Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial. Vagal modulation and symptomatology following a 6-month aerobic exercise program for women with fibromyalgia. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review An exercise program in the treatment of fibromyalgia. Adherence during an individualized home based 12-week exercise program in women with fibromyalgia. A Successful, Long-Term Exercise Program for Women With Fibromyalgia Syndrome and Chronic Fatigue and Immune Dysfunction Syndrome Effects of aerobic or combined aerobic resistance exercise on body composition in overweight and obese adults: gender differences. A randomized intervention study. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial. Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Maintenance of exercise in women with fibromyalgia. Feasibility and effectiveness of an aerobic exercise program in children with fibromyalgia: results of a randomized controlled pilot trial. Aerobic fitness effects in fibromyalgia. The effects of progressive strength training and aerobic exercise on muscle strength and cardiovascular fitness in women with fibromyalgia: a pilot study. The Effects of Nabilone on Sleep in Fibromyalgia: Results of a Randomized Controlled Trial Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool Zumba dancing can improve the pain and functional capacity in women with fibromyalgia. The effects of exercise and education, individually or combined, in women with fibromyalgia. Investigation of the effects of pool-based exercise on fibromyalgia syndrome Clinically Effective Treatment of Fibromyalgia Pain With High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization. Exercise, fibromyalgia, and fibrofog: a pilot study. Effects of exercise interventions during different treatments in breast cancer.
OBJECTIVE To investigate the effects of supervised aerobic exercise ( AE ) and a combined program of supervised aerobic , muscle strengthening , and flexibility exercises ( combined exercise [ CE ] ) on important health outcomes in women with fibromyalgia syndrome ( FMS ) . DESIGN R and omized controlled trial . SETTING Community-based supervised intervention . PARTICIPANTS Women ( N=64 ) with a diagnosis of FMS according to the American College of Rheumatology criteria . INTERVENTION Participants were r and omly allocated to 1 of 3 groups : supervised AE , supervised CE , or usual-care control . Exercise sessions were performed twice weekly ( 45 - 60min/session ) for 24 weeks . MAIN OUTCOME MEASURES The primary outcome measure was the Fibromyalgia Impact Question naire ( FIQ ) . Exploratory outcome measures were the 36-Item Short-Form Health Survey , Beck Depression Inventory ( BDI ) , aerobic capacity ( 6-minute walk test ) , h and -grip strength , and range of motion in the shoulders and hips . RESULTS Compliance with both interventions was excellent , with women in the exercise groups attending more than 85 % of sessions . A 14 % to 15 % improvement from baseline in total FIQ score was observed in the exercise groups ( P≤.02 ) and was accompanied by decreases in BDI scores of 8.5 ( P<.001 ) and 6.4 ( P<.001 ) points in the AE and CE groups , respectively . Relative to nonexercising controls , CE evoked improvements in the SF-36 Physical Functioning ( P=.003 ) and Bodily Pain ( P=.003 ) domains and was more effective than AE for evoking improvements in the Vitality ( P=.002 ) and Mental Health ( P=.04 ) domains . Greater improvements also were observed in shoulder/hip range of motion and h and grip strength in the CE group . CONCLUSION Given the equivalent time commitment required for AE and CE , our results suggest that women with FMS can gain additional health benefits by engaging in a similar volume of CE OBJECTIVES To examine the effects of a supervised aerobic exercise programme on heart rate variability ( HRV ) parameters and symptom severity in women with fibromyalgia ( FM ) . METHODS Thirty-two women with FM were r and omly allocated to one of two groups : aerobic exercise ( AE ) or usual care control for 24 weeks . Women allocated to AE performed two aerobic exercise sessions per week of 45 - 60 min duration including 15 - 20 min of steady-state aerobic exercise at 60 - 65 % of predicted maximum heart rate ( HRmax ) and 15 min of interval training at 75 - 80 % HRmax ( six repetitions of 1.5 min , with 1 min interpolated rest intervals ) . Cardiac autonomic modulation was assessed using power spectral analysis of HRV . Symptom severity was assessed by a 10 cm visual analogue scale ( VAS ) for pain , sleep disturbances , stiffness , anxiety and depression . RESULTS After 24 weeks , the women in the exercise group showed an increase ( 4.8 ± 0.2 to 5.2 ± 0.2 ) in total power ( LnTP , p<0.001 ) , low frequency power ( LnLF , p<0.01 ) , high frequency power ( LnHF , p<0.001 ) , and the root-mean-square of successive R-R intervals ( rMSSD , p<0.001 ) . In addition , significant group-by-time interaction effects were observed for LnHF ( p=0.036 ) and LnLF/HF ( p=0.014 ) . Improvements in anxiety and depression were also observed in AE versus control patients . CONCLUSIONS These results show that a programme of aerobic exercise training  induced changes in cardiac autonomic nervous system modulation in FM and that these changes in HRV parameters were accompanied by changes in anxiety and depression Aim Previous systematic review s have found hydrotherapy to be an effective management strategy for  fibromyalgia syndrome ( FMS ) .  