The Effect of Telerehabilitation on Symptoms in Fibromyalgia Patients
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      The aim of this study is to evaluate the effect of telerehabilitation-based high-intensity
      interval upper extremity exercise training on biochemistry parameters and disease symptoms in
      fibromyalgia patients. It has been reported that substances such as serotonin and tryptophan
      are found at abnormal levels in the serotonergic system in patients with fibromyalgia, and
      symptoms such as depression, pain, and fatigue related to the disease may be associated with
      this condition. In the literature, there are studies conducted in other disease groups
      showing that aerobic exercise regulates tryptophan and serotonin levels and can produce
      positive results regarding these symptoms. This study was planned to evaluate the effect of
      high-intensity interval exercise training, which is an aerobic exercise form, whose benefits
      are frequently mentioned in recent publications, on both blood parameters and symptoms in
      fibromyalgia patients.
    

Detailed description: 
      Fibromyalgia is a chronic musculoskeletal disease of unknown etiology accompanied by symptoms
      such as pain, hyperalgesia, sleep disorders, fatigue and mood disorders. It has been
      suggested that a defect in the serotonergic system is involved in the pathophysiology of the
      disease. The serotonergic system has been associated with many symptoms such as anxiety,
      depression, sleep problems, fatigue and pain. In studies on fibromyalgia, it was reported
      that plasma tryptophan and serotonin levels decreased in this patient group and that
      serotonin levels were abnormal in the endogenous pain blocking pathways. Although conflicting
      results have been reported, it was stated that vitamin D levels were also low in this patient
      group. Aerobic exercise makes muscles use branched-chain amino acids, reducing the amount of
      amino acids that compete with tryptophan and increasing the chance of tryptophan to cross the
      blood-brain barrier. Therefore, it has the potential to increase serotonin in the brain. In
      particular, aerobic exercise appears to modulate hormone, neurotrophin and neurotransmitter
      levels, depending on factors such as genes, age and hormonal status. On the other hand, it is
      reported that some types of exercise increase the production of free radicals and cause
      oxidative stress. It has been suggested that oxidative stress may be associated with pain,
      which is one of the main symptoms in fibromyalgia patients by affecting nociceptors. Studies
      have shown that when aerobic exercises are applied regularly for a long time, lipid
      peroxidation level, which is an indicator of oxidative stress, decreases and antioxidant
      enzyme activity increases. Regularly applied aerobic exercise programs have been reported as
      a suitable form of exercise for this patient group. Recent studies have focused on
      high-intensity interval training. This type of exercise; It is performed as successive short
      and intermittent sessions of high-intensity activity with periods of low intensity or rest.
      High-intensity interval training are shorter than moderate aerobic workouts and produce the
      same or more positive effects than moderate exercise. It is also reported that high-intensity
      interval training application improves oxidative capacity, antioxidant defense and
      endothelial functions. Telerehabilitation practices refer to the use of telematics procedures
      using telephone, video and computer technologies instead of traditional face-to-face
      approaches. The therapist ensures that patient communication and follow-up are maintained by
      maintaining social distance. It has been stated in studies that telerehabilitation can be
      used to increase the quality of life, to provide socialization and to treat pain in patients
      with fibromyalgia. This study was designed to evaluate the effectiveness of high-intensity
      interval training upper extremity exercise training, which is a form of aerobic exercise, on
      these parameters, associated symptoms and oxidative stress markers in fibromyalgia patients
      with negative effects on serotonin, tryptophan, vitamin D and related parameters.
    

Intervention name(s): High Intensity Interval Training; Moderate Exercise Training
Intervention type(s): Other; Other
Intervention description(s): Telerehabilitation-based high-intensity exercise training will be applied to the participants for 6 weeks, 3 times a week for 35 minutes, under the control of a physiotherapist.; The participants will be given telerehabilitation-based moderate exercise training under the control of a physiotherapist for 55 minutes, 3 times a week for 6 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: fibromyalgia; high intensity interval training; telerehabilitation; tryptophan