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The Effects of Exercise and Education, Individually or Combined, in Women with Fibromyalgia
SHARLA J. KING, JEAN WESSEL, YAGESH BHAMBHANI, DALE SHOLTER, and WALTER MAKSYMOWYCH
ABSTRACT. Methods. One hundred fifty-two women were randomized into one of 4 groups: exercise-only, education-only, exercise and education, or control. The duration of the study was 12 weeks. All subjects were analyzed at 3 times: before study, immediately upon completion, and 3 months after completion of the intervention program on measures of disability, self-efficacy, fitness, tender point count, and tender point tenderness. Of the 152 women, complete data were available for 95 and 69 who complied with the protocol. In order to determine the group ´ time interaction, a 2 way analysis of variance with repeated measures was used for each measure. Results. The only significant group ´ time interaction was reported with the compliance analysis for the Self-Efficacy Coping with Other Symptoms subscale and the Six Minute Walk. If the program was followed, the combination of a supervised exercise program and group education provided persons with FM with a better sense of control over their symptoms. Fitness improved in the 2 groups undergoing supervised aerobic exercise programs. However, the improvement in fitness was maintained at followup in the exercise-only group and not the combined group. Conclusion. Subjects receiving the combination of exercise and education and who complied with the treatment protocol improved their perceived ability to cope with other symptoms. In addition, a supervised exercise program increased walking distance at post-test, an increase that was maintained at followup in the exercise-only group. Results demonstrate the challenges with conducting exercise and education studies in persons with FM. (J Rheumatol 2002;29:2620-7 Key Indexing Terms:
AEROBIC EXERCISE
From the Health Science Council Office, University of Alberta, Edmonton; School of Rehabilitation Science, McMaster University, Hamilton, Ontario; Faculty of Rehabilitation Medicine, University of Alberta; and Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada. Funded by grants from the Medical Services Incorporated Foundation and from the Health Services Research and Innovation Fund, Alberta Health, administered by Alberta Heritage Foundation for Medical Research. S.J. King, PhD, Academic Coordinator, Health Science Council Office, University of Alberta; J. Wessel, PhD, Professor, School of Rehabilitation Science, McMaster University; Y. Bhambhani, PhD, Professor, Faculty of Rehabilitation Medicine; D. Sholter, MD, FRCPC, Division of Rheumatology; W. Maksymowych, MD, FRCPC, Associate Professor, Division of Rheumatology, University of Alberta. Address reprint requests to S.J. King, Health Science Council, 300 Campus Tower, 8625-112 St., University of Alberta, Edmonton, Alberta T6G 1K8. Submitted August 10, 2001; revision accepted May 29, 2002. |