The aim of this systematic review was to summarize the components of hydrotherapy programs used in r and omized controlled trials . Method A systematic review of r and omized controlled trials was conducted . Only trials that have reported significant FMS-related outcomes were included . Data relating to the components of hydrotherapy programs ( exercise type , duration , frequency and intensity , environmental factors , and service delivery ) were analyzed . Results Eleven r and omized controlled trials were included in this review . Overall , the quality of trials was good . Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component . Great variability was noted in both the environmental components of hydrotherapy programs and service delivery . Conclusions Aerobic exercise , warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes . Treatment duration of 60 minutes , frequency of three sessions per week and an intensity equivalent to 60%–80 % maximum heart rate were the most commonly reported exercise components . Exercise appears to be the most important component of an effective hydrotherapy program for FMS , particularly when considering mental health-related outcomes OBJECTIVE To assess the utility of an exercise program , which included aerobic , flexibility and strengthening elements , in the treatment of fibromyalgia ( FM ) . FM is a chronic musculoskeletal condition characterized by diffuse musculoskeletal pain and aching . It has been suggested that aerobic exercise is helpful in its treatment . METHODS We studied 60 patients who met American College of Rheumatology criteria for FM and had no significant comorbidities . Measurements performed on each patient at the pre and post study assessment included the number of tender points ( TP ) , total myalgic scores ( TM ) , aerobic fitness ( AF ) , flexibility and isokinetic strength . After initial evaluation patients were r and omly assigned to either an exercise or a relaxation group . Each group met 3 times per week for 6 weeks for 1 h of supervised exercise or relaxation . All patients data were stored in a computerized data base and statistical analysis was performed on all pre and post study assessment s. RESULTS Thirty-eight patients ( 18 exercise and 20 relaxation ) completed the study . Analysis of our data showed no significant difference between the groups in their pre study assessment . Post study assessment s , however , showed a significant improvement between the exercise and relaxation groups in TP ( p < 0.05 ) , TM ( p < 0.05 ) , and AF ( p < 0.05 ) . Similar improvements were also found when the pre and post study assessment of the exercise group were compared . CONCLUSION Exercise is helpful in the management of FM in the short term . It also shows that FM patients can undertake an exercise program which includes aerobic , flexibility , and strength training exercises without adverse effects . The long term utility of this type of exercise requires further evaluation OBJECTIVE Treatment recommendations for fibromyalgia ( FM ) include regular physical exercise . In this prospect i ve study we examined predictors for adherence to stretching and aerobic exercises in women provided with an individualized home based program .  METHODS Thirty-nine women kept exercise diaries for 12 weeks . RESULTS For both types of exercise , women who were less physically fit at baseline engaged in more exercise during the program . Yet for stretching , more lower body pain at baseline predicted engaging in less stretching exercise over time , whereas for aerobic exercise , more baseline upper body pain predicted more exercise over time . As time passed , participants with higher baseline physical fitness and /or older age were reducing their aerobic exercise practice at significantly faster rates , as were those women with higher baseline stress . CONCLUSION Given that adequate levels of adherence were limited to about half of the participants for both types of exercise , steps to reduce barriers to exercise ( e.g. , stress ) need to be taken when prescribing exercise in the treatment of FM This article describes an ongoing , long-term clinical exercise program for women with fibromyalgia syndrome ( FMS ) , some of whom also have chronic fatigue and immune dysfunction syndrome ( CFIDS ) . The recorded outcomes from the most recent year of the program also are reported . Participants engaged in sessions lasting 50 - 70 minutes , 5 days per week ; each session involved aerobic activity , resistance training , and other dynamic exercise . One group was in the program for 3 years and another group was in the program