Background Chronic Widespread Pain (CWP) is defined as pain in the right and left side of the body, above and below the waist combined with axial pain, for at least 3 months. The prevalence of CWP in general populations is in men between 3% and 9% and in women between 6.5% and 16%. Gender has been suggested to play a role in how patients with CWP respond to pain management programs. There is limited knowledge about the effects of exercise in men with CWP.
Objectives To investigate the effects of resistance exercise (RE) on land compared to aerobic pool exercise (PE) in men with CWP.
Methods Thirty-four men with CWP, mean age 49 (SD 8, range 26-59) years were randomized to 12 weeks of standardised pool exercise or land-based resistance exercise. The primary outcome was the Multidimensional Fatigue Inventory (MFI-20). Depression, anxiety, isometric force, pain and health related quality of life were also assessed.
Results No significant difference was found for change in MFI-20 between the two exercise groups. RE improved isometric force in right shoulder abduction (RE: Δ2.2 SD 1.5 N, PE: Δ0.6 SD 1.2 N, p=0.009), right knee flexion (RE: Δ50, SD 50 N, PE: Δ-17, SD 71 N, p=0.003) and left knee flexion (RE: Δ33 SD 39, PE: Δ-9 SD 52 N, p=0.017) as compared to pool exercise. The drop-out rate was 29% in the RE group and 18% in the PE group. Within-group analyses showed improvement in the resistance exercise group for MFI General fatigue (p=0.040) and isometric force (p=0.003→0.015) at 12 weeks after baseline. In the pool exercise group improvement was found for MFI Physical fatigue (p=0.044), MFI Reduced motivation (p=0.021), anxiety (p=0.028) and physical component of health related quality of life (p=0.006). Both exercise groups reported fewer pain localizations at post-test. (p=0.033 and p=0.022).
Conclusions A 12-week resistance exercise program improved isometric strength, when compared to a 12-week pool exercise program. The pool exercise group improved anxiety and health related quality of life over time. Both groups improved in fatigue and distribution of pain. Aerobic and resistance exercise appear to improve different aspects of health and the patients' goals and preferences should guide the choice of treatment. Further exercise studies with larger groups are needed to gain more knowledge about differences in outcomes in men with CWP.
Disclosure of Interest None declared
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