• Marcos Renato Assis, Luciana Eduardo Silva, Adriana Martins Barros Alves, Ana Paula Pessanha, Valéria Valim, Daniel Feldman, Turíbio Leite de Barros Neto, and Jamil Natour.
• Division of Rheumatology, São Paulo Federal University, Rua Botucatu 740, 04023-900 São Paulo, Brazil.
• Arthritis Rheum. 2006 Feb 15; 55 (1): 57-65.

ObjectiveTo compare the clinical effectiveness of aerobic exercise in the water with walking/jogging for women with fibromyalgia (FM).MethodsSixty sedentary women with FM, ages 18-60 years, were randomly assigned to either deep water running (DWR) or land-based exercises (LBE). Patients were trained for 15 weeks at their anaerobic threshold. Visual analog scale of pain, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory, Short Form 36 Health Survey (SF-36), and a patient's global assessment of response to therapy (PGART) were measured at baseline, week 8, and week 15. Statistical analysis included all patients.ResultsFour patients dropped out from each group. Both groups improved significantly at week 15 compared with baseline, with an average 36% reduction in pain intensity. For PGART, 40% of the DWR group and 30% of the LBE group answered "much better" at posttreatment. FIQ total score and FIQ depression improvements in the DWR group were faster (week 8) than the LBE group and kept improving (week 15; P < 0.05). Only the DWR group showed improvements in SF-36 role emotional (P = 0.006). No significant between-group differences were observed for peak oxygen uptake and other outcomes.ConclusionDWR is a safe exercise that has been shown to be as effective as LBE regarding pain. However, it has been shown to bring more advantages related to emotional aspects. Aerobic gain was similar for both groups, regardless of symptom improvement. Therefore, DWR could be studied as an exercise option for patients with FM who have problems adapting to LBE or lower limbs limitations.

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