Fibromialgia, atividade física e exercício
revisão narrativa
Palavras-chave:
Comportamento sedentário, aptidão física, força muscular, exercício, qualidade de vidaResumo
A fibromialgia é uma doença geralmente associada a maior prevalência de inatividade física e a uma diminuição no fitness cardiorrespiratório, o que leva a efeitos negativos na saúde e aumento da morbimortalidade. As evidências atuais indicam que a primeira estratégia de intervenção não farmacológica para essas pessoas é a prática regular de atividade física, e que tanto as atividades físicas aeróbicas, dentro e fora da água, como os exercícios de fortalecimento muscular não aumentam os sintomas da doença e têm efeitos benéficos na saúde física e mental. As recomendações para esses pacientes incluem diminuir o tempo sentado, aumentar o nível de atividade física diária, cumprir a recomendação de pelo menos 30 minutos diários de atividade física de intensidade moderada e realizar, em ao menos dois dias, exercícios de força muscular, para, assim, melhorar a capacidade funcional e a qualidade de vida
Referências
McLoughlin MJ, Colbert LH, Stegner AJ, Cook DB. Are women with fibromyalgia less physically active than healthy women? Med Sci Sports Exerc. 2011;43(5):905-12. PMID: 20881881; doi: 10.1249/MSS.0b013e3181fca1ea.
Joustra ML, Zijlema WL, Rosmalen JGM, Janssens KAM. Physical activity and sleep in chronic fatigue syndrome and fibromyalgia syndrome: associations with symptom severity in the general population cohort lifelines. Pain Res Manag. 2018;2018:5801510. PMID: 30533166; doi: 10.1155/2018/5801510.
Andrade A, Azevedo RK, Vilarino GT, Sieczkowska SM, Coimbra DR. Does volume of physical exercise have an effect on depression in patients with fibromyalgia? J Affect Disord. 2017;208:214-7. PMID: 27792965; doi: 10.1016/j.jad.2016.10.003.
Segura-Jiménez V, Borges-Cosic M, Soriano-Maldonado A, et al. Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: the al-Ándalus study. Scand J Med Sci Sports. 2017:27(1):83-92. PMID: 26644186; doi: 10.1111/sms.12630.
Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020-8. PMID: 30418471; doi: 10.1001/jama.2018.14854.
Kaleth AS, Slaven JE, Ang DC. Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia? Arthritis Care Res. 2014;66(12):1887-94. PMID: 25049001; doi: 10.1002/acr.22398.
Sanz-Baños Y, Pastor-Mira MÁ, Lledó A, er al. Do women with fibromyalgia adhere to walking for exercise programs to improve their health? Systematic review and meta-analysis. Disabil Rehabil. 2018;40(21):2475-87. PMID: 28687050; doi: 10.1080/09638288.2017.1347722.
Gaudreault N, Boulay P. Cardiorespiratory fitness among adults with fibromyalgia. Breathe (Sheff). 2018;14(2):e25-e33. PMID: 30131831; doi: 10.1183/20734735.019717.
García-Hermoso A, Saavedra JM, Escalante Y. Effects of exercise on functional aerobic capacity in adults with fibromyalgia syndrome: a systematic review of randomized controlled trials. J Back Musculoskelet Rehabil. 2015;28(4):609-19. PMID: 25408119; doi: 10.3233/BMR-140562.]
Bidonde J, Busch AJ, Schachter CL, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017;6:CD012700. PMID: 28636204; doi: 10.1002/14651858.CD012700.
Fernandes G, Jennings F, Nery Cabral MV, Pirozzi Buosi AL, Natour J. Swimming improves pain and functional capacity of patients with fibromyalgia: a randomized controlled trial. Arch Phys Med Rehabil. 2016;97(8):1269-75. PMID: 26903145; doi: 10.1016/j.apmr.2016.01.026.
Rivas Neira S, Pasqual Marques A, Pegito Pérez I, Fernández Cervantes R, Vivas Costa J. Effectiveness of aquatic therapy vs land-based therapy for balance and pain in women with fibromyalgia: a study protocol for a randomised controlled trial. BMC Musculoskelet Disord. 2017;18(1):22. PMID: 28103853; doi: 10.1186/s12891-016-1364-5.
Bidonde J, Busch AJ, Schachter CL, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017;6:CD012700. PMID: 28636204; doi: 10.1002/14651858.CD012700.
McDowell CP, Cook DB, Herring MP. The Effects of Exercise Training on Anxiety in Fibromyalgia Patients: A Meta-analysis. Med Sci Sports Exerc. 2017;49(9):1868-76. PMID: 28419024; doi: 10.1249/MSS.0000000000001290.
Nelson NL. Muscle strengthening activities and fibromyalgia: a review of pain and strength outcomes. J Bodyw Mov Ther. 2015;19(2):370-6. PMID: 25892394; doi: 10.1016/j.jbmt.2014.08.007.
Ericsson A, Palstam A, Larsson A, et al. Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial. Arthritis Res Ther. 2016;18:176. PMID: 27473164; doi: 10.1186/s13075-016-1073-3.
Bjersing JL, Larsson A, Palstam A, et al. Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin. BMC Musculoskelet Disord. 2017;18(1):106. PMID: 28288611; doi: 10.1186/s12891-017-1477-5.
Andrade A, de Azevedo Klumb Steffens R, Sieczkowska SM, Peyré Tartaruga LA, Torres Vilarino G. A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations. Adv Rheumatol. 2018;58(1):36. PMID: 30657077; doi: 10.1186/s42358-018-0033-9.
Batacan RB Jr, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med. 2017;51(6):494-503. PMID: 27797726; doi: 10.1136/bjsports-2015-095841.
Campbell E, Coulter EH, Paul L. High intensity interval training for people with multiple sclerosis: a systematic review. Mult Scler Relat Disord. 2018;24:55-63. PMID: 29936326; doi: 10.1016/j.msard.2018.06.005.
Bishop DJ, Botella J, Genders AJ, et al. High-Intensity Exercise and Mitochondrial Biogenesis: Current Controversies and Future Research Directions. Physiology (Bethesda). 2019;34(1):56-70. PMID: 30540234; doi: 10.1152/physiol.00038.2018.
US National Library of Medicine - Clinical Trials Gov. High-intensity Interval Training in Patients With Fibromyalgia. Disponível em: https://clinicaltrials.gov/ct2/show/NCT03924960. Acessado em 2019 (1 nov).
O’Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96(4):724-34.e3. PMID: 25529265; doi: 10.1016/j.apmr.2014.12.003.
Geneen LJ, Moore RA, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;1:CD011279. PMID: 28087891; doi: 10.1002/14651858.CD011279.pub3.
Sluka KA, Frey-Law L, Hoeger Bement M. Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain. 2018;159 Suppl 1:S91-S97. PMID: 30113953; doi: 10.1097/j.pain.0000000000001235.
ACSM”S. Guidelines for exercise testing and prescription. 10thedition. Philadelphia: Wolters Kluwer; 2018.27.Perrot S, Russell IJ. More ubiquitous effects from non-pharmacologic than from pharmacologic treatments for fibromyalgia syndrome: a meta-analysis examining six core symptoms. Eur J Pain. 2014;18(8):1067-80. PMID: 25139817; doi: 10.1002/ejp.564.
Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-28. PMID: 27377815; doi: 10.1136/annrheumdis-2016-209724.
Smith BE, Hendrick P, Bateman M, et al. Musculoskeletal pain and exercise-challenging existing paradigms and introducing new. Br J Sports Med. 2019;53(14):907-12. PMID: 29925503; doi: 10.1136/bjsports-2017-098983.