Strength Training Versus Walking on the Fibromyalgia Impact: A Blinded Randomised Controlled Trial

ABSTRACT Objective To compare the effect of 24 sessions of progressive intensity strength training on the impact of fibromyalgia (primary outcome). Furthermore, we evaluated its effects on sleep, anxiety, depression, wind‐up mechanism, conditioned pain modulation, cutaneous sensory threshold, musculoskeletal performance, walking ability, perceived improvement, and treatment adherence (secondary outcomes). Design A blinded randomised controlled trial. Setting After blinded outcome assessments, 66 people were randomised and concealed and allocated to progressive ( n = 22), constant ( n = 22), or walking ( n = 22) strength training groups. Participants People with fibromyalgia. Interventions In the progressive group, exercise intensity increased by 20% of maximum strength each month: 50% in the first month, 70% in the second month, and 90% in the third month. In the constant or walking exercise groups, moderate intensity was maintained at the end of the treatment. Each person received 24 individual exercise sessions (2x/week), with three months of exercise and three months of no exercise. Main Outcome Measure Fibromyalgia impact. Results Groups were similar at baseline. There were no significant between‐group differences in the primary outcome at any time point. In within‐group comparisons, we observed significant differences indicating that all three types of exercise reduced fibromyalgia symptoms; however, no variable achieved a minimal clinically important difference. In between‐group comparisons for the secondary outcomes, groups reported a positive perception of improvement, but most of each group did not adhere to treatment and/or did not answer about adherence after follow‐up without exercise. Conclusions Twenty‐four sessions of progressive intensity strength training did not provide a greater reduction in the fibromyalgia impact than constant intensity or walking exercises. Trial Registration Brazilian Registry of Clinical Trials (ReBEC): RBR‐9pbq9fg, date of registration: October 06, 2022. Protocol Publication BMC Musculoskeletal Disorders: Doi – 10.1186/s12891‐023‐06952‐3 | Published: Volume 24, article number 816, October 14, 2023.