Aerobic Fitness Effects in Fibromyalgia

VALÉRIA VALIM, LEDA OLIVEIRA, ALINA SUDA, LUCIANA SILVA, MARCOS de ASSIS, TURRIBIO BARROS NETO, DANIEL FELDMAN, and JAMIL NATOUR

ABSTRACT.

Objective. To compare 2 exercise modalities, aerobic fitness training and stretching exercises, in patients with fibromyalgia (FM) in relation to function, pain, quality of life, depression, and anxiety, and to correlate the cardiorespiratory fitness gain with symptom improvement.

Methods. Seventy-six women with FM between 18 and 60 years old were randomized to either an aerobic program or stretching program, for 20 weeks. They were evaluated at the beginning of the program and after 10 and 20 weeks in relation to the improvement of aerobic fitness, flexibility, function, Fibromyalgia Impact Questionnaire (FIQ), Short-form Health Survey (SF-36), and depression and anxiety levels. Ventilatory anaerobic threshold (VT) and maximum oxygen uptake (VO_2max) were determined by expired gas analyses.

Results. Aerobic exercise was superior to stretching in relation to VO_{2 max}, VT, function, depression, pain, and the emotional aspects and mental health domains of SF-36. Patients in the stretching group showed no improvement in depression, "role emotional," and "mental health." No association was noted between improvement in aerobic fitness as measured by VT and the improvement of pain, function, or scores in FIQ and SF-36.

Conclusion. Our results confirm that aerobic exercise is beneficial to patients with FM, but the cardiorespiratory fitness gain is not related to improvement of FM symptoms. (J Rheumatol 2003;30:1060-9)

Key Indexing Terms:

FIBROMYALGIA
AEROBIC FITNESS
EXERCISE
FLEXIBILITY
STRETCHING
ANAEROBIC THRESHOLD
OXYGEN UPTAKE

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From the Division of Rheumatology, Department of Medicine and Sports and Physical Medical Center, São Paulo Federal University, São Paulo, Brazil.

Supported by FAPESP (Research Support Fund of the State of São Paulo).

V. Valim, MD, Division of Rheumatology; L.M. Oliveira; A.L. Suda; L.E. Silva, Physiotherapists, Rheumatology Rehabilitation Section, Divison of Rheumatology; M.R. de Assis, MD, Division of Rheumatology; T.L. Barros Neto, PhD, Head, Sports and Physical Medical Center; D. Feldman, MD, Professor, Division of Rheumatology; J. Natour, MD, Head, Rheumatology Rehabilitation Section, Division of Rheumatology.

Address reprint requests to Dr. J. Natour, Division of Rheumatology, Universidade Federal de São Paulo, Rua Botucatu, 740, 04023-900 São Paulo, Brazil. E-mail: jnatour@reumato.epm.br

Submitted December 5, 2001; revision accepted October 18, 2002.

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