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  • Exercise Can Help Ease Fibromyalgia Symptoms, But No Clear Winner Between Aquatic and Land-Based Programs

    Exercise therapy can improve some symptoms of fibromyalgia, but conclusive evidence favoring aquatic or land-based programs as the best way to achieve those improvements is still lacking, according to a new Cochrane review of randomized controlled trials (article available through the Cochrane Database of Systematic Reviews in PTNow ArticleSearch). The study is part of a larger update of a Cochrane review on exercise for treating fibromyalgia syndrome.

    In an effort to determine how aquatic exercise training stacked up both to no exercise and land-based programs, researchers analyzed 16 aquatic training studies that included 866 women and 15 men. Aquatic exercise was compared with a non-exercise control group in 9 studies, and compared with land-based programs in 5 studies. In 2 studies, different types of aquatic exercise were compared with each other.

    When it comes to the benefits of aquatic exercise compared with no exercise, researchers found that individuals with fibromyalgia who participated in the aquatic programs reported improvements in physical function, pain, and stiffness. The studies also noted improvements in muscle strength and cardiovascular fitness. Although improvements were characterized as statistically significant across all measures, only stiffness and muscle strength met researchers' 15% threshold for clinical relevance. In general, authors described the evidence as "low to moderate quality" in favor of aquatic training.

    Comparisons of aquatic programs with land-based exercise yielded no clinically relevant differences between the 2, according to the study's authors, with evidence characterized as "very low to low quality."

    The final analysis is that there can't really be a final analysis when it comes to an assessment of aquatic vs land-based exercise for improvement of fibromyalgia symptoms, according to the review. "As so few studies have been done so far, we are very uncertain about the results," authors write.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.


    • I sat around after being injured and developed fibromyalgia and became morbidly obese because of sitting around and using food to block out pain. I couldn't do much on land, but I could do those things in water. Starting in water helped tremendously, and now I can do more on land. Losing weight has helped, too. A good PT program is a must with daily range of motion and some strengthening. Doing nothing gets you in more pain and doing less and less. Get professional help so you do it right. You have to build slowly. Overdoing it will cause more issues.

      Posted by Christel Sparks on 10/30/2014 10:22 PM

    • Dear Christel, That is probably the best post with the best advice I have ever heard regarding fibromyalgia! Your message is succinct and right on target. I often advise my patients to start in the water to get them moving with support and then make the segue to gentle land-based exercises such as Feldenkrais or therapeutic modified Pilates. Thank you for sharing your story! Sincerely, Sherri Betz, PT, GCS, PMA®-CPT TheraPilates® Physical Therapist

      Posted by Sherri Betz on 11/5/2014 8:36 PM

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