Purpose/Hypothesis: To determine if aquatic exercise programs consisting of aerobic and anaerobic exercise for 50-60 minutes 3x/week could produce clinically meaningful changes in persons with Fibromyalgia (FM) as detected through improvements in the Fibromyalgia Impact Questionnaire (FIQ) and the Visual Analog Scale (VAS).
Number of Subjects: 207
Materials and Methods: The following databases were searched PubMed, PEDro, and Medline using keywords and time frames (2008-2018). The key words were selected based on PICO format using Boolean operators of “AND” and “OR.” Population search: fibromyalgia OR chronic pain syndrome. Intervention search: Aqua* therapy OR aqua* exercises OR hydro*therapy OR aqua* rehab* OR swim*. Outcomes search: quality of life. Inclusion criteria: subjects 18 or older, 3x/week for 50-60 minutes frequency, warm up, aerobic exercise, strengthening, cool down, VAS, and FIQ. Exclusion criteria: frequency >3x/week, frequency <3x/week, balneotherapy.
Results: Four articles met the inclusion criteria. All articles met criteria for level 1b evidence. Each study consisted of females diagnosed with FM with the average age of 43-50 years. A positive linear relationship was demonstrated between exercise dose and changes in FIQ and VAS scores. Moderate or higher intensity aerobic exercise as determined by heart rate greater than 60-65% Hrmax is hypothesized to explain greater changes in FIQ and VAS contrasted to lower intensity exercise of less than 60% Hrmax.
Conclusions: There is moderate evidence that moderate intensity aerobic aquatic exercise shows clinically meaningful improvements in VAS and FIQ scores.
Clinical Relevance: The studies reviewed support moderate intensity aquatic exercise incorporating warm-up, strength training, aerobic, and cool down components for 50-60 minutes 3x/week for a minimum of five weeks demonstrates improvements in quality of life and pain for persons with FM.