# Pain Neuroscience Education and Resistance Training in Women With Fibromyalgia: A Randomized Control Pilot Study

## TL;DR

A pilot study found that combining pain education with resistance training may help women with fibromyalgia more than traditional exercise programs.

## Contribution

This study is the first to compare pain neuroscience education plus resistance training with aerobic and flexibility exercises in fibromyalgia patients.

## Key findings

- PNE + RT improved short-term pain intensity and trapezius pressure pain threshold more than AE + FE.
- PNE + RT also improved central sensitization symptoms and quadriceps pain thresholds long-term.
- Both groups improved disability, but only PNE + RT improved left hand strength.

## Abstract

Objective: The objective was to compare the effectiveness of a combined pain neuroscience education and resistance training program (PNE + RT) with that of a combined aerobic and flexibility exercise program (AE + FE).

Design: A randomized pilot study was conducted in women with fibromyalgia.

Methods: Thirty-one women with fibromyalgia were randomized into the experimental group (PNE + RT, n = 15) and the usual care group (AE + FE, n = 16). Both groups carried out the intervention 3 days a week for 12 weeks. Primary outcomes were pain intensity, disability, and symptoms related to central sensitization (CS). Among them, pain intensity was considered the main primary endpoint for statistical analysis and interpretation. Secondary outcomes were pressure pain threshold (PPT), maximum handgrip strength (MHS), and stiffness.

Results: Statistically significant between-group differences were found in favor of PNE + RT group for short-term pain intensity (p < 0.05) and PPT trapezius (p < 0.05). PNE + RT also showed statistically significant within-group improvements in pain intensity (p < 0.01), CS-related symptoms (p < 0.01), PPT quadriceps (p < 0.01), and MHS of the left hand (p < 0.01). Disability improved significantly in both groups (p < 0.01). There were no significant changes in stiffness.

Conclusion: The PNE + RT program is more effective than the AE + FE program in improving pain intensity in the short term and PPT in the trapezius muscle in the long term. PNE + RT is also effective in improving disability, pain intensity, CS-related symptoms (short and long term), and left MHS and PPT in the quadriceps muscle (long term), although it is not more effective than AE + FE. The AE + FE program is only effective in improving disability. These findings are preliminary, and larger studies are needed to confirm the results.

Trial Registration: ClinicalTrials.gov identifier: NCT04855851