A training program for fibromyalgia management: A 5-year pilot study

Abstract

We studied the effects of a specific cardio training program lasting 5 years on pain and quality of life in fibromyalgia patients.

Method: An observational longitudinal pilot study was conducted in 138 fibromyalgia women. Fibromyalgia women recruited were asked to carry out three sessions per week, each lasting 45 min, of moderate-intensity continuous training (64%-75% Maximal Heart rate [HRmax]). During the first year, the patients progressively increased their training intensity. During the last 2 years, the patients were asked to associate moderate-intensity continuous training and high-intensity interval training (85%-90% HRmax). Pain on a visual analog scale, anxiety and depression state on the Hospital Anxiety and Depression Scale, impact of fibromyalgia on daily life using the Fibromyalgia Impact Questionnaire, heart rate and sleep quality (visual analog scale) were assessed at baseline and each year for 5 years.

Results: Forty-nine patients dropped out in the first year. Depending on their training status, the remaining 89 patients were retrospectively assigned to one of the three groups: Active (moderate-intensity continuous training), Semi-Active (one or two sessions, low-intensity continuous training <60% HRmax) and Passive (non-completion of training), based on their ability to comply with the program. Alleviation of all symptoms (p < 0.0001) was observed in the Active group. Increasing exercise intensity enhanced the effects obtained with moderate-intensity continuous training. Significant change in the Fibromyalgia Impact Questionnaire (p < 0.0001) and depression (Hospital Anxiety and Depression Scale; p < 0.0001), and no significant decrease in pain were noted in the Semi-Active group. No effect of the training was observed in the Passive group.

Conclusion: The study intervention associated with multidisciplinary care alleviated pain, anxiety and depression, and improved both quality of life and quality of sleep, in fibromyalgia patients.

Keywords: Fibromyalgia; autonomic nervous system; pain; physical activity; training sessions.

Figure 1.

Program of cardio training session defined by HR (a) before T3 of the study (warm-up: biking; MICT: elliptical trainer; recovery: treadmill) and (b) after T3 of the study (warm-up: biking; MICT and HIIT: elliptical trainer; recovery: treadmill). HR: heart rate; MICT: moderate-intensity continuous training (64%–75% HRmax); HIIT: high-intensity interval training (15–60 s at 85%–110% HRmax, interspersed by 15–60 s of active recovery).

Figure 2.

Study design LICT: low-intensity continuous training; MICT: moderate-intensity continuous training associated with high-intensity interval training (HIIT) during the last 3 years. Reason for drop out (49): moving out (3), pregnancy (3), discovery of an exclusion factor (4), improvement of symptoms no longer requiring treatment at the pain center (18), lack of availability/time to carry out assessments visits (9), lack of engagement in the proposed study (3) and reason indeterminate (9).

Figure 3.

(a) Pain assessed by a visual analog scale (VAS) and (b) painkiller ladder in Active (AC), Semi-Active (SE) and Passive (PA) groups over 5 years (T0, T1, T2, T3, T4 and T5). Bars are standard error of the mean. *Significant difference (p < 0.05) for intergroup comparison at each time.

Figure 4.

(a) Anxiety and (b) depression (assessed by the HADS) and (c) impact of fibromyalgia on daily function (assessed by the FIQ) in Active (AC), Semi-Active (SE) and Passive (PA) groups over 5 years (T0, T1, T2, T3, T4 and T5). Bars are standard error of the mean. *Significant difference (p < 0.05) for intergroup comparison at each time.

Figure 5.

Sleep quality (assessed by a VAS) in Active (AC), Semi-Active (SE) and Passive (PA) groups over 5 years (T0, T1, T2, T3, T4 and T5). Bars are standard error of the mean. *Significant difference (p < 0.05) for intergroup comparison at each time.

Figure 6.

Resting heart rate (HR) in Active (AC), Semi-Active (SE) and Passive (PA) groups over 5 years (T0, T1, T2, T3, T4 and T5). Bars are standard error of the mean. *Significant difference (p < 0.05) for intergroup comparison at each time.