Fibromyalgia patients may improve their cardio fitness and reap strength benefits from video game-based workout regimens, or so-called exergames, a study suggests.
However, maintaining these regimens and/or making lifestyle choices is probably necessary for these effects to be long-term, the researchers said.
The findings were published in the International Journal of Environmental Research and Public Health, in a study titled “Effect of Exergame Training and Detraining on Lower-Body Strength, Agility, and Cardiorespiratory Fitness in Women with Fibromyalgia: Single-Blinded Randomized Controlled Trial.”
Among its many health benefits, regular physical exercise can help lessen pain and other symptoms of fibromyalgia (FM), and is considered a powerful non-pharmacological method for treating the condition.
“Exercise has the largest body of supporting evidence among all non-pharmacological therapies for its role in the reduction of symptoms associated with FM,” the researchers wrote.
Exergames combine virtual reality-based video games with exercises, and can help people stick to exercise routines by making them fun. The particular exergame evaluated in this study, VirtualEx-FM, has previously been shown to improve mobility and balance in people with FM. However, researchers are unclear whether exergame-based exercising has long-term benefits after it’s stopped.
“The present study aimed to evaluate the effects of a 24-week exergame-based intervention on lower-body strength, agility, and cardiorespiratory fitness in women with FM. It also aimed to observe the impact of a detraining period (24 weeks) after completing the exergame-based intervention,” the authors wrote.
Their clinical trial (ISRCTN65034180) enrolled 50 women with fibromyalgia, between 30 and 75 years old (average age was 54), who were divided into two groups of 25.
The control group was asked to continue living their lives as they had been, including taking any medications as normal.
The exergame group completed a 24-week intervention consisting of two hour-long exergame sessions per week. Each session was done in a small class directed by a physical therapist and included a warm-up, dancing game (for aerobic exercise), reaching game (for posture control), and walking game.
All participants underwent one evaluation at the start of the study and a second after 24 months. This was followed by a 24-month “detraining” period, during which participants did not do exergames, and then a third evaluation.
In total, 37 people (22 in the exergame group and 15 in the control group) completed all three evaluations and were included in the analysis. Notably, this was mostly due to participants missing the final evaluation: “89% of participants completed the 24-week intervention,” the researchers wrote. “This completion rate is higher than in aerobic interventions in which the average drop-out rate is around 22%.”
Participants’ fitness was evaluated with three tests: the six-minute walk test (6MWT, for cardiovascular fitness), the chair-stand test (for muscle strength), and the 10-step stair test (for agility). Scores at baseline (before the intervention) were not significantly different between the two groups.
Among participants in the exergame group, scores on the chair-stand test increased significantly following the 24-week intervention. After the detraining period, however, scores had returned to around what they had been, suggesting these improvements were relatively short-term and that continual engagement in the exergame program would be necessary to keep seeing those benefits.
Scores on the 6MWT also increased, though the difference wasn’t statistically significant, so it’s impossible to rule out the change being due to random chance. However, scores for the 6MWT in the control group significantly decreased after 24 and 48 weeks, which may suggest a relative benefit of the exercise program for preventing a normal decrease in cardiovascular fitness.
A different statistical analysis taking into account scores at all three time points also indicated a significant difference between the exergame and control groups for both 6MWT and chair-stand test scores.
Scores on the 10-step stair test did not significantly differ between the two groups or within groups over time, suggesting that the intervention did not affect agility.
Scores on the Fibromyalgia Impact Questionnaire (FIQ-r), which measures the impact of the disease on daily life, also did not differ between groups or at different times. “A potential explanation for this nonsignificant effect is the relatively low disease impact in women included in the study,” the researchers wrote.
They did note that participants in the exergame group self-reported slightly less time spent sedentary during their daily lives at the 48-week follow-up than did participants in the control group.
Although this difference was not statistically significant, the researchers speculated that “This could indicate that they continued to perform physical activity even after the intervention had finished,” which suggests a positive feedback loop wherein people who are more fit are more likely to be active.
“Future research should focus on lifestyle changes after long-term interventions,” the researchers said.