Zumba dancing can improve the pain and functional capacity in women with fibromyalgia. Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial A protocol and pilot study for managing fibromyalgia with yoga and meditation. Neurotherapy of fibromyalgia? Group exercise, education, and combination self-management in women with fibromyalgia: a randomized trial. Effectiveness of dance in patients with fibromyalgia: a randomized, single-blind, controlled study. White Matter Integrity Declined Over 6-Months, but Dance Intervention Improved Integrity of the Fornix of Older Adults Effects of Lifestyle Physical Activity in Adults With Fibromyalgia: Results at Follow-Up Predicting high physical function in people with fibromyalgia. Cognitive Benefits of Social Dancing and Walking in Old Age: The Dancing Mind Randomized Controlled Trial Effect of Transcutaneous Electrical Nerve Stimulation on Pain, Function, and Quality of Life in Fibromyalgia: A Double-Blind Randomized Clinical Trial Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life. What Makes Patients with Fibromyalgia Feel Better? Correlations Between Patient Global Impression of Improvement and Changes in Clinical Symptoms and Function: A Pooled Analysis of 4 Randomized Placebo-controlled Trials of Duloxetine A Randomized Clinical Trial of Acupuncture Compared with Sham Acupuncture in Fibromyalgia Exercise, fibromyalgia, and fibrofog: a pilot study. Childhood adversities in patients with fibromyalgia and somatoform pain disorder Sustained Pain Reduction Through Affective Self-awareness in Fibromyalgia: A Randomized Controlled Trial The effect of dance mat exergaming systems on physical activity and health – related outcomes in secondary schools: results from a natural experiment Multidisciplinary treatment of fibromyalgia: does cognitive behavior therapy increase the response to treatment? Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: a randomized controlled trial A pragmatic community-based intervention of multimodal physiotherapy plus deep water running (DWR) for fibromyalgia syndrome: a pilot study
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 Background The al- And alus physical activity intervention study is a r and omised control trial to investigate the effectiveness of a l and - and water-based exercise intervention for reducing the overall impact of fibromyalgia ( primary outcome ) , and for improving tenderness and pain-related measures , body composition , functional capacity , physical activity and sedentary behaviour , fatigue , sleep quality , health-related quality of life , and cognitive function ( secondary outcomes ) in women with fibromyalgia . Methods / Design One hundred eighty women with fibromyalgia ( age range : 35 - 65 years ) will be recruited from local associations of fibromyalgia patients in And alucía ( Southern Spain ) . Patients will be r and omly assigned to a usual care ( control ) group ( n = 60 ) , a water-based exercise intervention group ( n = 60 ) or a l and -based exercise intervention group ( n = 60 ) . Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions ( 60 min each ) per week during 24 weeks . Both exercise interventions will consist of aerobic , muscular strength and flexibility exercises . We will also study the effect of a detraining period ( i.e. , 12 weeks with no exercise intervention ) on the studied variables . Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients ' health status by implementing two types of exercise interventions . Results from this study will help to assess the efficacy of  exercise interventions for the treatment of fibromyalgia . If the interventions would be effective , this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia . Results from the al- And alus physical activity intervention will help to better underst and the potential of regular physical activity for improving the well-being of women with fibromyalgia . Trial registration Clinical Trials.gov ID : Fibromyalgia is a chronic syndrome characterized by widespread pain , sleep disturbance , stiffness , fatigue , headache , and mood disorders . Recent research has result ed in an improved underst and ing of fibromyalgia and its possible causes . This article highlights some of the current research , discusses a strategy for using yoga and meditation as a therapy for fibromyalgia sufferers , and presents the results of a preliminary 8-week study using yoga and meditation to help manage fibromyalgia symptoms . The study of 11 participants found significant improvement in the overall health status of the participants and in symptoms of stiffness , anxiety , and depression . Significant improvements were also seen in the reported number of days " felt good " and number of days " missed work " because of fibromyalgia . Nonsignificant improvements were seen in measures of pain , fatigue , and how one felt in the morning . Effect sizes were medium to large for most tested areas . This study supports the benefits of yoga and meditation for individuals with fibromyalgia and encourages further research to explore their use as st and ard therapies for fibromyalgia OBJECTIVE To evaluate the efficacy of a novel variant of electroencephalograph biofeedback , the Low Energy Neurofeedback System ( LENS ) , that utilizes minute pulses of electromagnetic stimulation to change brainwave activity for the amelioration of fibromyalgia ( FM ) symptoms . DESIGN R and omized , double-blind , placebo-controlled clinical trial . SETTING Tertiary referral academic medical center , outpatient . PATIENTS Thirty-four patients diagnosed with FM according to 1990 American College of Rheumatology classification criteria . INTERVENTIONS Active or sham LENS , depending on r and omization , for 22 treatment sessions . OUTCOME MEASURES Primary outcome measure was the Fibromyalgia Impact Question naire total score . Secondary outcome measures included number of tender points ( TPs ) and pressure required to elicit TPs on physical examination , quantitative sensory testing heat pain threshold , and self-reported cognitive dysfunction , fatigue , sleep problems , global psychological distress , and depression obtained at baseline , immediate post-treatment , and 3- and 6-month