One of the main problems of fibromyalgia, a widespread pathology that affects around two million Italians in Italy, over 90% of whom are women, is widespread musculoskeletal pain, which when it occurs not only due to physical exertion of a certain intensity, but after normal activity, leads to a real disability. Physical activity to improve the muscular endurance, strength and physical fitness of these patients represents an important possibility of intervention to reduce the disability induced by the disease, capable of determining not only an improvement in pain and physical efficiency, but also to reduce the psychological stress, muscular deconditioning, asthenia and depressive symptoms that very often afflict these patients.
In fact, the positive effects of physical exercise are not only exerted on the muscle, but on numerous organs and systems at the level of which alterations of the regulatory mechanisms of the autonomic nervous system have been documented in fibromyalgic patients, i.e. structures of the nervous system that regulate functions involuntary physiology.
Simple physical exercises such as swimming, walking, cycling represent for these patients a real drug that must be prescribed by the doctor in an individualized manner, taking into account the characteristics of each patient. The physiotherapist or the graduate in motor sciences, in collaboration with the doctor, can develop an adequate program of exercises both in the gym and in the swimming pool or at home, dedicated to the individual subject with the aim of keeping moving without reaching the fatigue limit of the muscle and avoiding injuries and counterproductive effects.
An effective physical exercise for fibromyalgia patients should involve, depending on the degree of training and the conditions of the subject, an increase in heart rate in a range between 40 and 80% of the maximum (which can also be calculated by subtracting from 200 the chronological age and controllable with the heart rate monitor), sessions lasting an average of between 45 and 60 minutes not on continuous days but two or three times a week with a duration of at least three months.
Activity sessions should always start with a low-load warm-up phase aimed at progressively activating muscles and circulation, followed by a low-load relaxation phase to gradually restore heart rate, blood pressure and temperature values body, preventing a rapid interruption of exercise from causing sudden drops in blood pressure or cardiac arrhythmias. Both of these phases will preferably be performed with bodyweight and low-load exercises coordinated with breathing. The session will end with a stretching phase, to recover elasticity and reduce muscle tension.
The exercises for strength and muscle strengthening, although very useful, can be undertaken with never too high loads on medical prescription and only on selected patients who have already recovered in good physical shape. Numerous scientific studies have documented how physical activity and rehabilitation in thermal water give excellent results on patients suffering from fibromyalgia as the chemical components of thermal waters and their characteristics of salinity, viscosity and temperature contribute to reducing pain and slowing down of articular cartilage degeneration. The warm temperature of the water is in fact capable of promoting muscle relaxation while the high specific weight allows an apparent reduction in body weight, making it easier to float.
The sessions in the thermal pool allow for a synergistic action between the advantages linked to the anti-inflammatory properties of the water and the rehabilitative exercises and lead to a proven reduction of pain with muscle relaxation, improvement of peripheral circulation, skin trophism, respiratory function, balance and posture, improving trunk and pelvis control with psychological gratification and social integration of the patient also linked to group practice.
For this reason the Amrer (Emilia Romagna Rheumatic Patients’ Association), particularly committed to the scientific research of rheumatic diseases and in the recognition of the rights of fibromyalgic patients, has created the “hydro-fibromyalgia” path in agreement with the spas belonging to the Thermal Consortium of Emilia Romagna to encourage the development of adapted physical activity in a thermal environment with the aim of improving painful symptoms by supporting the organization of 24 accesses in 12 weeks in which patients perform specific motor activity techniques in thermal water at 34 degrees assisted by experienced and qualified personnel.
In addition to physical exercise, fibromyalgia patients benefit from stress reduction, psychological techniques to promote muscle relaxation and quality sleep, a healthy lifestyle and an anti-inflammatory diet rich in fiber, vitamins and minerals and free from sweets, alcohol, saturated fats and refined foods. Gianfranco Beltrami