Background: Land and water-based exercise intervention programs have demonstrated positive effects on fibromyalgia symptoms¹. However, research comparing the efficacy of both protocols is limited.

Objectives: The aim of this study was to assess the effect of two exercise interventions (land-based and water-based training) and a subsequent detraining period on fatigue in women with fibromyalgia.

Methods: Among the 272 participants initially randomised, a total of 161 women (age: 50.7±7.7) completed all the assessments with an attendance of at least of 70% (land-based n=50, water-based n=44, control n=67). The intervention groups trained 3 non-consecutive days/week (60 min/ses) during 24 weeks. Each session involved exercises to improve cardiorespiratory fitness, muscle strength, and flexibility. Four dimensions of fatigue were assessed using the Multidimensional Fatigue Inventory. Participants were evaluated at baseline (pre-test), at the end of the intervention (post-test) and following a detraining period of 12 weeks (re-test). Land-based, water-based, and control groups were comparable in sociodemographic characteristics, disease duration, drugs intake, and body mass index. Age, tenderness, and baseline outcomes values were used as covariates in the comparisons (analysis of covariance) of the changes from baseline (post-test vs. pre-test and re-test vs. pre-test) between groups.

Results: The land-based exercise group reduced general fatigue (mean difference: -1.17; 95% confidence interval: -2.30 to -0.03; P=0.04) and physical fatigue (-2.48; -3.80 to -1.16; P<0.001) compared to the control group. The water-based exercise group reduced physical fatigue compared to the control group (-1.61; -3.04 to -0.19; P=0.02). No significant reductions were observed in other dimensions of fatigue in either group compared to the control group and no differences between intervention groups were observed (all comparisons, P>0.05). The reductions in fatigue were not sustained after the detraining period in any of the intervention groups (all comparisons, P>0.05).

Conclusion: Twenty-four weeks of land or water-based exercise were both effective in reducing physical fatigue of women with fibromyalgia. Furthermore, land-based exercise led to additional reductions in general fatigue. Reductions in fatigue were not sustained after a 12-week detraining period. Participation in regular exercise, specially land-based, might be an easily accessible treatment option to manage fatigue in this population.

References: [1] Macfarlane GJ, et al. Ann Rheum Dis, 2018; 76(2), 318-328.

Acknowledgments: This study was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639; I+D+I DEP2013-40908-R) and the Spanish Ministry of Education, Culture and Sport (FPU15/00002).

Disclosure of Interests: None declared