Background/Purpose: Fibromyalgia (FM) is a chronic widespread pain syndrome that causes deterioration of physical capacity.  Exercises are fundamental in the treatment of FM and walking is the most common aerobic exercise studied. However, it is not known the effects of swimming in patients with FM. The purpose of this study was to evaluate the effects of swimming on pain, functional capacity, health-related quality of life, general quality of life and aerobic capacity in patients with FM, compared to walking.

Methods: Seventy-five women with diagnosis of FM according to ACR criteria with age between 18 and 60 years were selected. The patients were randomized to swimming group (SG) or walking group (WG). The SG performed swimming in front-crawl style and the heart rate (HR) training was defined by subtracting 10 beats from anaerobic threshold heart rate to compensate underwater horizontal position. The WG performed walking at anaerobic threshold HR. Exercise sessions had duration of 50 minutes and were performed three times a week for 12 weeks. The outcome measures were visual analogue scale (VAS) for pain, Time Up and Go Test (TUG) for functional capacity, Fibromyalgia Impact Questionnaire (FIQ) for health-related quality of life and SF 36 for general quality of life. Aerobic capacity was measured by an incremental cardiopulmonary exercise testing protocol by treadmill.  The evaluations were done by a blinded assessor at baseline (T0), 6 (T6) and 12 weeks (T12) after randomization. It was used intention-to-treat analysis.

Results: Thirty-nine patients were randomized to SG and 36 to WG. The groups were homogeneous at baseline regarding clinical and demographic characteristics.  Five patients (3 in SG and 2 in WG) withdrew after few exercise sessions because of pain worsening. After 12 weeks, both groups improved pain, functional capacity and quality of life (FIQ and SF 36) compared to baseline, however there were no differences between groups. Regarding aerobic capacity, both groups did not show changes over time. Tolerance to exercise, measured by adherence to programs, was similar in both groups (77.8% in SG and 72.2% in WG).

Conclusion: Swimming is as effective as walking in improving pain, functional capacity, health-related quality of life and general quality of life in patients with FM. In addition, swimming is well-tolerated by patients with FM. However, clinical improvements are not associated to aerobic capacity. More studies are necessary to define the mechanisms by with aerobic exercises lead to symptom improvements in FM.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/swimming-is-as-effective-as-walking-for-treating-fibromyalgia-a-randomized-controlled-trial/