Exercise Guidelines for Fibromyalgia Patients

Tai-Chi: Tai-chi is a form of exercise that offers low to moderate activity and also contains breathing, relaxation and mental concentration. It’s thought to result in improved balance, coordination, gait, muscle strength and flexibility. A low- to moderate-intensity tai-chi program for 12 weeks has been shown to decrease pain in individuals with FMS after individual sessions and may have a cumulative effect in pain reduction after longer-term participation (longer than 16 weeks).¹⁵

Summary

Non-pharmacological approaches to the treatment of patients with fibromyalgia should include a strong emphasis on exercise and patient education. A wide range of exercise approaches—from traditional aerobic and strengthening programs to mind-body focused approaches—may be useful. Active patient participation, adherence to exercise and ability to self-manage symptoms are integral to maximizing patient outcomes. Additional research is needed to develop optimal exercise modes and dosage for individuals with FMS.

Marie B. Corkery, PT, DPT, MHS, is an associate clinical professor in the Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston.

Lauren Tarsi, DPT, graduated from Northeastern University in May 2015 with her clinical doctorate degree in physical therapy. Dr. Tarsi enjoys working with patients in the outpatient orthopedic and neurological setting.

References

1. Busch AJ, Webber SC, Brachaniec M, et al. Exercise therapy for fibromyalgia. Curr Pain Headache Rep. 2011 Oct;15(5):358–367.
2. Centers for Disease Control & Prevention. Arthritis: Fibromyalgia.
3. Wolfe F, Clauw DJ, Fitzcharles M-A, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. (Hoboken). 2010 May;62(5):600–610.
4. Fitzcharles M-A, Ste-Marie PA, Goldenberg DL, et al. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: Executive summary. Pain Res Manag. 2013 May–June;18(3):119–126.
5. Brosseau L, Wells GA, Tugwell P, et al. Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: Part 1. Phys Ther. 2008 Jul;88(7):857–871.
6. Brosseau L, Wells GA, Tugwell P, et al. Ottawa Panel evidence-based clinical practice guidelines for strengthening exercises in the management of fibromyalgia: Part 2. Phys Ther. 2008 Jul;88(7):873–886.
7. García-Martínez AM, De Paz JA, Márquez S. Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: A randomized controlled trial. Rheumatol Int. 2012 Jul;32(7):1869–1876.
8. 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. Arch Phys Med Rehabil. 2008 Dec;89(12):2250–2257.
9. Nijs J, Mannerkorpi K, Descheemaeker F, Van Houdenhove B. Primary care physical therapy in people with fibromyalgia: Opportunities and boundaries within a monodisciplinary setting. Phys Ther. 2010 Dec;90(12):1815–1822.
10. Lima TB, Dias JM, Mazuquin BF, et al. The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: A systematic review with meta-analysis. Clin Rehabil. 2013 Oct;27(10):892–908.
11. Castro-Sánchez AM, Matarán-Peñarrocha GA, Arroyo-Morales M, et al. Effects of myofascial release techniques on pain, physical function and postural stability in patients with fibromyalgia: A randomized controlled trial. Clin Rehabil. 2011 Sep;25(9):800–813.
12. Bourgault P, Lacasse A, Marchand S, et al. Multicomponent Interdisciplinary Group Intervention for Self-Management of Fibromyalgia: A mixed-methods randomized controlled trial. PLoS One. 2015;10(5):e0126324.
13. Martins MRI, Gritti CC, Junior RDS, et al. Randomized controlled trial of a therapeutic intervention group in patients with fibromyalgia syndrome. Rev Bras Reumatol (English Ed). 2014 May–Jun;54(3):179–184.
14. Altan L, Korkmaz N, Bingol U, Gunay B. Effect of pilates training on people with fibromyalgia syndrome: A pilot study. Arch Phys Med Rehabil. 2009 Dec;90(12):1983–1988.
15. Segura-Jimenez V, Romero-Zurita A, Carbonell-Baeza A, et al. Effectiveness of Tai-Chi for decreasing acute pain in fibromyalgia patients. Int J Sport Med. 2014 May;35(5):418–423.