People who suffer from fibromyalgia (FM), a still unexplained pain syndrome, don't often exhibit outward signs of their illness. But appearances can be deceiving. Although they may look healthy, inside, people with FM often experience pain so severe they are unable to perform simple tasks. "They look very normal except that they may find it almost impossible to hold down a full-time job, to look after their family or to do a lot of regular activities," explains Dr. Jean Wessel, a physical therapist at the University of Alberta. "These people may be completely disabled by pain and fatigue." It is estimated that one percent of the population suffer from FM. The majority of these people are female. Doctors have yet to pinpoint the cause of FM or learn to effectively treat it. Often the condition is misdiagnosed. "It was originally thought that FM was likely due to pain in soft tissues such as muscle or tendon. Bun in fact FM is probably a problem with pain perception," says Dr. Wessel. "It is the lack of control of this pain perception that seems to be the problem."
Dr. Wessel and Dr. Yagesh Bhambhani are currently co-supervising Sharla King's Ph.D. project on the effects of exercise and education on people with FM. It's hoped the results of this study will show that education-only and exercise-only programs, and programs that incorporate both exercise and education can benefit people with FM. Ms. King's study, which is funded through the Health Research Fund, is part of a larger research program with Heritage Research Scholar Dr. Walter Maksymowych and Dr. Dale Sholter to evaluate the effectiveness of treatments for FM. As part of the study, female participants will complete four questionnaires: a 10-item FM impact questionnaire measuring physical functioning, work status, depression, anxiety, sleep, pain, stiffness, fatigue, and well-being; a 15-item survey dealing with quality of life; a 20-item self-efficacy scale measuring their perceived ability to do specific tasks and control symptoms of their condition; and a six minute walking test. Some participants will also be measured for their physiological response to exercise to help researchers determine the relationship between physiological changes and changes in quality of life, self-efficacy and impact of the disease. Participants will be randomly assigned to one of four groups - control, education-only, exercise-only, or exercise-and-education - for the duration of the program. It's hoped that 120 women will take part in the 12-week program by the study's conclusion in April 1999. Control group members receive educational information about FM, but aren't required to participate in supervised sessions with health care professionals. Exercise-only members participate in supervised exercise sessions, including aerobic exercise, and walking on a treadmill or cycling on a stationary bike. Education-only members meet with health care professionals and are given information on FM and practice coping strategies, problem-solving, and goal-setting techniques. They also receive information on the benefits and importance of exercise. Exercise-and-education members participate in supervised education and exercise sessions that include the same content as the education-only and exercise-only groups. All participants will then be reassessed using the same four questionnaires upon completion of the program. Results of the pre-program questionnaires will be compared with post-program questionnaires. Researchers will use this date to make comparisons between the four study groups. While the study is not yet complete, previous research has shown that education and exercise do help people with FM. The Edmonton-based study will examine whether the combination of exercise and education is better than either alone. Education programs provide people with strategies for dealing with the condition and its symptoms, Dr. Wessel explains. "A lot of FM sufferers will have an improved outlook on their future once they know they have something that is recognized as a condition, that it is not all in their head." Exercise may also prove beneficial, Dr. Wessel says. "Most people with FM are sedentary, show decreased endurance and strength, and have poor fitness levels due to limited physical activity. Adding exercise to their daily routines seems to increase their feeling of well-being, improve their pain tolerance, and reduce anxiety and tension." Until health care professionals have a better understanding of FM and how to treat it, Dr. Wessel says people with the condition will have to continue steering the course of their disease. "It's all in their hands in terms of being able to help themselves," she says. Dr. Jean Wessel is funded through the Health Research Fund, administered by AHFMR on behalf of Alberta Health.
Support groups
Fibromyalgia Support Group of Calgary
Fibromyalgia Support Group of Edmonton |
Symptoms of this mysterious condition include vicious cycle of aches and pains, stiffness of the body, sleep disturbances, fatigue, headaches, and depression. Until now, these symptoms have usually been treated with anti-depressants or anti-inflammatory drugs.
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