Effects of water- and land-based exercises on quality of life and physical aspects in women with fibromyalgia: A randomized clinical trial
Corresponding Author
André Britto
School of Medicine, Federal University of Maranhão, Pinheiro, Brazil
Correspondence
André Britto, School of Medicine, Estrada Pinheiro/Pacas, Km 10, 65200-000, Pinheiro, MA, Brazil.
Email: andre.britto@ufma.br
Search for more papers by this authorVandilson Rodrigues
Department of Morphology, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorAlcione M. dos Santos
Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorMarta Rizzini
Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorPaula Britto
Physiotherapy Service, Club Sante, São Luís, Brazil
Search for more papers by this authorLucio Britto
Physiotherapy Service, Club Sante, São Luís, Brazil
Search for more papers by this authorJoão B. S. Garcia
Health Science Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorCorresponding Author
André Britto
School of Medicine, Federal University of Maranhão, Pinheiro, Brazil
Correspondence
André Britto, School of Medicine, Estrada Pinheiro/Pacas, Km 10, 65200-000, Pinheiro, MA, Brazil.
Email: andre.britto@ufma.br
Search for more papers by this authorVandilson Rodrigues
Department of Morphology, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorAlcione M. dos Santos
Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorMarta Rizzini
Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorPaula Britto
Physiotherapy Service, Club Sante, São Luís, Brazil
Search for more papers by this authorLucio Britto
Physiotherapy Service, Club Sante, São Luís, Brazil
Search for more papers by this authorJoão B. S. Garcia
Health Science Graduate Program, Federal University of Maranhão, São Luís, Brazil
Search for more papers by this authorAbstract
Introduction
Fibromyalgia (FM) is consistently associated with fatigue, sleep disturbances, morning stiffness, and anxiety and depression, affecting physical capacities and skills and thereby reducing quality of life. The aim of this study was to compare the effects of water-based and land-based therapies as an adjuvant treatment for women with FM in relation to quality of life and physical aspects.
Methods
FM women were randomized into a water-based exercise group (WG) and land-based exercise group (LG). The interventions were conducted for 8 weeks, three times a week, and each therapy session had a 60-min duration. Evaluations were performed before and after intervention using the Fibromyalgia Impact Questionnaire, the Visual Analogue Scale, the number of tender points (TPs), and the Wells bench sit and reach test score.
Results
Both interventions produced significantly positive clinical effects in most aspects evaluated. However, only WG obtained significant improvements for the variables functional capacity, number of TPs, and flexibility.
Conclusions
The findings suggest that water-based exercise is effective as an adjuvant FM treatment, including FM-related physical and psychological health aspects.
REFERENCES
- Ambrose, K. R., & Golightly, Y. M. (2015). Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Practice & Research Clinical Rheumatology, 29(1), 120–130. https://doi.org/10.1016/j.berh.2015.04.022
- Andrade, C. P., Zamuner, A. R., Forti, M., Tamburús, N. Y., & Silva, E. (2019). Effects of aquatic training and detraining on women with fibromyalgia: Controlled randomized clinical trial. European Journal of Physical and Rehabilitation Medicine, 55(1), 79–88. https://doi.org/10.23736/S1973-9087.18.05041-4
- Arnold, L. M., Bennett, R. M., Crofford, L. J., Dean, L. E., Clauw, D. J., Goldenberg, D. L., … Buskila, D. (2019). AAPT diagnostic criteria for fibromyalgia. The Journal of Pain, 20(6), 611–628. https://doi.org/10.1016/j.jpain.2018.10.008
- Assis, M. R., Silva, L. E., Alves, A. M. B., Pessanha, A. P., Valim, V., Feldman, D., … Natour, J. (2006). A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Care & Research, 55(1), 57–65. https://doi.org/10.1002/art.21693
- Avila, M. A., Camargo, P. R., Ribeiro, I. L., Alburquerque-Sendín, F., Zamunér, A. R., & Salvini, T. F. (2017). Effects of a 16-week hydrotherapy program on three–dimensional scapular motion and pain of women with fibromyalgia: A single-arm study. Clinical Biomechanics, 49, 145–154. https://doi.org/10.1016/j.clinbiomech.2017.09.012
- Bernardy, K., Klose, P., Welsch, P., & Häuser, W. (2018). Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome—A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain, 22(2), 242–260. https://doi.org/10.1002/ejp.1121
- Bidonde, J., Busch, A. J., Webber, S. C., Schachter, C. L., Danyliw, A., Overend, T. J., … Rader, T. (2014). Aquatic exercise training for fibromyalgia. Cochrane Database of Systematic Reviews, 10, 1–139, CD011336. https://doi.org/10.1002/14651858.CD011336
- Boonstra, A. M., Preuper, H. R. S., Balk, G. A., & Stewart, R. E. (2014). Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain, 155(12), 2545–2550. https://doi.org/10.1016/j.pain.2014.09.014
- Burckhardt, C. S., Clark, S. R., & Bennett, R. M. (1991). The fibromyalgia impact questionnaire: Development and validation. The Journal of Rheumatology, 18(5), 728–733.
