Impact of a specific training programme on the neuromodulation of pain in female patient with fibromyalgia (DouFiSport): a 24-month, controlled, randomised, double-blind protocol

Abstract

IntroductionThe main symptom of fibromyalgia (FM) is diffuse pain. There is currently no aetiological treatment for FM. However, all pain associations and best practice guidelines strongly advocate the practice of aerobic physical activity to improve the symptoms of FM subjects. The mechanisms of dysfunctional pain are mostly central and related to stress axis dysfunction (autonomic nervous system and corticotropic axis). Our main objective is to assess the efficacy of a specific training programme on endogenous pain control mechanisms in female patients with FM. Further aims include rebalancing the autonomic neurovegetative system, improving quality of life and sleep quality, and reintegrating patients into society and work.Methods and analysis110 female patients with FM diagnosed on American College of Rheumatology 2010 criteria, aged 18–65 years and meeting inclusion conditions will be recruited and randomised into two groups (active and semiactive). The training programme will consist of three 45 min sessions per week of supervised, individualised physical activity over 2 years. Only the intensity of the exercises will differ between the two groups (moderate intensity vs low intensity).All outcome measures will be conducted at baseline (T0), after 6–9 months of training (T6–9) and after 24 months of training (T24). The primary endpoint will be an improvement of pain modulation (activation of diffuse noxious inhibitory control) evaluated by the stimulation test. The secondary endpoint will be relief of pain, anxiety, depression, stress, sleep disorders, pain impact on life quality, and improved heart rate, blood pressure and salivary cortisol.Ethics and disseminationThis study is approved by the Committee for the Protection of Persons West VI. The results will be published in specialised scientific journals and will be presented at scientific meetings on pain and/or physical activity.Trial registration numberNCT02486965; Pre-results.

Effects of Combined Training Programs in Individuals with Fibromyalgia: A Systematic Review

“…In the studies that were analysed, significant values were found for at least one of the evaluated parameters in all studies: (i) physical fitness tests [ 1 , 23 , 33 , 36 , 37 , 39 , 40 , 41 ]; (ii) decreased symptoms and impact of FM on participants [ 1 , 5 , 15 , 17 , 23 , 33 , 36 , 37 , 41 ]; (iii) lower limb strength [ 1 , 15 , 33 ]. These results are in line with other authors who claim that physical exercise programs are important stimuli with positive influence, attenuating the symptoms of the disease, through changes in the hypothalamic–pituitary–adrenal axis (HPA)—resulting in the release of neurotransmitters due to exercise and controlling and/or reducing localised pain [ 16 , 42 ]. The major findings were the improvement of health-related life quality, pain intensity, stiffness, fatigue, physical function, withdrawals and absence of adverse events [ 17 , 43 , 44 , 45 ].…”

“…Aerobic exercises seem to be fundamental stimuli in exercise programs as they induce adaptations in several systems, namely in the cardiovascular, energetic, neuromuscular and neuroendocrine systems [ 43 ]. The latter allows an increase in serotonin and norepinephrine concentrations, with a consequent improvement in mood and greater physical well-being [ 16 , 47 ]. The norepinephrine and serotonin are involved in the modulation of arousal and mood and have been related to a variety of affective functions as well as associated clinical dysfunctions [ 50 , 51 ].…”

“…Physical exercise promotes several benefits on a physical and psychological level. A physical exercise program works as an important mechanism that positively influences this population, attenuating the main symptoms, such as: the feeling of fatigue, depression, anxiety, muscle stiffness and sleep disturbances [ 16 ]. In this way, physical exercise has been used as a form of non-pharmacological intervention [ 17 ].…”

Pain and Cortisol in Patients with Fibromyalgia: Systematic Review and Meta-Analysis

“…In the studies selected for this review, cortisol levels were determined using diagnostic tests on blood, saliva or urine samples. Several authors have established that morning cortisol levels in serum [ 49 ], saliva [ 50 , 51 ] or hair [ 51 ] are lower in subjects with chronic musculoskeletal pain [ 52 ], FM [ 49 , 50 ] or chronic fatigue syndrome [ 49 ].…”

Análisis del Síndrome de Edorexia y su relación con la actividad física en población universitaria

“…La diferencia entre los individuos con edorexia y el grupo control parece indicar que el ejercicio se puede emplear como una herramienta para conseguir una finalidad como, por ejemplo, compensar la ingesta de alimentos o aliviar el malestar después de comer en exceso y así conseguir un alivio de sus emociones. El uso de actividad física como una técnica para aliviar síntomas no es nuevo, se emplea en diabetes (van Laake-Geelen, Smeets, Quadflieg, Kleijnen, y Verbunt, 2019), fibromialgia (Bonnabesse et al, 2019) e incluso en los trastornos alimentarios (Danielsen, Ro, y Bjornelv, 2018).…”