Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA.
Exercise Science Program, Marquette University, Milwaukee, Wisconsin, USA.
Phys Ther. 2023 Jun 5;103(6). doi: 10.1093/ptj/pzad033.
Exercise is recommended as a main treatment in fibromyalgia. However, many people have limited exercise tolerance and report exacerbated pain and fatigue during and following a bout of exercise. This study examined the local and systemic changes in perceived pain and fatigue during exercise and through the 3-day recovery following isometric and concentric exercises in people with and without fibromyalgia.
Forty-seven participants with a physician diagnosis of fibromyalgia (44 women; mean age [SD] = 51.3 [12.3] years; mean body mass index [SD] = 30.2 [6.9]) and 47 controls (44 women; mean age [SD] = 52.5 [14.7] years; mean body mass index [SD] = 27.7 [5.6]) completed this prospective, observational cohort study. A bout of submaximal resistance exercise (isometric and concentric) was performed localized to the right elbow flexors on 2 separate days. Baseline attributes (pain, fatigue, physical function, physical activity, and body composition) were assessed prior to exercise. Primary outcomes were: change in perceived pain and fatigue (0 to 10 on the visual analog scale) in the exercising limb and whole body during recovery with movement (immediately, 1 day following exercise, and 3 days following exercise). Secondary outcomes were perceived pain and exertion during exercise performance and pain and fatigue at rest during recovery.
Following a single bout of isometric or concentric exercise, there was increased perceived pain (ηp2 = 0.315) and fatigue (ηp2 = 0.426) in the exercising limb, which was greater in people with fibromyalgia (pain: ηp2 = 0.198; fatigue: ηp2 = 0.211). Clinically, relevant increases in pain and fatigue during exercise and through the 3-day recovery occurred in individuals with fibromyalgia only. Concentric contractions led to greater perceived pain, exertion, and fatigue during exercise compared with isometric exercise for both groups.
People with fibromyalgia experienced significant pain and fatigue in the exercising muscle during recovery from low-intensity and short-duration resistance exercise, with greater pain during concentric contractions.
These findings highlight a critical need to assess and manage pain and fatigue in the exercising muscles of people with fibromyalgia up to 3 days following a single bout of submaximal resistance exercise.
If you have fibromyalgia, you might have significant pain and fatigue up to 3 days following an exercise bout, with the pain and fatigue localized to the exercising muscles and no changes in whole-body pain.
运动被推荐作为纤维肌痛的主要治疗方法。然而，许多人运动耐量有限，并报告在运动过程中和运动后疼痛加剧和疲劳。本研究检测了纤维肌痛患者和非纤维肌痛患者在进行等长和向心运动期间和运动后 3 天恢复期间，感知疼痛和疲劳的局部和全身变化。
47 名经医生诊断患有纤维肌痛的参与者（44 名女性；平均年龄[标准差]为 51.3[12.3]岁；平均体重指数[标准差]为 30.2[6.9]）和 47 名对照组参与者（44 名女性；平均年龄[标准差]为 52.5[14.7]岁；平均体重指数[标准差]为 27.7[5.6]）完成了这项前瞻性观察队列研究。在 2 天内，对右侧肘屈肌进行亚最大阻力运动（等长和向心）。在运动前评估基线属性（疼痛、疲劳、身体功能、身体活动和身体成分）。主要结局是：运动恢复期间（运动后立即、1 天和 3 天）运动肢体和全身感知疼痛和疲劳（视觉模拟量表 0 至 10）的变化。次要结局是运动过程中感知疼痛和用力，以及恢复期间休息时的疼痛和疲劳。
单次等长或向心运动后，运动肢体的感知疼痛（ηp2=0.315）和疲劳（ηp2=0.426）增加，纤维肌痛患者的增加更明显（疼痛：ηp2=0.198；疲劳：ηp2=0.211）。临床上，仅在纤维肌痛患者中，运动和运动后 3 天的恢复期间出现与临床相关的疼痛和疲劳增加。与等长收缩相比，向心收缩在运动过程中导致更大的感知疼痛、用力和疲劳。
纤维肌痛患者在低强度和短时间的抗阻运动后恢复期间，运动肌肉会出现明显的疼痛和疲劳，向心收缩时疼痛更明显。
这些发现强调了在单次亚最大抗阻运动后，需要评估和管理纤维肌痛患者运动肌肉的疼痛和疲劳，运动肌肉的疼痛和疲劳可持续 3 天。
如果你患有纤维肌痛，你可能会在单次运动后 3 天内出现明显的肌肉疼痛和疲劳，疼痛和疲劳局限于运动肌肉，而全身疼痛没有变化。
