THU0348 Adherence and effectiveness of a simple program of home-made stretching in fibromyalgia
Authors: L. Cavagna, R. Caporali, L. Lepri, S. Rossi, S. Balduzzi, E. Prisco, C. Montecucco
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Fibromyalgia (FM) is an heterogeneous and complex condition that deeply impact the quality of live of affected patients. Moreover FM imposes also a significant economic burden on society, mainly driven by indirect costs from lost productivity. FM treatment is based on a multidisciplinary approach, with a combination of pharmacological and non-pharmacological therapies. As indicated in the EULAR recommendations for the treatment of FM, individual tailored exercise programs, including aerobic exercise and strength training, can be beneficial in these patients; although this point has been confirmed in several studies, the adherence to various kind of exercise's programs is generally poor when the patients had to exercise on their own. <h3>Objectives</h3> To evaluate the effectiveness and patients' adherence to a simple program of home-made stretching exercises in fibromyalgia. <h3>Methods</h3> We enrolled all FM patients (ACR 1990 classification criteria), referring consecutively to our outpatients clinic from March to June 2011 and on stable treatment in the previous 6 months. Patients were randomly allocated in 2 groups. <i>Group 1</i> was trained in a simple home-made stretching program based on 8 exercises; patients were asked to perform at least 4 exercises, for at least 20 minutes, for at least 3 days a week. Paper supports with explanations and cartoons representing exercises were handed to all these patients; moreover the patients were asked to sign in a daily diary the exercises performed and the time employed. <i>Group 2</i> was first motivated about the effectiveness of a correct physical activity and then asked to perform stretching exercises, scheduled similarly to <i>group 1</i>. No treatment changes were planned in both groups. A well validated questionnaire, Fibromyalgia impact questionnaire (FIQ), was used as outcome measure; FIQ was assessed at baseline and then after three months of exercises; results were analyzed by the Paired-Samples T Test. Adherence of patients to the program was also evaluated. <h3>Results</h3> We enrolled 44 patients, 22 in <i>group 1</i> (mean age 46.8 years, standard deviation ± 10 years) and 22 in <i>group 2</i> (mean age 47.7 years, standard deviation ± 10.5 years). Mean basal FIQ was 70 (standard deviation ± 18) in <i>group 1</i> and 68 (standard deviation ± 19) in <i>group 2</i>. After 3 months FIQ was significantly reduced in <i>group 1</i> (mean value 45, standard deviation ± 15, p value 0.001), whereas no substantial changes were observed in <i>group 2</i> (mean value 69, standard deviation ± 18, p value 0.232). Program adherence in <i>group 1</i> was 100% (at least 6 exercises for at least 30 minutes in each training section; at least 4 training section every week); <i>group 2</i> patients did not perform any kind of exercises. <h3>Conclusions</h3> Our results indicate that an easily designed program of home-made stretching may improve the impact of FM on affected patients. The enhancement of adherence with an extended support program (eg direct explanation of exercises, cartoons representing the exercises, report of training sections in a diary) is the key point for FM patients improvement. <h3>References</h3> Wolfe F, et al. Arthritis Rheum 1990;33:160-72. Salaffi F, et al. Clin Exp Rheumatol 2009;27:S67-74. Sarzi-Puttini P, et al. Clin Exp Rheumatol 2003;21:459-64. Carville SF, et al. Ann Rheum Dis 2008;67:536-41. <h3>Disclosure of Interest</h3> None Declared