Fibromyalgia Patients Should Do Therapeutic Exercises to Improve Functional Performance, Study Says

Fibromyalgia Patients Should Do Therapeutic Exercises to Improve Functional Performance, Study Says

Women with fibromyalgia (FM) show lower functional performance compared with healthy individuals of the same age and physical activity level, a study suggests.

These results indicate the important of therapeutic exercises of different modalities for FM patients, the researchers said.

In addition, the investigators said such functionality should be evaluated using functional tests rather than isokinetic dynamometry.

The study, titled “Comparison of functional and isokinetic performance between healthy women and women with fibromyalgia,” was published in the Journal of Bodywork & Movement Therapies.

Fibromyalgia is a condition that predominantly affects women and is characterized by chronic pain. Several studies suggest that physical exercise can help improve pain, general function, and quality of life among people with the disorder.

However, the fact that fibromyalgia patients experience chronic pain leads to great difficulty in initiating and maintaining a physical exercise program. Further, those with the disorder tend to have decreased in muscle strength — a prime component of physical fitness — which leads to a reduction in functional performance.

Therefore, the researchers said, it is necessary to perform a complete and reliable physical evaluation so as to help physicians understand the degree of functional performance and prescribe appropriate exercise programs.

The most commonly used tests to evaluate functional performance help assess physical abilities and detect functional deficits. These evaluations include the 6 Minute Walk Test (6MWT), the Timed Up & Go Test (TUGT), and the Chair Stand Test.

The 6MWT is an exercise assessment that involves measuring the distance that a patient walks over the span of six minutes. Meanwhile, TUGT requires patients to go from sitting to standing and walking for three meters, before turning around and walking back as quickly as possible. This test helps determine fall risk and measures the progress of balance. Lastly, the Chair Stand Test helps evaluate leg strength and endurance by asking partcipants to repeatedly stand and sit in the chair as many times as possible within a 30-second period.

Aside from these commonly administered tests, another possible strategy for evaluating functionality is isokinetic dynamometry. This technique is considered a gold standard for determining important muscle performance variables such as strength, power, work, and balance in muscle groups.

Although isokinetic dynamometry is more often used in evaluating athletes, it has been used to assess the muscular performance of people with fibromyalgia. The approach can help further determine the functional capacity of fibromyalgia patients when it comes to physical exercise.

To learn more, a group of Brazilian researchers conducted a study comparing the functional and isokinetic performance of women with fibromyalgia with healthy women.

The cross-sectional study evaluated 40 women, divided into two groups: 20 in the Healthy Group (HG) and 20 in the Fibromyalgia Group (FG).

The participants underwent an evaluation of functional performance through the TUGT, the Chair Stand Test, the 6MWT, and the Sit and Reach Test — which determines lower back and hamstring muscles flexibility. The women also were evaluated for isokinetic performance of the knee muscle groups.

The results demonstrated that the FG women presented lower rates for the 6MWT, VO2 Peak — oxygen consumption during peak exercise — and the Chair Stand Test in relation to the Hg women.

Specifically, these results demonstrate that women with fibromyalgia have lower muscle strength in their lower limbs and lower aerobic capacity when compared with healthy individuals of the same age, BMI, and physical activity level.

Interestingly, while it was expected that individuals with fibromyalgia would present a decrease in isokinetic muscle performance, this study found no significant differences between the studied groups.

The researchers theorize that this may be because isokinetic evaluation is a tool that assesses biomechanical variables and a non-functional movement pattern, instead of functional performance.

Therefore, they suggest that isokinetic evaluation may not be the best strategy for evaluating functionality in people with fibromyalgia.

“There is a need to evaluate individuals with FM through tools that focus precisely on functionality rather than muscle individualities,” the researchers said.

“The results point to lower functional performance in individuals with fibromyalgia when compared to healthy individuals of the same age and physical activity level,” they concluded. “Therefore, it is evident that performing therapeutic exercises of different modalities to improve the functional performance of patients with FM is important.”