Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain and other physical and psychological features. In this study, we aimed to analyze the effect of a low-intensity physical exercise (PE) program, combining endurance training and coordination, on psychological aspects (i.e., pain catastrophizing, anxiety, depression, stress), pain perception (i.e., pain acceptance, pressure pain threshold (PPT), and quality of life and physical conditioning (i.e., self-perceived functional capacity, endurance and functional capacity, power and velocity) in women with FM. For this purpose, a randomized controlled trial was carried out.

Thirty-two women with FM were randomly allocated to a PE group (PEG, n = 16), performing an eight-week low-intensity PE program and a control group (CG, n = 16). Pain catastrophizing, anxiety, depression, stress, pain acceptance, PPT, quality of life, self-perceived functional capacity, endurance and functional capacity, power, and velocity were assessed before and after the intervention

We observed a significant improvement in all studied variables in the PEG after the intervention (p < 0.05). In contrast, the CG showed no improvements in any variable, which further displayed poorer values for PPT (p < 0.05).

In conclusion, a low-intensity combined PE program, including endurance training and coordination, improves psychological variables, pain perception, quality of life, and physical conditioning in women with FM.

Introduction

Fibromyalgia (FM) is a chronic condition characterized by widespread pain associated with other physical symptoms, such as fatigue or decreased physical capacity, and psychological alterations [1].

One of the psychological alterations that has been associated with FM is pain catastrophizing, a specific psychosocial construct of pain, which includes cognitive and emotional processing, sense of helplessness, pessimism, and rumination about pain-related symptoms [2].

Pain catastrophizing has been associated with pain severity and disability [3], which is being considered a risk factor for pain chronification [4]. Furthermore, this construct of pain has been shown to decrease pain acceptance, which, in turn, may aggravate the symptomatology of FM [5].

Pain acceptance is lower in FM patients [6], which has been linked to a higher degree of disability [7] and a lower quality of life [8].

In addition to pain catastrophizing, other psychological alterations that can aggravate the symptomatology of FM are anxiety and depression. These alterations, together with high levels of stress, have been proposed as precipitating and/or perpetuating factors of this condition [9] and are inversely related to quality of life among FM patients [10].

In this regard, it has been suggested that the higher the level of pain catastrophizing, anxiety, and depression in FM individuals, the greater their sensitivity to non-painful stimuli and difficulty in coping with the painful process [11].

Interestingly, pain catastrophizing, has also been inversely related to muscular endurance [12]. This tendency has proven to have a negative impact on neuromuscular, cardiovascular, immune, and neuroendocrine systems [13].

In turn, such an impact causes an alteration of functional capacity [4], which can be assessed both objectively and subjectively. An objective decline in physical conditioning has a detrimental effect on the ability to perform activities of daily life, but also the subjectively altered perception of functional capacity can lead to actual physical inactivity and a progressive deconditioning [14].

Physical deconditioning may negatively impact the individual’s quality of life [15] and his/her professional performance, which leads to absenteeism [16].