Núm. 65 (2017)
REVISIONES/ REVIEWS

Fibromialgia y ejercicio terapeútico. Revisión sistemática cualitativ / Fibromyalgia and Therapeutic Exercise. Qualitative Systematic Review

Publicado marzo 6, 2017

Resumen

14. Fisioterapia y rehabilitación / Physiotherapy and rehabilitation


Objetivos: El objetivo de esta revisión es determinar qué ejercicio es más eficaz  para reducir la sintomatología de la fibromialgia.

Estrategia de búsqueda: Se realizaron búsquedas en las principales bases de datos de las ciencias de la salud: PEDro, PubMed, Cochrane Plus, ISI (Web of Knowledge), y PsycINFO, y en las revistas no indexadas del área, entre marzo y octubre de 2013.

Resultados: Se analizó el nivel de evidencia y se aplicaron criterios de exclusión e inclusión para obtener 32 artículos en la revisión, clasificados en 5 categorías en función del tipo de ejercicio. Todos ellos eran ensayos clínicos aleatorios.

Conclusiones: El ejercicio terapéutico es eficaz para reducir la sintomatología de la fibromialgia. El ejercicio acuático, el combinado y las actividades alternativas parecen más eficaces para el tratamiento de puntos sensibles, de la depresión, y tiene mayores niveles de adherencia terapéutica. Para el tratamiento del resto de síntomas, todos los tipos de ejercicio tienen similares resultados.

PALABRAS CLAVE: Fibromialgia, tratamiento, fisioterapia, ejercicio, actividad física, deporte.

 

ABSTRACT

Objective: The goal of this review is to determine which exercise is the best to reduce the symptomatology of fibromyalgia.

Search Strategy: Intervention studies in fibromyalgia were retrieved through searches in the main health-science databases: PEDro, PubMed, Cochrane Plus, ISI (Web of Knowledge), y PsycINFO, and in in publications of the field, Fisioterapia y Cuestiones de Fisioterapia, between March and October 2013.

Results: After applying inclusion and exclusion criteria, and analyze the level of evidence, 32 publications were accepted in this review, classified in 5 different categories, depending on the type of activity. They were all randomized clinical trials.

Conclusions: Exercise is effective for reducing symptomatology of fibromyalgia. Aquatic and combined exercise, and alternative activities seem to be more accurate in the treatment of tender points, depression, and they have higher levels of adherence. Relating to the rest of the symptoms, every other type of exercise has similar results.

KEY WORDS: Fibromyalgia, treatment, physical therapy, exercise, physical activity, sport.

Citas

Brecher LS, Cymet TC. A practical approach to fibromyalgia. J Am Osteopath Assoc. 2001;101(4 Suppl Pt 2):S12-7.

Spaeth M. Epidemiology, costs, and the economic burden of fibromyalgia. Arthritis Research & Therapy. 2009;11(3):117.

Carmona L, Ballina J, Gabriel R, Laffon A. The burden of musculoskeletal diseases in the general population of spain: Results from a national survey. Annals of the Rheumatic Diseases. 2001;60(11):1040-45.

Wolfe F. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19-28.

Wolfe F, Smythe HA, Yunus MB, et al. The American college of rheumatology 1990 criteria for the classification of fibromyalgia. report of the multicenter criteria committee. Arthritis Rheum. 1990;33(2):160-72.

Wolfe F, Clauw DJ, Fitzcharles M, et al. The American college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research. 2010;62(5):600-10.

Collado Cruz A, Torres i Mata X, Arias i Gassol A, et al. Efficiency of multidisciplinary treatment of chronic pain with locomotor disability. Med Clin (Barc). 2001;117(11):401-5.

Karjalainen KF, Malmivaara A FAU,- van Tulder, van Tulder MF, et al. Multidisciplinary rehabilitation for fibromyalgia and musculoskeletal pain in working age adults.Cochrane database of systematic reviews (Online) JID - 100909747. 0706(1469-93).

Worrel LM, Krahn LE, Sletten CD, Pond GR. Treating fibromyalgia with a brief interdisciplinary program: Initial outcomes and predictors of response. Mayo Clin Proc. 2001;76(4):384-90.

