Respostas de um programa de alongamento supervisionado remotamente durante Pandemia por Covid-19 no quadro doloroso, depressão, sono e funcionalidade em mulheres com fibromialgia: um ensaio clínico randomizado

Abstract

The present study aimed to verify the effects of a remotely supervised stretching program during the covid-19 pandemic on pain, depressive symptoms, sleep quality, and flexibility in women with fibromyalgia. The study included 28 women with primary fibromyalgia aged between 30 and 60 years who were randomized into two groups: an experimental group (n = 13; 49.9 ± 8.0 years) that received a stretching exercise counseling guide with video explanatory about the execution of the exercises and performed the proposed activities during remotely supervised sessions twice a week; and the active control group (n = 15; 47.0 ± 6.5 years), which also received the stretching exercise counseling guide with explanatory video to be performed in isolation. The intervention lasted 12 weeks with study outcome measures before (week 0), during (week 6), and after the intervention (week 13). Study outcomes were measured by the instruments (1) Widespread Pain Index (WPI), (2) Symptom Severity Scale, (3) Fibromyalgia Impact Questionnaire (FIQ), (4) Beck Depression Inventory (BDI), (5) Pittsburgh Sleep Quality Index (PSQI) and (6) International Physical Activity Questionnaire (IPAQ), which were self-administered and completed online using Google Forms. In addition, pain at rest and after the movement was measured using the Visual Analog Pain Scale (VAS) during video call, as well as the flexibility of the lower limbs, which was measured using the Flexitest. Data analysis was performed per protocol and intention-to-treat using the Generalized Estimating Equations (GEE) test and Bonferroni posthoc test (α=0.05). The results showed a reduction in the generalized pain index (EG: 45.1 ± 30.3%; CG: 35.7 ± 29.1%), improvement in sleep quality (EG: 28.7 ± 34.2%; CG: 2.7 ± 26.7%), reduction in the severity of symptoms (EG: 29.5 ± 43.7%; CG: 18.1 ± 32.6%), reduced depressive symptoms (EG: 38.1 ± 32.8%; CG: 1.6 ± 68.4%) and reduction in the impact of fibromyalgia in quality of life (EG: 20.6 ± 21.1%; CG: 7.7 ± 5.4%) after the intervention for both groups, with no difference between them. Regarding the level of pain measured by VAS, there was a reduction in pain values at rest (EG: 38.2 ± 43.0%; GC: 16.912 ± 17.3%) and after movement (EG: 49.7 ± 40.2%; CG: 20.8 ± 23.5%) in both groups, with no differences between them. Additionally, the intention-to-treat analysis demonstrated an improvement in flexibility (EG: -13.0 ± 53.9; GC: -60.4 ± 70.1) in both groups after the intervention. The stretching program can be concluded, whether supervised or not, it was effective in promoting improvement in the painful condition, depressive symptoms, sleep quality, and flexibility of women with fibromyalgia.