Resistance exercise for persons with fibromyalgia
Short description
Fibromyalgia (FM) is characterized by generalized pain and associated with impaired physical capacity and activity limitations. Many women with FM suffer from activity-induced pain which may be a reason why they avoid activities that can cause increased pain. However such pain can be avoided by actively involving the patient in the planning of the treatment as well as by gradually increasing the load. The purpose of the project was to increase knowledge about how person-centred physical exercise can affect health, disease-specific symptoms, activity limitations and physical capacity in FM. 130 women with FM were randomized to strength exercise or relaxation. Standardized questionnaires on symptoms, health-related quality of life, activity limitations and physical capacity as well as functional tests were used for evaluation and follow-up
Short description of main results
Women with FM who performed person-centred progressive resistance exercise for 15 weeks improved their muscle strength, health status, pain intensity, pain management and participation in everyday activities (Larsson et al 2015).
Several personal and environmental factors promoted the ability of women with FM to be physically active. Although they wanted to be physically active, they needed the support, guidance and understanding of a person with knowledge of the disease to be able to find the right type of activity based on their preferences, adjust the load, and manage pain during and after activity (Larsson et al 2020).
The study has also led to important knowledge about biological pain mechanisms in FM.
Publications
Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia-a randomized controlled trial. Larsson A*, Palstam A*, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K. Arthritis Res Ther 2015;17(161). (*Authors contributed equally). https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-015-0679-1
Factors promoting physical activity in women with fibromyalgia:a qualitative interview study. Larsson A, Feldthusen C, Mannerkorpi K. BMJ open. 2020;10(8):e031693. https://bmjopen.bmj.com/content/10/8/e031693.abstract
Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia. Larsson A, Palstam A, Bjersing J, Löfgren M, Ernberg M, Kosek E, Gerdle B, Mannerkorpi K. BMC Musculoskelet Disord. 2018;19(1):121. https://link.springer.com/article/10.1186/s12891-018-2047-1
Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin. Bjersing J, Larsson A, Palstam A, Ernberg M, Bileviciute-Ljungar I, Löfgren M, Gerdle B, Kosek E, Mannerkorpi K. BMC Musculoskelet Disord. 2017:18:106. https://link.springer.com/article/10.1186/s12891-017-1477-5
Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial. Ericsson A, Palstam A, Larsson A, Löfgren M, Bileviciute-Ljungar I, Bjersing J, Gerdle B, Kosek E, Mannerkorpi K. Arthritis Res Ther (2016)18:176. https://link.springer.com/article/10.1186/s13075-016-1073-3
Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial. Palstam A, Larsson A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K. Arthritis Res Ther (2016)18:116. https://link.springer.com/article/10.1186/s13075-016-1007-0
Percieved exertion at work in women with fibromyalgia: explanatory factors and comparison with healthy women. Palstam A, Larsson A, Bjersing J, Löfgren M, Ernberg M, Bileviciute-Ljungar I, Ghafouri B, Sjörs A, Larsson B, Gerdle B, Kosek E, Mannerkorpi K, J Rehabil Med 2014; 46, 773-780. https://pdfs.semanticscholar.org/5051/067681ae6734780973b7e537ce69f89ecd8d.pdf
Pain and fear avoidance partially mediate change in muscle strength during resistance exercise in women with fibromyalgia. Larsson A , Palstam A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K. J Rehabil Med 2017,49(9):744-750.https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A1326641&dswid=topdog
Gerdle B, Ernberg M, Mannerkorpi K, Larsson B, Kosek E, Christidis N, Ghafouri B. Increased Interstitial concentrations of glutamate and pyruvate in vastus lateralis of women with fibromyalgia syndrome are normalized after an exercise intervention - a case-control study. Plos One 2016,11(10):e0162010. doi: 10.1371/journal.pone.0162010.
Tour J, Löfgren M, Mannerkorpi K, Gerdle B, Larsson A, Palstam A, Bileviciute-Ljungar I, Bjersing J, Invgar M, Ernberg M, Schalling M, Kosek E. Gene-to-gene interactions regulate endogenous pain modulation in fibromyalgia patients and healthy controls – antagonistic effects between opioid and serotonin related genes. Pain 2017, Mars 7. doi: 10.1097/j.pain.0000000000000896.
Ernberg M, Christidis N, Ghafouri B, Bileviciute-Ljungar I, Löfgren M, Larsson A, Palstam A, Bjersing J, Mannerkorpi K, Kosek E, Gerdle B. Effects of 15 weeks of resistance exercise on pro-inflammatory cytokine levels in the vastus lateralis muscle of patients with fibromyalgia. Arthritis Res Ther. 2016; 18: 137. doi: 10.1186/s13075-016-1041-y
Stensson N, Ghafouri N, Ernberg M, Mannerkorpi K, Kosek E, Gerdle B, Ghafouri B. The relationship of endocannabinoidome lipid mediators with pain and psychological stress in women with fibromyalgia: A case-control study. The Journal of Pain 2018;(19)11: 1318-1328.
Researchers
Project coordinator and scientific leader
Kaisa Mannerkorpi, Professor, physiotherapist, Gothenburg University
Members of the project group
Anette Larsson, PhD, physiotherapist, Närhälsan, Research, Education, Development & Innovation, Primary Health Care, Gothenburg university
Annie Palstam, associate professor, physiotherapist, Gothenburg university
Jan Bjersing, MD, associate professor, rheumatologist, scientist Gothenburg university
Anna Ericsson, PhD, physiotherapist, Närhälsan, Närhälsan, Research, Education, Development & Innovation, Primary Health Care.
Group partners
Eva Kosek, professor, MD, Karolinska institutet
Monika Löfgren, associate professor, physiotherapist, Karolinska institutet
Malin Ernberg, professor, Karolinska Institutet
Björn Gerdle, professor, MD, Linköpings universitet