Arnold B, Hauser W, Arnold M, et al. Multicomponent therapy of fibromyalgia syndrome. systematic review, meta-analysis and guideline. Schmerz. 2012;26(3):287-90.

Arnold LM, Clauw DJ, Dunegan LJ, Turk DC, FibroCollaborative. A framework for fibromyalgia management for primary care providers. Mayo Clin Proc. 2012;87(5):488-96.

Bennett R. The fibromyalgia impact questionnaire (FIQ): A review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S154-62.

Cleeland CS, Ryan KM. Pain assessment: Global use of the brief pain inventory. Ann Acad Med Singapore. 1994;23(2):129-38.

Germain A, Hall M, Krakow B, Katherine Shear M, Buysse DJ. A brief sleep scale for posttraumatic stress disorder: Pittsburgh sleep quality index addendum for PTSD. J Anxiety Disord. 2005;19(2):233-44.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.

SCImago. (2007). SJR — SCImago journal & country rank. Retrieved june 08, 2013, from http://www.scimagojr.com.

Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ. 2001;323(7308):334-6.

Moher D, hopewell S, schulz KF, montori V, gøtzsche PC, devereaux PJ, elbourne D, egger M, altman DG, for the CONSORT group. CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trial. BMJ 2010;340:c869.

Sanudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: A randomized controlled trial. Arch Phys Med Rehabil. 2010;91(12):1838-43.

Gowans SE, Dehueck A, Voss S, Silaj A, Abbey SE. Six-month and one-year followup of 23 weeks of aerobic exercise for individuals with fibromyalgia. Arthritis Rheum. 2004;51(6):890-8.

da Costa D, Abrahamowicz M, Lowensteyn I, et al. A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia [with consumer summary]. Rheumatology. 2005;44(11):1422-7.

Mannerkorpi K, Nordeman L, Cider A, Jonsson G. Does moderate-to-high intensity nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther. 2010;12(5):R189.

Fontaine KR, Conn L, Clauw DJ. Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: Results of a randomized trial. Arthritis Research & Therapy. 2010;12(2):R55.

Newcomb LW, Koltyn KF, Morgan WP, Cook DB. Influence of preferred versus prescribed exercise on pain in fibromyalgia. Med Sci Sports Exerc. 2011;43(6):1106-13.

Fontaine KR, Conn L, Clauw DJ. Effects of lifestyle physical activity in adults with fibromyalgia: Results at follow-up. Journal of Clinical Rheumatology. 2011;17(2):64-8.

Dobkin PL, Abrahamowicz M, Fitzcharles MA, Dritsa M, da Costa D. Maintenance of exercise in women with fibromyalgia. Arthritis Rheum. 2005;53(5):724-31.

Hooten WM, Qu W, Townsend CO, Judd JW. Effects of strength vs aerobic exercise on pain severity in adults with fibromyalgia: A randomized equivalence trial. Pain. 2012;153(4):915-23.

Kayo AH, Peccin MS, Sanches CM, Trevisani VF. Effectiveness of physical activity in reducing pain in patients with fibromyalgia: A blinded randomized clinical trial. Rheumatol Int. 2012;32(8):2285-92.

Bircan C, Karasel SA, Akgun B, El O, Alper S. Effects of muscle strengthening versus aerobic exercise program in fibromyalgia. Rheumatol Int. 2008;28(6):527-32.

Kingsley JD, Panton LB, Toole T, Sirithienthad P, Mathis R, McMillan V. The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia. Arch Phys Med Rehabil. 2005;86(9):1713-21.

Valkeinen H, Alen M, Hannonen P, Hakkinen A, Airaksinen O, Hakkinen K. Changes in knee extension and flexion force, EMG and functional capacity during strength training in older females with fibromyalgia and healthy controls [with consumer summary]. Rheumatology. 2004;43(2):225-8.

Hoeger Bement MK, Weyer A, Hartley S, Drewek B, Harkins AL, Hunter SK. Pain perception after isometric exercise in women with fibromyalgia. Arch Phys Med Rehabil. 2011;92(1):89-95.

