Abstract
The aim of this study was to investigate the effectiveness of intensive dynamic exercises on the oxidative status in patients with primary fibromyalgia (FM) and to explore the importance of these effects on the outcome of FM. We measured levels of stress oxidants (protein carbonyls, nitric oxide, and thiobarbituric acid reactive substances) and antioxidant parameters (thiols and catalase) in blood samples from 40 FM patients and from healthy controls (n = 25) at presentation and after 12 weeks of intensive exercise program that comprised aerobic and strengthening exercises (lasting 1 h three times per week). In the patients, pain was assessed using the visual analog scale and tender points counts, and the Fibromyalgia Impact Questionnaire and the Beck Depression Inventory were applied at presentation and after 12 weeks of exercise therapy. At presentation, the serum levels of the oxidative stress parameters were significantly higher (P < 0.001), whereas the serum levels of antioxidant parameters were significantly lower (P < 0.001) in patients with FM than in controls. There was a higher significant decrease (P < 0.001) in the oxidative stress parameters following the 12-week exercise regime, whereas the antioxidant parameter levels showed a higher significant increase (P < 0.001) after the exercise treatment. Tender points, visual analog scale, Fibromyalgia Impact Questionnaire, and Beck Depression Inventory showed a higher significant (P < 0.001) improvement with exercise therapy. Twelve weeks of intensive dynamic exercise program should be recommended to patients with FM as it was effective in decreasing the oxidative stress parameters, increasing the antioxidant parameters, and improving the clinical outcome of this disease.
Highlights
Fibromyalgia syndrome (FMS) is a pain syndrome originating from the muscle and its connective tissues and it is characterized by widespread noninflammatory pain, cognitive dysfunction, fatigue, sleep disturbance, and a heterogeneous complex of somatic symptoms [1]
There are many pathologic mechanisms, which are postulated as a possible etiology of FMS; one of them is local hypoxia, which is suggested to play a potential role in the pathophysiology of disease manifestations [3]
There was a statistically significant decrease in the mean Visual analog scales (VASs) (P < 0.001), number of tenderness points (TP) (P < 0.001), Fibromyalgia Impact Questionnaire (FIQ) (P < 0.001), Beck Depression Inventory (P < 0.001), Jenkins’ Sleep Questionnaire (P < 0.001), and Modified Health Assessment Questionnaire (MHAQ) (P < 0.001) after the exercise program compared with their mean before the exercise program (Table 2)
Summary
The aim of this study was to investigate the effectiveness of intensive dynamic exercises on the oxidative status in patients with primary fibromyalgia (FM) and to explore the importance of these effects on the outcome of FM. Patients and methods We measured levels of stress oxidants (protein carbonyls, nitric oxide, and thiobarbituric acid reactive substances) and antioxidant parameters (thiols and catalase) in blood samples from 40 FM patients and from healthy controls (n = 25) at presentation and after 12 weeks of intensive exercise program that comprised aerobic and strengthening exercises (lasting 1 h three times per week). Pain was assessed using the visual analog scale and tender points counts, and the Fibromyalgia Impact Questionnaire and the Beck Depression Inventory were applied at presentation and after 12 weeks of exercise therapy
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