The effects of a group exercise and education programme on symptoms and physical fitness in patients with fibromyalgia: a prospective observational cohort study

Given the limited attention on a combined exercise and education approach for those with chronic musculoskeletal pain disorder such as fibromyalgia, the purpose of this was to evaluate the efficacy of a combined exercise and education programme on symptoms and physical fitness in participants with fibromyalgia. Using a prospective observational cohort study, participants with fibromyalgia (<i>n</i> = 75) volunteered. The 6-minute-walk-test (6MWT) and revised-fibromyalgia-impact-questionnaire (FIQR) were used before, after (6 weeks) and 6-months post an exercise and education programme. Forty-three participants (age = 49.7 ± 15.2 y) completed the 6-week programme, with improvements observed for the 6MWT (67 m, <i>p</i> &lt; 0.001) and FIQR (11 AU, <i>p</i> &lt; 0.001), though only two (6MWT) and five (FIQR) participants, respectively, achieved the minimal clinically important difference (MCID). Using 74% of the intial sample, a small-to-moderate improvement in scores were observed across the 6-month period for the 6MWT (37 m, <i>p</i> = 0.002) and FIQR (3 AU, <i>p</i> = 0.01), with only two participants achieving the MCID for the 6MWT. The results in this study indiciate small-to-moderate improvements in the 6MWT and FIQR after a combined exercise and education programme, with direct delivery being more effective.Implications for rehabilitationA six-week exercise and education programme elicited moderate, short-term (6 weeks) benefits on physical fitness and key symptoms in patients with fibromyalgia.On average, these benefits were sustained in the long-term (6 months) following the programme but were small-to-moderate and lower than the MCID.Regular follow-up may be required to improve adherence to the education and exercise programme and maintain or increase the observed improvements in 6MWT and FIQR. A six-week exercise and education programme elicited moderate, short-term (6 weeks) benefits on physical fitness and key symptoms in patients with fibromyalgia. On average, these benefits were sustained in the long-term (6 months) following the programme but were small-to-moderate and lower than the MCID. Regular follow-up may be required to improve adherence to the education and exercise programme and maintain or increase the observed improvements in 6MWT and FIQR.

鉴于目前针对纤维肌痛（fibromyalgia）这类慢性肌肉骨骼疼痛障碍患者的运动与教育联合干预方案的相关研究关注度有限，本研究旨在评估该联合运动教育项目对纤维肌痛患者症状与体能状态的改善效果。本研究采用前瞻性观察队列研究设计，共纳入75名自愿参与的纤维肌痛患者（n=75）。在联合运动教育项目实施前、实施后（6周）以及项目结束后6个月，分别采用6分钟步行试验（6-minute-walk-test, 6MWT）与修订版纤维肌痛影响问卷（revised-fibromyalgia-impact-questionnaire, FIQR）进行评估。最终有43名患者完成了6周的干预项目，其年龄为49.7±15.2岁，干预后6MWT步行距离提升67米（p<0.001）、FIQR评分降低11个量化单位（AU, p<0.001），但仅分别有2名（6MWT组）与5名（FIQR组）患者达到了最小临床重要差异（minimal clinically important difference, MCID）。以初始样本的74%作为分析样本，在项目结束后的6个月随访期内，6MWT步行距离提升37米（p=0.002）、FIQR评分降低3个量化单位（p=0.01），仅2名患者达到6MWT的MCID。本研究结果显示，联合运动教育项目可使患者的6MWT与FIQR评分出现小幅度至中等幅度的改善，且直接干预模式的效果更优。康复领域启示：为期6周的联合运动教育项目可使纤维肌痛患者的体能状态与核心症状获得中等程度的短期（6周）改善。平均而言，这些获益在项目结束后的长期随访（6个月）中得以维持，但改善幅度仍为小至中等，且低于MCID阈值。为提升患者对运动与教育项目的依从性，并维持或进一步改善6MWT与FIQR的评估结果，可能需要定期进行随访干预。为期6周的联合运动教育项目可使纤维肌痛患者的体能状态与核心症状获得中等程度的短期（6周）改善。平均而言，这些获益在项目结束后的长期随访（6个月）中得以维持，但改善幅度仍为小至中等，且低于MCID阈值。为提升患者对运动与教育项目的依从性，并维持或进一步改善6MWT与FIQR的评估结果，可能需要定期进行随访干预。