Effectiveness of a combined pool-based exercise and education programme compared to usual care in fibromyalgia syndrome: a randomised controlled trial

Background: The aim of this study was to determine the effectiveness of a 6-week combined education and hydrotherapy programme and usual care versus usual care alone in the treatment of patients with fibromyalgia syndrome (FMS).Methods: Eighty-six women with FMS were recruited to this study; participants were randomly allocated to “usual care” delivered by a consultant rheumatologist or an “intervention” group. The intervention consisted of a 6-week pool-based exercise and patient education programme. The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). Participants were assessed at baseline and at three follow-up time points approximately 8 weeks, 20 weeks and 72 weeks post recruitment.Results: Both groups were similar at baseline in terms of demographic characteristics, and outcome scores. On the basis of a per protocol analysis, using AUC and univariate ANCOVA there was no significant between group difference in the FIQ over time (p = 0.856). However, there were significant improvements in pressure pain threshold at tender points (p = 0.037), and the physical function domain of the AIMS2 questionnaire (p = 0.037), for the intervention group over the control group. Conclusions: The results showed that there was limited benefit from the addition of a brief pool-based exercise and educational intervention to usual medical care for patients with well established FMS.