Fibromyalgia syndrome (FMS) is a widespread musculoskeletal disorder characterized by troublesome symptoms, such as joint and muscle pain, chronic fatigue, sleep difficulty, and mood and memory issues.
The FITT principle provides an exercise prescription framework to optimize training. An individual’s physical ability, level of fitness, health status, and social environment are factors that should be considered when designing a training program according to the FITT principle.
In most cases, individuals with FMS do not show signs of joint deformities or joint disease. As a result, FMS is not considered a true form of arthritis but is related to aberrant central pain and elevated sensory processing activity.
Lower Fitness Levels
Individuals with FMS show reduced aerobic and muscle function, such as strength and endurance. Overall, these reductions in physical fitness are caused by the occurrence of chronic pain.
In general, exercise improves cardiorespiratory function, neuromuscular function, flexibility, pain, and other symptoms of FMS. For example, a small increase in physical activity participation can considerably improve physical function, pain, and mood.
Exercise Prescription
Many studies examined and are interested in the connection between FMS and physical activity. Yet, there is no evidence-based statement to define the exact training dose for individuals with FMS. Thus, exercise prescription is similar to healthy individuals; however, several training modifications are applied to create a safe training environment.
Training Considerations
1) Symptoms reduction is more significant and efficient when exercise training frequency = 3 days per week.
2) Symptoms dependent – during the symptoms flare-ups phase, exercise should be set at low intensity.
3) Minimize eccentric training, specifically during flare-ups.
4) Give a proper recovery time between exercises and training.
5) Decrease exercise volume during symptoms flare-ups.
Chronic Pain and Physically Inactive
Individuals with FMS like similar others coping with chronic pain are at greater risk of being physically inactive. The primary reasons for the reduction in physical activities are clear and understandable. Individuals with FMS are coping with elevated sensory pain levels, which tremendously affects daily function. Thus, physical activity is turning to be an impossible mission.
The FITT Recommendations for Individuals With Fibromyalgia
| Aerobic | Resistance | Flexibility | |
|---|---|---|---|
| Frequency | Start with 1-2 days, and progress to 3 days a week. | 2-3 days a week - minimum of 48 hours between training sessions. | Start with 1-3 day a week, and progress to 5 days a week. |
| Intensity | Start light < 30% Vo2max - progress to 40 - 60% Vo2max. | 40%-80% - gradually increase to 60%- 80% 1RM. | Stretch to the the point of tightness. |
| Time | Start with 10 minutes per day and progress to 30-60 minutes per day. | Start easy - 4-5 and progress to 8-12 repetitions. | 10-30 seconds. |
| Type | Optimal - non weight-bearing exercise - water exercise, swimming, cycling. | Therabands, dumbbells, body weight exercises, weight machines. | Non weight-bearing stretching. |
Yoga
These exercise platforms are also shown to be beneficial, especially, if instructors are qualified in training for people with chronic pain conditions.
Activities such as yoga and tai chi are considered to be favored over other programs, like stretching and strength training.
The practice of yoga was shown to be an excellent example of developing adequate coping strategies to manage symptoms of FMS. In a study of 53 fibromyalgia patients, those who followed a yoga program also showed greater pain-coping skills, fatigue, mood, and other associated fitness benefits.
Yoga is a great workout that not only combines physical abilities but also teaches breathing techniques. Joints and musculoskeletal alignment is desired; the body is able to achieve a sense of homeostasis, which is the stage of acquiring full balance or stable equilibrium. Such therapeutic health effects can be achieved through yoga by developing a high quality of body awareness and building physical strength.
Tai Chi:
Thai chi is a practice that combines mind and body along with a gentle flowing movement. In a study that examined 226 patients with fibromyalgia, the effect of tai chi was similar or even more efficient for improving symptomatic conditions than aerobic exercise. In another study involving 101 patients, many in the study also received benefits from tai chi. Thus, tai chi may provide long term improvement in common fibromyalgia symptoms; such improvements can include better pain management and increased physical mobility.
