Telerehab Exercise Program Shows Promise for Fibromyalgia Treatment

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A six-week telerehabilitation exercise program, including mobility, strength and high-intensity workouts, significantly reduced pain, improved pain inhibition and decreased fibromyalgia impact in women with fibromyalgia. Only two 45-minute weekly sessions led to better pain control and quality of life, highlighting the potential of virtual exercise as a nonpharmacological treatment option.

“Emerging treatment modalities, such as telerehabilitation, have shown promise in addressing both the physical and psychological dimensions of fibromyalgia,” wrote a team of Spanish investigators. “This approach, which integrates exercise and pain management education delivered remotely, has demonstrated significant improvements in physical functionality, symptom severity and reductions in pain catastrophizing in fibromyalgia patients, particularly women.”

Exercise has been shown to improve physical functionality and pain modulation in people with fibromyalgia, without the side effects associated with pharmacologic treatments. It can also decrease pain perception by improving sleep quality and mood while reducing fatigue.

Although the benefits are evident, investigators say it’s important to tailor the exercise program to the patient, with variables including frequency, intensity, session duration and modality. As these patients often live with chronic fatigue, these programs need to incorporate adaptable exercise protocols.

The observational study enrolled 53 women with fibromyalgia to determine the effects of a virtual exercise program on pain, disability and psychological variables. Investigators measured pressure pain threshold (PPT), the conditioned pain modulation (CPM) paradigm, pain levels on measurement day as well as last week’s average, anxiety and the impact of fibromyalgia using the Fibromyalgia Impact Questionnaire (FIQ). Patients were given the option of entering the intervention group or the control group.

The exercise program began with a whole-body warmup, followed by strength training consisting of two upper-body and two lower-body exercises, performed in three sets with 10 repetitions each. Participants ended the workout with four minutes of high-intensity interval training. Participants were able to choose between three different levels of exercise based on their pain levels, and all exercises could be performed while seated. They were advised to do the routine two or more times a week for six weeks. Patients in the control group were told to continue living as usual without adding exercise or other healthy habits.

In the telerehab group, the average age was 52 years, average disease duration was 8.37 years, and baseline FIQ scores were 71.53.

Patients in the telerehabilitation program demonstrated significant changes in PPT, CPM and FIQ. After six weeks, the exercise group experienced significantly less pain sensitivity than the control group, especially in the finger and trapezius muscles. Their ability to naturally regulate pain also improved. Pain intensity over the past 24 hours decreased notably, while weekly pain levels showed some improvement — although they weren’t statistically significant. Quality of life significantly improved for those in the exercise program, although anxiety levels remained unchanged in both groups.

Investigators noted the study has several limitations that should be considered when interpreting the results. First, participants were able to choose their own group (intervention or control), which may have introduced selection bias, potentially dividing them into more active versus more sedentary individuals and affecting baseline characteristics and generalizability. Additionally, the sample was small and exclusively female and the short intervention period made it difficult to determine whether the benefits would be sustained over time.

“Telerehabilitation provides a valuable approach for women with fibromyalgia, allowing them to manage symptoms through tailored exercises and therapies in the comfort of their homes, improving adherence to treatment plans and being an effective nonpharmacological strategy for managing fibromyalgia,” investigators concluded.