Strength Training Versus Walking on the Fibromyalgia Impact: A Blinded Randomised Controlled Trial

Abstract

Objective: To compare the effect of 24 sessions of progressive intensity strength training on the impact of fibromyalgia (primary outcome). Furthermore, we evaluated its effects on sleep, anxiety, depression, wind-up mechanism, conditioned pain modulation, cutaneous sensory threshold, musculoskeletal performance, walking ability, perceived improvement, and treatment adherence (secondary outcomes).

Design: A blinded randomised controlled trial.

Setting: After blinded outcome assessments, 66 people were randomised and concealed and allocated to progressive (n = 22), constant (n = 22), or walking (n = 22) strength training groups.

Participants: People with fibromyalgia.

Interventions: In the progressive group, exercise intensity increased by 20% of maximum strength each month: 50% in the first month, 70% in the second month, and 90% in the third month. In the constant or walking exercise groups, moderate intensity was maintained at the end of the treatment. Each person received 24 individual exercise sessions (2x/week), with three months of exercise and three months of no exercise.

Main outcome measure: Fibromyalgia impact.

Results: Groups were similar at baseline. There were no significant between-group differences in the primary outcome at any time point. In within-group comparisons, we observed significant differences indicating that all three types of exercise reduced fibromyalgia symptoms; however, no variable achieved a minimal clinically important difference. In between-group comparisons for the secondary outcomes, groups reported a positive perception of improvement, but most of each group did not adhere to treatment and/or did not answer about adherence after follow-up without exercise.

Conclusions: Twenty-four sessions of progressive intensity strength training did not provide a greater reduction in the fibromyalgia impact than constant intensity or walking exercises.

Trial registration: Brazilian Registry of Clinical Trials (ReBEC): RBR-9pbq9fg, date of registration: October 06, 2022.

Protocol publication: BMC Musculoskeletal Disorders: Doi - 10.1186/s12891-023-06952-3 | Published: Volume 24, article number 816, October 14, 2023.

Keywords: aerobic exercise; musculoskeletal system; pain; quality of life; rehabilitation.