Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial

Functional training and Mat Pilates have a positive effect on non-motor symptoms improving cognition, depressive symptoms, anxiety, and happiness in people with Parkinson's disease: a randomized controlled clinical trial with follow-up

OBJECTIVES

To analyze the short-term (12-wk post-intervention) and long-term (6-month follow-up) effects of two exercise interventions (functional training or Mat Pilates) compared to a control group and a healthy reference group on non-motor symptoms in people with Parkinson's disease.

METHOD

35 individuals with Parkinson's disease were randomized into three groups: functional training, Mat Pilates, and control group, along with 11 age- and sex-matched healthy individuals for the healthy reference group. The exercise groups received twice-weekly 60-min sessions for 12 wk. The control group and healthy reference group maintained routine activities and also received educational lectures during the 12-wk period. Outcome measures included cognition (MoCA), depressive symptoms (BDI), anxiety (BAI), mood (BRUMS), and aging perspective (Sheppard Inventory).

RESULTS

Short-term effects were observed for the functional training group in the short term for depressive symptoms (p = 0.010) and cognition (p = 0.040), and in the short and long term for anxiety (p = 0.007) and happiness (aging perspective) (p = 0.002). For the Mat Pilates group, effects were observed in cognition (p = 0.048) and confusion (p = 0.049) in the short term, and in depressive symptoms (p < 0.001), anxiety (p = 0.033), happiness (p < 0.001), and loneliness (aging perspective) (p = 0.017) in the short and long term. The control group showed worsening in depressive symptoms (p = 0.030) and confusion (p = 0.033).

CONCLUSION

Mat Pilates and functional training classes were effective in improving cognition, depressive symptoms, anxiety, and happiness. The control group and healthy reference group did not show significant effects in most studied variables. Both types of exercise can be recommended by professionals working with people with Parkinson's disease.

REGISTRATION

ReBEC - RBR-6ckggn.

The glamor of and insights regarding hydrotherapy, from simple immersion to advanced computer-assisted exercises: A narrative review

Water-based therapy has been gaining attention in recent years and is being widely used in clinical settings. Hydrotherapy is the most important area of water-based therapy, and it has distinct advantages and characteristics compared to conventional land-based exercises. Several new techniques and pieces of equipment are currently emerging with advances in computer technologies. However, comprehensive reviews of hydrotherapy are insufficient. Hence, this study reviewed the status quo, mechanisms, adverse events and contraindications, and future prospects of the use of hydrotherapy. This study aims to comprehensively review the latest information regarding the application of hydrotherapy to musculoskeletal diseases, neurological diseases, and COVID-19. We have attempted to provide a "take-home message" regarding the clinical applications and mechanisms of hydrotherapy based on the latest evidence available.

Effect of Pilates on Pain and Health-Related Quality of Life in Fibromyalgia Patients: A Systematic Review and Meta-Analysis

Background: Pilates is one of the non-pharmacological interventions for fibromyalgia (FM). However, its impacts on pain and health-related quality of life (HRQOL) in fibromyalgia patients (FMPs) are inconclusive. This study aimed to assess the effects of Pilates on pain and HRQOL among FMPs. Methods: A systematic review and meta-analysis were conducted. Four databases-PubMed, ScienceDirect, Scopus, and Cochrane CENTRAL-along with one grey literature source, Google Scholar, were searched for randomized controlled trials comparing Pilates with other exercises or usual care in FMPs. The outcomes were pain and HRQOL. A meta-analysis was performed using a random-effects model. Results: Six studies were included (n = 265). We found that the effects of Pilates from each individual study on pain were inconsistent. Our pooled analysis of visual analog scale (VAS) scores demonstrated significant pain reduction (mean difference (MD), -0.71, 95%CI, -1.33 to -0.10, p = 0.023; (I2 = 29.3%, p = 0.226)). However, neither the algometric score (AS) nor tender point count (TPC) showed an insignificant difference (AS: MD, -0.43, 95%CI, -2.60 to 1.74, p = 0.700; (I2 = 0.0%, p = 0.654); TPC: MD, -0.16, 95%CI, -2.22 to 1.89, p = 0.520; (I2 = 0.0%, p = 0.515)). Regarding HRQOL, Pilates showed statistically significant improvements on the Fibromyalgia Impact Questionnaire (FIQ) (MD, -7.28, 95%CI, (-12.06 to -2.49), p = 0.003; (I2 = 95.7%, p < 0.001)). A sensitivity analysis of three RCTs (n = 176) based on the ACR 2010 supported this finding (MD, -7.68, 95% CI, -8.60 to -6.76, p < 0.001; (I2 = 0.0%, p = 0.832)) with non-important heterogeneity. Conclusions: Pilates may benefit FMPs. It could reduce pain and improve HRQOL. Given the small number of studies and the presence of data heterogeneity, future high-quality RCTs would provide a clearer conclusion.

