Comparison of Muscle Energy Techniques and Breathing Exercises for Functional Improvement in Fibromyalgia
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes; Respiratory Aspiration
Study type: Interventional

Summary: 
      This study is planned to compare the effects of Muscle Energy Techniques (MET) with breathing
      exercises for improving functional outcomes in patients with fibromyalgia. A randomized
      controlled trial will be conducted. Sample size would be 26 patients with fibromyalgia
      randomly allocated to the Muscle energy techniques group and breathing exercise group. Both
      the groups will receive 8 weeks of treatment, 3 times per week. Data will be collected at
      baseline 5th week and 8th week. Outcome measurements include a Numeric pain rating scale, 6
      min walk test, chest expansion, Pittsburgh sleep quality index, and Fibromyalgia Impact
      Questionnaire scores.
    

Detailed description: 
      Fibromyalgia (FM) is a common syndrome characterized by widespread pain and at least 11/18
      painful tender points (American College of Rheumatology). Fibromyalgia syndrome (FMS) is a
      rheumatic condition of increasing prevalence worldwide) approximately 2-7% of the populations
      are affected. Some of the symptoms associated with fibromyalgia is sleep disturbance,
      dizziness, headache, fatigue, depression/tension, pain, cognitive disorder, irritable bowel
      syndrome, and different somatic symptoms. These factors negatively influence physical and
      emotional characteristics and decrease the quality of life. Fatigue and dyspnea are the
      significant signs and symptoms of fibromyalgia, which can be related to respiratory system
      changes. Major affected areas in fibromyalgia include breathing mechanics, the upper
      trapezius muscle, the cervical muscle mass, the scalene, Sternocleidomastoid, and the area
      around the second rib and all the paravertebral muscle mass. These regions are coordinated
      with the tender points placed in the upper half body of patients with FM. Fibromyalgia
      patients, without a doubt, exhaust and come to be fatigue due to the dyspnea. It is
      widespread among females; however, it can additionally affect both men and teenagers. Many
      pharmacological therapies were being used to treat FM with uncertain consequences, and
      steadily growing small doses are usually recommended to maximize efficacy. Among non
      pharmacological management including exercise is typically endorsed in the management of
      patients with fibromyalgia. Regular workout is an essential keystone of fibromyalgia
      management. Aerobic workout interventions have shown reduced ache, depression, and fatigue,
      improving health-related quality of life (HRQOL). Related literature includes meta-analysis
      regarding the exercise effects (endurance, aerobic, or mixed aerobic and strength workout) on
      worldwide welfare in people with fibromyalgia. Breathing issues tend to intensify FM
      symptoms. The FM patients exhaust quickly, and dyspnea causes fatigue related to respiratory
      muscle weakness, mainly diaphragmatic deficiency, that can decrease the physical condition
      and capability inside the daily activities. Breathing exercises have been proven to be useful
      in decreasing symptoms of FM. MET is the osteopathic manipulation strategies of the tender
      tissues that evolved to recover the musculoskeletal system's function and decrease pain. Both
      these techniques have proven effects for reduction of symptoms in FM patients. This study is
      intended to compare the effects of both in order to find out the technique that can
      effectively improve the functional outcomes in patients with fibromyalgia.
    

Intervention name(s): METs; Breathing exercise group
Intervention type(s): Other; Other
Intervention description(s): The isometric contraction of 7 sec will be applied followed by a stretching of 30 sec in painless range. This treatment will be given to the both sides of the neck targeting the three major accessory muscles of respiration.; Three exercises will be performed in a circuit, 2 circuits in every session. It will include diaphragmatic breathing exercise in which patient will be in supine position inhaling through nose and expiration through moth with half closed lips. Second exercise pursed lip breathing also in supine position with the hands on abdomen and then inspiration through nose and expiration through mouth with half closing of lips. Third exercise resisted diaphragmatic breathing also in same pattern as second exercise with an addition of 1 kg weight on abdomen.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Diaphragmatic breathing; Fibromyalgia; Muscle energy techniques; Breathing exercises