Efficacy of Aquatic Respiratory Exercise-Based Program in Patients with Fibromyalgia: randomized clinical trial / Eficácia de um programa de exercícios respiratórios aquáticos em indivíduos com fibromialgia: ensaio clínico randomizado




Fibromyalgia syndrome is a chronic rheumatic condition with unknown etiology and unclear pathogenesis. It is characterized by pain, sleep disturbances and fatigue. Psychological symptoms are also observed, including mood disturbance, anxiety, depression, phobia and panic syndrome, contributing to the complex disease symptomatology, as well as to the reduced quality of life and impaired functional capacity observed in these patients. Due to an incomplete understanding of the disease mechanisms, in addition to multiple, non visible symptoms typical of FMS, a patients treatment is a challenging task. Widely varied therapeutic approaches ranging from physical therapy, massage, acupuncture, aerobic and strengthening exercises to cognitive-behavioral therapies have been applied with variable efficacy. This study assessed the effects of aquatic respiratory exercise-based program in the quality of life, functional capacity, pain, dyspnea, anxiety and quality of sleep in patients with fibromyalgia syndrome. Forty women, aged between 20 and 60, were randomly assigned into 2 groups of 20 patients: aquatic respiratory exercise-based program (EX) and control group (CT). EX group performed the exercise program, for 1-hour, 4 times a week, for 4 weeks, which included: I) warm-up; II) respiratory exercises, consisting of 5 different breathing patterns, along with upper, lowers limbs and trunk movements (45min); III) relaxation exercises. Both groups were included in supervised-recreational activities, for 1-hour, once a week, for 4 weeks. Questionnaires were applied before and after intervention to assess quality of life and functional capacity (Medical Outcome Study 36-Item Short Form - SF-36, Fibromyalgia Impact Questionnaire - FIQ), anxiety (Hamilton Anxiety Scale - HAS) and quality of sleep (Pittsburg Sleep Quality Index - PSQI). Number of tender points and pain (VAS - visual analogue scale) were also evaluated. At baseline there was no difference between groups, including number of tender points, pain and questionnaire responses. After intervention, EX group, compared with CT group, showed improvement in SF-36 scores (physical functioning p=.001, bodily pain p=.001, vitality p=.009, social functioning p=.001, emotional role p=.001), in FIQ (total score p=.049, work missed p=.036, fatigue p=.013, morning tiredness p=.007) plus in VAS-pain (p=.029), VAS-dyspnea (p=.004), anxiety (HAS p=.005), and quality of sleep (PSQI p=.004). Short-term aquatic respiratory exercisebased program improved quality of life, functional capacity, pain, dyspnea, anxiety and quality of sleep in patients with fibromyalgia and may be a relevant addition to the treatment of these patients.


ansiedade/terapia hydrotherapy/methods terapia por exercício/métodos pain/therapy qualidade de vida randomized clinical trial dispinéia/terapia dyspnea/therapy physical therapy (specialty)/methods fisioterapia (especialidade)/métodos sono fibromyalgia/therapy therapy by exercises/methods fibromialgia/terapia anxiety/therapy quality of life dor/terapia ensaios clínicos controlados aleatórios hidroterapia/métodos sleep

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