To examine the effects of strength training on maximal force, cross-sectional area (CSA), and electromyographic (EMG) activity of muscles and serum hormone concentrations in elderly females with fibromyalgia (FM).
Twenty-six patients with FM were randomly assigned to a training (FMT; n = 13; mean age 60 years) or a control (FMC; n = 13; 59 years) group. FMT performed progressive strength training twice a week for 21 weeks. The measurements included maximal isometric and concentric leg extension forces, EMG activity of the vastus lateralis and medialis, CSA of the quadriceps femoris, and serum concentrations of testosterone (T), free testosterone (FT), growth hormone (GH), insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulfate (DHEAS), and cortisol. Subjectively perceived symptoms of FM were also assessed.
All patients were able to complete the training. In FMT strength training led to increases of 36% (p<0.001) and 33% (p<0.001) in maximal isometric and concentric forces, respectively. The CSA increased by 5% (p<0.001) and the EMG activity in isometric action by 47% (p<0.001) and in concentric action by 57% (p<0.001). Basal serum hormone concentrations remained unaltered during strength training. The subjective perceived symptoms showed a minor decreasing tendency (ns). No statistically significant changes occurred in any of these parameters in FMC.
Progressive strength training increases strength, CSA, and voluntary activation of the trained muscles in elderly women with FM, while the measured basal serum hormone concentrations remain unaltered. Strength training benefits the overall physical fitness of the patients without adverse effects or any exacerbation of symptoms and should be included in the rehabilitation programmes of elderly patients with FM.
"A previous metaanalysis that included six studies published up to July of 2005, and in which one of the outcomes for widespread pain and tenderness was tender-points (TP) assessment, concluded that moderate-intensity aerobic exercise training probably leads to little or no difference in TP scores while strength training may result in large reductions in TP scores . However , since that time, additional studies leading to conflicting results on this topic have been published and/or located    . In addition, while the authors preferentially analyzed intention-to-treat results, they also mixed these analyses with per-protocol results if data for the former were not available. "
[Show abstract][Hide abstract] ABSTRACT: Fibromyalgia is a major public health problem affecting an estimated 200 to 400 million people worldwide. The purpose of this study was to use the meta-analytic approach to determine the efficacy and effectiveness of randomized controlled exercise intervention trials (aerobic, strength training, or both) on tender points (TPs) in adults with fibromyalgia. Using random effects models and 95% confidence intervals (CI), a statistically significant reduction in TPs was observed based on per-protocol analyses (8 studies representing 322 participants) but not intention-to-treat analyses (5 studies representing 338 participants) (per-protocol, g, -0.68, 95% CI, -1.16, -0.20; intention-to-treat, g, -0.24, 95% CI, -0.62, 0.15). Changes were equivalent to relative reductions of 10.9% and 6.9%, respectively, for per-protocol and intention-to-treat analyses. It was concluded that exercise is efficacious for reducing TPs in women with FM. However, a need exists for additional well-designed and reported studies on this topic.
"For example, a recent meta-analysis indicated that low to moderate–intensity, but not low-intensity, aerobic exercise reduced pain [13••], and 29 of 34 women randomly assigned to Nordic walking in a recent RCT tolerated moderate to high–intensity aerobic exercise . Several studies also have demonstrated that participants with fibromyalgia showed similar training effects as healthy control patients, with improvements in fatigue, depression, and pain in response to progressive strength-training exercise [42–44]. "
[Show abstract][Hide abstract] ABSTRACT: Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being.
Current Pain and Headache Reports 07/2011; 15(5):358-67. DOI:10.1007/s11916-011-0214-2 · 2.26 Impact Factor
"The initial session (examination and NE) was subsequently followed by a series of seven physical therapy visits, which included additional NE and other treatment strategies that have been reported to improve outcomes in patients with chronic pain, such as aquatic therapy (Assis et al, 2006), cardiovascular exercise (Bonifazi et al, 2006; Brosseau et al, 2008a; Busch et al, 2007; Carville et al, 2008; Goldenberg, Burckhardt, and Crofford, 2004; Gowans et al, 2001; Rooks et al, 2007; Sim and Adams, 2002), and strengthening (Brosseau et al, 2008b; Valkeinen et al, 2005). The therapeutic activities are listed in Table 2. "
[Show abstract][Hide abstract] ABSTRACT: Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. A 64-year-old female with history of CLBP was the patient for this case report. A physical examination, the Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Zung Depression Scale were assessed during her initial physical therapy visit, immediately after her first physical therapy session, and at 7-month follow-up. Treatment consisted of an abbreviated NE approach, exercises (range of motion, stretches, and cardiovascular), and aquatic therapy. She attended twice a week for 4 weeks, or 8 visits total. Pre-NE, the patient reported NPRS = 9/10; ODI = 54%; FABQ-W = 25/42,; FABQ-PA = 20/24, and Zung = 58. Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.
Physiotherapy Theory and Practice 07/2011; 28(1):50-62. DOI:10.3109/09593985.2011.562602
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