Mental effects of physical activity in patients with fibromyalgia: A narrative review

INTRODUCTION

Fibromyalgia (FM) is a multifaceted disease that is often associated with neuropsychiatric disorders and is burdened by a high degree of psychological distress. Non-pharmacological interventions, including physical exercise and complementary therapies, have shown satisfactory results for either physical or psychological FM symptoms.

METHODS

In this narrative review, we analyzed scientific evidence of moderate to high quality regarding the psychological and neurocognitive effects of physical therapies for FM. A total of 29 studies were selected after searching the PubMed and Google Scholar databases using the combination of terms « fibromyalgia», «psychological distress», «fibrofog», mental disorder», «aerobic exercise», «strength exercise», «Pilates», «Tai chi» and «Yoga».

RESULTS

Aerobic exercise can improve depression, anxiety, stress, mental function and mood, thanks to the remodulation of neurotransmitters and hormones. Strength training, on the other hand, has been shown to alleviate mental confusion, anger and depression. Finally, mind-body disciplines appear to be effective for depression, anxiety, catastrophizing, memory and coping strategies. Based on these findings, we devised an ideal exercise program that could relieve the psychological distress of FM patients, thus interrupting the pathogenic neuroendocrine circuits that lead to the exacerbation of pain and other FM-related symptoms.

CONCLUSIONS

Thanks to neuroendocrine remodulation, physical exercise may simultaneously improve the physical and mental health of FM patients. This narrative review collects current evidence on the effects of specific physical interventions on psychological and neurocognitive domains of FM patients and additionally provides an evidence-based training program that could be prescribed to FM patients with high psychological distress or neuropsychiatric symptoms.

Effects of Electro-Muscle Stimulation Exercise Combined with Mat Pilates on Pain, Anxiety, and Strength in Sedentary Females with Fibromyalgia: A Single-Blind Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Fibromyalgia syndrome (FM) is a chronic pain disorder that is ranked as one of the four most common rheumatological diseases in the world. This study aims to investigate the effects of an eight-week mat Pilates and electro-muscle stimulation (EMS) with combined mat Pilates exercises on pain, depression, anxiety, and strength in sedentary women.

METHODS

This study is a single-blind randomized controlled trial. A total of 30 sedentary female patients (Pilates (n = 15), EMS (n = 15)) diagnosed with FM were included in the study. The patients were subjected to Beck Depression (BDIs) and Anxiety Inventories (BAIs); a Fibromyalgia Impact Questionnaire (FIQ); five different Single-Leg Hop Tests (SLHTs); modified push-up (MPU), Handgrip Strength (HGS), Deep Squat (DSQ), V-Sit Flexor, bent-arm hang (BA), sit-up and Biering-Sørensen tests; and anthropometric tests before and after the 8-week exercise program.

