The Effectiveness of Education and Aerobic Exercise in Higher Functioning Patients with Fibromyalgia: an Evaluation of A New Service

Background Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain, fatigue and reduced physical function. Exercise has positive effects on physical function, fatigue and well-being in FMS1. However, patients find it difficult to engage in exercise and often have low self-efficacy for exercise.Objectives The aim of this study was to evaluate a new early access service consisting of a 6-week education and aerobic exercise intervention in patients with FMS, who were classified as “high functioning”.Methods Participants (n=32) were referred from WRH rheumatology department and attended a 6-week exercise and education intervention delivered by physiotherapist and occupational therapist. Participants completed the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Score (HAD) Six-Minute-Walk Test (6MWT) and Exercise Self-Efficacy Scale (ESES). Follow up was carried out post and 3 months post programme.Results Participants who completed the intervention had a significant improvement in mean (SD) pain from baseline 7.01 (1.8) to the end of the programme 5.6 (2.9), p=0.03. Mean (SD) 6MWT improved from 386m (96) to 416m (57) at the end of the programme (p=0.05), this was maintained at 3 month follow-up. There was no significant change in total FIQ score or the HAD scale, however, participants' exercise self-efficacy significantly improved from 58.2 (18.6) to 68 (11.6), p=0.01.Conclusions Improvements were recorded post programme in exercise capacity, exercise self-efficacy and VAS pain. Improvement was maintained at 3 months follow up. Anticipated service developments are use of FIQ to subgroup2, longer term follow up, vocational rehabilitation and pedometer use to evaluate exercise adherence.3ReferencesHauser, W., Klose, P., Langhorst, J., Moradi, B., Steinbach, M., Schiltenwolf, M. & Busch, A. (2010) Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Arthritis Research & Therapy, 12(3), R79.De Souza, (2009) Fibromyalgia Subgroups: Profiling distinct subgroups using the Fibromyalgia Impact Questionnaire. A Preliminary Study. Rheumatology Int.29:509-515Tudor-Locke C., Craig C., Aoyagi Y., (2011). How many steps/day are enough? For older adults and special populations. A literature Review. International Journal of Behavioural Nutrition and Physical Activity 8:80