for 2 years . Program outcomes for the year ( comparing beginning and end-of-year results ) are presented for both groups on physical fitness , psychosocial , and FMS/CFIDS symptoms . The outcomes support that all of the women appear to have benefited from the program in numerous ways , suggesting that the program works . Also , those outcomes are in agreement with past research reported in this journal . Implication s for clinical nurse specialists working with FMS/CFIDS patients are discussed BACKGROUND In the literature , it is not yet clear whether sex may affect the outcomes of exercise training in obese adults . AIM The aim of this study was to investigate gender difference in the effects of combined aerobic resistance exercise ( ARE ) versus aerobic exercise ( AE ) alone on body composition in overweight and obese adults . DESIGN R and omized clinical trial . SETTING University-based outpatient clinic . POPULATION Sixty-five healthy , untrained overweight and obese men and women METHODS They were r and omized into one of two intervention groups ; AE group ( N.=33 ) performed leg cycle exercises with increasing duration and frequency ; ARE group ( N.=32 ) performed additionally progressive weight-resistance exercises for the upper and lower parts of body . Both groups were asked not to change their diet . Body composition including percentage of fat ( PF ) , fat mass ( FM ) and fat free mass ( FFM ) in regional and whole body was determined by dual-energy X-ray absorptiometry ( DXA ) at baseline and week 12 . RESULTS ARE leads to more gains on regional and whole body FFM than AE . ARE was more effective in increasing the FFM of arms , trunk and whole body and decreasing PF of trunk in men and superior on reducing FM of legs in women when comparing with AE . CONCLUSION In order to reduce the trunk fat in men and leg fat in women , resistance exercise can be added into an aerobic training program . CLINICAL REHABILITATION IMPACT Dissimilar results of exercises on sex obtained in our study serves as a guide for prescribing exercises in overweight and obese men and women OBJECTIVES To evaluate the effects of a 16-week exercise therapy in a chest-high pool of warm water through applicable tests in the clinical practice on the global symptomatology of women with fibromyalgia ( FM ) and to determine exercise adherence levels . DESIGN A r and omized controlled trial . SETTING Testing and training were completed at the university . PARTICIPANTS Middle-aged women with FM ( n=60 ) and healthy women ( n=25 ) . INTERVENTION A 16-week aquatic training program , including strength training , aerobic training , and relaxation exercises . MAIN OUTCOME MEASURES Tender point count ( syringe calibrated ) , health status ( Fibromyalgia Impact Question naire ) ; sleep quality ( Pittsburgh Sleep Quality Index ) ; physical ( endurance strength to low loads tests ) , psychologic ( State Anxiety Inventory ) , and cognitive function ( Paced Auditory Serial Addition Task ) ; and adherence 12 months after the completion of the study . RESULTS For all the measurements , the patients showed significant deficiencies compared with the healthy subjects . Efficacy analysis ( n=29 ) and intent-to-treat analysis ( n=34 ) of the exercise therapy was effective in decreasing the tender point count and improving sleep quality , cognitive function , and physical function . Anxiety remained unchanged during the follow-up . The exercise group had a significant improvement of health status , not associated exclusively with the exercise intervention . There were no changes in the control group . Twenty-three patients in the exercise group were exercising regularly 12 months after completing the program . CONCLUSIONS An exercise therapy 3 times a week for 16 weeks in a warm pool could improve most of the symptoms of FM and cause a high adherence to exercise in unfit women with heightened FM symptomatology . The therapeutic intervention 's effects can be assessed through applicable tests in the clinical practice This study aim ed to examine the effectiveness of a multidisciplinary intervention with aftercare ( MD ) compared to aerobic exercise ( AE ) and usual care ( UC ) in recently diagnosed patients with fibromyalgia ( FM ) . In a Zelen-like design , eligible patients from the outpatient rheumatology clinics of three medical centres in the South of the Netherl and s were consecutively recruited and pre-r and omised to MD ( n = 108 ) , AE ( n = 47 ) or UC ( n = 48 ) .  