Public Release:  Program of exercise and education improves function and symptoms in women with fibromyalgia

The JAMA Network Journals

An exercise program that incorporates walking, strength training and stretching may improve daily function and alleviate symptoms in women with fibromyalgia, according to a report in the November 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. These benefits appear to be enhanced when exercise is combined with education about managing the disease.

Fibromyalgia affects approximately 3.4 percent of women and 0.5 percent of men in the United States, according to background information in the article. Patients with fibromyalgia experience chronic pain throughout their bodies for at least three months, along with specific sites of tenderness. Causes and mechanisms are poorly understood. "Even with the recent approval of pregabalin by the Food and Drug Administration to treat fibromyalgia symptoms, pharmacotherapy is often insufficient to resolve persistent symptoms or improve functional limitations and quality of life," the authors write.

Daniel S. Rooks, Sc.D., from Brigham & Women's Hospital and Harvard Medical School, Boston, and now with Novartis Institutes for Biomedical Research, Inc., Cambridge, Mass., and colleagues recruited 207 women taking medication for fibromyalgia between 2002 and 2004. For 16 weeks, the women were randomly assigned to four groups: 51 performed aerobic and flexibility exercises only; 51 added in strength training; 50 received a self-help course on managing fibromyalgia; and 55 participated in all the exercises and the education course. The exercise groups met twice weekly, gradually increasing the length and intensity of their workouts, with instructions to perform a third day of exercise on their own.

A total of 135 women completed the study and underwent a six-month follow-up assessment. As measured by two self-assessment questionnaires and one performance test, women who participated in all forms of exercise improved their physical function, an effect that was larger in the combined education and exercise group. "Social function, mental health, fatigue, depression and self-efficacy also improved," the authors write. "The beneficial effect on physical function of exercise alone and in combination with education persisted at six months."

"The present study suggests that progressive walking, simple strength training movements and stretching activities are effective at improving physical, emotional and social function, key symptoms and self-efficacy in women with fibromyalgia who are being actively treated with medication," the authors write. "Furthermore, the benefits of exercise are enhanced when combined with targeted self-management education, and improvements in physical function continue for six months after completion of the intervention. Our findings suggest the need for inclusion of appropriate exercise and patient education in the treatment of individuals with fibromyalgia."

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(Arch Intern Med. 2007;167(20):2192-2200. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This research was supported by an Arthritis Foundation Investigator Award (Dr. Rooks) and National Institutes of Health grants. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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