Spa treatment for primary fibromyalgia syndrome

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Spa treatment for primary fibromyalgia syndrome: a combination of

thalassotherapy, exercise and patient education improves symptoms and

quality of life

 

Rheumatology 2005 44(4):539-546; doi:10.1093/rheumatology/keh537

 

T. R. Zijlstra1, M. A. F. J. van de Laar1,2, H. J. Bernelot Moens1, E.

Taal2, L. Zakraoui3 and J. J. Rasker1,2

 

1 Department of Rheumatology, Medisch Spectrum Twente Hospital and 2

Department of Rheumatology and Communication Studies, University Twente,

Enschede, The Netherlands and 3 Mongi Slim Hospital, Department of

Rheumatology, Tunis, Tunisia.

 

Correspondence to: T. R. Zijlstra, Campherbeeklaan 105, 8024 BV Zwolle, The

Netherlands. E-mail: t.r.zijlstra

 

Objectives. To study the effect of a combination of thalassotherapy,

exercise and patient education in people with fibromyalgia.

 

Methods. Patients with fibromyalgia, selected from a rheumatology

out-patient department and from members of the Dutch fibromyalgia patient

association, were pre-randomized to receive either 21/2 weeks of treatment

in a Tunisian spa resort, including thalassotherapy, supervised exercise

and group education (active treatment) or treatment as usual (control

treatment). Primary outcome measure was health-related quality of life,

measured with the RAND-36 questionnaire. Secondary measures included the

Fibromyalgia Impact Questionnaire, the McGill Pain Questionnaire, the Beck

Depression Inventory, tender point score and a 6-min treadmill walk test.

 

Results. Fifty-eight participants receiving the active treatment reported

significant improvement on RAND-36 physical and mental component summary

scales. For physical health, differences from the 76 controls were

statistically significant after 3 months, but not after 6 and 12 months. A

similar pattern of temporary improvement was seen in the self-reported

secondary measures. Tender point scores and treadmill walk tests improved

more after active treatment, but did not reach significant between-group

differences, except for walk tests after 12 months.

 

Conclusions. A combination of thalassotherapy, exercise and patient

education may temporarily improve fibromyalgia symptoms and health-related

quality of life.

 

KEY WORDS: Fibromyalgia, Thalassotherapy, Exercise, Health-related quality

of life