JMIR Publications

ABSTRACT

Background:

Fibromyalgia (FM) is a chronic musculoskeletal pain disorder, seldom reported in China. Recent researches have focused on non-drug treatments, particularly physical therapy, as an alternative. With the rise of smartphones and mobile communication, mobile health technology has become a significant area of study.

Objective:

This study aims to explore whether using remote network applications to supervise patient exercise, in combination with medication, can improve FM pain. It builds on previous research that focuses on drug treatments and offers insights into individualized exercise therapy for FM.

Methods:

The study used a prospective, randomized controlled design with 80 participants, who were divided into two groups: supervised and unsupervised. Both groups received a drug regimen: oral pregabalin (75-150 mg twice daily) and duloxetine (30-60 mg once daily). The supervised group followed exercise routines with guidance from an online rehabilitation therapist via a remote network application, while the unsupervised group exercised without supervision. The study was blinded to the participants. Primary outcomes were pain levels over the past 24 hours as measured by the Brief Pain Inventory (BPI). Secondary outcomes included pain relief, sleep improvement, quality of life, and adverse event occurrences. Observations were made at the start of treatment (T0), one month after treatment (T1), and three months after treatment (T3).

Results:

Compared with T0, the WPI, SSS, and BPI (Pain on Average, least pain in past 24h, Pain right now) scores of two groups of FM patients at T1 were significantly lower. Compared with T0, the WPI, SSS, BPI (Pain on Average, Worst pain in past 24h, Least pain in past 24h, Pain right now), and FIQ scores of two groups of FM patients at T3 were significantly lower. The WPI, SSS, BPI (Pain on Average, Worst pain in past 24h, Pain right now), and PSQI scores of the two groups at T3 were significantly lower than at T1. The changes in scores from T0 to T1 (T1 - T0), from T0 to T3 (T3 - T0), and from T1 to T3 (T3 - T1) in the supervised group were all less statistically significant compared to the unsupervised group.

Conclusions:

The study showed that exercise combined with drug therapy can significantly improve the prognosis of FM, including pain relief, sleep, and overall quality of life; long-term supervised exercise training is more effective in improving FM symptoms and is safer and more reliable. Clinical Trial: The trial was registered on the Chinese Clinical Trial Registry (ChiCTR) with a registration number of ChiCTR2500096370.