Abstract
BackgroundFibromyalgia (FM) affects approximately 1–3 % of the general population. Fatigue limits the work ability and social life of patients with FM. A few studies of physical exercise have included measures of fatigue in FM, indicating that exercise can decrease fatigue levels. There is limited knowledge about the effects of resistance exercise on multiple dimensions of fatigue in FM. The present study is a sub-study of a multicenter randomized controlled trial in women with FM. The purpose of the present sub-study was to examine the effects of a person-centered progressive resistance exercise program on multiple dimensions of fatigue in women with FM, and to investigate predictors of the potential change in fatigue.MethodsA total of 130 women with FM (age 22–64 years) were included in this assessor-blinded randomized controlled multicenter trial examining the effects of person-centered progressive resistance exercise compared with an active control group. The intervention was performed twice a week for 15 weeks. Outcomes were five dimensions of fatigue measured with the Multidimensional Fatigue Inventory (MFI-20). Information about background was collected and the women also completed several health-related questionnaires. Multiple linear stepwise regression was used to analyze predictors of change in fatigue in the total population.ResultsA higher improvement was found at the post-treatment examination for change in the resistance exercise group, as compared to change in the active control group in the MFI-20 subscale of physical fatigue (resistance group Δ –1.7, SD 4.3, controls Δ 0.0, SD 2.7, p = 0.013), with an effect size of 0.33. Sleep efficiency was the strongest predictor of change in the MFI-20 subscale general fatigue (beta = −0.54, p = 0.031, R2 = 0.05). Participating in resistance exercise (beta = 1.90, p = 0.010) and working fewer hours per week (beta = 0.84, p = 0.005) were independent significant predictors of change in physical fatigue (R2 = 0.14).ConclusionsPerson-centered progressive resistance exercise improved physical fatigue in women with FM when compared to an active control group.Trial registrationClinicalTrials.gov NCT01226784. Registered 21 October 2010.
Highlights
Fibromyalgia (FM) affects approximately 1–3 % of the general population
Multidimensional fatigue There was significantly greater improvement at the posttreatment examination according to change in the MFI20 subscales for general fatigue (p = 0.031), physical fatigue (p = 0.013) and mental fatigue (p = 0.008) in the resistance exercise group, as compared to the change over time in the active control group (Table 1)
There was a baseline difference between the resistance exercise group and the active control group in the Pittsburgh Sleep Quality Index (PSQI) subscale of sleep efficiency (Table 1)
Summary
Fatigue limits the work ability and social life of patients with FM. The purpose of the present sub-study was to examine the effects of a personcentered progressive resistance exercise program on multiple dimensions of fatigue in women with FM, and to investigate predictors of the potential change in fatigue. Socio-demographic aspects such as female gender, younger age, low working capacity and low level of education have been shown to be associated with higher levels of fatigue in FM [14]. Background data such as age, education, employment, duration of pain, sick leave, disability pension, and medication were obtained by a standardized interview. The procedure of the resistance exercise and adjustment of loads in the present study has been described in detail previously [32]
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