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Effectiveness of exercise in management of fibromyalgia.Curr Opin Rheumatol. 2004 Mar;16(2):138-42.Gowans SE, DeHueck A.Department of Rehabilitation Services, University Health Network,Physiotherapy Department, Joseph Brant Memorial Hospital, and Department ofPhysical Therapy, University of Toronto, Toronto, Ontario, Canada.PMID: 14770100
SUMMARY
URPOSE OF REVIEW Exercise was established as an integral part of thenonpharmacological treatment of fibromyalgia approximately 20 years ago.Since then many studies have investigated the effects of exercise-eitheralone or in combination with other interventions. This review will discussthe benefits of exercise alone and provide practical suggestions on howpatients can exercise without causing a long-term exacerbation of their pain.
RECENT FINDINGS Short-term exercise programs for individuals withfibromyalgia have consistently improved physical function, especiallyphysical fitness, and reduced tenderpoint pain. Exercise has also producedimprovements in self-efficacy. These effects can persist for periods of upto 2 years but may require participants to continue to exercise. Mostexercise studies have examined the effects of moderately intense aerobicexercise. Only in the past 2 years have muscle-strengthening programs, inisolation, been evaluated. To be well tolerated, exercise programs muststart at a level just below the capacity of the participants and thenprogress slowly. Even with these precautions, exercise may still producetolerable, short-term increases in pain and fatigue that should abatewithin the first few weeks of exercising.
SUMMARY Future studies should investigate the possible benefits oflow-intensity exercise and test strategies that may enhance long-termcompliance with exercise. Individuals with fibromyalgia also need to beable to access community exercise programs that are appropriate for them.This may require community instructors to receive instruction on exerciseprescription and progression for individuals with fibromyalgia.