Participating in either aquatic physiotherapy or a health education program has health benefits for people with fibromyalgia, according to a new study. However, it remains unclear whether one intervention was superior to the other, or if they might be best used in combination.
The study with that finding, “Effects of aquatic physiotherapy or health education program in women with fibromyalgia: a randomized clinical trial,” was published in the journal Physiotherapy Theory and Practice.
When it comes to managing the symptoms of fibromyalgia, every person is different; there isn’t a one-size-fits-all approach that works for everyone. Medication often is helpful, but non-pharmacological interventions also can be effective. The most common interventions in this category include acupuncture, physiotherapy, cognitive behavioral therapy, aquatic physiotherapy (AP) and health education programs (HEP).
In the new study, researchers compared, for the first time, the effects of AP, which involves doing exercises in a heated pool, and HEP, in which participants learn about health. The particular program used in the study was the Inter-relational School of Fibromyalgia (ISF), which focuses on educating people with fibromyalgia about the disease and helping them cope with its symptoms.
The study included 46 individuals with fibromyalgia; all of them were female, between 25 and 60 years old, with a BMI lower than 30 kg/cm. They were randomly assigned to participate in either aquatic physiotherapy (27 participants) or the ISF (19), both of which involved hour-long commitments once per week, for about three months.
Before, after, and in the middle of the study, participants were given a battery of surveys to evaluate their perceived quality of life. Self-reported pain was measured with the McGill Pain questionnaire, fatigue with the Piper Fatigue Scale-Revised, anxiety with the Beck Anxiety Inventory, depression with the Beck Depression Inventory, and quality of sleep with the Pittsburgh Sleep Quality Index. Additionally, the Fibromyalgia Impact Questionnaire (FIQ) was used to assess how much the disease was affecting participants’ lives.
In the aquatic physiotherapy group, reported anxiety scores significantly decreased (from an average of 23.1 before the intervention to 17.6 after), as did depression scores (18.3 to 15.4), and FIQ scores (58.4 to 49.9). Sleep scores also decreased (10.9 to 8.4), which is indicative of fewer sleep disturbances and consequently, better sleep.
In the ISF group, there were statistically significant decreases in these same four scores: anxiety (24.9 to 15.5), depression (18.8 to 13.1), FIQ (57.8 to 36.3), and sleep (10.1 to 7.3).
There were not statistically significant changes over the course of the intervention for any of the other scores measured.
Additionally, there were no statistically significant differences for any of the scores at any time point between the aquatic physiotherapy and ISF groups, despite results being slightly favorable to ISF. Thus, this study showed some benefits to both interventions, but the data do not suggest that one intervention is “better” than the other.
Moreover, researchers noted, “the absence of comparison of the interventions with a non-active group, does not allow to affirm that these interventions are effective for each of the outcomes of interest.”
Future studies with more participants will be needed for such comparisons and to validate the findings of this small study.
The researchers also noted that, “It is possible that the techniques evaluated in this study are not competing among themselves but are complementary to each other,” suggesting that future studies could try utilizing both interventions concurrently.
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