Op0089-Hpr pilates Is Better Than Walking for Patients With Fibromyalgia: A Randomized Controlled Trial

Abstract

BackgroundFibromyalgia (FM) is defined as a chronic syndrome characterized by diffuse musculoskeletal pain and several symptoms that reflect on the functional capacity and quality of life of the affected patients. Different types of exercises are recommended in the treatment of FM. Pilates is a method of physical conditioning that has been frequently used in rehabilitation programs, due to the benefits perceived in musculoskeletal disorders, as well as in other conditions.ObjectivesTo evaluate the efficacy of Pilates method compared to aerobic exercise in pain, quality of life related to the disease, depression, quality of life in general, functional capacity, kinesiophobia, catastrophizing, treatment satisfaction and reduction in the use of medication by women presenting FM.MethodsSixty-six female patients diagnosed with FM were included, aging 18 to 65, presenting pain between 3 to 8 in numerical pain scale (NPS). Patients with inflammatory rheumatic diseases, neurological diseases, under psychiatric treatment, who have started or changed physical activities or medication in the last three months, patients with uncontrolled cardiorespiratory and cardiovascular diseases or any condition that may limit the practice of exercises, with non-diabetes mellitus controlled and other musculoskeletal diseases that could prevent the use of this method were excluded. The selected patients were randomized into two groups: Pilates and Control. The Pilates group (PG) had Pilates sessions three times a week for 12 weeks. The Control patients (CG) used a treadmill three times a week for 12 weeks. The treatment sessions in both groups lasted 50 minutes and the groups were instructed to use acetaminophen750 mg each 8 hours in case of pain, but the use was controlled. The evaluations were done by blind assessor at baseline (T0), 45 days (T45), 90 days (90) and 180 (T180) days after initiation of the study using the following instruments: for pain: NPS; Fibromyalgia Impact Questionnaire (FIQ), to evaluate the quality of life related to disease; Beck Depression Inventory (BDI) for depression; The short form 36 (SF-36) to evaluate the quality of life in general; the 6-minutes walking test (6MWT) to evaluate the functional capacity; kinesiophobia scale (Tampa) to evaluate the fear of movement; Fear Avoidance Beliefs Questionnaire (FABQ), to evaluate catastrophizing and the Likert scale to evaluate the patient satisfaction towards the treatment.ResultsThirty four patients were randomized for the GP and 32 for the CG. The groups were homogeneous at baseline. In the comparison between groups over time, we found better results for PG with statistical differences when compared to CG for: pain (p<0,001), disease-related quality of life (p<0,001), psychological status (p=0,026), some domains of SF-36 – pain (p=0,014) and general health status (p<0,044), kinesiophobia scale (p<0,001), reduction in analgesic consumption (p=0,042) and on the Likert scale (p=0,003).ConclusionPilates method is effective in the treatment of women with FM, presenting pain improvement, quality of life related to the disease, psychological status, the SF-36 (pain, general health) domains, the kinesiophobia scale, the analgesic consumption reduction and satisfaction with treatment with better results when compared to walking.References[1]Castel A, Fontova R, Montull S, et al. Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: a randomized controlled trial. Arthritis Care Res (Hoboken). 2013 Mar;65(3):421-31.[2]Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, W Häuser, E Fluß, et al. EULAR revised recommendations for the management of fibromyalgia. BMJ Journals. 2017. Annals of the rheumatic disease. Vol. 76, Issue 2. Disponível em:https://ard.bmj.com/content/76/2/318.[3]Byrnes K, Wu Ping-Jung, Whillier S. Is Pilates an effective rehabilitation tool? A systematic review. J Bodyw Mov Ther. 2018 Jan;22(1):192-202.Acknowledgements:NIL.Disclosure of InterestsNone Declared.