Sanudo B, Galiano D, Carrasco L, de Hoyo M, McVeigh JG. Effects of a prolonged exercise program on key health outcomes in women with fibromyalgia: A randomized controlled trial. J Rehabil Med. 2011;43(6):521-6.

Garcia-Martinez AM, de Paz JA, Marquez S. Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: A randomized controlled trial. Rheumatol Int. 2012;32(7):1869-76.

Wennemer HK, Borg-Stein J, Gomba L, et al. Functionally oriented rehabilitation program for patients with fibromyalgia: Preliminary results. Am J Phys Med Rehabil. 2006;85(8):659-66.

Sanudo B, de Hoyo M, Carrasco L, et al. The effect of 6-week exercise programme and whole body vibration on strength and quality of life in women with fibromyalgia: A randomised study. Clin Exp Rheumatol. 2010;28(6 Suppl 63):S40-5.

Evcik D, Yigit I, Pusak H, Kavuncu V. Effectiveness of aquatic therapy in the treatment of fibromyalgia syndrome: A randomized controlled open study. Rheumatol Int. 2008;28(9):885-90.

Munguia-Izquierdo D, Legaz-Arrese A. Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol. 2007;25(6):823-30.

Munguia-Izquierdo D, Legaz-Arrese A. Assessment of the effects of aquatic therapy on global symptomatology in patients with fibromyalgia syndrome: A randomized controlled trial. Arch Phys Med Rehabil. 2008;89(12):2250-7

Gusi N, Tomas-Carus P, Hakkinen A, Hakkinen K, Ortega-Alonso A. Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum. 2006;55(1):66-73.

Tomas-Carus P, Gusi N, Leal A, Garcia Y, Ortega-Alonso A. El tratamiento para la fibromialgia con ejercicio fisico en agua caliente reduce el impacto de la enfermedad en la salud fisica y mental de mujeres afectadas (the fibromyalgia treatment with physical exercise in warm water reduces the impact of the disease on female patients' physical and mental health) [spanish]. Reumatologia Clinica. 2007;3(1):33-7.

Tomas-Carus P, Raimundo A, Adsuar JC, Olivares P, Gusi N. Efectos del entrenamiento acuatico y posterior desentrenamiento sobre la percepcion e intensidad del dolor y el numero de puntos sensibles de mujeres con fibromialgia. Apunts Medicina de L'esport. 2007;42(154):76-81.

Altan L, Bingol U, Aykac M, Koc Z, Yurtkuran M. Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int. 2004;24(5):272-7.

Assis MR, Silva LE, Alves AM, et al. A randomized controlled trial of deep water running: Clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum. 2006;55(1):57-65.

de Andrade SC, de Carvalho RF, Soares AS, de Abreu Freitas RP, de Medeiros Guerra LM, Vilar MJ. Thalassotherapy for fibromyalgia: A randomized controlled trial comparing aquatic exercises in sea water and water pool. Rheumatol Int. 2008;29(2):147-52.

Jones KD, Sherman CA, Mist SD, Carson JW, Bennett RM, Li F. A randomized controlled trial of 8-form tai chi improves symptoms and functional mobility in fibromyalgia patients. Clin Rheumatol. 2012;31(8):1205-14.

Wang C, Schmid CH, Rones R, et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med. 2010;363(8):743-54.

Taggart HM, Arslanian CL, Bae S, Singh K. Effects of T'ai chi exercise on fibromyalgia symptoms and health-related quality of life. Orthop Nurs. 2003;22(5):353-60.

Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the yoga of awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-39.

Altan L, Korkmaz N, Bingol U, Gunay B. Effect of pilates training on people with fibromyalgia syndrome: A pilot study. Arch Phys Med Rehabil. 2009;90(12):1983-8.

American college of sports medicine position stand. the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30(6):975-91.

Oriel KN, Marchese VG, Shirk A, Wagner L, Young E, Miller L. The psychosocial benefits of an inclusive community-based aquatics program. Pediatr Phys Ther. 2012;24(4):361-7.