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.

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.