Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial

Kevin R Fontaine, Lora Conn, Daniel J Clauw, Kevin R Fontaine, Lora Conn, Daniel J Clauw

Abstract

Introduction: Although exercise is therapeutic for adults with fibromyalgia (FM), its symptoms often create obstacles that discourage exercise. We evaluated the effects of accumulating at least 30 minutes of self-selected lifestyle physical activity (LPA) on perceived physical function, pain, fatigue, body mass index, depression, tenderness, and the six-minute walk test in adults with FM.

Methods: Eighty-four minimally active adults with FM were randomized to either LPA or a FM education control (FME) group. LPA participants worked toward accumulating 30 minutes of self-selected moderate-intensity LPA, five to seven days per week, while the FME participants received information and support.

Results: Seventy-three of the 84 participants (87%) completed the 12-week trial. The LPA group increased their average daily steps by 54%. Compared to FME, the LPA group reported significantly less perceived functional deficits (P = .032) and less pain (P = .006). There were no differences between the groups on the six-minute walk test (P = .067), fatigue, depression, body mass index, or tenderness.

Conclusions: Accumulating 30 minutes of LPA throughout the day produces clinically relevant changes in perceived physical function and pain in previously minimally active adults with FM.

Trial registration: clinicaltrials.gov NCT00383084.

Figures

Figure 1
Figure 1
Participant flow.
Figure 2
Figure 2
Average steps per day (with 95% confidence interval) for the study groups.

References

    1. Perrot S, Dickenson AH, Bennett RM. Fibromyalgia: Harmonizing science with clinical practice considerations. Pain Pract. 2008;8:177–189. doi: 10.1111/j.1533-2500.2008.00190.x.
    1. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F. Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States Part II. Arthritis Rheum. 2008;58:26–35.
    1. Marcus DA. Fibromyalgia diagnosis and treatment options. Gend Med. 2009;Suppl 2:139–151. doi: 10.1016/j.genm.2009.01.004.
    1. Williams DA, Clauw DJ. Understanding fibromyalgia: Lessons from the broader pain research community. J Pain. 2009;10:777–791. doi: 10.1016/j.jpain.2009.01.213.
    1. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004;292:2388–2385. doi: 10.1001/jama.292.19.2388.
    1. Gore M, Sadosky AB, Zlatera G, Clauw DJ. Clinical characteristics, pharmacotherapy and healthcare resource use amongpatients with fibromyalgia newly prescribed gabapentin or pregabalin. Pain Pract. 2009;9:363–374. doi: 10.1111/j.1533-2500.2009.00292.x.
    1. Busch AJ, Schacter CL, Overend TJ, Peloso PM, Barber A. Exercise for fibromyalgia: a systematic review. J Rheum. 2008;35:1130–1144.
    1. Jones KD, Liptan GL. Exercise Interventions in Fibromyalgia: Clinical Applications from the Evidence. Rheum Dis Clin North Am. 2009;35:373–391. doi: 10.1016/j.rdc.2009.05.004.
    1. Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW III, Blair SN. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. JAMA. 1999;281:327–334. doi: 10.1001/jama.281.4.327.
    1. Plonczynski DJ, Wilbur JE, Larson JL, Keith TK. Lifestyle Physical Activity of Older Rural Women. Res Nurs Health. 2008;31:501–513. doi: 10.1002/nur.20282.
    1. U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta; 1996.
    1. Fontaine KR, Haaz S. Effects of lifestyle physical activity on health status, pain, and function in adults with fibromyalgia syndrome. J Musculoskel Pain. 2007;15:3–9. doi: 10.1300/J094v15n01_02.
    1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichbroun AS, Masi AT, Mccain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160–172. doi: 10.1002/art.1780330203.
    1. Blair SN, Dunn AL, Marcus BH, Carpenter RN, Jaret P. Active Living Every Day. Champaign: Human Kinetics; 2002.
    1. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: Development and validation. J Rheum. 1991;18:728–733.
    1. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–23.
    1. Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401. doi: 10.1177/014662167700100306.
    1. Pankoff B, Overend T, Lucy D, White K. Validity and responsiveness of the 6 minute walk test for people with fibromyalgia. J Rheum. 2000;27:2666–2670.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2. Hillsdale: Erlbaum; 1988.
    1. Bennett RM, Bushmakin AG, Cappelleri JC, Zlateva G, Sadosky AB. Minimally clinically important difference in the Fibromyalgia Impact Questionnaire. J Rheum. 2009;36:1304–1311. doi: 10.3899/jrheum.081090.
    1. Goldenberg DL. Multidimensional modalities in the treatment of fibromyalgia. J Clin Psychiatry. 2008;69:30–34. doi: 10.4088/JCP.1008e30.
    1. Rooks DS, Gautim S, Romeling M, Cross ML, Stratigakis D, Evans B, Goldenberg DL, Iversen MD, Katz JN. Group exercise, education, and combination self-management in women with fibromyalgia. Arch Intern Med. 2007;167:2192–2200. doi: 10.1001/archinte.167.20.2192.
    1. Nørregaard J, Lykkegaard J, Mehlsen J, Danneskiold-Samsøe B. Exercise training in treatment of fibromyalgia. J Musculoskel Pain. 1997;5:71–79. doi: 10.1300/J094v05n01_05.
    1. Jones KD, Burckhardt CS, Clark SR, Bennett RM, Potempa KM. A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol. 2002;29:1041–1048.
    1. Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M. Revisiting "how many steps are enough?". Med Sci Sports Exerc. 2008;40:S537–543. doi: 10.1249/MSS.0b013e31817c7133.
    1. Tudor-Locke C, Washington TL, Hart TL. Expected values for steps per day in special populations. Prev Med. 2009;49:3–11. doi: 10.1016/j.ypmed.2009.04.012.

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