In a recent study titled “A New Approach in Fibromyalgia Exercise Program: A Preliminary Study Regarding the Effectiveness of Balance Training”, published in the journal Archives of Physical Medicine and Rehabilitation, a team of researchers from Turkey was able to show that a six-week balance training program had a beneficial effect on the static balance and functional levels of patients with Fibromyalgia Syndrome (FMS). Results from the study also showed that depression deterioration was related to balance deficit and fall risk, and a higher body mass index (BMI) was associated with the balance deficit and fall frequency.
Fibromyalgia syndrome is a rheumatological disorder with clinical features such as widespread pain, fatigue, cognitive symptoms, and nonrestorative sleep. A variety of neurological signs and symptoms, for example dizziness, vertigo, tingling, and burning, have been associated with FMS and consequently with balance problems and increased fall frequency. As such, daily living activities of those suffering from FMS are significantly decreased due to balance deficit and inactivity.
Patients with FMS experience a reduction in cognitive functions and various pathological conditions, such as depression, headaches, and variable bowel habits may occur concomitantly. Therefore, symptom-based treatment methods lead to polypharmacy, which combined with cognitive impairment may also facilitate the balance deficit and falling in patients with FMS. However, it is still not clear which associated risk factors are related to the balance deficit.
The European League Against Rheumatism (EULAR) has recommended individually tailored exercise programs for those suffering with FMS, including aerobic and strength exercises, nonetheless research focused on balance exercises is still scarce.
To determine the effectiveness of balance exercises on the functional level and quality of life (QoL) of patients with FMS and investigate the circumstances associated with balance disorders, a research team led by Sibel Kibar, MD, Assistant Professor at the Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine, Turkey, designed a Randomized Controlled Trial including 77 patients aged between 18 and 65 years with FMS who were evaluated by an experienced physiatrist between 2011 and 2013.
Patients were randomly assign to one of two groups of exercise for a period of 6 weeks. Group 1 was given balance exercises along with dynamic and static balance training on the Sports Kinesthetic Ability Trainer (KAT) 4000 device, along with flexibility exercises. Group 2 received only flexibility exercises.
After the training programs, results revealed that group-1 (n=28), improved in all study parameters (functional, dynamic and static balance, fall risk, quality of life and depression levels), however, no improvement was seen in group-2 (n=29).
According to the researchers, a balance assessment should be performed during the first evaluation of these patients and balance training should be included in the treatment protocols of FMS patients with a balance disorder.
Results from this study are still preliminary and the authors advise further studies should be conducted to determine whether balance training can improve postural stability and reduce falls in FMS.