Prescribed Versus Preferred Intensity Resistance Exercise in Fibromyalgia Pain

Abstract

Exercise is the treatment of choice for fibromyalgia (FM), but little is known about resistance exercise prescription to modulate pain in this condition. This study aimed to compare the effects of different resistance exercise models, comprising self-selected or prescribed intensity, on pain in FM patients. In a cross-over fashion, 32 patients underwent the following sessions: (i) standard prescription (STD; 3 × 10 repetitions at 60% of maximal strength); (ii) self-selected load with fixed number of repetitions (SS); (iii) self-selected load with volume load (i.e., load × sets × repetitions) matched for STD (SS-VM); and (iv) self-selected load with a free number of repetitions until achieving score 7 of rating perceived exertion (SS-RPE). Pain, assessed by Visual Analogic Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ), was evaluated before and 0, 24, 48, 72, and 96 h after the sessions. Load was significantly lower in SS, SS-VM, SS-RPE than in STD, whereas rating perceived exertion and volume load were comparable between sessions. VAS scores increased immediately after all sessions (p < 0.0001), and reduced after 48, 72, 96 h (p < 0.0001), remaining elevated compared to pre-values. SF-MPQ scores increased immediately after all exercise sessions (p = 0.025), then gradually reduced across time, reaching baseline levels at 24 h. No significant differences between sessions were observed. Both prescribed and preferred intensity resistance exercises failed in reducing pain in FM patients. The recommendation that FM patients should exercise at preferred intensities to avoid exacerbated pain, which appears to be valid for aerobic exercise, does not apply to resistance exercise.

Impaired exercise‐induced hypoalgesia in individuals reporting an increase in low back pain during acute exercise

“…Interestingly, back pain NRS assessed just before walking, which was somewhat lower than the average clinical pain intensity during the last 24 hr, did not as robustly differentiate participants who reported an increase ≥2 NRS from participants who reported an increase of <2 NRS during walking, indicating that the association between EIH and clinical pain intensity is not consistent and may be influenced by how and when clinical pain intensity is assessed. The association between pain flares during exercise and impaired EIH has often been observed in individuals with widespread pain conditions (da Cunha Ribeiro et al, 2018;Vierck et al, 2001), however, almost 30% of the participants with LBP in this study reported an increase in NRS score F I G U R E 2 Mean (±95% CI, n = 96) Numerical Rating Scale (NRS) ratings of the low back pain intensity before and during the 6-min walk test. Significantly different between Walk-Pain Index ≥ 2 and Walk-Pain Index < 2 (*p < 0.05) F I G U R E 3 Mean (+SEM, n = 96) change in pressure pain thresholds reflecting the exercise-induced-hypoalgesia effect (EIH-effect) at the lower back and calf after the 6-min walk test in participants reporting an increase in Numerical Rating Scale (NRS) ratings of clinical back pain ≥2 during walking compared with participants reporting no or little increase in clinical pain.…”

Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain

“…In addition, in high pain-sensitive patients, an increase in temporal summation of pain was observed after aerobic exercise 177 , 197 possibly mimicking the pain flare-up after exercise reported in clinical practice by some individuals with widespread chronic pain. 24 Also, Fingleton et al 40 observed reduced pressure pain thresholds (hyperalgesia) after both aerobic and isometric exercises in individuals with knee osteoarthritis who demonstrated an impaired CPM response. By contrast, pain thresholds increased in knee osteoarthritis individuals with a normal CPM response suggesting that patients with impaired CPM, which is also a common finding in individuals with chronic pain, 114 , 121 may have less acute hypoalgesic effect from exercise.…”

O treinamento resistido reduz a dor em mulheres com fibromialgia

“…In the present study, the protocol used provided practice of RT three times a week, with loading based on the subjective perception of the patients; however we do not found a difference between the intervention group and the control group, so the recommendation that patients with FM should exercise at preferred intensities to avoid exacerbated pain may be valid for aerobic exercise, but not for RT, as in a previously study. 23 Sedentary behaviors are also a factor that could justify the positive effect of the exercise even if practiced in a short period; however, further studies are needed to understand this relationship.…”

“…[17][18][19][20][21] There are even studies analyzing the acute effect of RT in these patients, showing conflicting results in pain and possible positive effect on mood. [22][23][24] Most of the studies that found changes in patients' pain used protocols with durations of ≥8 weeks, [25][26][27] making it important to test the effects of RT in shorter durations to determine if it is possible to obtain positive responses therein.…”