Pool-Based and Land-Based Aerobic Exercises on Functional Status and Physical Fitness among Individuals with Fibromyalgia Syndrome

Fibromyalgia syndrome is a prevalent musculoskeletal disorder, i.e., characterized by chronic bone pain, dyspnea, paresthesia, and sleep disturbances. Additionally, it prevents body rejuvenation and causes early fatigue, along with numerous touch–sensitive points that their extent and symmetric distribution are determined. Despite the economic and human costs associated with fibromyalgia and the vital role that training programs have in reducing symptoms, few studies have evaluated such training programs. Therefore, this study compared the effect of water–based and land–based aerobic exercises on the functional condition and physical fitness in individuals with fibromyalgia syndrome.

This quasi–experimental study evaluated the intra– and inter–group differences (in the experimental and control groups) at the baseline (pretest), immediately after 8 weeks of intervention, as well as two months after the completion of the training program. The statistical population of the present study included patients with fibromyalgia syndrome who were diagnosed by a specialist physician at a medical center in Tehran City, Iran. The sample matching process involved pairing the ones that closely matched (up to 15 people). Each of these 15 people was then assigned to one group. The study subjects were randomly divided into three groups. The exercise protocols included two groups of water–axis and drought–axial aerobic exercises. The intensity of the exercises in all three groups was moderate (60%–80% of maximum heart rate), and its frequency was 3 times a week for 8 weeks (10). In the warm–up section, the heart rate was kept at a maximum of 40%. Heart rate control was performed in the water–axis and drought–axis drill conditions to match the training intensity. Perceived Pressure Exertion (RPE) was also determined using the conventional Borg Scale (6–20 scores). The drought–based intervention group conducted exercises using weight (2–3 sets with 15–20 repetitions). The water–centered exercise group practiced in a water–to–breast pool (at 28–30°C). The intensity of training and the muscles involved were as close as possible to the drought–based group (although the heart rate in water is 17 times less dramatic than water in terms of water stress). Static stretching was included in the heating and cooling programs, as well as ground drill exercises. Cognitive status tests, fitness factors related to health (muscle strength, cardiovascular endurance, & flexibility), and pre– and post–functional status and the 2–month follow–up after the completion of training interventions were conducted. A) Measures related to health fitness (muscular strength, cardiovascular endurance, & flexibility) were conducted using one–time repeated tests (on chest and leg presses), and 6–minute walk and sit and reach tests. B) The condition of the upper crossover was used by the cranio–verbal angle and the taper. C) Functional status was measured using the Fibromyalgia Impact Questionnaire (FIQ).

The results showed that pool–based and land–based aerobic exercises had an effect on cardiovascular endurance and flexibility and functional status of patients (p<0.001). The results also showed that these effects persisted over time (p<0.001).

The treatment protocol with hot water suggested no improvement in any of the FIQ sub–scales; however, a significant improvement observed in physical function, pain, morning leakage, fatigue, and stiffness aspects. It is suggested that more extended training periods be applied to improve depression and anxiety by achieving the remaining long–term benefits.