Assessment of the Effects of Aquatic Therapy on Global Symptomatology in Patients With Fibromyalgia Syndrome: A Randomized Controlled Trial

Abstract 

Munguía-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: a randomized controlled trial.

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 randomized 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 Questionnaire); 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.

Key Words: Exercise therapy, Fibromyalgia, Health status, Pain, Rehabilitation, Sleep

List of Abbreviations: ACR, American College of Rheumatology, FIQ, Fibromyalgia Impact Questionnaire, FM, fibromyalgia, ICC, intraclass correlation coefficient, ITT, intent to treat, PASAT, Paced Auditory Serial Addition Task, PSQI, Pittsburgh Sleep Quality Index, SAI, State Anxiety Inventory, 6MWT, six-minute walk test, VAS, visual analog scale