- Carbonell-Baeza, A., Aparicio, V. A., Ortega, F. B., Cuevas, A. M., Alvarez, I. C., Ruiz, J. R., & Delgado-Fernandez, M. (2011). Does a 3-month multidisciplinary intervention improve pain, body composition and physical fitness in women with fibromyalgia? British Journal of Sports Medicine, 45(15), 1189–1195. http://doi.org/10.1136/bjsm.2009.070896
- Cazzola, M., Atzeni, F., Salaffi, F., Stisi, S., Cassisi, G., & Sarzi-Puttini, P. (2010). Which kind of exercise is best in fibromyalgia therapeutic programmes? A practical review. Clinical and Experimental Rheumatology, 28(26), S117–S124.
- Evcik, D., Yigit, I., Pusak, H., & Kavuncu, V. (2008). Effectiveness of aquatic therapy in the treatment of fibromyalgia syndrome: A randomized controlled open study. Rheumatology International, 28(9), 885–890. https://doi.org/10.1007/s00296-08-0538-3
- Fink, L., & Lewis, D. (2017). Exercise as a treatment for fibromyalgia: A scoping review. The Journal for Nurse Practitioners, 13(8), 546–551. https://doi.org/10.1016/j.nurpra.2017.06.018
- Gusi, N., & Tomas-Carus, P. (2008). Cost-utility of an 8-month aquatic training for women with fibromyalgia: A randomized controlled trial. Arthritis Research & Therapy, 10(1), R24. https://doi.org/10.1186/ar2377
- Häuser, W., Ablin, J., Fitzcharles, M. A., Littlejohn, G., Luciano, J. V., Usui, C., & Walitt, B. (2015). Fibromyalgia. Nature Reviews Disease Primers, 1(1), 15022. https://doi.org/10.1038/nrdp.2015.22
- Häuser, W., Clauw, D. J., & Fitzcharles, M. A. (2017). Treat-to-target strategy for fibromyalgia: Opening the dialogue. Arthritis Care & Research, 69(4), 462–466. https://doi.org/10.1002/acr.22970
- Häuser, W., Klose, P., Langhorst, J., Moradi, B., Steinbach, M., Schiltenwolf, M., & Busch, A. (2010). Efficacy of different types of aerobic exercise in fibromyalgia syndrome: A systematic review and meta–analysis of randomised controlled trials. Arthritis Research & Therapy, 12(3), R79. https://doi.org/10.1186/ar3002
- Hecker, C. D., Melo, C., Tomazoni, S. S., Martins, R., & Leal-Junior, E. C. P. (2011). Analysis of effects of kinesiotherapy and hydrokinesiotherapy on the quality of life of patients with fibromyalgia—A randomized clinical trial. Fisioterapia Em Movimento, 24(1), 57–64. https://doi.org/10.1590/S0103-51502011000100007
10.1590/S0103-51502011000100007 Google Scholar
- Homann, D., Goes, S. M., da Silva Timossi, L., & Leite, N. (2011). Assessment of functional capacity in women with fibromyalgia: Direct and self-reported methods. Brazilian Journal of Kinanthropometry and Human Performance, 13(4), 292–298. https://doi.org/10.5007/1980-0037.2011v13n4p292
- Langhorst, J., Musial, F., Klose, P., & Häuser, W. (2009). Efficacy of hydrotherapy in fibromyalgia syndrome—A meta–analysis of randomized controlled clinical trials. Rheumatology, 48(9), 1155–1159. https://doi.org/10.1093/rheumatology/kep182
- Lima, T. B., Dias, J. M., Mazuquin, B. F., da Silva, C. T., Nogueira, R. M. P., Marques, A. P., … Cardoso, J. R. (2013). The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: A systematic review with meta-analysis. Clinical Rehabilitation, 27(10), 892–908. https://doi.org/10.1177/0269215513484772
- Munguía-Izquierdo, D., & Legaz-Arrese, A. (2007). Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clinical & Experimental Rheumatology, 25(6), 823–830. https://doi.org/10.1016/j.apmr.2008.03.026
- Munguía-Izquierdo, D., & Legaz-Arrese, A. (2008). Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 89(12), 2250–2257. https://doi.org/10.1016/j.apmr.2008.03.026
- Naumann, J., & Sadaghiani, C. (2014). Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: A qualitative systematic review and meta–analysis of randomized controlled trials. Arthritis Research & Therapy, 16(4), R141. https://doi.org/10.1186/ar4603
- Plazier, M., Ost, J., Stassijns, G., De Ridder, D., & Vanneste, S. (2015). Pain characteristics in fibromyalgia: Understanding the multiple dimensions of pain. Clinical Rheumatology, 34(4), 775–783. https://doi.org/10.1007/s10067-014-2736-6
- Saltskår Jentoft, E., Grimstvedt Kvalvik, A., & Marit Mengshoel, A. (2001). Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain. Arthritis Care & Research, 45(1), 42–47. https://doi.org/10.1002/1529-0131(200102)45:1<42::AID-ANR82>3.0.CO;2-A
- Schweiger, V., Del Balzo, G., Raniero, D., DeLeo, D., Martini, A., Sarzi-Puttini, P., & Polati, E. (2017). Current trends in disability claims due to fibromyalgia syndrome. Clinical and Experimental Rheumatology, 35(Suppl 105), S119–S126.