follow-up . RESULTS Participants who received the active or sham interventions improved ( Ps < 0.05 ) on the primary and a variety of secondary outcome measures , without statistically significant between group differences in evidence at post-treatment or 3- or 6-month follow-up . Individual session self-reported ratings of specific symptoms ( cognitive dysfunction , fatigue , pain , and sleep , and overall activity level ) over the course of the 22 intervention sessions indicated significant linear trends for improvement for the active intervention condition only ( Ps < 0.05 ) . CONCLUSION LENS can not be recommended as a single modality treatment for FM . However , further study is warranted to investigate the potential of LENS to interact synergistically with other pharmacologic and nonpharmacologic therapies for improving symptoms in FM BACKGROUND Self-management has increasingly been recommended as part of st and ard care for fibromyalgia , a common , poorly understood condition with limited treatment options . Data that assess popular self-management recommendations are scarce . We evaluated and compared the effectiveness of 4 common self-management treatments on function , symptoms , and self-efficacy in women with fibromyalgia . METHODS A total of 207 women with confirmed fibromyalgia were recruited from September 16 , 2002 , through November 30 , 2004 , and r and omly assigned to 16 weeks of ( 1 ) aerobic and flexibility exercise ( AE ) ; ( 2 ) strength training , aerobic , and flexibility exercise ( ST ) ; ( 3 ) the Fibromyalgia Self-Help Course ( FSHC ) ; or ( 4 ) a combination of ST and FSHC ( ST-FSHC ) . The primary outcome was change in physical function from baseline to completion of the intervention . Secondary outcomes included social and emotional function , symptoms , and self-efficacy . RESULTS Improvements in the mean Fibromyalgia Impact Question naire score in the 4 groups were -12.7 for the ST-FSHC group , -8.2 for the AE group , -6.6 for the ST group , and -0.3 for the FSHC group . The ST-FSHC group demonstrated greater improvement than the FSHC group ( mean difference , -12.4 ; 95 % confidence interval [ CI ] , -23.1 to -1.7 ) . The ST-FSHC ( mean difference , 13.6 ; 95 % CI , 2.3 to 24.9 ) and AE ( mean difference , 13.1 ; 95 % CI , 1.6 to 25.6 ) groups had similar improvements in physical function scores on the 36-Item Short-Form Health Survey . Bodily pain scores on the 36-Item Short-Form Health Survey improved in the ST-FSHC ( 14.8 ) , AE ( 13.2 ) , and ST ( 5.7 ) groups . Social function , mental health , fatigue , depression , and self-efficacy also improved . The beneficial effect on physical function of exercise alone and in combination with education persisted at 6 months . CONCLUSIONS Progressive walking , simple strength training movements , and stretching activities improve functional status , key symptoms , and self-efficacy in women with fibromyalgia actively being treated with medication . The benefits of exercise are enhanced when combined with targeted self-management education . Our findings suggest that appropriate exercise and patient education be included in the treatment of fibromyalgia OBJECTIVES The aim of the present study was to assess the effectiveness of belly dance as a treatment option for patients with fibromyalgia . METHODS Eighty female patients with fibromyalgia between 18 to 65 years were r and omly allocated to a dance group ( n=40 ) and control group ( n=40 ) . Patients in the dance group underwent 16 weeks of belly dance twice a week , while the patients in the control group remained on a waiting list . The patients were evaluated with regard to pain ( VAS ) , function ( 6MWT ) , quality of life ( FIQ and SF-36 ) , depression ( Beck Inventory ) , anxiety ( STAI ) and self-image ( BDDE ) . Evaluations were carried out at baseline , 16 weeks and 32 weeks by a blinded assessor . RESULTS The dance group achieved significant improvements in VAS for pain ( p<0.001 ) , six-minute walk test ( p<0.001 ) , FIQ ( p=0.003 ) , BDDE ( p<0.009 ) as well as the pain ( p<0.001 ) , emotional aspects ( p<0.003 ) and mental health ( p<0.021 ) subscales on the SF-36 . CONCLUSIONS Belly dance can be used in the treatment of fibromyalgia to reduce pain and improve functional capacity , quality of life and self-image Degeneration of cerebral white matter ( WM ) , or structural disconnection , is one of the major neural mechanisms driving age-related decline in cognitive functions , such as processing speed . Past cross-sectional studies have demonstrated beneficial effects of greater cardiorespiratory fitness , physical activity , cognitive training , social engagement , and nutrition on cognitive functioning and brain health in aging . Here , we collected diffusion magnetic resonance ( MRI ) imaging data from 174 older ( age 60–79 ) adults to study the effects of 6-months lifestyle interventions on WM integrity . Healthy but low-active participants were r and omized into Dance , Walking , Walking + Nutrition , and Active Control ( stretching and toning ) intervention groups ( NCT01472744 on Clinical Trials.gov ) . Only in the fornix there was a time × intervention group interaction of change in WM integrity : integrity declined over 6 months in all groups but increased in the Dance group . Integrity in the fornix at baseline was associated with better processing speed , however , change in fornix integrity did not correlate with change in processing speed . Next , we observed a decline in WM integrity across the majority of brain regions in all participants , regardless of the intervention group . This suggests that the aging of the brain is detectable on the scale of 6-months , which highlights the urgency of finding effective interventions to slow down this process . Magnitude of WM decline increased with age and decline in prefrontal WM was of lesser magnitude in older adults spending less time sedentary and more engaging in moderate-to-vigorous physical activity . In addition , our findings support the anterior-to-posterior gradient of greater-to-lesser decline , but only in the in the corpus callosum . Together , our findings suggest that combining physical , cognitive , and social engagement ( dance ) may help maintain or improve WM health and more physically active lifestyle is associated with slower WM decline . This study emphasizes the importance of a physically active and socially engaging lifestyle among aging adults Background : In a 12-week r and omized controlled trial of the effects of lifestyle physical activity ( LPA ) on symptoms and function among adults with fibromyalgia , we found that  LPA participants increased their average daily step count by 54 % , improved their self-reported functioning by 18 % , and reduced their pain by 35 % . Objectives : The objective of the study was to evaluate the intermediate ( 6 months ) and long-term ( 12 months ) effects of the LPA intervention on outcomes . Methods : Participants completed follow-up assessment s of physical activity , pain , fibromyalgia-related function , fatigue , depression , number of tender points , 6-minute walk test , and perceived improvement at 6 and 12 months after intervention . Results : Of the 73 participants who completed the 12-week trial , 53 ( 73 % ) completed both the 6- and 12-month follow-up . Although the LPA participants reported greater perceived improvement at each follow-up , they did not differ from controls on pain , physical activity , tenderness , fatigue , depression , or the 6-minute walk test . Self-reported functioning declined markedly at follow-up for the LPA participants . Conclusions : Although participants reported greater perceived improvement at each assessment , the beneficial effects of LPA on physical activity , function , and pain found after the 12-week intervention were not sustained over time . This recidivism is seen in studies of activity and exercise in nearly any condition , and innovative methods that may prevent this are a focus of future studies PURPOSE The purpose of this study was to investigate predictors of high physical function in people with fibromyalgia ( FM ) . DESIGN Cross-sectional descriptive , correlational study of 2,580 persons with FM who responded to an online survey during fall 2005 . METHODS The survey indicated self-reported physical activity levels , functional abilities , symptoms , health care costs , employment status , work productivity , self management strategies . It had adequate validity and reliability . A significant binary logistic regression model of predictors of physical function ( individual factors , symptoms , self management strategies ) was vali date d using backwards logistic regression . FINDINGS Significant explanatory variables of high physical function were : men , greater education , younger age , lower intensity fatigue , spasticity , and balance problems , not using prescription pain medications , using aerobic or strength training exercise , and not using relaxation methods . CONCLUSIONS People with FM suffer from multiple symptoms and use many modalities to control symptoms to remain functional . Given knowledge of predictors of physical function in FM , health care providers might be able to develop strategies to promote better functioning . Prospect i ve trials are needed to track the natural course of study variables , measuring their effect on function , and to test effects of interventions to maximize function Background A physically active lifestyle has the potential to prevent cognitive decline and dementia , yet the optimal type of physical activity/exercise remains unclear . Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive , social , and affective dimensions . Objectives To determine whether dance benefits executive function more than walking , an activity that is simple and functional . Methods Two-arm r and omized controlled trial among community-dwelling older adults . The intervention group received 1 h of ballroom dancing twice weekly over 8 months ( ~69 sessions ) in local community dance studios . The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization . Main outcomes Executive function tests : processing speed and task shift by the Trail Making Tests , response inhibition by the Stroop Color-Word Test , working memory by the Digit Span Backwards test , immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test , and visuospatial recall by the Brief Visuospatial Memory Test ( BVST ) . Results One hundred and fifteen adults ( mean 69.5 years , SD 6.4 ) completed baseline and delayed baseline ( 3 weeks apart ) before being r and omized to either dance ( n = 60 ) or walking ( n = 55 ) . Of those r and omized , 79 ( 68 % ) completed the follow-up measurements ( 32 weeks from baseline ) . In the dance group only , “ non-completers ” had significantly lower baseline scores on all executive function tests than those who completed the full program . Intention-to-treat analyses showed no group effect . In a r and om effects model including participants who completed all measurements , adjusted for baseline score and covariates ( age , education , estimated verbal intelligence , and community ) , a between-group effect in favor of dance was noted only for BVST total learning ( Cohen ’s D Effect size 0.29 , p = 0.07 ) and delayed recall ( Cohen ’s D Effect size = 0.34 , p = 0.06 ) . Conclusion The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported . Dance improved one of the cognitive domains ( spatial memory ) important for learning dance . Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects , particularly for novice dancers . Trial registration Australian and New Zeal and Clinical Trials Register ( ACTRN12613000782730 ) Background Fibromyalgia is a common chronic pain condition that has a significant impact on quality of life and often leads to disability . To date , there have been few well-controlled trials assessing the utility of nonpharmacological treatment modalities such as transcutaneous electrical nerve stimulation ( TENS ) in the management of pain and improvement in function in individuals with fibromyalgia . Objectives The purpose of this study will be to complete a long-term , multicenter study to assess the effects of TENS in women with fibromyalgia . Design This will be a phase II r and omized , double-blind , placebo-controlled , multicenter clinical trial . Participants Three hundred forty-three participants with fibromyalgia will be recruited for this study . Intervention Participants will be r and omly assigned to 1 of 3 groups : the intervention ( TENS ) , placebo , or no treatment . After completing the r and omized period , all participants will receive the intervention for 1 month . The participants will be asked to use TENS at the highest tolerable level for at least 2 hours daily during physical activity . Measurements The primary outcome will be pain with movement , with secondary outcomes assessing functional abilities , patient-reported outcomes , and quantitative sensory testing . Limitations Because having participants refrain from their typical medications is not practical , their usage and any change in medication use will be recorded . Conclusions The results of this study will provide some of the first evidence from a large-scale , double-blind , placebo-controlled trial on the effectiveness of TENS on pain control and quality -of-life changes in patients with fibromyalgia Introduction Although exercise is therapeutic for adults with fibromyalgia ( FM ) , its symptoms often create obstacles that discourage exercise . We evaluated the effects of accumulating at least 30 minutes of self-selected lifestyle physical activity ( LPA ) on perceived physical function , pain , fatigue , body mass index , depression , tenderness , and the six-minute walk test in adults with FM . Methods Eighty-four minimally active adults with FM were r and omized to either LPA or a FM education control ( FME ) group . LPA participants worked toward accumulating 30 minutes of self-selected moderate-intensity LPA , five to seven days per week , while the FME participants received information and support . Results Seventy-three of the 84 participants ( 87 % ) completed the 12-week trial . The LPA group increased their average daily steps by 54 % . Compared to FME , the LPA group reported significantly less perceived functional deficits ( P = .032 ) and less pain ( P = .006 ) . There were no differences between the groups on the six-minute walk test ( P = .067 ) , fatigue , depression , body mass index , or tenderness . Conclusions Accumulating 30 minutes of LPA throughout the day produces clinical ly relevant changes in perceived physical function and pain in previously minimally active adults with FM.Trial Registration clinical trials.gov Background Fibromyalgia ( FM ) is characterized by persistent widespread pain , increased pain sensitivity and tenderness . Women with FM also report disability , in terms of negative consequences on activities of daily living . Our recent r and omized controlled trial ( RCT ) is the first study of resistance exercise to show positive effects on pain disability . The resistance exercise program of our RCT emphasized active involvement of participants in planning and progression of the exercise , using the principles of person-centeredness , to support each participant ’s ability to manage the exercise and the progress of it . The aim of this sub- study was to investigate explanatory factors for reduced pain disability in women with FM participating in a 15-week person-centered progressive resistance exercise program .  Methods A total of 67 women with FM were included in this sub- study of an RCT examining the effects of person-centered progressive resistance exercise performed twice a week for 15 weeks . Tests of physical capacity and health-related question naires were assessed at baseline and after the intervention period . Multivariable stepwise regression was used to analyze explanatory factors for improvements in pain disability . Results Reduced pain disability was explained by higher pain disability at baseline together with decreased fear avoidance beliefs about physical activity ( R2 = 28 , p = 0.005 ) . The improvements in the disability domains of recreation and social activity were explained by decreased fear avoidance beliefs about physical activity together with higher baseline values of each disability domain respectively ( R2 = 32 , p = 0.025 and R2 = 30 , p = 0.017 ) . The improvement in occupational disability was explained by higher baseline values of occupational disability ( R2 = 19 , p = 0.001 ) . Conclusion The person-centered resistance exercise intervention , based on principles of self-efficacy , had a positive effect on recreational , social and occupational disability . The reduced pain disability seemed to be mediated by decreased fear avoidance beliefs . Age , symptom duration , pain intensity , and muscle strength at baseline had no explanatory value for reduced pain disability , indicating that the person-centered resistance exercise program has the potential to work for anyone with FM who has interest in physical exercise . The trial was registered on October 21 , 2010 with Clinical Trials.gov identification number : NCT01226784 OBJECTIVES To study the effect of a combination of thalassotherapy , exercise and patient education in people with fibromyalgia . METHODS Patients with fibromyalgia , selected from a rheumatology out-patient department and from members of the Dutch fibromyalgia patient association , were pre-r and omized to receive either 2(1/2 ) weeks of treatment in a Tunisian spa resort , including thalassotherapy , supervised exercise and group education ( active treatment ) or treatment as usual ( control treatment ) . Primary outcome measure was health-related quality of life , measured with the R AND -36 question naire . Secondary measures included the Fibromyalgia Impact Question naire , the McGill Pain Question naire , the Beck Depression Inventory , tender point score and a 6-min treadmill walk test . RESULTS Fifty-eight participants receiving the active treatment reported significant improvement on R AND -36 physical and mental component summary scales . For physical health , differences from the 76 controls were statistically significant after 3 months , but not after 6 and 12 months . A similar pattern of temporary improvement was seen in the self-reported secondary measures . Tender point scores and treadmill walk tests improved more after active treatment , but did not reach significant between-group differences , except for walk tests after 12 months . CONCLUSIONS A