Original article
Effects of Concurrent Strength and Endurance Training on Physical Fitness and Symptoms in Postmenopausal Women With Fibromyalgia: A Randomized Controlled Trial

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Abstract

Valkeinen H, Alén M, Häkkinen A, Hannonen P, Kukkonen-Harjula K, Häkkinen K. Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial.

Objective

To examine the effectiveness of concurrent strength and endurance training on muscle strength, aerobic and functional performance, and symptoms in postmenopausal women with fibromyalgia (FM).

Design

Randomized controlled trial.

Setting

Local gym and university research laboratory.

Participants

Twenty-six women with FM.

Intervention

Progressive and supervised 21-week concurrent strength and endurance training.

Main Outcome Measures

Muscle strength of leg extensors, upper extremities, and trunk; peak oxygen uptake (Vo2peak), maximal workload (Wmax), and work time; 10-m walking and 10-step stair-climbing time and self-reported functional capacity (Health Assessment Questionnaire); and symptoms of FM.

Results

After concurrent strength and endurance training, the groups differed significantly in Wmax (P=.001), work time (P=.001), concentric leg extension force (P=.043), walking (P=.001) and stair-climbing (P<.001) time, and fatigue (P=.038). The training led to an increase of 10% (P=.004) in Wmax and 13% (P=.004) in work time on the bicycle but no change in Vo2peak.

Conclusions

Concurrent strength and endurance training in low to moderate volume improves the muscle strength of leg extensors, Wmax, work time, and functional performance as well as perceived symptoms, fatigue in particular. Concurrent strength and endurance training is beneficial to postmenopausal women with FM without adversities, but more extensive studies are needed to confirm the results.

Section snippets

Participants

Altogether 180 postmenopausal women with FM who had previously visited an outpatient clinic were sent an invitation letter concerning the study. The main inclusion criteria were women, age over 50 years, and diagnosis of FM.23 A total of 71 women were willing to participate, and they were assessed for eligibility (fig 1). Thirty-three volunteers were excluded because of severe cardiovascular disease, diabetes, severe osteoarthritis of the large joints, disorders of thyroid gland, or any other

Results

Two subjects from the training group dropped out after few weeks of training because of moving away and cardiovascular symptoms unrelated to the present training. Thus, the results are presented from 13 subjects of the training group and 11 subjects of the control group, except the aerobic test results from 12 subjects of the training group because 1 subject felt uncomfortable with the face mask.

The baseline characteristics were comparable between the groups (table 2). The FM diagnosis had been

Discussion

Our results showed that aerobic performance as measured by maximal workload (Wmax) and work time, muscle strength as measured by concentric force of the leg extensors, and functional performance as assessed by walking and stair-climbing time improved in postmenopausal women with FM after concurrent strength and endurance training. The present training protocol loaded lower extremities and, thus, contributed to their improved function. Moreover, the training decreased fatigue. In addition, the

Conclusions

This study showed that postmenopausal women with FM were able to practice concurrent strength and endurance training with beneficial effects on symptoms and without training injuries. The observed changes in physical fitness were mainly seen as increased dynamic muscle strength of leg extensors, improved Wmax, work time, and walking and stair-climbing time because both training modes loaded the same muscle groups. However, the amount of strength training was most likely too low to improve the

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      At the end of the 21-week trial, the non-exercising control subjects with FM demonstrated no change in the number of tender points and had increased VAS pain scores. Strength outcomes appear to improve to significantly among study participants with FM when compared to non-exercising controls with FM (Valkieinen et al., 2008; Alen et al., 2001; Hakkinen et al., 2001). Likewise, individuals with FM engaging in MSA show similar strength increases when compared to healthy aged-matched individuals participating in MSA (Kingsley et al., 2010; Valkeinen et al., 2004; Hakkinen et al., 2002).

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    Supported by the Ministry of Education of Finland and Peurunka-Medical Rehabilitation Foundation, Laukaa, Finland.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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