- Segura-Jiménez, V., Borges-Cosic, M., Soriano-Maldonado, A., Estévez-López, F., Álvarez-Gallardo, I. C., Herrador-Colmenero, M., … Ruiz, J. R. (2017). Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: The al-Ándalus study. Scandinavian Journal of Medicine & Science in Sports, 27(1), 83–92. https://doi.org/10.1111/sms.12630
- Senna, E. R., De Barros, A. L. P., Silva, E. O., Costa, I. F., Pereira, L. V. B., Ciconelli, R. M., & Ferraz, M. B. (2004). Prevalence of rheumatic diseases in Brazil: A study using the COPCORD approach. The Journal of Rheumatology, 31(3), 594–597.
- Shipley, M. (2010). Chronic widespread pain and fibromyalgia syndrome. Medicine, 38(4), 202–204. https://doi.org/10.1016/j.mpmed.2009.12.009
10.1016/j.mpmed.2009.12.009 Google Scholar
- Silva, T. F. G., Suda, E. Y., Marçulo, C. A., Paes, F. H. S., & Pinheiro, G. T. (2008). Comparison of transcutaneous electrical nerve stimulation and hydrotherapy effects on pain, flexibility and qualiQty of life in patients with fibromyalgia. Fisioterapia e Pesquisa, 15(2), 118–124. https://doi.org/10.1590/S1809-29502008000200002
10.1590/S1809-29502008000200002 Google Scholar
- Thomas, E. N., & Blotman, F. (2010). Aerobic exercise in fibromyalgia: A practical review. Rheumatology International, 30(9), 1143–1150. https://doi.org/10.1007/s00296-010-1369-6
- Tomas-Carus, P., Gusi, N., Häkkinen, A., Häkkinen, K., Leal, A., & Ortega-Alonso, A. (2008). Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: A randomized controlled trial. Journal of Rehabilitation Medicine, 40(4), 248–252. https://doi.org/10.2340/16501977-0168
- Valim, V., Natour, J., Xiao, Y., Pereira, A. F. A., da Cunha Lopes, B. B., Pollak, D. F., … Russell, I. J. (2013). Effects of physical exercise on serum levels of serotonin and its metabolite in fibromyalgia: A randomized pilot study. Revista Brasileira de Reumatologia, 53(6), 538–541. https://doi.org/10.1016/j.rbre.2013.02.001
- Vitorino, D. F., de Carvalho, L. B. C., & do Prado, G. F. (2006). Hydrotherapy and conventional physiotherapy improve total sleep time and quality of life of fibromyalgia patients: Randomized clinical trial. Sleep Medicine, 7(3), 293–296. https://doi.org/10.1016/j.sleep.2005.09.002
- Wilder, R. P., Greene, J. A., Winters, K. L., Long, W. B. III, Gubler, K. D., & Edlich, R. (2006). Physical fitness assessment: An update. Journal of Long-Term Effects of Medical Implants, 16(2), 193–204. https://doi.org/10.1615/JLongTermEffMedImplants.v16.i2.90
- Wolfe, F., Brähler, E., Hinz, A., & Häuser, W. (2013). Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population. Arthritis Care & Research, 65(5), 777–785. https://doi.org/10.1002/acr.21931
- Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Katz, R. S., Mease, P., … Yunus, M. B. (2010). The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research, 62(5), 600–610. https://doi.org/10.1002/acr.20140
- Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., … Fam, A. G. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis and Rheumatism, 33(2), 160–172. https://doi.org/10.1002/art.1780330203
- Wu, W. T., Hong, C. Z., & Chou, L. W. (2015). The Kinesio taping method for myofascial pain control. Evidence-Based Complementary and Alternative Medicine, 2015, 1–9. https://doi.org/10.1155/2015/950519
- Zamunér, A. R., Andrade, C. P., Arca, E. A., & Avila, M. A. (2019). Impact of water therapy on pain management in patients with fibromyalgia: Current perspectives. Journal of Pain Research, 12, 1971–2007. https://doi.org/10.2147/JPR.S161494
- Zech, N., Hansen, E., Bernardy, K., & Häuser, W. (2017). Efficacy, acceptability and safety of guided imagery/hypnosis in fibromyalgia—A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain, 21(2), 217–227. https://doi.org/10.1002/ejp.933