AHMF: 1999 De Becker Abstract

Usefulness of a Readaption Program in Patients with Primary FM and CFS Patients with Concomitant FM

P. De Becker, E. Joos, K. De Meirleir.

Human Physiology and Medicine
Vrije Universiteit Brussel, Brussels, Belgium

To examine the effect of a low-level exercise program on the physical fitness of fibromyalgia patients.

20 patients with primary fibromyalgia or CFS patients with concomitant fibromyalgia were asked to step into the study.

An individual rehabilitation program was designed for each patient. There were three different stages in the program:

Initially all patients had muscle-relaxation therapy.
Gradually the physical fitness training was introduced, monitored by their private physiotherapist. They exercised daily for 5 to 20 minutes at a heart rate similar to that reached at RQ = 1 during the bicycle exercise protocol that was performed prior to the start of the program.
After 3 weeks they exercised at least 15 minutes at heart rate RQ = 1, they exercised on their own with continuous heart rate monitoring. The physiotherapist weekly monitored the exercise intensity and performed stretching exercises, muscle relaxation and massages.

Once a month the patients were seen by the physician in the hospital. The treatment period was 12 months; after 6 months and at the end of the study the patients again performed bicycle exercise test. During the study, no major changes of the medication were allowed.

There was a high drop-out rate: 3 early drop-outs, another 6 patients after the first 6 months and 4 in the second 6 months.

The first 9 patients stopped the program because of practical problems and domestic commitments, the last 4 patients did not feel any improvement and refused to continue the program.

Patients who completed the 12 months exercise program were all subjectively feeling better although after 6 months they did not feel any improvement.

Maximal workload increased after 6 months and even more after 12 months. After 12 months also the maximal heart rate and work-output on submaximal level increased.

Low-level exercise training can be advantageous for fibromyalgia patients. These training programs have to be individually adapted and cannot be compared with reconditioning programs for healthy individuals.

Although no normal level was reached, the slightest improvement in physical fitness parameters together with the other beneficial aspects of physical training are probably responsible for the subjective feeling of well being in the patients.

Motivation and close-monitoring of the patients (e.g. phone contact several times a week) could be very important to prevent drop-out.