combination of thalassotherapy , exercise and patient education may temporarily improve fibromyalgia symptoms and health-related quality of life Objective . To investigate the relationship between changes in clinical rating scale items and endpoint Patient Global Impression of Improvement ( PGI-I ) . Methods . Data were pooled from 4 r and omized , double-blind , placebo-controlled studies of duloxetine in patients with fibromyalgia ( FM ) . Variables included in the analyses were those that assessed symptoms in FM domains of pain , fatigue , sleep , cognitive difficulties , emotional well-being , physical function , and impact on daily living . The association of endpoint PGI-I with changes from baseline in individual variables was assessed using Pearson product-moment correlations ( r ) . Stepwise linear regression was used to identify those variables for which changes from baseline were statistically significant independent predictors of the endpoint PGI-I ratings . Results . Changes in pain variables and interference of symptoms with the ability to work were highly correlated ( r ≥ 0.5 or r ≤ −0.5 ) with endpoint PGI-I. Moderate correlation with endpoint PGI-I ( 0.30 ≤ r < 0.5 or −0.5 < r ≤ −0.30 ) included changes in variables that assessed physical functioning , depression , anxiety , fatigue , and several variables related to impact on daily living . Independent predictor variables of endpoint PGI-I identified by stepwise linear regression included assessment s for pain , physical function , vitality , anxiety , social function , and tender point thresholds . Conclusion . In addition to pain reduction , what makes patients with FM feel better may include improvement in fatigue , physical functioning , mood , and impact on daily living . An assessment of these domains may be important in clinical trials of FM and in the management of patients with FM Context A substantial number of patients use acupuncture to treat the symptoms of fibromyalgia , but previous r and omized trials of this intervention are inconclusive , in part because of control groups that did not permit adequate blinding of the patients . Contribution This study r and omly assigned 100 patients with fibromyalgia to 12 weeks of either true acupuncture treatment or one of 3 types of sham acupuncture . No differences in pain were identified between acupuncture and sham acupuncture . Caution s The study had too few patients to detect small differences between the groups . Patients could use other fibromyalgia therapies , so this study evaluates acupuncture as adjunctive treatment . The Editors Fibromyalgia is a condition of unknown cause that is characterized by chronic , diffuse pain and tenderness to palpation at specific musculoskeletal sites ( 1 ) . It is the second most common rheumatologic condition after osteoarthritis , afflicting 2 % to 4 % of the U.S. population ( 2 ) . Most r and omized , controlled trials of allopathic interventions have not demonstrated sustained benefit , and use of complementary and alternative medicine for fibromyalgia is common ( 3 ) . For example , 60 % to 90 % of patients with fibromyalgia report using 1 or more complementary or alternative treatments ( 4 , 5 ) , and 22 % of these patients have tried acupuncture ( 6 ) . Despite skepticism in western cultures , the literature suggests that acupuncture may alleviate chronic pain ( 7 ) . R and omized , controlled trials of acupuncture face many method ologic challenges , including the identification of appropriate treatment and control groups , blinding of study participants , and the inability to blind practitioners ( 8) . Needle placement and the extent to which needle insertion and stimulation is necessary are also controversial ( 7 - 9 ) . In the only rigorous r and omized , controlled trial of acupuncture for fibromyalgia , 7 of 8 outcome measures significantly improved after 3 weeks of treatment with electroacupuncture ( 10 ) . However , because blinding was not assessed and electroacupuncture involves perceptible current , these promising results could reflect a lack of blinding to treatment condition . Moreover , the study followed patients only during treatment . Because fibromyalgia is a chronic condition , longer-term outcomes should be examined . To address these method ologic problems , we performed a r and omized , controlled trial of acupuncture to treat fibromyalgia that included 3 sham acupuncture treatments to account for the effects of needle insertion and placement . The adequacy of participant blinding was carefully evaluated . We sought to determine whether directed acupuncture that is design ed to treat fibromyalgia relieves pain better than does sham acupuncture in adults with fibromyalgia . On the basis of the scant literature and our clinical experience , we hypothesized a priori that directed acupuncture would result in the greatest clinical improvement . Methods Participants Participants were recruited from the greater Seattle , Washington , metropolitan area between January 2001 and September 2002 . Recruitment strategies included dissemination of information on the study through newspapers , television , advertisements , signs posted at university-affiliated hospitals , and letters to local fibromyalgia support groups and health care providers with large caseloads of patients with fibromyalgia . Potential participants were told that they had an equal chance of being assigned to 1 of 4 acupuncture interventions , none of which have been proven but 1 of which was believed to have the most potential to improve the symptoms of fibromyalgia . The institutional review boards at the participating institutions approved the study , and participants provided written informed consent . Eligible participants were English-speaking adults 18 years of age or older in whom fibromyalgia was diagnosed by a physician and who had a prer and omization global pain score of 4 or greater on a visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Participants agreed to undergo r and omization and kept use of any fibromyalgia-related pharmacologic and nonpharmacologic therapies constant throughout the study . At the baseline evaluation before r and omization , a research coordinator trained