropout rates to the resistance training and facilitated greater improvements in the domains of functionality Abstract : Fibromyalgia ( FM ) is a disorder characterised by diffuse widespread musculoskeletal aching and stiffness and multiple tender points [ 1 ] . Its pathophysiology is poorly understood . The influence of aerobic endurance exercise on pain in patients with FM was investigated . Twenty-seven patients ( 25 female , 2 male ) participated in a controlled clinical study and performed 12 weeks of jogging , walking , cycling or swimming following a given schedule .  Twelve sedentary FM patients ( 11 female , 1 male ) served as controls . Before and after training both the study and the control groups were evaluated spiroergometrically .  Tender point pain was quantified by dolorimetry . The painful body surface was estimated by a pain body diagram , and its intensity by a visual analogue scale and a ranking scale . Patients trained for an average of 25 min two to three times a week , with an average intensity of 50 % of maximal oxygen uptake ( VO2max ) . Unlike the control group , the training group exhibited a decrease in heart rate and VO2 and an increase in respiratory quotient during submaximal workload . Maximal performance capacity and VO2max remained unchanged , whereas the wattpulse ( watt/heart rate ) improved at maximal workload . Pain parameters remained unchanged in the control group , but in the training group the mean number of positive tender points ( 15.4/12.7 ) , the mean pain threshold of the gluteal tender point ( 2.89 kp/3.50 kp ) and the painful body surface ( 18%/15 % body surface ) decreased significantly . Subjective general pain condition deteriorated in two patients but improved in 17 . Our results suggest a positive effect of aerobic endurance exercise on fitness and well-being in patients with FM OBJECTIVE Fibromyalgia syndrome ( FMS ) is characterized by widespread musculoskeletal pain and lowered pain threshold . Other prominent symptoms include disordered sleep and fatigue . FMS affects an estimated 2 % of the population , predominantly women . This trial was design ed to evaluate the efficacy and safety of pregabalin , a novel alpha(2)-delta lig and , for treatment of symptoms associated with FMS . METHODS This multicenter , double-blind , 8-week , r and omized clinical trial compared the effects of placebo with those of 150 , 300 , and 450 mg/day pregabalin on pain , sleep , fatigue , and health-related quality of life in 529 patients with FMS . The primary outcome variable was the comparison of end point mean pain scores , derived from daily diary ratings of pain intensity , between each of the pregabalin treatment groups and the placebo group . RESULTS Pregabalin at 450 mg/day significantly reduced the average severity of pain in the primary analysis compared with placebo ( -0.93 on a 0 - 10 scale ) ( P < /= 0.001 ) , and significantly more patients in this group had > /=50 % improvement in pain at the end point ( 29 % , versus 13 % in the placebo group ; P = 0.003 ) . Pregabalin at 300 and 450 mg/day was associated with significant improvements in sleep quality , fatigue , and global measures of change .  Pregabalin at 450 mg/day improved several domains of health-related quality of life . Dizziness and somnolence were the most frequent adverse events . Rates of discontinuation due to adverse events were similar across all 4 treatment groups . CONCLUSION Pregabalin at 450 mg/day was efficacious for the treatment of FMS , reducing symptoms of pain , disturbed sleep , and fatigue compared with placebo . Pregabalin was well tolerated and improved global measures and health-related quality of life OBJECTIVE Fibromyalgia syndrome ( FMS ) is a condition of chronic widespread pain that is difficult to control and is associated with strains in physician-patient interaction . Shared decision making ( SDM ) can be a potential solution to improve interaction . We evaluated the effects of an SDM intervention , including an SDM communication training program for physicians , in a r and omized controlled trial with FMS patients . The main objective was to assess whether SDM improves the quality of physician-patient interaction from patients ' perspective . METHODS Patients were r and omized to either an SDM group or an information-only group .  The SDM group was treated by physicians trained in SDM communication and had access to a computer-based information package ; the information-only group received only the information package and was treated by st and ard physicians . All patients were offered the same evidence -based treatment options for FMS . Patients were assessed with question naires on physician-patient interaction ( main outcome criteria ) and decisional processes . Physicians filled out a question naire on interaction difficulties . Assessment took place immediately after the initial consultation . RESULTS Data from 85 FMS patients ( 44 in the SDM group and 41 in the information-only group ) were analyzed . The mean age was 49.9 years ( S.D.=10.2 ) , and 91.8 % of patients were female . The quality of physician-patient interaction was significantly higher in the SDM group than in the information-only group ( P<.001 ) . We found no differences in secondary outcome measures . CONCLUSIONS SDM with FMS patients might be a possible means to achieve a positive quality of physician-patient interaction . A specific SDM communication training program teaches physicians to perform SDM and reduces frustration in patients BACKGROUND Fibromyalgia syndrome ( FMS ) is a chronic , generalized and diffuse pain disorder accompanied by other symptoms such as emotional and cognitive deficits . The FMS patients show a high prevalence of gastrointestinal symptoms . Recently it has been found that microbes in the gut may regulate brain processes through the gut-microbiota-brain axis , modulating thus affection , motivation and higher cognitive functions . Therefore , the use of probiotics might be a new treatment that could improve the physical , psychological and cognitive state in FMS ; however , no evidence about this issue is available . METHODS This paper describes the design and protocol of a double-blind , placebo-controlled and r and omized pilot study . We use vali date d question naires , cognitive task through E-Prime and biological measures like urine cortisol and stool fecal sample s. The trial aim is to explore the effects of eight weeks of probiotics therapy in physical ( pain , impact of the FMS and quality of life ) , emotional ( depression , and anxiety ) and cognitive symptoms ( attention , memory , and impulsivity ) in FMS patients as compared to placebo . CONCLUSION This pilot study is the first , to our knowledge , to evaluate the effects of probiotics in FMS . The primary hypothesis was that FMS patients will show a better performance on cognitive tasks , and an improvement in emotional and physical symptoms . These results will contribute to a better underst and ing in the gut-brain axis . Here we present the design and protocol of the study
Conclusion The main results included reduction in pain , fatigue , number of tender points , depression , and anxiety , with increased functional capacity and quality of life .
Background Fibromyalgia ( FM ) is characterized by chronic and generalized musculoskeletal pain .
There is currently no cure for FM , but palliative treatments are available .
One type of treatment is strength training ( ST ) .
However , there is a need for more information on optimal training protocol s , intensity , and volume needed to improve symptoms .
The aim of this study was to analyze the effects of ST in the treatment of FM through a systematic review of experimental research .