RESULTS

The eight weeks of mat Pilates exercises combined with mat Pilates and EMS revealed significant results (p < 0.05) in anthropometric data (abdomen, lower abdomen, hips) (p < 0.05) except for the results of chest circumference measurements (p > 0.05). In addition, there were statistically significant positive results in BDIs, BAIs, FIQs, lower extremity (all SLHTs and DSQ), upper extremity (MPU, HGS, BA), and core (V-SIT, sit-up, Biering-Sørensen test) strength test findings (p < 0.05).

CONCLUSIONS

Combining the mat Pilates exercises with EMS is an effective and reliable method to improve the pain, anxiety, depression, and strength of female patients diagnosed with FM.

Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial

OBJECTIVE

To determine the efficacy of two physiotherapeutic interventions - aquatic therapy (AT) and land-based therapy (LBT) - for reducing pain in women with fibromyalgia.

DESIGN

Single-blind, randomised controlled, equivalence trial.

SETTING

Fibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Association in A Coruña, Spain.

PARTICIPANTS

Forty women with fibromyalgia were assigned at random in a 1:1 manner to two groups: AT (n = 20) and LBT (n = 20).

INTERVENTIONS

Two therapeutic exercise programmes, with 60-min sessions, were undertaken three times per week for 12 weeks. Sessions were carried out in groups by a trained physiotherapist.

OUTCOME

The primary outcome was pain intensity (visual analogue scale). The secondary outcomes were pressure pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory) and physical ability (6-Minute Walk Test). Patients were evaluated at baseline, 12 weeks (post-treatment) and 18 weeks (follow-up). The statistical analysis was per-protocol. P < 0.05 was considered to indicate significance. Effect size was calculated.

RESULTS

The mean age was 50 [standard deviation (SD) 9] years, with median body mass index of 27 [interquartile range (IQR) 25-30] kg/m2 and median symptom duration of 11 (IQR 6-15) years. No differences were observed between the groups post-treatment, but differences in favour of AT were found in pain intensity [2.7 (IQR 1.5-4.9) vs 5.5 (IQR 3.3-7.6); p= 0.023; large effect, Cohen's d= 0.8; 95% confidence interval (CI) 0.1-1.5] and sleep quality [12.0 (IQR 7.3-15.3) vs 15.0 (IQR 13.0-17.0); p= 0.030; large effect, Cohen's d= 0.8; 95% CI 0.1-1.5] at follow-up.

CONCLUSIONS

The results suggest that AT is better than LBT for reducing pain intensity and improving sleep quality after 6 weeks of follow-up. AT may be a good treatment option for women with fibromyalgia.

CLINICAL TRIALS REGISTRATION NUMBER

ClinicalTrials.gov NCT02695875 CONTRIBUTION OF THE PAPER.

Aquatic therapy improves self-reported sleep quality in fibromyalgia patients: a systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis aimed to evaluate the effectiveness of aquatic therapy on pain, sleep quality, psychological symptoms, quality of life, and health status in people diagnosed with fibromyalgia.

METHODS

We searched PubMed, CINAHL, The Cochrane Library, PEDro and Scopus databases. Articles were eligible if they were randomised controlled trials (RCTs) analysing the effects of aquatic therapy in adult people diagnosed with fibromyalgia, and published by October of 2022 in English or Spanish. The Cochrane Risk of Bias tool was employed to conduct the methodological quality assessment of the encompassed studies, and the overall quality of evidence for each comparison was determined using the GRADE approach.

RESULTS

Of 375 articles found, 22 met the inclusion criteria. Forest plot analysis of Pittsburgh sleep quality index at short- and mid-term follow-up showed a trend in favour of aquatic therapy, although not statistically significant, with weighted mean difference (WMD) = -1.71 (95% CI: -4.17 to -0.75, p = 0.17). Heterogeneity was substantial (χ2 = 8.74, df = 5 (p < 0.000001; I2 = 95%). Relating the pain outcome by fibromyalgia impact questionnaire (FIQ) short term showed a trend in favour of the aquatic therapy group with WMD = -5.04 (95% CI: - 9.26 to - 0.82, p =  = 0.02) with heterogeneity χ2 = 11.07, df = 4 (p = 0.03; I2 = 64%). Great heterogeneity was found between trials in medium term.

