Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and psychological symptoms. Autonomic nervous system (ANS) dysfunction, marked by increased sympathetic and reduced parasympathetic activity, is considered one of its possible mechanisms. Although exercise is recommended in treatment, low motivation and fatigue often limit participation. Therefore, inspiratory muscle training (IMT), which targets the respiratory muscles, is seen as an easy-to-apply alternative.This randomized, controlled, double-blind study will be conducted at Niğde Ömer Halisdemir University Hospital. Fifty-one women aged 18-65 years who meet the 2010/2016 ACR criteria for fibromyalgia will be randomly assigned to three groups: training (30% of maximal inspiratory pressure), sham (0-10%), and control (no training). ANS functions will be assessed using heart rate variability and the COMPASS-31 questionnaire. Pain, sleep quality, fatigue, anxiety, depression, and respiratory muscle strength will also be evaluated. Training will be performed with the Powerbreathe® device twice daily for six weeks.The study aims to investigate the effects of IMT on ANS functions in fibromyalgia and to explore its relationship with symptoms such as pain, fatigue, sleep disturbances, anxiety, and depression.
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and psychological symptoms, the exact cause of which remains unclear. Autonomic nervous system (ANS) dysfunction, characterized by increased sympathetic activity and decreased parasympathetic tone, is considered one of the major pathophysiological mechanisms of the disease. Exercise is a strongly recommended non-pharmacological approach in the treatment of fibromyalgia; however, low motivation, fatigue, and poor adherence often limit the applicability of conventional aerobic or resistance exercise programs. Therefore, inspiratory muscle training (IMT), which specifically targets the respiratory muscles, is considered an alternative method that is easy to apply and may have regulatory effects on ANS function. This randomized, controlled, double-blind, and prospective study will be conducted in the Rheumatology and Cardiology Clinics of Niğde Ömer Halisdemir University Training and Research Hospital. A total of 51 female participants aged 18-65 years who meet the 2010/2016 American College of Rheumatology (ACR) criteria for fibromyalgia will be randomly assigned to three groups: the training group (30% maximal inspiratory pressure \[MIP\]), the sham group (0-10% MIP), and the control group (no training). ANS functions will be evaluated by heart rate variability (HRV) and the COMPASS-31 questionnaire. Pain will be assessed using the Visual Analog Scale and pressure pain threshold; sleep quality by the Pittsburgh Sleep Quality Index; fatigue by the Modified Fatigue Impact Scale; anxiety and depression by the Hospital Anxiety and Depression Scale; and respiratory muscle strength by the Powerbreathe® K5 device. Training will be performed using the Powerbreathe® Classic device twice daily, seven days per week, for six weeks. The primary aim of this study is to evaluate the effects of inspiratory muscle training on autonomic nervous system functions in patients with fibromyalgia. Secondarily, the effects of this training on symptoms such as pain, fatigue, sleep disturbances, anxiety, and depression, as well as the relationship between these symptoms and changes in ANS activity, will be investigated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
51
Inspiratory muscle training program will be applied to the study and sham group for 7 days/6 weeks.
Niğde Ömer Halisdemir Üniversitesi
Niğde, Niğde Province, Turkey (Türkiye)
Autonomic nervous system- HRV
The procedure will be performed using a 24-hour ECG Holter monitor.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Autonomic Nervous System- COMPASS-31
The Composite Autonomic Symptom Score-31 questionnaire will be used.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Pain- Visual Analogue Scale
Visual Analogue Scale will be used.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Pain- Pressure Pain Treshold
The pain threshold will be assessed using a standard pressure algometer
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Sleep- Pittsburgh sleep quality index
Pittsburgh sleep quality index questionnaire will be used.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Fatigue- Modified Fatigue Impact Scale
Modified Fatigue Impact Scale will be used.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Anxiety and Depression- Hospital Anxiety and Depression Scale
Hospital Anxiety and Depression Scale questionnaire will be used.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
Maximal inspiratory pressure
Measurements will be taken using the PowerBreathe K5 MIP device to determine the exercise load.
Time frame: At the time participants joined the study and after the 6-week training for the intervention and sham groups, and 6 weeks later for the control group.
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