OBJECTIVE: To investigate the effects of supervised aerobic exercise (AE) and a combined program of supervised aerobic, muscle strengthening, and flexibility exercises (combined exercise (CE)) on important health outcomes in women with fibromyalgia syndrome (FMS). DESIGN: Randomized controlled trial. SETTING: Community-based supervised intervention. PARTICIPANTS: Women (n = 64) with a diagnosis of FMS according to the American College of Rheumatology criteria. INTERVENTION: Participants were randomly allocated to 1 of 3 groups: supervised AE, supervised CE, or usual-care control. Exercise sessions were performed twice weekly (45 to 60 min/session) for 24 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were the 36-Item Short-Form Health Survey, Beck Depression Inventory (BDI), aerobic capacity (6-minute walk test), hand-grip strength, and range of motion in the shoulders and hips. RESULTS: Compliance with both interventions was excellent, with women in the exercise groups attending more than 85% of sessions. A 14% to 15% improvement from baseline in total FIQ score was observed in the exercise groups (p <= 0.02) and was accompanied by decreases in BDI scores of 8.5 (p < 0.001) and 6.4 (p < 0.001) points in the AE and CE groups, respectively. Relative to nonexercising controls, CE evoked improvements in the SF-36 Physical Functioning (p = 0.003) and Bodily Pain (p = 0.003) domains and was more effective than AE for evoking improvements in the Vitality (p = 0.002) and Mental Health (p = 0.04) domains. Greater improvements also were observed in shoulder/hip range of motion and handgrip strength in the CE group. CONCLUSION: Given the equivalent time commitment required for AE and CE, our results suggest that women with FMS can gain additional health benefits by engaging in a similar volume of CE.

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