Date of Award

Fall 2020

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Physical Therapy

First Advisor

Hoeger Bement, Marie

Second Advisor

Hunter, Sandra K.

Third Advisor

Frey Law, Laura

Abstract

Exercise training is recommended as a first-line treatment in the management of fibromyalgia due to its ability to improve symptoms and function. However, many with fibromyalgia report limited tolerance to exercise due to exacerbation of pain and fatigue during and following participation of a single bout of exercise. The purpose of this dissertation was to determine the influence of contraction type on local and systemic experimental pain sensitivity, performance fatigue, and perceived pain and fatigue during exercise and through recovery in people with and without fibromyalgia.Experimental and perceived pain were measured before and after a single bout of submaximal intermittent contractions (isometric, concentric, and eccentric) of the right elbow flexors in people with and without fibromyalgia of similar age, sex, body composition, physical activity, and strength. Performance and perceived fatigue were also assessed with each contraction type. Changes in pain and fatigue were evaluated immediately after exercise and through the multiple day recovery following exercise.People with fibromyalgia reported a transient increase in local perceived pain and fatigue with exercise and no systemic changes in widespread pain and fatigue. Additionally, there was no change in local or systemic experimental pain sensitivity across all contraction types. Performance fatigability was dependent on contraction type as isometric and concentric contractions led to greater reductions in local force production in the exercising muscle in fibromyalgia compared to controls while both groups demonstrated similar changes in local performance fatigability following eccentric exercise. Finally, concentric and isometric contractions led to greater perceived pain and fatigue in the exercising limb during and following exercise compared to eccentric contractions. These findings indicate when prescribing exercise to people with fibromyalgia, the concurrent management of pain and fatigue in the exercising limb is warranted during and following a single bout of exercise. Additionally, findings from this dissertation contrast anecdotal beliefs on limiting eccentric contractions in people with chronic pain.

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