'Exercise to me is a scary word': perceptions of fatigue, sleep dysfunction, and exercise in people with fibromyalgia syndrome-a focus group study.

Fibromyalgia syndrome (FMS) is a common and complex chronic pain condition. Exercise is recommended in the management of the FMS; however, people with FMS often find exercise exacerbates their condition and causes overwhelming fatigue. The objective of this study was to explore the perceptions of fatigue and sleep dysfunction, and exercise in people with FMS. Three, 60-90 min focus groups were conducted with people with FMS (n = 14). Participants were recruited from patient support groups who had experienced therapeutic exercise in the management of their condition. Focus groups were video and audio recorded and transcriptions analysed for thematic content by three independent evaluators. Fatigue, sleep dysfunction, and pain were universally reported by participants. The over-arching theme to emerge was a lack of understanding of the condition by others. A huge sense of loss was a major sub-theme and participants felt that they had fundamentally changed since the onset of FMS. Participants reported that they were unable to carry out their normal activities, including physical activity and exercise. The invisibility of FMS was associated with the lack of understanding by others, the sense of loss, and the impact of FMS. People with FMS perceive that there is a lack of understanding of the condition among health care professionals and the wider society. Those with FMS expressed a profound sense of loss of their former 'self'; part of this loss was the ability to engage in normal physical activity and exercise.

The effect of 6-week exercise programme and whole body vibration on strength and quality of life in women with fibromyalgia: a randomised study.

OBJECTIVES: The aim of this study was to investigate the effectiveness of a 6-week traditional exercise programme with supplementary whole-body vibration (WBV) in improving strength and health status in women with fibromyalgia (FM). METHODS: Thirty postmenopausal women with FM (mean (SD) age: 59 (7.90) years) were randomised into one of two groups, one intervention group (GEV n=15), which combined exercise training (two days a week) with three days of WBV (3 sets of 45 s at 20 Hz-3 mm and four sets of unilateral static squats at 20 Hz-2 mm) and another control group (n=15), that performed the same physical activity programme but without vibration training (GEnV). The Fibromyalgia Impact Questionnaire (FIQ) and the global score of the SF-36 were used to assess functional capacity and quality of life. Two additional tests were employed to assess muscle strength. Baseline data and pre-test and post-test data were collected before and after the six-week intervention period. RESULTS: Significant improvements in all outcomes measured were found from baseline in both groups. A 5% improvement from baseline in total FIQ score was observed in the exercise groups (p≤0.05), and was accompanied by reductions in SF36 scores of 9.8% (p<0.001) and 7.9% (p<0.001) in the GEV and GEnV group, respectively. Improvements were also observed in muscle strength in both groups but greater in the GEV group. CONCLUSIONS: The results suggest that women with FMS can gain additional health benefits by engaging in a 6-week traditional exercise programme with supplementary WBV.

Tender point count and total myalgic score in fibromyalgia: changes over a 28-day period.

Tender point count (TPC) is central to fibromyalgia syndrome (FMS), and with total myalgic score (TMS) is often used to monitor the patient's condition. This study aimed to determine the stability of TPC and TMS over time, and to examine how well these measures reflected patients' perceptions of their condition. Twenty-four patients with FMS completed the Fibromyalgia Impact Questionnaire (FIQ) and a visual analogue scale (VAS) measuring well-being, at entrance into the study, and 7 and 28 days later. There was no significant change in TPC (P = 0.074), FIQ score (P = 0.291) or VAS (P = 0.079) of well-being with time. However, mean TMS score did change over time (P = 0.021). There was no correlation between total FIQ score and the other measures (all P-values > 0.05). The significant change in TMS over time may reflect the natural fluctuation in the clinical presentation of FMS.

Patients' perceptions of exercise therapy in the treatment of fibromyalgia syndrome: a survey.

OBJECTIVE: To identify patients' perceptions of the role and benefits of exercise in the treatment of fibromyalgia syndrome (FMS). DESIGN: A postal questionnaire was sent to all 225 members of the Northern Ireland Fibromyalgia Support Group. The questionnaire consisted of 19 questions and was sub-divided into four sections: (1) background information; (2) previous treatment; (3) opinions on the role of exercise in FMS and (4) current participation in, and barriers to, exercise. Data were analysed using descriptive statistics. RESULTS: A response rate of 51.1% (115/225) was achieved. Forty nine percent (57) of respondents were receiving FMS-associated disability benefits and 13% (15) were working full-time. All reported previous treatment for FMS. Ninety-six (84%) had received medication and 82 (71%) exercise-based therapy. Just over half (42/82) of those who had participated in exercise therapy reported it to be an effective management strategy. Two thirds (48/71) of those who used bedrest, and over half (52/96) of those who used medications reported these interventions to be effective. Eighty-two per cent (94) 'agreed' or 'strongly agreed' that exercise improved fitness and 60% (69) 'agreed' or 'strongly agreed' that exercise increased feelings of well-being, but only 13.9% (16) reported that it reduced their pain. The most commonly reported barriers to exercise were fatigue (85%, 98) and pain (73%, 84). CONCLUSION: Exercise therapy is a common treatment for fibromyalgia syndrome, but while respondents accepted its general health benefits, the vast majority did not report that it reduced their pain.