Diffuse noxious inhibitory control after three months of strength training in patients with fibromyalgia: a longitudinal study

• Grant number: 23/03474-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2023
• End date: September 30, 2024
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Mariana Arias Avila Vera
• Grantee: Letícia Menegalli Santos
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Introduction: Fibromyalgia (FM) is a condition characterized by a range of symptoms, including chronic widespread pain. One of the recommendations for the treatment of FM is exercise. Exercise recommendations for FM treatment point out that strength training is particularly interesting for this population, due to patients' preference. However, there are still no studies that clearly describe the effects of strength training on pain modulation mechanisms in patients with FM. An important phenomenon for the understanding of these mechanisms is the diffuse noxious inhibitory control, being the phenomenon by which a pain (pain x) reduces the perception of another pain (pain y), evaluated by the conditioned pain modulation test. This test measures endogenous pain in humans, known through the phenomenon "inhibiting pain". However, there are still no studies that investigated the outcomes in patients with FM undergoing strength training. It is known that, in healthy individuals, the biological adaptations resulting from exercise occur over a period of up to ninety days (observable through the mechanism of diffuse noxious inhibitory control), but in people with FM this has not yet been investigated. Thus, the aim of this study is to evaluate the diffuse noxious inhibitory control of patients with FM and compare it to that of healthy sedentary people, before and after three months of strength training. Methods: A longitudinal study. We will include individuals of both sexes, aged between 18 and 65 years, healthy and diagnosed with fibromyalgia. We will divide them into two groups: healthy, sedentary group (with no pain and/or any other diagnosed chronic diseases); and fibromyalgia group according to the criteria of the American College of Rheumatology. The fibromyalgia group will perform 24 exercise sessions, through the exercises: sitting calf raise, knee extension machine, leg press, incline bench press, seated row machine, and dumbbell lateral raise, according to the guidelines of the American College of Medicine in Sports, which recommends two weekly sessions, with an average duration of 40 minutes and 10 minutes of rest after the exercise session. Scientific and social feedback: according to the gaps presented in the introduction, understanding the effects of this intervention on pain modulation will advance FM studies with a focus on health promotion in this population.