CONCLUSION

This systematic review and meta-analysis demonstrated the effectiveness of aquatic therapy as an adjunct treatment to usual care in people suffering from fibromyalgia. Aquatic therapeutic exercise improves the symptomats of sleep quality, pain, and quality of life of adults with fibromyalgia. Further research on long-term outcomes may contribute to the currently available evidence.

Effects of aquatic physical therapy on clinical symptoms, physical function, and quality of life in patients with fibromyalgia: A systematic review and meta-analysis

INTRODUCTION

The main feature of fibromyalgia syndrome is extensive musculoskeletal pain and tenderness. It not only has a significant impact on patients but also brings a huge burden to families and society. Exercise is considered to be the most important part of the fibromyalgia treatment, and aquatic physical therapy can be considered one of the most recommended interventions. Therefore, the effects of aquatic physical therapy on fibromyalgia patients were discussed in this article.

OBJECTIVE

The purpose of this study was to evaluate the effects of aquatic physical therapy on clinical symptoms, physical function, and quality of life in patients with fibromyalgia.

METHODS

Eight databases were retrieved. "Fibromyalgia," "Aquatic Therapy," "Aquatic Exercise," and "Hydrotherapy" was used for retrieval. Randomized controlled trials of the effects of aquatic physical therapy on patients with fibromyalgia were included. The Cochrane risk of bias tool to assess research quality. Meta-analysis was performed by Revman version 5.3.

RESULTS

Finally, 14 articles (762 patients) were included in the analysis. Compared with other exercises or no exercise, aquatic physical therapy has more significant effects. There were significant differences in visual analogue scale (MD: - 0.98, 95%CI: - 1.36 to - 0.60, Z = 5.03, P < .00001), six minute walk test (MD: 38.12, 95%CI: 13.65 to 62.59, Z = 3.05, P = .002), fibromyalgia impact questionnaire total scores(MD: - 7.35, 95%CI: - 13.05 to - 1.65, Z = 2.53, P = .01), vitality of short form 36 (MD: 9.53, 95%CI: 0.62 to 18.43, Z = 2.10, P = .04) and general health of short form 36 (MD: 10.39, 95%CI: 1.42 to 19.36, Z = 2.27, P = .02).

CONCLUSIONS

Aquatic physical therapy may have some benefits on the clinical symptoms, physical function, and quality of life of patients with fibromyalgia.

Effects of a telerehabilitation-based exercise program in patients with systemic sclerosis

BACKGROUND

This study aimed to evaluate the effect of telerehabilitation-based exercise programs in systemic sclerosis (SSc) patients.

METHODS

Forty-six SSc patients were randomly separated into two groups as telerehabilitation and control. Videos comprising clinical Pilates-based exercises were designed and uploaded to YouTube™ for the telerehabilitation group by physiotherapists. A video interview was conducted with the SSc patients once a week and an exercise program was performed twice daily for 8 weeks in the telerehabilitation group. The same exercise programs were printed on paper brochures and patients were instructed on their application in the form of a home exercise program to be continued for 8 weeks in the control group. Pain, fatigue, quality of life, sleep, physical activity, anxiety, and depression were assessed in all patients at the beginning and end of the study.

RESULTS

The clinical and demographic characteristics were similar in both groups (p > 0.05). Fatigue, pain, anxiety, and depression decreased in both groups, while quality of life and sleep quality increased after the exercise program (p < 0.05). However, the improvements in the telerehabilitation group were statistically more significant than in the control group for all studied parameters (p < 0.05).

CONCLUSION

The results of our study demonstrate the superior efficacy of telerehabilitation-based treatment programs over home exercise programs, hence, we suggest widespread use of this innovative treatment program in SSc patients.