MD consisted of a 12-week course of sociotherapy , physiotherapy , psychotherapy and creative arts therapy ( three half days per week ) , followed by five aftercare meetings in 9 months . AE was given twice a week in a 12-week course . UC varied but incorporated at least education and lifestyle advice . Primary outcomes were health-related quality of life ( HR-Qol ) , participation and health care utilisation . Secondary outcome was the Fibromyalgia Impact Question naire ( FIQ ) . Total follow-up duration of the study was 21–24 months . As willingness to participate in AE was limited , this group has been analysed but interpretation of the data is considered arguable . Within the MD group , a statistically significantly improved HR-Qol and a statistically significant reduction in number of hours sick leave , number of contacts with general practitioners and number of contacts with medical specialists was found . Moreover , statistically significant improvements were found on the FIQ , which increased after the intervention . However , no statistically significant between-group differences were found at the endpoint of the study . MD seemed to yield positive effects , but firm conclusions with regard to effectiveness can not be formulated due to small between-group differences and limitations of the study OBJECTIVES To compare the cognitive function performance in patients with fibromyalgia ( FM ) with respect healthy controls and to evaluate the short-term efficacy of exercise therapy in a warm , chest-high pool on pain and cognitive function in women with FM . METHODS Sixty middle-aged women with FM were r and omly assigned to either an exercise training group ( n = 35 ) to perform 3 sessions per week of aquatic training ( 32 degrees C ) including mobility , aerobic , strengthening , and relaxation exercises for 16 weeks , or a control group ( n = 25 ) . Twenty-five healthy women matched for age , weight , body mass index , and educational and physical activity levels were recruited .  Pain was assessed in patients using a syringe calibrated like a pressure dolorimeter , and a visual analog scale . The severity of FM was evaluated using the Fibromyalgia Impact Question naire . Cognitive function was measured in healthy individuals and patients using several st and ardized neuropsychological tests . All patients were measured at baseline and post-treatment . RESULTS At baseline , the healthy group evidence d cognitive performance that was significantly superior to the group of patients with FM in all of the neuropsychological tests . The exercise group significantly improved their pain threshold , tender point count , self-reported pain , severity of FM , and cognitive function , while in the control group the differences were not significant . CONCLUSION An exercise therapy three times per week for 16 weeks in a warm-water pool is an adequate treatment to decrease the pain and severity of FM well as to improve cognitive function in previously unfit women with FM and heightened painful symptomatology OBJECTIVE To identify predictors of maintenance of exercise for women with fibromyalgia ( FM ) . METHODS Women with FM who had been r and omized to the exercise arm of a clinical trial were studied prospect ively during and 3 months following treatment . Subjects completed exercise logs weekly and returned the data via postal mail . Outcome variables were duration of aerobic and stretching exercises .  Two separate multivariate models for longitudinal data were built with adjustment for in-treatment adherence and time . Pretreatment characteristics ( self efficacy , pain , disability , stress , exercise barriers and benefits , and age ) and changes during treatment ( pain , disability , stress , and exercise barriers and benefits ) were considered potential predictors of exercise maintenance . RESULTS  Stretching  significantly decreased in the 3 months following treatment . High stress at baseline and increases in stress during treatment were associated with poor maintenance of stretching . Disability at baseline ( measured with the Fibromyalgia Impact Question naire ) , an increase in barriers to exercise during treatment , and increases in upper-body pain during treatment were associated with worse maintenance of aerobic exercise in the 3 months following treatment . CONCLUSION The maintenance of an exercise program in women with FM appears to be contingent on being able to deal with stress , pain , barriers to exercise , and disability OBJECTIVE To determine the feasibility of conducting a r and omized controlled trial of a 12-week exercise intervention in children with fibromyalgia ( FM ) and to explore the effectiveness of aerobic exercise on physical fitness , function , pain , FM symptoms , and quality of life ( QOL ) . METHODS FM patients ages 8 - 18 years were r and omized to a 12-week exercise intervention of either aerobics or qigong . Both groups participated in 3 weekly training sessions . Program adherence and safety were monitored at each session . Data were collected at 3 testing sessions , 2 prior to and 1 after the intervention , and included FM symptoms , function , pain , QOL , and fitness measures . RESULTS Thirty patients participated in the trial . Twenty-four patients completed the program ; 4 patients dropped out prior to training and 2 dropped out of the aerobics program . Better adherence was reported in the aerobics group than in the qigong group ( 67 % versus 61 % ) . Significant improvements in physical function , functional capacity , QOL , and fatigue were observed in the aerobics group . Anaerobic function , tender point count , pain , and