The effect of blood flow restricted aerobic exercise on pain, functional state, quality of life and hormonal response to exercise in fibromyalgia patients: Randomized double blind study

Objective: The aim of the study is to investigate the effects of aerobic exercise program with blood flow restriction on pain, functional status, quality of life and hormonal response to exercise in patients diagnosed with fibromyalgia. Methods: 46 female patients with fibromyalgia, aged 24-55 years, were included in this prospective, randomized, controlled double-blind study. Participants were randomized into two groups as the blood flow restricted aerobic exercise group (n = 23) and the control group (n = 23). The patients in both groups underwent supervised aerobic exercise four times a week for six weeks. Blood flow restriction was provided with elastic bandages at the groin level during exercise, while the real blood flow restriction protocol was applied to the experimental group, sham blood flow restriction was applied to the control group in the same time and number of sessions. The Fibromyalgia Impact Questionnaire (FIQ), which addresses the severity of the disease from many aspects, was used as the primary outcome measure. As a secondary outcome criterion; Central Sensitization Index (CSI), Beck Depression Scale (BDS), Pain Assessment with Visual Analogue Scale (VAS Pain), Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), 24-hour urine VMA and 5-HIAA levels were used. Measurements were repeated before the intervention, immediately after the 6-week intervention and at the third month after the intervention. Results: The mean age of the patients was 43.2 ± 7.2 years. In the initial evaluation, the two groups were found to be homogeneous in terms of demographic and clinical parameters. Compared to the control group, a significant decrease in FIQ values was detected in the blood flow restricted exercise group (p <0.001), a significant decrease in CSI, BDI values, and a significant increase in 24-hour urine VMA and 5-HIAA levels (p <0.001) were also detected. Although there was a significant decrease in the VAS Pain value and a significant increase in the CPAQ-8 value, there was no significant difference between the groups concerning these outcomes. Conclusion: In this study, it was found that the functioning, central sensitization, mood improved and catecholamine-serotonin levels increased more with the aerobic exercise program with blood flow restriction applied than aerobic training without blood flow restriction in women diagnosed with fibromyalgia. In addition, reduction in pain and increase in pain acceptance was achieved.