The efficacy of a telerehabilitation-based clinical Pilates program on lumbopelvic muscle morphology and strength in female patients with fibromyalgia syndrome: a randomized controlled trial

Clin Rheumatol. 2025 Oct 6. doi: 10.1007/s10067-025-07712-5. Online ahead of print.

ABSTRACT

INTRODUCTION: The current study aims to assess the effects of a tele-rehabilitation-based clinical Pilates exercise program on morphological structure, endurance, central sensitization, pain, fatigue, anxiety, and depression in Fibromyalgia syndrome (FMS) patients.

METHOD: Thirty women with FMS were randomized into two groups: the telerehabilitation group (TG) or the control group (CG). An online clinical Pilates-based exercise program targeting stability and strength that was conducted for 8 weeks with 2 sessions per week was developed for TG. The same exercise programs for the CG were provided in printed brochures. Lumbopelvic muscle thickness, core endurance tests, disease activity, fatigue, central sensitization, pain, anxiety, and depression were evaluated in patients at the beginning and end of the study.

RESULTS: Decrease in lumbopelvic muscle thickness and core endurance strength in FMS patients compared to healthy individuals (p < 0.017). There was a significant effect of group × time interaction (F = 4.900, p = 0.035; F = 5.063, p = 0.032) for external oblique (right and left, respectively), fatigue (F = 15.489, p < 0.001), central sensitization (F = 17.518, p < 0.001), anxiety (F = 8.672, p = 0.006) in favor of the TG. Significant time effects were observed across all examined outcomes, covering lumbopelvic muscle thickness, fatigue, central sensitization, anxiety, depression, and core endurance strength (p < 0.05). Following the 8-week intervention, both groups exhibited significant within-group decreases in disease activity and pain. However, the TG demonstrated significantly greater improvements in disease activity and pain compared with the CG (p < 0.05).

CONCLUSION: Telerehabilitation-based treatment programs are effective in increasing lumbopelvic muscle thickness and core muscle endurance. Accordingly, we recommend the widespread use of this innovative treatment approach in FMS. Keypoints • FMS patients indicated lower core endurance strengths compared to healthy groups • TG showed greater improvements in muscle thickness and core endurance strength • Telerehabilitation is feasible and effective for managing the complexities of FMS • The telerehabilitation program was superior and more effective than home exercises.

PMID:41053520 | DOI:10.1007/s10067-025-07712-5