symptom severity improved similarly in both groups . CONCLUSION It is feasible to conduct an exercise intervention trial in children with FM . Children with FM tolerate moderate-intensity exercise without exacerbation of their disease . Significant improvements in physical function , FM symptoms , QOL , and pain were demonstrated in both exercise groups ; the aerobics group performed better in several measures compared with the qigong group . Future studies may need larger sample sizes to confirm clinical improvement and to detect differences in fitness in childhood FM OBJECTIVE To compare 2 exercise modalities , aerobic fitness training and stretching exercises , in patients with fibromyalgia ( FM ) in relation to function , pain , quality of life , depression , and anxiety , and to correlate the cardiorespiratory fitness gain with symptom improvement . METHODS Seventy-six women with FM between 18 and 60 years old were r and omized to either an aerobic program or stretching program , for 20 weeks . They were evaluated at the beginning of the program and after 10 and 20 weeks in relation to the improvement of aerobic fitness , flexibility , function , Fibromyalgia Impact Question naire ( FIQ ) , Short-form Health Survey ( SF-36 ) , and depression and anxiety levels . Ventilatory anaerobic threshold ( VT ) and maximum oxygen uptake ( VO2max ) were determined by expired gas analyses . RESULTS Aerobic exercise was superior to stretching in relation to VO2 max , VT , function , depression , pain , and the emotional aspects and mental health domains of SF-36 . Patients in the stretching group showed no improvement in depression , " role emotional , " and " mental health . " No association was noted between improvement in aerobic fitness as measured by VT and the improvement of pain , function , or scores in FIQ and SF-36 . CONCLUSION Our results confirm that aerobic exercise is beneficial to patients with FM , but the cardiorespiratory fitness gain is not related to improvement of FM symptoms OBJECTIVE To determine the safety , feasibility and consequences of a program of progressive strength training and cardiovascular exercise in women with fibromyalgia syndrome ( FMS ) . METHODS Fifteen women with confirmed FMS were monitored for injury and exercise compliance , and assessed for muscle strength ( 1-repetition maximum technique ) , cardiovascular endurance ( 6-minute walk test ) , and functional status ( Fibromyalgia Impact Question naire [ FIQ ] ) before and after a 20-week exercise intervention . RESULTS Zero injuries and an 81 % compliance rate occurred during training . Improvement was seen in muscle strength of the lower ( 191 + /- 75 to 265 + /- 67 pounds ; P < 0.001 ) and upper ( 61 + /- 18 to 76 + /- 18 pounds ; P < 0.001 ) body , 6-minute walk distance ( 530 + /- 80 to 629 + /- 74 meters ; P < 0.001 ) , and in FIQ score ( 44 + /- 9 to 32 + /- 14 ; P < 0.01 ) . CONCLUSION A program of progressive strength training and cardiovascular exercise can be safe , well tolerated , and effective at improving muscle strength , cardiovascular endurance and functional status in women with FMS without exacerbating symptoms . This program may also contribute to a reduction in the severity of several symptoms BACKGROUND : Sleep disorders affect many patients with chronic pain conditions . Cannabis has been reported by several patient population s to help sleep . We evaluated the safety and efficacy of nabilone , a synthetic cannabinoid , on sleep disturbance in fibromyalgia ( FM ) , a disease characterized by widespread chronic pain and insomnia . METHODS : We conducted a r and omized , double-blind , active-control , equivalency crossover trial to compare nabilone ( 0.5–1.0 mg before bedtime ) to amitriptyline ( 10–20 mg before bedtime ) in patients with FM with chronic insomnia . Subjects received each drug for 2 wk with a 2-wk washout period . The primary outcome was sleep quality , measured by the Insomnia Severity Index and the Leeds Sleep Evaluation Question naire . Secondary outcomes included pain , mood , quality of life , and adverse events ( AEs ) . RESULTS : Thirty-one subjects were enrolled and 29 completed the trial ( 26 women , mean age 49.5 yr ) . Although sleep was improved by both amitriptyline and nabilone , nabilone was superior to amitriptyline ( Insomnia Severity Index difference = 3.2 ; 95 % confidence interval = 1.2–5.3 ) . Nabilone was marginally better on the restfulness ( Leeds Sleep Evaluation Question naire difference = 0.5 [ 0.0–1.0 ] ) but not on wakefulness ( difference = 0.3 [ −0.2 to 0.8 ] ) . No effects on pain , mood , or quality of life were observed . AEs were mostly mild to moderate and were more frequent with nabilone . The most common AEs for nabilone were dizziness , nausea , and dry mouth . CONCLUSIONS : Nabilone is effective in improving sleep in patients with FM and is well tolerated . Low-dose nabilone given once daily at bedtime may be considered as an alternative to amitriptyline . Longer trials are needed to determine the duration of effect and to characterize