in tender-point examination confirmed the diagnosis of fibromyalgia by using the 1990 criteria of the American College of Rheumatology ( 1 ) . Participants were excluded if they reported other pain-related medical conditions or potential contraindications to acupuncture treatment ( such as bleeding disorders or severe needle phobia ) , were pregnant or breastfeeding , used narcotics ( which could blunt the effects of acupuncture ) , were involved in litigation related to fibromyalgia ( which might reduce their incentive for improvement ) , or had previously received acupuncture ( to maximize blinding ) . R and omization Procedure A research coordinator screened and enrolled participants at an academic research center . After participants completed a baseline evaluation , another research coordinator who was uninvolved with data collection r and omly assigned them to 1 of 4 treatment groups by using a computer-generated , blocked r and om-allocation sequence with a block size of 4 . This research coordinator informed the acupuncture clinic of the treatment assignment . Intervention Eight U.S.-trained and licensed acupuncturists with a median of 10 years of experience ( range , 4 to 18 years ) provided study treatments in their private offices . One investigator trained the acupuncturists in the study procedures to increase their comfort with delivering all 4 treatments and monitored compliance with the protocol throughout the study . Participants were assigned an acupuncturist according to geographic convenience and schedule availability , and every effort was made to have them treated by the same acupuncturist for the entire 12 weeks . The primary acupuncturist was defined as the practitioner from whom a participant received the most treatments . In all groups , participants were asked to attend treatment sessions twice weekly for 12 weeks ( 24 treatments ) . We considered participants who attended 80 % or more ( 19 of 24 ) of acupuncture appointments to have completed a full course of treatment . Outcome measures were collected at regularly scheduled time points from participants who discontinued treatment . Participants received directed acupuncture design ed to treat fibromyalgia according to the practice of Traditional Chinese Medicine or 1 of 3 sham acupuncture treatments . One sham intervention , a control for acupoint specificity , involved acupuncture typically used to treat irregular menses or early menses due to Blood Heat ( an unrelated condition ) according to Traditional Chinese Medicine . Another sham intervention , which was also a control for acupoint specificity , used body locations not recognized as true acupoints or meridians for needling ( sham needling ) . The third sham treatment , a control for needle insertion , consisted of noninsertive simulated acupuncture at the same acupoints used in directed acupuncture ( simulated acupuncture ) . This technique , in which a toothpick in a needle guide-tube is used to mimic needle insertion and withdrawal , has been shown to be indistinguishable from true acupuncture in acupuncture-nave patients with back pain ( 9 ) . Simulated acupuncture more closely duplicates the needle insertion experience than do techniques using placebo needles that require placing adhesive or plastic foam on the skin ( 11 , 12 ) . Acupoints and sham points ( Appendix Figure ) were chosen by a study acupuncturist with 15 years of experience in treating fibromyalgia and were approved by 3 other senior acupuncturists . In all groups that underwent needle insertion , needles were retained at st and ard depths ( 13 ) for 30 minutes at each acupoint . Disposable Chinese , Japanese , or Korean needles ( 34 to 40 gauge ) were used , depending on the practitioner 's preference . In the simulated acupuncture group , participants remained on the table for 30 minutes after simulated insertion and then underwent simulated needle withdrawal . Efforts were made to imitate the sounds of opening needle packs and needle disposal . Acupuncturists were not blinded to the treatments they delivered . To maximize participant blinding , we included only acupuncture-nave persons who could not compare their treatment with previous experiences with acupuncture , limited contact among study participants , restricted conversation between acupuncturists and participants , and blindfolded participants during treatment . All research personnel who collected or analyzed data were unaware of treatment group . At the end of 12 weeks , we collected data to assess the adequacy of blinding . Outcome Measures Demographic measures collected at the baseline evaluation included age , sex , race , education , marital status , and duration of pain and diagnosis of fibromyalgia . Participants also listed the types of therapies they had previously tried for their pain . We grouped this information into manual therapies ( physical , ergonometric , chiropractic , or massage therapy ) , mental health therapies ( psychotherapy or cognitive behavioral therapy ) , dietary changes , or other therapies ( nerve blocks , hypnosis , or biofeedback ) . Outcome measures were collected at baseline ; after 1 , 4 , 8 , and 12 weeks of acupuncture treatment ; and 3 and 6 months after completion of treatment ( weeks 24 and 36 ) . The primary outcome was subjective pain , as measured by a st and ard 10-cm visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Other outcomes measured by using a visual analogue scale were intensity of fatigue ( 0 = none , 10 = worst ever ) , sleep quality ( 0 = worst ever , 10 = best ever ) , and overall well-being ( 0 = worst ever , 10 = best ever ) . We assessed physical and mental functioning by using the Medical Outcomes Study 36-item Short-Form Health Survey ( 14 ) , which has high reliability and validity in many patient groups , including 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 Primary fibromyalgia is regarded as disorder with a complex symptomatology , and no morphological alterations . Findings increasingly point to a dysfunction of the central nervous pain processing . The study aims to discuss vulnerability for fibromyalgia from a developmental psychopathological perspective . We investigated the presence of