The aim was to explore the feasibility and acceptability of performing a six-week home-based stretching intervention for people with fibromyalgia prior to a two-armed, randomised, controlled trial (RCT). Secondary objectives included evaluating changes in health-related quality of life (FIQ-R total score), physical functioning, fatigue, pain, flexibility, pain sensitivity, and exercise adherence, including recruitment rate and attrition.
Twelve people, aged 18-55 years, diagnosed with fibromyalgia in accordance with the ACR diagnostic criteria were recruited through the Danish Fibromyalgia & Pain Association in the North Denmark region. Quantitative assessments included demographic information, the Revised Fibromyalgia Impact Questionnaire (FIQ-R), the Short Form-36 Health Survey (SF-36), the International Physical Activity Questionnaire (IPAQ) short form, pressure pain thresholds (PPT) Passive knee extension range of range of motion (Biodex®) and self-reported adherence collected through a mHealth App (My Physiotherapist). Participants (n=12) were assigned to a home-based stretching intervention with weekly follow-up by a physiotherapist via a mHealth app. The intervention comprised six minutes of daily static stretches of the knee flexors, hip abductors, and shoulder elevators. Participants were instructed to avoid changes in their current pharmacological treatment and maintain regular physical activity levels. Assessments were conducted at baseline and after six weeks at an independent time point, not following a stretching protocol. We conducted two semi-structured focus group interviews to gain insight into the participant's experience and acceptance of the intervention. Interviews were transcribed verbatim and analysed using thematic analysis. We analysed secondary outcomes with intention-to-treat methods using Wilcoxon signed Rank tests. We also performed a power analysis for the FIQ-R total score to determine the sample size for a future RCT.
Twelve participants (n=12 female) were recruited over 43 days. One participant withdrew from the study due to illness. The intervention was found acceptable and safe by the participants, but there were some potential barriers among participants relating to the description of the intervention and measurement procedures. The adherence rate was 91%. There were significant improvements in health-related quality of life (mean change=12±8.3; p=0.003), physical functioning (mean change=2.5±3.4; p=0.035), fatigue (mean change=15.8±15.1; p=0.011) and pain (mean change=9.0±9.7; p=0.017). There were, however, no significant improvements in flexibility (mean change=1.8±14.9; p=0.515) or pain sensitivity (mean change >2.8±23.6; p>0.130). Based on our power analysis, the sample size for a future RCT should include 58 participants.
This study provides evidence of the feasibility, acceptability, and potential benefits of performing a home-based stretching intervention for people with fibromyalgia. The participants had excellent adherence to the intervention and low attrition.
This study determined that performing a home-based stretching intervention is feasible and potentially beneficial in increasing quality of life and reducing the burden of symptoms in people with fibromyalgia.
Stretching
Rehabilitation
