Interventions global pain rating, and an overall improvement

Interventions for fibromyalgia patients is highly dependent on the individual’s specific pain and limitations. Complementary medicine is also often included along with more traditional treatments to help them find relief. It is highly recommended to promote self-efficacy in patients with fibromyalgia. This helps with the patient’s performance during exercises and also their future adherence to the exercise program. To promote adherence, it is also recommended to start with low-intensity exercise and gradually progress. We looked at one study using a RCT on the application of self-myofascial release to provide benefits such as fatigue, ROM, and perceived pain. The study assessed the impact of self-myofascial release program on cervical spine, shoulder, and hip ROM. Improvements were found in ROM in the intervention group compared to the control group. Also, utilizing traditional yoga poses, meditation, and breathing exercises in conjunction with range of motion and relaxation exercises in water resulted in significant improvement of range of motion, global pain rating, and an overall improvement of fibromyalgia symptoms, and functional deficits (Busch et al., 2011). Evidence supporting flexibility exercise in treatment of fibromyalgia is very limited. However, it is indicated to include stretching exercises as part of the cool-down at the end of treatment. There are no valid indications for joint mobilizations with fibromyalgia patients, since these could potentially lead to increased pain in patients. Also, in the patients that it does provides pain relief, they could become reliant on these treatments instead of other options. Progressive resistance exercise was found to be a feasible mode of exercise for women with FM. It helped by improving muscle strength, health status, and current pain intensity when assessed immediately after the interventions (Busch et al., 2011). This was seen in a RCT that implemented resistance training 2x/week for 15 weeks in fibromyalgia patients. When implementing resistance exercises for fibromyalgia patients, it is recommended to start with lower resistance than what is predicted as normal for same age individuals. Intensity can be increased once current intensity is performed without exacerbating symptoms for 1-2 weeks. It is important to avoid significant post-exertion pain and fatigue with exercises, as this can lead to reduced adherence by the patient.  Other studies have shown Pilates to be effective, which emphasize core strengthening, posture, coordination of breathing with movement. Patients who participated in one-hour sessions, four times a week, for four weeks, reported a significant reduction in pain according the Visual Analog Scale, and the FIQR. When developing aerobic interventions, prescribing a quota-based aerobic program has been indicated with fibromyalgia patients to increase adherence and performance in aerobic exercise. It has been shown in studies to increase the distance walking by patients as well as decreasing fibromyalgia-associated symptoms. Aerobic and strengthening exercise have produced the most consistent positive results in fibromyalgia patients, however it is strongly recommended to include multiple types of exercises. Exercise also should be tailored to patient preferences and setting. The main goal is to achieve optimal benefits and long-term adherence; therefore, the chosen interventions and intensities must be careful to avoid any exercise-related fatigue, pain, or musculoskeletal injury.