psychosocial adversities affecting the childhood of adult fibromyalgia patients ( FM ) and compared them to those of patients with somatoform pain disorders ( SOM ) and a control group ( CG ) with medically explained chronic pain . Using the  structured biographical interview for pain patients ( SBI‐P ) , 38 FM patients , 71 SOM patients , and 44 CG patients were compared on the basis of 14 childhood adversities verified as relevant regarding longterm effects for adult health by prospect i ve studies . The FM patients show the highest score of childhood adversities . In addition to sexual and physical maltreatment , the FM patients more frequently reported a poor emotional relationship with both parents , a lack of physical affection , experiences of the parents ’ physical quarrels , as well as alcohol or other problems of addiction in the mother , separation , and a poor financial situation before the age of 7 . These experiences were found to a similar extent in the SOM patients , but distinctly less frequently in the CG . The results point to early psychosocial adversities as holding a similar etiological meaning in fibromyalgia as well as in somatoform pain disorders . The potential role of these factors as increasing the vulnerability for fibromyalgia is discussed BACKGROUND AND OBJECTIVE Affect and how it is regulated plays a role in pain perception , maintenance of pain , and its resolution . This r and omized , controlled trial evaluated an innovative affective self-awareness ( ASA ) intervention , which was design ed to reduce pain and improve functioning in individuals with fibromyalgia . PARTICIPANTS AND METHODS Forty-five women with fibromyalgia were r and omized to a  manualized ASA intervention ( n = 24 ) or wait-list control ( n = 21 ) . The intervention began with a one-time physician consultation , followed by 3 weekly , 2-h group sessions based upon a mind-body model of pain . Sessions focused on structured written emotional disclosure and emotional awareness exercises . Outcomes in both conditions were measured by a blinded assessor at baseline , post-intervention , and 6-month follow-up . MEASURES The primary outcome was pain severity ( Brief Pain Inventory ) ; secondary outcomes included tender-point threshold and physical function ( SF-36 Physical Component Summary ) . Intent-to-treat analyses compared groups on outcomes using analysis of covariance and on the proportion of patients achieving ≥30 % and ≥50 % pain reduction at 6 months . RESULTS Adjusting for baseline scores , the intervention group had significantly lower pain severity ( p < 0.001 ) , higher self-reported physical function ( p < 0.001 ) , and higher tender-point threshold ( p = 0.02 ) at 6 months compared to the control group . From baseline to 6 months , 45.8 % of the ASA intervention group had ≥30 % reduction in pain severity , compared to none of the controls ( p < 0.001 ) . CONCLUSIONS The affective self-awareness  intervention improved pain , tenderness , and self-reported physical function for at least 6 months in women with fibromyalgia compared to wait-list control . This study suggests the value of interventions targeting emotional processes in fibromyalgia , although further studies should evaluate the efficacy of this intervention relative to active controls Background Exergaming has been proposed as an innovative method for physical activity promotion . However , large effectiveness studies are rare . In January 2011 , dance mat systems  were introduced in secondary schools in two districts in Engl and with the aim of promoting an innovative opportunity for physical activity . The aim of this natural experiment was to examine the effect of introducing the dance mat exergaming systems on physical activity and health-related outcomes in 11–13 year old students using a non-r and omised controlled design and mixed methods . Methods Participants were recruited from five schools in intervention districts ( n = 280 ) and two schools in neighbouring control districts ( n = 217 ) .  Data on physical activity ( accelerometer ) , anthropometrics ( weight , BMI and percentage of body fat ) , aerobic fitness ( 20-m multistage shuttle run test ) , health-related quality of life ( Kidscreen question naire ) , self-efficacy ( children ’s physical activity self-efficacy survey ) , school attendance , focus groups with children and interviews with teachers were collected at baseline and approximately 12 months follow-up . Results There was a negative intervention effect on total physical activity ( -65.4 cpm CI : -12.6 to -4.7 ) , and light and sedentary physical activity when represented as a percentage of wear time ( Light : -2.3 % CI : -4.5 to 0.2 ; Sedentary : 3.3 % CI : 0.7 to 5.9 ) . However , compliance with accelerometers at follow-up was poor . There was a significant positive intervention effect on weight ( -1.7 kg , 95 % CI : -2.9 to -0.4 ) , BMI ( -0.9 kg/m2 , 95 % CI : -1.3 to -0.4 ) and percentage of body fat ( -2.2 % , 95 % CI : -4.2 to -0.2 ) . There was also evidence of improvement in some health-related quality of life parameters : psychological well-being ( 2.5 , 95 % CI : 0.1 to 4.8 ) and autonomy and parent relation ( 4.2 , 95 % CI : 1.4 to 7.0 ) . Conclusions The implementation of a dance mat exergaming scheme was associated with improvement in anthropometric measurements and parameters of health-related quality of life . However , the mechanisms of these benefits are unclear as there was insufficient data from physical activity to draw robust conclusions . Qualitative findings suggest that there was declining support for the initiative over time , meaning that potential benefits may not have been achieved OBJECTIVE Multidisciplinary treatments ( MTs ) are usually recommended for reducing fibromyalgia ( FM ) symptoms and include physical exercise , drug management , education , and cognitive behavior therapy ( CBT ) . However , there is no evidence that CBT adds efficacy to the other therapeutic components . This r and omized controlled trial analyzed the response of FM patients to two MTs , with and without CBT , according to the presence of concurrent symptoms . METHODS Eighty-three women with FM were r and omly assigned to MT or combined