Multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our experience and literature review

Abstract

SUMMARY OBJECTIVE We reported our multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our aim was to verify the effectiveness of a proprioceptive training program as a complementary therapy for a traditional protocol of education, mindfulness, and exercise training for the management of fibromyalgia associated with imbalance. METHODS Retrospective cohort study on 84 women, with primary fibromyalgia associated to imbalance. A group of patients performed traditional exercise training; in a second group the training was supplemented with proprioception exercises. Each session lasted from 40 to 60 minutes and was performed three times a week for 12 weeks. RESULTS After three months of training and eight months after the end of the training, the balance evaluation revealed significant differences in the comparison of the Timed Up and Go test, Berg Balance Scale, and Tinetti scale with the baseline, there was a better improvement in the proprioceptive training group (p<0.05). A reduction in pain and improvement in functional and muscular performance and quality of life were observed in both groups (p<0.05), but with no significant differences between them in the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, and Short Form Health Survey (p>0.05). Fifteen months after the end of the program, the effects of training were not maintained. CONCLUSION The present study revealed that training supplemented with proprioception exercises has beneficial effects on clinical findings and improves balance in patients with fibromyalgia, even if the positive results did not persist after the interruption of the rehabilitative program in the long term.

Comorbid Conditions in Temporomandibular Disorders Myalgia and Myofascial Pain Compared to Fibromyalgia

“…FM is a well-known type of wide-spread chronic musculoskeletal pain with an occurrence of 2 to 4% in the adult population. Patients with FM often complain of increased tenderness in muscles, stress, morning stiffness, imbalance, body mass index (BMI) and fatigue [ 5 , 7 ]. In the orofacial region, TMDs are the most frequent type of chronic pain affecting 5 to 12% of the population.…”

Mindbody Methods and Massage Therapy for Fibromyalgia: A Systematic Review

“…There is strong evidence for the use of cardiovascular and strengthening exercises to reduce pain, and improve function for fibromyalgia syndrome clients (Bidonde et al, 2019;Chiaramonte, Bonfiglio & Chisan, 2019;MacFarlane et al, 2017;Sosa-Reina et al, 2017;Ambrose & Golightly, 2015;Busch et al, 2011). Regular exercise has a similar effect on pain levels as the use of pain killers (Ambrose & Golightly, 2015).…”

“…Preliminary results suggest that movement therapies reduce pain and may improve insomnia (Zou et al, 2017;Theadom et al, 2015). The mindful attention to balance which is often part of these programmes may also help reduce falls in patients who are at risk (Chiaramonte et al, 2019).…”

“…There was strong support in the literature for the use of cardiovascular exercise and exercise in general for fibromyalgia (Bidonde et al, 2019;Chiaramonte et al, 2019;MacFarlane et al, 2017;Sosa-Reina et al, 2017;Ambrose & Golightly, 2015). Too much exercise can however be counter-productive (Busch et al, 2011).…”

Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures

“…Unfortunately, FM patients rarely meet the guidelines for PA, including walking [ 15 ], and patients frequently avoid this behavior as a way of minimizing the pain they feel [ 16 ]. Patients argue that they feel an increase in pain when doing the activity, which leads them to stop [ 17 ].…”