What is Fibromyalgia?

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain.  An estimated 1.2 million Canadians, about 5% of the population, suffer at least one of chemical sensitivity, chronic fatigue syndrome or fibromyalgia.  Although the disease affect both men and women, 80% of those afflicted are women between the ages of 20 and 55. Fibromyalgia is characterized by the presence of chronic pain and tenderness at specific locations referred to as “tender points”.

Additional symptoms include sleep disturbance, chronic fatigue, morning stiffness, abnormal tingling in the extremities, altered perception of physical exertion, depression and anxiety. Secondary symptoms include impaired functional ability, poor physical fitness, social isolation, low self-esteem and poor quality of life.

Effects of exercise training

Studies have shown that training is both safe and effective in producing the same general benefits for individuals with FM as it does for healthier individuals. The majority of subjects who achieved some health-related benefits typically engaged in aerobic exercise for at least 20 min a day, two days a week, and performed strength training two to three times a week utilizing 8-12 reps per exercise for an average of 12 weeks.

The main goal of exercise training in this population is to restore and maintain functional ability.

Recommendations for Exercise Training

It is difficult to provide definitive recommendations for exercise programming in this population because of methodological inconsistencies and high attrition rates among participants in published studies.  It appears that exercise should primarily consist of low to moderate-intensity aerobic activities.  Programs should consist of non or low-impact activities that minimize the eccentric contraction.  Because the small muscles of the shoulder do not tolerate sustained overhead activities, exercise programs involving the lower body are recommended.  Activities such as tai chi and yoga have also been shown to be beneficial and should be considered in the program design.  Strength training activities alone have not been found to consistently improve pain and impact of FM; nevertheless, due to the general deconditioned state of an individual with FM, strength training should be considered as part of the overall exercise program to improve fitness.  Since people with this disease have a poor tolerance for eccentric movements, exercise should be designed to minimize the eccentric component.

RESOURCE: J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, Scott O. Roberts; ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities