The effectiveness of education and aerobic exercise in ‘high functioning’ patients with fibromyalgia: evaluation of a new service.

Background. Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain, fatigue and reduced physical function. Exercise has positive effects on physical function, fatigue and well-being in FMS. However, patients find it difficult to engage in exercise and often have low self-efficacy for exercise.Objectives The aim of this study was to evaluate a new early access service consisting of a 6-week education and aerobic exercise intervention in patients with FMS, who were classified as “high functioning”.Methods. Participants (n=32) were referred from WRH rheumatology department and attended a 6-week exercise and education intervention delivered by physiotherapist and occupational therapist. Participants completed the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Score (HAD) Six-Minute-Walk Test (6MWT) and Exercise Self-Efficacy Scale (ESES). Follow up was carried out post and 3 months post programme.Results. Participants who completed the intervention had a significant improvement in mean (SD) pain from baseline 7.01 (1.8) to the end of the programme 5.6 (2.9), p=0.03. Mean (SD) 6MWT improved from 386m (96) to 416m (57) at the end of the programme (p=0.05), this was maintained at 3 month follow-up. There was no significant change in total FIQ score or the HAD scale, however, participants' exercise self-efficacy significantly improved from 58.2 (18.6) to 68 (11.6), p=0.01.Conclusions. Improvements were recorded post programme in exercise capacity, exercise self-efficacy and VAS pain. Improvement was maintained at 3 months follow up. Anticipated service developments are use of FIQ to subgroup, longer term follow up, vocational rehabilitation and pedometer use to evaluate exercise adherence.