Mechanisms hypothesized for pain-relieving effects of exercise in fibromyalgia: a scoping review

Background

Exercise is one of the most recommended management strategies by treatment guidelines for fibromyalgia (FM); however, the mechanism through which exercise improves pain in FM is still unknown.

Objective

We aimed to summarize the hypothesized theoretical mechanisms for the pain-relieving effects of exercise in people with FM.

Eligibility Criteria

Randomized controlled trials (RCTs) in English reporting mechanisms for pain-relieving effects of exercise in the 'Introduction' and 'Discussion' sections and significant within- group or between-group effects of exercise interventions were included.

Sources of Evidence

We searched the databases Ovid MEDLINE(R), EMBASE, CINAHL, COCHRANE, Sports Discuss, and AMED with the keywords: exercise and fibromyalgia until December 2021.

Charting Methods

Two authors independently performed title/abstract, full-text review, and data abstraction using a data abstraction form. The hypothesized mechanisms from individual studies were grouped into three categories.

Results

The literature search resulted in 2147 studies, out of which 220 studies were considered for full-text review. A total of 50 RCTs proposing 29 unique mechanisms for the pain-relieving effects of exercise were included. These mechanisms were divided into three categories: physical, neuro-physiological, and psychological. The neuro-physiological category was further subdivided into exercise-induced hypoalgesia (EIH), pain sensitization, the autonomic system, the immune system, the endocrine system, and miscellaneous categories. The most frequently hypothesized mechanisms were EIH (n = 15), autonomic modulation (n = 7), improved sleep (n = 6), muscle oxygenation (n = 6), self-efficacy (n = 5), mental health (n = 4), and benefits of the aquatic environment (n = 12). While all exercise interventions involved FM patients, most of the supporting evidence for these mechanisms was cited from previous studies conducted on healthy samples. No studies performed analyses to demonstrate causal associations between the mechanisms and outcomes.

Conclusion

Multiple mechanisms were hypothesized for the positive influence of exercise in people with FM. Future studies using causal analyses, such as mediation analysis, are recommended to validate these mechanisms.

The effectiveness of aerobic exercise for pain management in patients with fibromyalgia

The effectiveness of exercise therapy is being increasingly studied in patients with fibromyalgia. The aim of our systematic review was to determine the effectiveness of different types of aerobic exercise programs for pain management in patients with fibromyalgia. The literature search was performed by two independent researchers in the PubMed, CINAHL and PEDro databases using various combinations of the following keywords: fibromyalgia, pain and aerobic exercise. Studies were eligible if they included adults diagnosed with fibromyalgia and examined the effectiveness of at least one aerobic exercise program on pain management. A total of 14 randomized controlled trials were screened in full-text, nine of which were included in the systematic review. Overall, our results indicate that aerobic exercise is effective for pain management in patients with fibromyalgia. The results of the aerobic exercise programs were more effective for pain management than stretching exercises, but did not differ significantly from those of pilates, muscle strengthening exercises, relaxation techniques and stress management treatment. Additional high-quality studies are warranted to determine accurate clinical guidelines in terms of aerobic exercise programs for pain management in patients with fibromyalgia.

Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome

A wide variety of musculoskeletal, arthritic, connective tissue, and vasculitic diseases fall under the umbrella of "rheumatic diseases". Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the three members of this disease group with relatively high prevalence. Pharmacological options are at the center of therapeutic algorithms in treating rheumatic diseases, particularly in reducing inflammation. Despite significant advances in pharmacological treatment in recent years, achieving complete treatment success in a group of patients is impossible. Therefore, patients with rheumatic diseases frequently utilize alternative treatment options, such as complementary and alternative medicine. Complementary and alternative medicine is a broad category of health practices not part of the leading health system. Patients with rheumatic diseases turn to complementary and alternative medicine for various reasons, including restricted access to some treatments due to high prices and rigorous regulations, worries about drug side effects, and symptoms that continue despite pharmacological treatment. In addition, because complementary and alternative medicine options are considered natural, they are frequently accepted as well tolerated and have few harmful effects. Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the primary foci of this comprehensive review. First, we attempted to summarize the non-traditional physical medicine and complementary and alternative medicine options that can be utilized to manage these diseases. Second, we addressed the link between exercise and inflammation in rheumatic diseases. We briefly discussed the possible benefits of exercise-based approaches. In addition, we highlighted the benefits of cooperation between rheumatology and physical medicine-rehabilitation clinics.

