The Effect of a Remote Network Technology Supervised Exercise Program Combined With Drug Treatment for Fibromyalgia: Randomized, Single-Blind, Controlled Trial.

Abstract

Background: Fibromyalgia (FM) is a chronic musculoskeletal pain disorder that is seldom reported in China. Recent studies have focused on nondrug treatments, particularly physical therapy, as an alternative to treatments using medication. With the rise of smartphones and mobile communication, mobile health technology has become a significant area of study.

Objective: This study aims to explore whether using remote network applications to supervise patient exercise, in combination with medication, can improve FM pain. It builds on previous research that focuses on drug treatments and offers insights into individualized exercise therapy for FM.

Methods:  The study used a prospective, randomized controlled design with 80 participants, who were divided into 2 groups: supervised and unsupervised. Both groups received a drug regimen: oral pregabalin (75-150 mg twice daily) and duloxetine (30-60 mg once daily). The supervised group followed exercise routines with guidance from web-based rehabilitation therapist via a remote network application, while the unsupervised group exercised without supervision. The study was blinded to the participants. Primary outcomes were pain levels over the past 24 hours as measured by the Brief Pain Inventory (BPI). Secondary outcomes included pain relief, sleep improvement, quality of life, and adverse event occurrences. Observations were made at the start of treatment (T0), 1 month after treatment (T1), and 3 months after treatment (T3).

Results: We recruited 80 participants, evenly divided into 2 groups, from August 2022 to December 2023 at West China Hospital of Sichuan University. Comparisons of the 2 groups were performed using analysis of variance and Bonferroni post hoc analyses (SPSS version 25 for Windows, P<.05 considered as significant). Compared with T0, the Widespread Pain Index (WPI), symptom severity score (SSS), and BPI (pain on average, least pain in past 24 h, pain right now) scores of the 2 groups of patients with fibromyalgia at T1 were significantly lower. Compared with T0, the WPI, SSS, BPI (pain on average, worst pain in past 24 h, least pain in past 24 h, pain right now), and Fibromyalgia Impact Questionnaire scores of the 2 groups of patients at T3 were significantly lower. The WPI, SSS, BPI (pain on average, worst pain in past 24 h, pain right now), and Pittsburgh Sleep Quality Index scores of the 2 groups at T3 were significantly lower than at T1. However, the significance of some of the data did not exist after Bonferroni correction. The changes in scores from T0 to T1 (T1-T0), from T0 to T3 (T3-T0), and from T1 to T3 (T3-T1) in the supervised group were all less statistically significant compared to the unsupervised group.

Conclusions: The study showed that exercise combined with drug therapy can significantly improve the prognosis of FM, including pain relief, better sleep, and better overall quality of life; long-term supervised exercise training is more effective in improving FM symptoms and is safer and more reliable than unsupervised exercise.