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Influence of preferred versus prescribed exercise on pain in fibromyalgia
Newcomb LW, Koltyn KF, Morgan WP, Cook DB
Medicine and Science in Sports and Exercise 2011 Jun;43(6):1106-1113
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: The purpose of this study was to examine the influence of a preferred- versus a prescribed-intensity exercise session on pain in women with fibromyalgia (FM). METHODS: Twenty-one women with FM (mean age 44 yr) completed two randomly assigned exercise sessions consisting of 20 min of cycle ergometry at a self-selected intensity and a prescribed intensity. Experimental pain perception was assessed before and after aerobic exercise. During exercise, HR, watts, RPE, and muscle pain were assessed every 5 min. Clinical pain was assessed with the Short-Form McGill Pain Questionnaire (SF-MPQ) immediately and 24, 48, 72, and 96 h after exercise. Data were analyzed with repeated-measures ANOVA. RESULTS: Women with FM preferred a lower intensity of exercise than what was prescribed as indicated by significantly lower HR, watts, and RPE responses (p < 0.05). Muscle pain in the legs, however, was similar in the two conditions and significantly increased during exercise (p < 0.05). Pain thresholds and pain tolerances increased significantly after exercise, whereas peak pain ratings decreased after exercise (p < 0.05). Furthermore, pain (SF-MPQ) in the follow-up period was found to be lower than baseline (p < 0.05). CONCLUSIONS: It is concluded that the women with FM who participated in this study experienced significant improvements in pain after exercise. The results from this study are novel and indicate that recommendations for exercise prescription for individuals with FM should consider the preferred-intensity exercise model as a strategy to reduce pain.

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