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. 2018 Aug 10:9:1097.
doi: 10.3389/fphys.2018.01097. eCollection 2018.

Prescribed Versus Preferred Intensity Resistance Exercise in Fibromyalgia Pain

Roberta P da Cunha Ribeiro  1 , Tathiane C Franco  2 , Ana J Pinto  2 , Marco A G Pontes Filho  1 , Diogo S Domiciano  1 , Ana L de Sá Pinto  1 , Fernanda R Lima  1 , Hamilton Roschel  1   2 , Bruno Gualano  1   2
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Prescribed Versus Preferred Intensity Resistance Exercise in Fibromyalgia Pain

Roberta P da Cunha Ribeiro et al. Front Physiol. .

Abstract

Exercise is the treatment of choice for fibromyalgia (FM), but little is known about resistance exercise prescription to modulate pain in this condition. This study aimed to compare the effects of different resistance exercise models, comprising self-selected or prescribed intensity, on pain in FM patients. In a cross-over fashion, 32 patients underwent the following sessions: (i) standard prescription (STD; 3 × 10 repetitions at 60% of maximal strength); (ii) self-selected load with fixed number of repetitions (SS); (iii) self-selected load with volume load (i.e., load × sets × repetitions) matched for STD (SS-VM); and (iv) self-selected load with a free number of repetitions until achieving score 7 of rating perceived exertion (SS-RPE). Pain, assessed by Visual Analogic Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ), was evaluated before and 0, 24, 48, 72, and 96 h after the sessions. Load was significantly lower in SS, SS-VM, SS-RPE than in STD, whereas rating perceived exertion and volume load were comparable between sessions. VAS scores increased immediately after all sessions (p < 0.0001), and reduced after 48, 72, 96 h (p < 0.0001), remaining elevated compared to pre-values. SF-MPQ scores increased immediately after all exercise sessions (p = 0.025), then gradually reduced across time, reaching baseline levels at 24 h. No significant differences between sessions were observed. Both prescribed and preferred intensity resistance exercises failed in reducing pain in FM patients. The recommendation that FM patients should exercise at preferred intensities to avoid exacerbated pain, which appears to be valid for aerobic exercise, does not apply to resistance exercise.

Keywords: chronic pain; hyperalgesia; non-pharmacological intervention; physical activity; strength.

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Figures

FIGURE 1
FIGURE 1
Study design. ∗Seven day-interval between each experimental condition. Abbreviations: 1-RM, 1-repetition maximum; RPE, Rating of Perceived Exertion; VAS, Visual Analogic Scale; SF-MPQ, Short-Form McGill Pain Questionnaire; POMS, Profile of Mood States; FS, Feeling Scale.
FIGURE 2
FIGURE 2
Load (A), volume load (B), repetitions (C), and RPE (D) in STD, SS, SS-VM, SS-RPE sessions. Data expressed as mean and standard deviation. ∗p < 0.05 vs. STD; #p < 0.05 in vs. SS-VM.
FIGURE 3
FIGURE 3
VAS scores across time in STD, SS, SS-VM, SS-RPE sessions. Data expressed as mean and standard deviation. ∗p < 0.05 vs. VAS Pre, and #p < 0.05 vs. VAS Post.
FIGURE 4
FIGURE 4
SF-MPQ scores across time in STD, SS, SS-VM, SS-RPE sessions. Data expressed as mean and standard deviation.∗p < 0.05 vs. SF-MPQ Pre, #p < 0.05 vs. SF-MPQ Post, and ∼p < 0.05 vs. SF-MPQ 24.
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