The AM-FM Study (Aquatic physiotherapy Management in FibroMyalgia): Exploring Patients' Perceptions About Aquatic Exercise in the Treatment and Management of Fibromyalgia

Abstract

Background and Purpose: Fibromyalgia is a complex long-term condition characterized by widespread chronic pain, fatigue, and cognitive disturbances. Between 2.9% and 7% of the UK population may be affected. Hydrotherapy (therapeutic aquatic exercise) is frequently used in the management of fibromyalgia, and most research to date has compared hydrotherapy with a comparator or control group in controlled studies. No study has evaluated the role of hydrotherapy from the patient's perspective. The main purpose of the present study was to explore and examine the experiences and views of patients on hydrotherapy in the treatment and management of fibromyalgia. Methods: An online UK-wide survey was conducted with closed- and open-text answers using a convenience sample of participants with fibromyalgia with experience of hydrotherapy. Results: In total, 37 participants aged 25 to 79 years (M = 49.2 years) completed the survey; 34 (92%) participants were female, 3 (8%) were male, and 33 (89%) were of White ethnicity. Thirty-one (84%) participants reported hydrotherapy to be beneficial in their management, but 28 (76%) identified barriers to accessing suitable hydrotherapy facilities. Twenty-six (70%) respondents reported beneficial effects of hydrotherapy in relation to pain relief, 25 (68%) reported in relation to physical function, 23 (62%) reported in relation to promoting relaxation, and 21 (57%) reported in relation to an improved sense of well-being. Themes arising from free-text responses included beneficial effects for relaxation and sleep, positive attributes of the properties of the water, and patient preferences for hydrotherapy over land-based exercise. Discussion and Conclusions: The findings highlight beneficial effects of hydrotherapy beyond those of pain relief and improved physical function identified by previous studies including relaxation effects and positive effect on sleep, among others. Specific access factors may pose obstacles to continued self-directed hydrotherapy for some individuals.