FIBROMYALGIA Sabrina Murphy
FIBROMYALGIA: WHAT IS IT? Chronic widespread pain and stiffness in the muscles and joints. Related symptoms include Unusual tiredness Poor sleep quality Impaired cognitive abilities Irritable Bowl Syndrome (IBS)
DIAGNOSIS American College of Rheumatology created the criteria for Fibromyalgia (1990) History of widespread pain At least 11 of 18 tender points present
WHO DOES THIS EFFECT More common in women than in males. Seen most commonly in women of childbearing age and older. Those who have a 1 st degree relative with fibromyalgia are at an 8 times greater risk for developing it themselves
PATHOPHYSIOLOGY The cause of Fibromyalgia is unknown. High rate of comorbidity Depression Anxiety Individuals exhibit hyperalgesia and/or allodynia High levels of substance P have been found in those with fibromyalgia. Reduced serum levels of serotonin and L-tryptophan
TREATMENTS Treatment of sleep disorders Pharmacotherapy Exercise Psychotherapy (CBT) Education Medications NSAID’s Pregabalin Gabapentin Antidepressants
PRE-EXERCISE CONSIDERATIONS Each program will vary depending on client symptoms. Clients already experience muscle and joint pain and/or stiffness. Most discontinue regimen once clinical guidance stops. Severe symptom days may call for rest.
EXERCISE TESTING Sub-max testing protocols. Test should last between 8-12 minutes Modified Bruce treadmill protocol, standard bicycle test.
AEROBIC EXERCISE Frequency: 3-5x/wk Intensity: Low to moderate intensity % of HR max. Type: Low impact activities. Water based activities, walking, cycling etc. Time: 30 minutes/session
ANAEROBIC EXERCISE Frequency: 3x/wk Intensity: 2-3 sets of 6-8 reps 40-60% of 1RM max. Type: resistance training; dumbbells, barbells machines, resistance bands. Time:15-20 minutes Flexibility routines should be included
CASE STUDY Caucasian female, 34 y/o with one, 3 y/o child. She is a non-smoker. She is 64 inches and 140lbs with a BMI of 24. Her resting BP is 120/76 and HR is 68 BPM. Her father suffered a heart attack at the age of 53 y/o. Her total cholesterol level is 180, with an HDL reading of 50. She was going on walks 4 nights a week with her family, but reduced it to 2 due to her fibromyalgia pain. She is currently not taking any medicine for this condition. Risk Factors: 1 Risk Stratification: Low Goals: She would like to begin a workout program to help alleviate some of her fibromyalgia symptoms before she tries medications.
REFERENCES Ang, D. (2010). Research to Encourage Exercise for Fibromyalgia (REEF): Use of motivational interviewing design and method. Contemporary Clinical Trials, 32(1), Clauw, D. (2009). Fibromyalgia: An Overview. The American Journal of Medicine, 122(12A), S3-S13. Ehrman, J., Gordon, P., Visich, P., & Keteyian, S. (2013). Multiple Sclerosis. In Clinical Exercise Physiology (Third ed., pp ). Human Kinetics, Iverson, M., & Mannerkorpi, K. Physical Exercise in Fibromyalgia and Related Syndromes. Best - Practice and Research Clinical Rheumatology, Fibromyalgia. (2013). In HarvardMedicalSchool, Harvard Medical School Health Topics A-Z. Boston, MA: Harvard Health Publications. Mahan, M. (2015). Is Fibromyalgia a Real Pathology? World Neurosurgery News, 83(5), Skinner, J. S., & Skinner, J. S. (11/01/2005). ACSM's health & fitness journal: Get with the program American College of Sports Medicine.