Effects of strength vs aerobic exercise on pain severity in adults with fibromyalgia: A randomized equivalence trial

Abstract

Strength training and aerobic exercise have beneficial effects on pain in adults with fibromyalgia. However, the equivalence of strengthening and aerobic exercise has not been reported. The primary aim of this randomized equivalence trial involving patients with fibromyalgia admitted to an interdisciplinary pain treatment program was to test the hypothesis that strengthening (n=36) and aerobic (n=36) exercise have equivalent effects (95% confidence interval within an equivalence margin ± 8) on pain, as measured by the pain severity subscale of the Multidimensional Pain Inventory. Secondary aims included determining the effects of strengthening and aerobic exercise on peak Vo(2) uptake, leg strength, and pressure pain thresholds. In an intent-to-treat analysis, the mean (± standard deviation) pain severity scores for the strength and aerobic groups at study completion were 34.4 ± 11.5 and 37.6 ± 11.9, respectively. The group difference was -3.2 (95% confidence interval, -8.7 to 2.3), which was within the equivalence margin of Δ8. Significant improvements in pain severity (P<.001), peak Vo(2) (P<.001), strength (P<.001), and pain thresholds (P<.001) were observed from baseline to week 3 in the intent-to-treat analysis; however, patients in the aerobic group (mean change 2.0 ± 2.6 mL/kg/min) experienced greater gains (P<.013) in peak Vo(2) compared to the strength group (mean change 0.4 ± 2.6 mL/kg/min). Knowledge of the equivalence and physiological effects of exercise have important clinical implications that could allow practitioners to target exercise recommendations on the basis of comorbid medical conditions or patient preference for a particular type of exercise. This study found that strength and aerobic exercise had equivalent effects on reducing pain severity among patients with fibromyalgia.

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

“…Thus, increasing tissue oxygenation as a result of aerobic exercise could potentially diminish peripheral and central sensitization and reduce clinical pain (3). The exercise-induced endogenous opioid activity in the central and peripheral nervous system (37) could also partially justify pain reductions observed following exercise programs in FM (3,4).…”

“…We considered these covariates, as they are known potential confounders of the association under study (23)(24)(25). Because there is evidence suggesting that improving physical fitness might reduce pain (3,4), each pain-related outcome was treated as a dependent variable, and physical fitness measurements as independent variables, in all the analyses.…”

“…Physical fitness is a well-known powerful marker of health that might be enhanced through exercise programs. Intervention studies have shown concomitant increases in fitness with reduced levels of pain (3,4) and improved quality of life in FM patients. Likewise, low physical fitness has been related to exacerbated pain, fatigue, and stiffness (5) and to higher risk of falls in this population (6).…”

“…However, Henriksen et al (9) observed that the association between knee muscle strength and TPC in these patients was weak. The association of flexibility and motor agility with pain has received little attention (7,12), and exercise programs for the management of FM rarely focus on improving these fitness components (3,4).…”

Efeito do treinamento resistido em paciente com fibromialgia: estudo de caso

“…A literatura apresenta evidências sobre semelhanças entre os benefícios dos treinamentos de força e aeróbio (HOOTEN et al 2012), porém, ainda necessita-se destas informações associadas à população com FM, para que haja quebra de preconceitos e o aumento nas possibilidades de práticas corporais efetivas para os portadores de FM. Apesar dos benefícios encontrados no presente trabalho, entendemos a limitação de relatar respostas de uma única avaliada.…”