Effectiveness of aquatic therapy on sleep in persons with fibromyalgia. A meta-analysis

CONTEXT

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by persistent, widespread pain, myofascial tenderness, negative affect, fatigue, memory problems and sleep disturbances.

OBJECTIVE

To summarize the evidence of the effects of aquatic therapy on sleep quality in patients with FMS.

METHODS

This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2020 (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), whit the registration number CRD42021249982. Cochrane library, Medline (PubMed), Science Direct Web of Science (WOS), Scopus, and PEDro were searched from inception until September 2021. The search included only randomized clinical trials.

RESULTS

Of the 7711 studies identified in the initial search, a total of 7 trials (361 participants) satisfied the eligibility criteria. Finally, a meta-analysis was conducted with 6 studies (311 participants). The overall pooled effect favored aquatic therapy interventions in improving sleep quality in patients with FMS (pooled MD, -2.05; 95% CI, -4.35 to 0.25).

CONCLUSIONS

The results of this systematic review and meta-analysis provide evidence that aquatic therapy improved sleep quality in patients with FMS. This study highlights the importance of aquatic therapy for sleep. Nonetheless, although an aquatic therapy intervention may represent a good option to improve sleep, given the low number of studies the evidence should be taken with caution.

Is Pilates more effective and cost-effective than aerobic exercise in the treatment of patients with fibromyalgia syndrome? A randomized controlled trial with economic evaluation

BACKGROUND

The aim of this study was to assess the effectiveness and cost-effectiveness of Pilates versus aerobic exercises in the treatment of patients with fibromyalgia syndrome from a societal perspective.

METHODS

This two-arm randomized controlled trial with blinded assessor and economic evaluation included 98 patients diagnosed with fibromyalgia syndrome using the American College of Rheumatology 2010 criteria, aged between 20 and 75 years, and pain intensity ≥3 points in the Pain Numerical Rating Scale. Patients were randomly allocated into the aerobic or Pilates group. Treatment was performed twice a week for 8 weeks. The primary outcome was the impact of fibromyalgia measured 8 weeks after randomization. Cost-effectiveness and cost-utility analyses were conducted for the impact of fibromyalgia and quality-adjusted life-years (QALYs), respectively, with a 12-month time horizon.

RESULTS

There was no difference between the groups for the impact of fibromyalgia (MD: 6.5 points; 95% CI: -1.8 to 14.9). The incremental cost-effectiveness ratio showed that 1-point increase in the impact of fibromyalgia was on average associated with a societal cost of £56 for the Pilates group compared to the aerobic group. The cost-utility analysis showed that the Pilates group had a 0.71 probability of being cost-effective at a willingness-to-pay of £30,000 per QALY gained.

CONCLUSION

There was no significant difference between groups for the impact of fibromyalgia. Pilates was not cost-effective compared to aerobic exercises for the impact of fibromyalgia. However, Pilates seemed to be the preferred option of treatment considering QALYs, although it depends on the willingness-to-pay threshold.

SIGNIFICANCE

Pilates showed to be a safe and effective alternative for the treatment of patients with fibromyalgia syndrome. Pilates presented similar results for the impact of fibromyalgia and superior results for pain relief compared to aerobic exercises, a highly recommended intervention for the treatment of fibromyalgia syndrome. Pilates was not cost-effective compared to aerobic exercises for the impact of fibromyalgia. However, Pilates seemed to be a cost-effective intervention for QALYs, depending on the decision-maker's willingness-to-pay threshold.

