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血流限制有氧运动训练对纤维肌痛患者疼痛、功能状态、生活质量及运动激素反应的影响:一项随机双盲研究

The effect of blood flow restricted aerobic exercise training on pain, functional status, quality of life and hormonal response to exercise in fibromyalgia patients: a randomized double-blind study.

作者信息

Zure Mert, Arman Sina, Ketenci Ayşegül

机构信息

Department of Physical Medicine and Rehabilitation, University of Health Sciences Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye -

Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Türkiye.

出版信息

Eur J Phys Rehabil Med. 2025 Jun;61(3):564-571. doi: 10.23736/S1973-9087.25.08817-3. Epub 2025 May 28.

Abstract

BACKGROUND

Fibromyalgia is a chronic pain condition with symptoms such as pain, fatigue, and decreased quality of life. Although aerobic exercise is an effective treatment for fibromyalgia, patients often struggle with exercise intolerance due to fatigue, limiting long-term adherence. Research on blood flow-restricted (BFR) exercise suggests it may provide benefits similar to traditional exercise with reduced intensity, but its effects on fibromyalgia-related symptoms remain underexplored.

AIM

This study investigated the impact of a BFR aerobic exercise program on pain, functional status, quality of life, and hormonal response in women with fibromyalgia.

DESIGN

A prospective, randomized, double-blind, sham-controlled trial.

SETTING

Outpatient rehabilitation center.

POPULATION

Fifty women diagnosed with fibromyalgia were included in this study.

METHODS

Participants were randomly assigned to two groups receiving supervised aerobic exercise four times weekly for six weeks. The experimental group used blood flow restriction aid with elastic bandages at the groin level, while the control group received a sham restriction. Primary outcomes were assessed with the Fibromyalgia Impact Questionnaire (FIQ). Secondary outcomes included the Central Sensitization Index (CSI), Beck Depression Inventory (BDI), Visual Analogue Scale (VAS) for pain, Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), and 24-hour urine levels of vanillyl mandelic acid (VMA) and 5-hydroxy indole acetic acid (5-HIAA). Evaluations were conducted before, immediately after, and three months post-intervention.

RESULTS

The mean age of participants was 43.2±7.2 years, with comparable baseline characteristics between groups. Both groups showed significant improvements across all outcomes, with the BFR group exhibiting superior improvements in FIQ (P<0.001), CSI, and BDI scores, as well as increased urine levels of VMA and 5-HIAA. Although both groups improved in pain and pain acceptance, these changes were not significantly different between groups.

CONCLUSIONS

Patients with fibromyalgia who have limited exercise tolerance may find that BFR aerobic exercise improves pain, function, central sensitization, mood, and catecholamine-serotonin levels. Additional research is needed to further understand its effects and broaden the scope of this technique in the treatment of fibromyalgia.

CLINICAL REHABILITATION IMPACT

BFR aerobic training could improve adherence to exercise therapy in fibromyalgia by offering a lower-intensity alternative with enhanced benefits, potentially leading to better symptom management in clinical settings.

摘要

背景

纤维肌痛是一种慢性疼痛病症,伴有疼痛、疲劳和生活质量下降等症状。尽管有氧运动是治疗纤维肌痛的有效方法,但患者常因疲劳而难以耐受运动,限制了长期依从性。关于血流限制(BFR)运动的研究表明,它可能在降低运动强度的情况下提供与传统运动类似的益处,但其对纤维肌痛相关症状的影响仍未得到充分探索。

目的

本研究调查了BFR有氧运动计划对纤维肌痛女性患者的疼痛、功能状态、生活质量和激素反应的影响。

设计

一项前瞻性、随机、双盲、假对照试验。

地点

门诊康复中心。

研究对象

50名被诊断为纤维肌痛的女性纳入本研究。

方法

参与者被随机分为两组,每周接受4次有监督的有氧运动,共6周。实验组在腹股沟水平使用弹性绷带进行血流限制辅助,而对照组接受假限制。主要结局用纤维肌痛影响问卷(FIQ)评估。次要结局包括中枢敏化指数(CSI)、贝克抑郁量表(BDI)、疼痛视觉模拟量表(VAS)、慢性疼痛接受问卷-8(CPAQ-8)以及香草扁桃酸(VMA)和5-羟色胺乙酸(5-HIAA)的24小时尿水平。在干预前、干预后立即和干预后3个月进行评估。

结果

参与者的平均年龄为43.2±7.2岁,两组基线特征相当。两组在所有结局方面均有显著改善,BFR组在FIQ(P<0.001)、CSI和BDI评分方面表现出更优的改善,同时VMA和5-HIAA的尿水平升高。尽管两组在疼痛和疼痛接受度方面均有所改善,但两组之间的这些变化无显著差异。

结论

运动耐受性有限的纤维肌痛患者可能会发现,BFR有氧运动可改善疼痛、功能、中枢敏化、情绪以及儿茶酚胺-血清素水平。需要进一步研究以深入了解其效果,并扩大该技术在纤维肌痛治疗中的应用范围。

临床康复影响

BFR有氧运动训练可以通过提供一种强度较低但益处增强的替代方案,提高纤维肌痛患者对运动疗法的依从性,有可能在临床环境中实现更好的症状管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0356/12405945/09338bb03518/8817-f1.jpg

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