Low-intensity exercise eases multiple psychological symptoms — including pain catastrophizing, stress, anxiety, and depression — and improves life quality for women with fibromyalgia, results of an eight-week clinical trial suggest.
The study, “Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial,” was published in the International Journal of Environmental Research and Public Health.
Physical exercise has received substantial attention as an alternative to medications for easing fibromyalgia-associated pain and improving quality of life. Still, it remains unclear what kind of exercise is most beneficial for these people. The effects of exercise on psychological symptoms — rather than fatigue or pain — are also incompletely understood.
Researchers in Spain and Russia recruited 32 women with fibromyalgia, who were randomly divided into two groups of 16.The physical exercise group underwent an eight-week exercise intervention that involved two 60-minute sessions each week of aerobic and resistance exercises designed to improve coordination and endurance.
Those in the control group were instructed to continue with life as usual.
Both groups were similar in terms of age, weight, height, and reported pain levels; all patients continued on their regular medications. Mean age in the physical exercise group was 55.1.
Before and after the intervention, both groups underwent a battery of assessments. Based on results from previous studies, the researchers were especially interested in the effects of exercise on pain catastrophizing — the tendency to report more extreme pain, to perseverate on pain, and to feel more helpless in response to pain.
Exercise “has been posited as one of the most effective strategies to distract attention from pain and reduce negative thoughts about pain, especially rumination,” the researchers wrote.
The Pain Catastrophizing Scale was used to measure catastrophic thinking about pain. In turn, the Hospital Anxiety and Depression Scale assessed anxiety, the Beck Depression Inventory-Second Edition evaluated depression, the Perceived Stress Scale-10 analyzed stress levels, and the Revised Fibromyalgia Impact Questionnaire was used to study quality of life.
In all measurements, higher scores indicate more severe symptoms or worse quality of life.
Eight weeks of physical exercise led to lower (better) scores across all outcomes: pain catastrophizing scores decreased from 27.31 to 20 points, anxiety lowered from 11.81 to 9.94, depression from 31.13 to 23.81, stress from 25.31 to 22.88 points, and quality of life scores dropped by almost 10 points, from 71.47 to 61.49.
Physical exercise also led to significant improvements in objective measures of physical health: mean distance in the six-minute walk test increased from 481 to 513 meters, and mean time on the five-repetition sit-to-stand test — where a person stand up from an armless chair five times as quickly as possible — decreased from 18.18 to 11.33 seconds.
None of the above scores changed significantly over the eight weeks among control group patients.
“The results obtained from this study show that a combined low-intensity PE [physical exercise] program, including endurance training and coordination, improves pain catastrophizing in women with FM [fibromyalgia],” the researchers wrote. “Furthermore, the proposed protocol improves other psychological variables (i.e., anxiety, depression, and stress), perceived pain, quality of life, and physical conditioning.”
Future studies are needed to confirm the results, they added, noting that this intervention involved women only (who are disproportionately affected by fibromyalgia), and its findings may not reflect the general population.