Wednesday, 30 April 2014

Fibromyalgia and Exercise

Fibromyalgia (FM) is a complex, multidimensional, rheumatological disorder. It is the third most common rheumatological disorder in the United States. It affects both men and women; however, a higher prevalence is seen in women, with 80% of people affected being women between the ages of 20 and 55 years.

FM is characterized by the presence of chronic pain and tenderness at specific anatomical sites, known as “tender points”. Other symptoms may include:
·         Sleep disturbance
·         Chronic fatigue
·         Morning stiffness
·         Paresthesia (tingling sensation) in the hands and feet
·         Enhanced perception of physical exertion
·         Depression
·         Anxiety
As a result of these symptoms, those affected with FM may also suffer from:
·         Impaired functional ability
·         Low self-esteem
·         Poor physical fitness
·         Social isolation
·         Poor quality of life

The exact cause of FM is as yet unknown; however, the following factors are believed to increase the risk of developing FM:
·         Muscle abnormalities
·         Neuroendocrine and autonomic system regulation disorders
·         Genetic predisposition

Due to the multidimensional nature of FM, a multidisciplinary approach to the management of FM patients has been shown to provide the best results. This includes appropriate medications to manage symptoms, client education, cognitive behavioural therapy, hypnosis, acupuncture, and an appropriate exercise programme.

People with FM will reap the same benefits of exercise that individuals without FM receive; however, the main goal of a regular exercise programme for individuals with FM is to restore and maintain functional ability. The benefits of exercise that are more specific to those with FM include the following:
·         Reduced number of tender points
·         Reduced pain at the tender points
·         Decreased general pain
·         Improved sleep and therefore less fatigue
·         Improved self-esteem
·         More frequent and meaningful social interactions
·         Improved functional ability

Because of their symptoms, people with FM often become sedentary and, therefore, very deconditioned. They often complain of morning stiffness, exaggerated delayed-onset muscle soreness, poor recovery from exercise, and difficulty using their arms when elevated above their shoulders. High-impact, vigorous activities are also not well-tolerated. Therefore, low- to moderate-intensity aerobic activity is recommended for people with FM. One must begin the exercise programme slowly and progression should be slow and controlled. Supervised exercise therapy sessions with a biokineticist will ensure appropriate progression and will potentially increase exercise adherence.

ACSM’s Exercise Management for Person’s with Chronic Diseases and Disabilities

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