MT and CBT . The MT included medical intervention , physical training , education , and discussion of the syndrome . The CBT focused on coping with stress , modifying lifestyles , and changing pain behaviors . Demographic and clinical data , information regarding tender points , and question naire responses about functional capability [ Fibromyalgia Impact Question naire ( FIQ ) ] , health status [ 36-item Short Form Health Survey ( SF-36 ) ] , and mental health [ Symptom Checklist-90-Revised ( SCL-90-R ) ] were obtained at the beginning , at the end of the 15-week treatment , and at 6-month follow-up . Subgroups are identified in relation to treatment response . RESULTS Sixty-six women ( 80 % ) completed treatment . Although the variance of the total sample had changed at posttreatment ( F=2.67 , P=.031 ) , there was no significant effect for the TimexTreatment interaction ( F=1.65 , P=.16 ) . Univariate tests detected a significant fall in the FIQ score . The subgroup of patients with fatigue showed a better response with MT+CBT than with MT . At 6-month follow-up , the statistical differences had been maintained . Intention-to-treat analysis ratified these results . CONCLUSIONS MT improves functional capability and reduces symptom impact . CBT increases mildly the effect of MT in patients with fatigue This study was aim ed to investigate the effects of an exercise trial on self-esteem , self-concept and quality of life in patients with fibromyalgia and to evaluate whether improvements in psychological distress were related to changes in physical functioning . Twenty-eight women with a primary diagnosis of fibromyalgia were r and omized to a usual care control group or to a 12-week supervised training programme consisting of 3 weekly sessions of aerobic , strengthening and flexibility exercises . Outcomes were physical functioning ( Fibromyalgia Impact Question naire ( FIQ ) , lower-body strength and flexibility ) and psychological functioning ( SF-36 , Rosenberg self-esteem scale and Erdmann self-concept scale ) . Outcomes were measured at study entry and at the end of the intervention . Compared to the control group , statistically significant improvements in self-esteem , self-concept , FIQ , physical functioning , role physical , bodily pain , vitality , role emotional , social functioning , mental health , isometric strength , muscular endurance and flexibility were evident in the exercise group at the end of treatment . Self-esteem and self-concept scores were correlated positively with role emotional , mental health and the mental component summary of SF-36 and were negatively correlated to FIQ scores . No significant correlation existed between self-esteem or self-concept and isometric strength , muscular endurance or flexibility . Our results highlight the need for a broader array of physical and mental outcomes and the importance of examining patient ’s perceptions in future research therapies Evidence -based recommendations support the use of multimodal therapy and hydrotherapy for fibromyalgia syndrome ; however , there is little st and ardisation of such programmes . The aim of the study was to assess the effectiveness of a pool-based exercise using deep water running ( DWR ) as part of a multimodal physiotherapy programme for patients with fibromyalgia syndrome . For a non-r and omised clinical study , 44 patients diagnosed with fibromyalgia were recruited from primary care . Patients in the experimental group received a multimodal programme incorporating pool-based exercise using DWR three times a week for an 8-week period . The control group received a leaflet containing advice and continued with normal activities . Patients were evaluated for physical function ( Fibromyalgia Impact Question naire , FIQ ) , pain , general health ( Short Form-12 Health Survey ) and quality of life ( European Quality of Life Scale-5D ) pre- and post intervention . Statistically significant results were found for the experimental group for FIQ total score , incorporating physical function , pain , fatigue , stiffness and psychological variables ( p < 0.05 ) . Statistically significant differences between the experimental group and control were also found for general health ( p < 0.05 ) and quality of life ( p < 0.05 ) . The results of this pilot study and the high level of compliance and adherence and low level of attrition suggest that this multimodal programme incorporating DWR is a safe and effective intervention for fibromyalgia syndrome that is acceptable to patients
To our knowledge this will be the first attempt to systematic ally identify knowledge of dance as a potential intervention for adults with fibromyalgia .
This scoping review offers a feasible means for describing the evidence specific to dance and fibromyalgia ; results will provide unique insights concerning the breadth and depth of literature in the area .
An analysis of this body of literature as a whole may reveal new research directions or unknown ways this intervention could strengthen current management approaches of the disease
BACKGROUND Fibromyalgia is a chronic disorder characterized by widespread muscular tenderness , pain , fatigue , and cognitive difficulties .
Nonpharmacological treatment options , such as physical activity , are important for people with fibromyalgia .
There are strong recommendations to support engagement in physical activity for symptom management among adults with fibromyalgia .
Dance is a mode of physical activity that may allow individuals with fibromyalgia to improve their physical function , health , and well-being .
Dance has the potential to promote improved pain processing while simultaneously providing the health and social benefits of engaging in physical activity that contributes to symptom management .
However , we are unaware of current evidence on dance as a nonpharmacological/physical activity intervention for adults with fibromyalgia .
OBJECTIVE The aims of the study are to provide an overview of the extant evidence to underst and how dance is used for individuals with fibromyalgia ; to examine the extent , range , and nature of research activity in the area ; and to determine the value of undertaking a full systematic review .