Effect of Exercise Interventions on Health-Related Quality of Life in Patients with Fibromyalgia Syndrome: A Systematic Review and Network Meta-Analysis

OBJECTIVE

Several guidelines highlight the beneficial impact of exercise on the management of symptoms and health-related quality of life (HRQOL) in patients with fibromyalgia syndrome (FMS). However, few analyses have compared different types of exercise. We, therefore, intent to compare the effects of different exercise types on improving the overall HRQOL and typical symptoms in patients with FMS.

METHODS

Medline, Embase, the Cochrane Register of Clinical Trials, and NIH ClinicalTrials.gov were searched from inception to April 21, 2022. Randomized clinical trials (RCTs) were included to assess the impact of exercise intervention on health parameters in adult FMS patients. Data were extracted independently and a frequentist network meta-analyses (NMA) was performed to rank the effects of interventions according to P-scores. The NMA evidence certainty was assessed using the method recommended by Grading of Recommendations Assessment, Development, and Evaluation Working Group.

RESULTS

A total of 57 RCTs were identified, including 3319 participants, involving 9 interventions (7 types of exercise, 2 controls). Of all treatments compared with usual care in efficacy outcomes, Mind-body exercise was associated with the best HRQOL (SMD, -12.12; 95% CI, -15.79 to -8.45). On the other characteristic symptom dimensions, based on moderate quality evidence, sensorimotor training was associated with minimal pain scores compared with usual care (SMD, -1.81; 95% CI, -2.81 to -0.82), whole body vibration therapy was most promising for improving sleep quality (SMD, -6.95; 95% CI, -10.03 to -3.87), pool-based aerobic exercise was most likely to ease anxiety (SMD, -4.83; 95% CI, -7.47 to -2.19), and whole body vibration was most likely to improve depression (SMD, -10.44; 95% CI, -22.00 to 1.12).

CONCLUSION

Mind-body exercise seems to be the most effective exercise to improve the overall HRQOL of patients with FMS. But at the same time, clinicians still need to develop individualized exercise plans for patients according to their symptoms and accessibility.

The role of physiotherapy in fibromyalgia: Current and future perspectives

Fibromyalgia is a chronic pain condition characterized by generalized musculoskeletal pain, hyperalgesia and allodynia, commonly associated with other symptoms such as fatigue, poor sleep quality, anxiety and depression. The clinical manifestations of this rheumatic disease have significant psychosocial and economic repercussions, with a substantial impact on health status, quality of life and social activities. Currently, recommendations for the management of fibromyalgia include patient education and non-pharmacological interventions, and among the indicated treatments, clinical guidelines include several physiotherapeutic resources, essential for individuals affected by this syndrome. Research in the physiotherapy field has demonstrated its effectiveness, but there is a need to update the literature. This study aims to identify the effectiveness of physiotherapy in the treatment of individuals with fibromyalgia. We performed a literature review looking for articles dated from March 2012 to March 2022 using the terms “fibromyalgia”, “physiotherapy”, “physical therapy”, “rehabilitation” in different languages in various databases and their main information was read and collected and presented in a descriptive way. The effects of physiotherapy interventions are summarized in order to provide a reference for future research and clinical application. Research on non-pharmacological physiotherapy-oriented treatments has grown in recent years as an alternative for fibromyalgia treatment. This review allows fibromyalgia patients to receive appropriate physical therapy interventions to promote their health.

