ABSTRACT
OBJECTIVE: Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM). Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE) on autonomic modulation, pain perception and the quality of life (QOL) of FM patients. METHODS: Eighty sedentary women with FM (ACR 1990) were randomly selected to participate in STRE or flexibility (FLEX) exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM) in 12 different exercises. Outcomes were Visual Analog Scale (VAS) for pain, Heart Rate Variability (HRV) analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench), maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ), the Beck and Idate Trait-State Inventory (IDATE), a short-form health survey (SF-36). RESULTS: The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (p<0.05). The FLEX group showed higher improvements in anxiety (p<0.05). Both groups showed improvements in the QOL, and there was no significant difference observed between the groups. There was no change in the HRV of the STRE and FLEX groups. CONCLUSIONS: Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises. Despite the benefits in fitness, pain, depression, anxiety and quality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov NCT02004405.
Subject(s)
Autonomic Nervous System/physiopathology , Fibromyalgia/physiopathology , Fibromyalgia/therapy , Quality of Life , Resistance Training , Adult , Anxiety/complications , Anxiety/physiopathology , Demography , Depression/complications , Depression/physiopathology , Female , Fibromyalgia/complications , Heart Rate , Humans , Isometric Contraction/physiology , Middle Aged , Pain/physiopathology , Physical FitnessABSTRACT
Trabalhos de diferentes autores constataram que, um aumento na concentração de serotonina (5-HT) no cérebro, durante exercício físico intenso e prolongado, está diretamente relacionado a um prejuízo na função do Sistema Nervoso Central (SNC), com correspondente desenvolvimento da fadiga e consequente diminuição do desempenho. No presente trabalho, 10 ratos Wistar foram submetidos a sessões de corrida até o esgotamento físico em esteira rolante. Os protocolos experimentais foram divididos em quatro fases: Fase 1 - avaliação do tempo médio de corrida dos animais até o esgotamento físico; Fase 2 - avaliação do tempo médio de corrida dos animais até o esgotamento físico, sob tratamento com fluoxetina; Fase 3 - "washout" de sete dias; Fase 4 - "washout" de 14 dias. Este estudo sugere que a administração crônica de fluoxetina aumenta substancialmente o tempo médio de corrida até o esgotamento físico em ratos submetidos a exercício em esteira rolante.
Works of different authors have been shown that an increase in the concentration of serotonin (5-HT) in the brain during intense and long-term physical exercise, is directly associated with a harm in the function of the Central Nervous System (CNS), with corresponding development of the fatigue and consequence decrease of the performance. In the present work, 10 rats Wistar were submitted to run-sessions until the exhaustion in treadmill. The experimental protocols were splited in 4 phases: Phase 1: evaluation of the range run-time of the animals until the physical exhaustion. Phase 2: evaluation of the range run-time of the animals until the physical exhaustion on treatment with fluoxetine. Phase 3: washout seven days. Phase 4 washout 14 days. The present study suggest that chronic administration of fluoxetine increase substantially the run-time until the physical exhaustion in rats submitted to exercises in treadmill.
Las obras de diferentes autores encontraron que un aumento en la concentración de la serotonina (5-HT) en el cerebro durante el ejercicio intenso y prolongado está directamente relacionado con deterioro de la función del Sistema Nervioso Central (SNC), con el correspondiente desarrollo de la fatiga y su consecuente reducción en el rendimiento. En este estudio, 10 ratas Wistar fueron sometidas a la ejecución de sesiones en una cinta hasta el agotamiento físico. Los protocolos experimentales fueron divididos en cuatro fases: Fase 1 - Evaluación de la carrera media de los animales al agotamiento físico, la Fase 2 - Evaluación de la carrera media de los animales al agotamiento físico, están en tratamiento con fluoxetina, la Fase 3 - "lavado "de siete días; Fase 4 -" lavado "de 14 días. Este estudio sugiere que la administración crónica de fluoxetina incrementa sustancialmente la tarifa media del agotamiento físico en ratas sometidas a ejercicio en una caminadora.