long-term safety Background There are no approved medications for juvenile fibromyalgia ( JFM ) , a disorder that is often under-diagnosed . The effects of milnacipran , a drug approved for the management of fibromyalgia ( FM ) in adults , was assessed in a clinical trial program for JFM . Methods Patients , ages 13–17 years who met the Yunus and Masi criteria for JFM and /or 1990 American College of Rheumatology criteria for FM , were enrolled in a responder-enriched , r and omized withdrawal trial . After receiving open-label milnacipran ( 8 weeks ) , patients with ≥50 % improvement in pain underwent double-blind r and omization ( 1:2 ) to either placebo or continuing treatment with milnacipran ( 8 weeks ) . All patients , including those who did not meet the r and omization criteria for double-blind withdrawal , were allowed to enter an extension study with open-label milnacipran ( up to 52 weeks ) . The primary endpoint was loss of therapeutic response ( LTR ) during the double-blind period . Additional outcome measures included the Patient Global Impression of Severity ( PGIS ) , Pediatric Quality of Life Inventory ( PedsQL : Generic Core Scales , Multidimensional Fatigue Scale ) , and Multidimensional Anxiety Scale for Children ( MASC ) . Safety assessment s included adverse events ( AEs ) , vital signs , electrocardiograms , and laboratory tests . Results The milnacipran program was terminated early due to low enrollment . Because only 20 patients were r and omized into the double-blind withdrawal period , statistical analyses were not conducted for the LTR endpoint . However , 116 patients entered the open-label period of the initial study and 57 participated in the open-label extension study . Their experience provides preliminary information about the use of milnacipran in JFM patients . During both open-label periods , there were mean improvements in pain severity , PGIC , PedsQL , and MASC scores . No unexpected safety issues were detected . The most commonly reported treatment-emergent AEs were nausea , headache , vomiting , and dizziness . Mean increases in heart rate and blood pressure were observed , and were consistent with the AE profile in adults with FM . Conclusions The open-label findings provide preliminary evidence that milnacipran may improve symptoms of JFM , with a safety and tolerability profile that is consistent with the experience in adult FM patients . Future trial design s for JFM should consider the relatively low recognition of this condition compared to adult FM and the difficulties with enrollment . Trial registration NCT01328002 ; The aim of this study was to evaluate the effectiveness of aerobic exercise in water pool compared with aerobic exercise performed in sea by women with fibromyalgia ( FM ) . A total of 46 patients were r and omly allocated into two groups : pool group ( 23 patients ) and sea group ( 23 patients ) that performed the same aerobic exercise program . Patients were evaluated baseline and after 12 weeks using : VAS , number of tender points , FIQ , SF-36 , PSQI , and BDI . Both groups improved significantly in post-treatment for all the evaluated variables . There were no significant differences between two groups , except for BDI ( F = 2.418 , P < 0.0001 ) . Aerobic exercise program performed in water ( pool or sea ) was effective for patients with FM . However , sea water exercises have been shown to bring more advantages related to emotional aspects . Then , exercise performed sea water ( thalassotherapy ) is an option for effective treatment with low cost for patients with FM INTRODUCTION The importance of physical exercise for patients with fibromyalgia ( FM ) is very clear in the literature . Dancing is a type of aerobic exercise that has great acceptance . In addition to the beneficial effects of aerobic exercise , Zumba works on motor coordination and also has socializing as a part that should be included in patients with fibromyalgia . OBJECTIVES To evaluate the effectiveness of Zumba dancing in improving pain , functional capacity , quality of sleep and quality of life of women with fibromyalgia . DESIGN A pre-post treatment design . METHODS We evaluated 19 women with fibromyalgia , selected by convenience . Data were collected in the second half of 2016 . Zumba dancing was performed twice a week for 12 weeks . Patients were evaluated at week 0 ( T0 ) and at week 12 ( T12 ) , by the following instruments : VAS ( Visual Analogic Scale ) , Likert Scale , TUG ( Timed Up an Go Test ) , 6MWT ( Six-minute Walk Test ) , FIQ ( Fibromyalgia Impact Question naire ) , PSQI ( Pittsburgh Sleep Quality Index ) , ESS ( Epworth Sleepiness Scale ) and SF-36 quality of life . RESULTS We found differences in pain ( VAST0 = 6.21 and VAST12 = 4.53 ) with p = 0.001 and in the domain physical functioning of SF36 ( T0 = 42.37 and T12 = 52.11 ) with p = 0.04 . No differences were found for the other variables between the times . CONCLUSION Zumba dancing as a form of treatment for three months for patients with fibromyalgia was effective in improving pain and physical functioning . Future controlled and r and omized clinical trials should be performed to improve the evidence of Zumba dancing in women with fibromyalgia OBJECTIVE To examine the effectiveness of a supervised aerobic exercise program , a self-management education program , and the combination of exercise and education for women with fibromyalgia ( FM ) . METHODS One hundred fifty-two women were r and omized into one of 4 groups : exercise-only , education-only , exercise and education , or control . The duration of the study was 12 weeks . All subjects were analyzed at 3 times : before study , immediately upon completion , and 3 months after completion of the intervention program on measures of disability , self-efficacy , fitness , tender point count , and tender point tenderness .  Of the 152 women , complete data were available for 95 and 69 who complied with the protocol . In order to determine the group time interaction , a 2 way analysis of variance with repeated measures was used for each measure . RESULTS The only significant group time interaction was reported with the compliance analysis for the Self-Efficacy Coping with Other Symptoms subscale and the Six Minute Walk . If the program was followed , the combination of a supervised exercise program and group education provided persons with FM with a better sense of control over their symptoms . Fitness improved in the 2 groups undergoing supervised aerobic exercise programs . However , the improvement in fitness was maintained at followup in the exercise-only group and not the combined group . Conclusion . Subjects receiving the combination of exercise and education and who complied with the treatment protocol improved their perceived ability to cope with other symptoms . In addition , a supervised exercise program increased walking distance at post-test , an increase that was maintained at followup in the exercise-only group . Results demonstrate the challenges with conducting exercise and education studies in persons with FM Objective The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome ( FMS ) patients . Methods Fifty female patients diagnosed with FMS according to the American College of Rheumatism ( ACR ) criteria were r and omly assigned to two groups : group 1 ( n=25 ) with pool-based exercise , and in group 2 ( n=25 ) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks . In both groups , pre- ( week 0 ) and post-treatment ( weeks 12 and 24 ) evaluation was performed by one of the authors , who was blind to the patient group . Evaluation parameters included pain , morning stiffness , sleep , tender points , global evaluation by the patient and the physician , fibromyalgia impact question naire , chair test , and Beck depression inventory . Statistical analysis was done on data collected from three evaluation stages . Results Twenty-four exercise and 22 balneotherapy patients completed the study . Pretreatment ( week 0 ) measurements did not show any difference between the groups . In group 1 , statistically significant improvement was observed in all parameters ( P<0.01 ) except for the chair test at both weeks 12 and 24 . In group 2 , week 12 measurements showed significant improvement in all parameters ( P<0.01 ) except for the chair test and Beck depression inventory . Week 24 evaluation results in group 2 showed significant improvements in pain and fatigue according to visual analogue scale ( VAS ) , 5-point scale , number of tender points , algometric and myalgic scores , and patient and physician global evaluation ( P<0.01 and P<0.05 , respectively ) , while improvements were nonsignificant in morning stiffness , sleep , fibromyalgia impact question naire ( FIQ ) , chair test , and Beck depression inventory parameters in this group . Comparison of the two groups based on the post-treatment ( weeks 12 and 24 ) percent changes and difference scores relative to pretreatment ( week 0 ) values failed to show a significant difference between the groups for any parameter except Beck depression inventory ( P<0.01 ) . Conclusion The results of our study showed that pool-based exercise had a longer-lasting effect on some of the FMS symptoms , but statistical analysis failed to show a significant superiority of pool-based exercise over balneotherapy without exercise . While we believe that exercise is a gold st and ard in FMS treatment , we also suggest in light of our results that balneotherapy is among the valid treatment options in FMS , and further research regarding the type and duration of the exercise programs is necessary UNLABELLED Despite promising preliminary results in treating fibromyalgia ( FM ) pain , no neuromodulation technique has been adopted in clinical practice because of limited efficacy , low response rate , or poor tolerability . This phase II open-label trial aims to define a methodology for a clinical ly effective treatment of pain in FM by establishing treatment protocol s and screening procedures to maximize efficacy and response rate . High-definition transcranial direct current stimulation ( HD-tDCS ) provides targeted subthreshold brain stimulation , combining tolerability with specificity . We aim ed to establish the number of HD-tDCS sessions required to achieve a 50 % FM pain reduction , and to characterize the biometrics of the response , including brain network activation pain scores of contact heat-evoked potentials . We report a clinical ly significant benefit of a 50 % pain reduction in half ( n = 7 ) of the patients ( N = 14 ) , with responders and nonresponders alike benefiting from a cumulative effect of treatment , reflected in significant pain reduction ( P = .035 ) as well as improved quality of life ( P = .001 ) over time . We also report an aggregate 6-week response rate of 50 % of patients and estimate 15 as the median number of HD-tDCS sessions to reach clinical ly meaningful outcomes . The methodology for a pivotal FM neuromodulation clinical trial with individualized treatment is thus supported . ONLINE REGISTRATION Registered in Clinical trials.gov under registry number NCT01842009 . PERSPECTIVE In this article , an optimized protocol for the treatment of fibromyalgia pain with targeted subthreshold brain stimulation using high-definition transcranial direct current stimulation is outlined BACKGROUND This pilot study was design ed to test the efficacy of a physical activity program for improving psychological variables and fibromyalgia syndrome ( FMS ) symptoms and to provide preliminary evidence regarding the effects on perceived cognitive symptoms and objective ly measured cognitive performance by FMS patients . METHODS Sixteen women diagnosed with FMS were r and omly assigned to an 18-week physical activity program or to a control condition .  Psychological measures , FMS symptoms , perceived cognitive function , objective measures of cognition , and walking capacity were assessed at baseline and posttest . RESULTS At posttest , there were significant differences in fatigue ( effect size , ES=1.86 ) , depression ( ES=1.27 ) , FMS symptoms ( ES=1.56 ) , self-reported cognitive symptoms ( ES=1.19 ) , and delayed recall performance ( ES=1.16 ) between the physically active group and the control group , indicating that the FMS patients benefited from physical activity . Beneficial effects were also observed for 6 of the 7 objective measures of cognition and ranged from small to large ( ESs=0.26 to 1.06 ) . CONCLUSIONS Given that all FMS patients do not respond well to conventional treatments , these beneficial effects of physical activity are important . Future studies with larger sample s are warranted to test the reliability of the findings for the objective measures of cognition Previous findings suggest that exercise is a safe and efficacious means of improving physiological and psychosocial outcomes in female breast cancer survivors . To date , most research has focused on post-treatment interventions . However , given that the type and severity of treatment-related adverse effects may be dependent on the type of treatment , and that the effects are substantially more pronounced during treatment , an assessment of the safety and efficacy of exercise during treatment is warranted . In this review , we present and evaluate the results of r and omized controlled trials ( RCTs ) conducted during breast cancer treatment . We conducted literature search es to identify studies examining exercise interventions in breast cancer patients who were undergoing chemotherapy or radiation .  Data were extracted on physiological and psychosocial outcomes . Cohen 's d effect sizes were calculated for each outcome . A total of 17 studies involving 1,175 participants undergoing active cancer therapy met the inclusion criteria . Findings revealed that , on average , exercise interventions result ed in moderate to large improvements in muscular strength : resistance exercise ( RE , 𝑑 = 0.86 ) , aerobic exercise  ( AE , 𝑑 = 0.55 ) , small to moderate improvements in cardiovascular functioning ( RE , 𝑑 = 0.45 ; AE , 𝑑 = 0.17 , combination exercise ( COMB , 𝑑 = 0.31 ) and quality of life ( QoL ; RE , 𝑑 = 0.30 ; AE , 𝑑 = 0.50 ; COMB , 𝑑 = 0.63 ) . The results of this review suggest that exercise is a safe , feasible , and efficacious intervention in breast cancer patients who are undergoing different types of treatment . Additional research addressing the different modes of exercise during each type of treatment is warranted to assess the comparable efficacy of the various exercise modes during established breast cancer treatments
Pain was significantly reduced post treatment by l and -based and water-based AE , exercises with slight to moderate intensity and frequency of two or three times per week .
Positive effects on depressed mood , HRQOL and physical fitness could be maintained at follow-up .
Continuing exercise was associated with positive outcomes at follow-up .
Introduction The efficacy and the optimal type and volume of aerobic exercise ( AE ) in fibromyalgia syndrome ( FMS ) are not established .
We therefore assessed the efficacy of different types and volumes of AE in FMS .