The use of Pilates for pain control in patients with fibromyalgia

Abstract Introduction: Although the Pilates method is commonly used to treat fibromyalgia (FM) in clinical practice, research is scarce, and little is known about its real effectiveness in pain management. Objective: Systematically review the literature to determine whether Pilates affects pain control in FM patients. Methods: The PubMed, Science Direct, PEDro and Cochrane databases were searched to identify randomized controlled trials that investigated the effects of Pilates in individuals diagnosed with FM. The descriptors used were: “pilates based exercise” OR “pilates training” OR “pilates exercise” OR “pilates” AND “fibromyalgia.” Independent reviewers performed abstract/full-text screening, data extraction, and methodological quality assessments using the PEDro scale. Results: The search identified 646 potential articles, four of which were used in the analysis. The Pilates method had positive effects on pain control, physical function, quality of life and biopsychosocial factors such as stress and depression in individuals with FM in four studies. However, improvement in these parameters did not differ between intervention groups in three studies. Additionally, the control group showed no significant improvement for the same parameters in one study. The PEDro scale scores of the studies ranged from 6 to 8 points. Conclusion: Evidence suggests that Pilates influences pain control in individuals with FM, and is more effective than no intervention or minimal intervention in the treatment of FM.

Intervention Therapies to Reduce Pain-Related Fear in Fibromyalgia Syndrome: A Systematic Review of Randomized Clinical Trials

OBJECTIVE

This systematic review aimed to evaluate the effectiveness of different interventions at reducing pain-related fear in people with fibromyalgia and to analyze whether the included trials reported their interventions in full detail.

DESIGN

Systematic review.

SETTING

No restrictions.

METHODS

The Cochrane Library, CINAHL, EMBASE, PsycINFO, PubMed, and Scopus were searched from their inception to April 2020, along with manual searches and a gray literature search. Randomized clinical trials were included if they assessed pain-related fear constructs as the primary or secondary outcome in adults with fibromyalgia. Two reviewers independently performed the study selection, data extraction, risk-of-bias assessment, Template for Intervention Description and Replication (TIDieR) checklist assessment, and grading the quality of evidence.

RESULTS

Twelve randomized clinical trials satisfied the eligibility criteria, including 11 cohorts with a total sample of 1,441 participants. Exercise, multicomponent, and psychological interventions were more effective than controls were in reducing kinesiophobia. However, there were no differences in decreasing kinesiophobia when self-management and electrotherapy were used. There were also no differences between groups with regard to the rest of the interventions and pain-related constructs (fear-avoidance beliefs, fear of pain, and pain-related anxiety). However, a serious risk of bias and a very serious risk of imprecision were detected across the included trials. This caused the overall certainty of the judged evidence to be low and very low. Additionally, the included trials reported insufficient details to allow the full replication of their interventions.

CONCLUSIONS

This systematic review shows that there are promising interventions, such as exercise, multicomponent, and psychological therapies, that may decrease one specific type of fear in people with fibromyalgia, i.e., kinesiophobia. However, because of the low-very low certainty of the evidence found, a call for action is needed to improve the quality of randomized clinical trials, which will lead to more definitive information about the clinical efficacy of interventions in this field.

Effect of water exercise in blood pressure and sleep quality of hypertensive adults

BACKGROUND

Together with ageing there is an increase in blood pressure levels. However, physical activity is one of the most recommended strategies for preventing the increase of blood pressure. Water exercise involves numerous advantages, one of which is the comfort proportioned by water temperature. The aim of this study was to evaluate the effects of a water exercise program on blood pressure, physical fitness, quality of sleep and the likelihood of having sleep apnea (SA) in hypertensive adults.

METHODS

We evaluated 21 sedentary hypertensive subjects of both sexes. The water exercise was conducted over 13 weeks, three times/week, 50 min/day. Resting blood pressure, height, body weight, waist and hip circumference, functional capability, as well as sleep quality and the likelihood of having sleep apnea were evaluated before and after the experimental period.

RESULTS

There was a significant decrease in systolic and mean blood pressure. Significant increases in strength, muscular and aerobic endurance, coordination, agility, dynamic balance and flexibility were also seen. In addition, a reduction in the likelihood of sleep apnea was identified, despite a deterioration in sleep quality.

CONCLUSIONS

Water exercise was effective in reducing systolic blood pressure, in improving functional capacity variables, and in reducing probability of sleep apnea in hypertensive subjects, however it promoted worsening of sleep quality.