Effectiveness of Aquatic Therapy vs Landbased Therapy for Balance and Pain in Women with Fibromyalgia

Background: Fibromyalgia is a disease with an increasing incidence. It impairs the quality of life of patients and
decreases their functional capacity. Aquatic therapy has already been used for managing the symptoms of this
syndrome. However, aquatic therapy has only recently been introduced as a treatment modality for improving
proprioception in fibromyalgia. The main objective of this study is to determine the effectiveness of two physiotherapy
protocols, one in and one out of water, for improving balance and decreasing pain in women with fibromyalgia.

Methods/Design: The study protocol will be a single-blind randomised controlled trial. Forty women diagnosed with
fibromyalgia will be randomly assigned into 2 groups: Aquatic Therapy (n = 20) or Land-based Therapy (n = 20). Both
interventions include 60-min therapy sessions, structured into 4 sections: Warm-up, Proprioceptive Exercises, Stretching
and Relaxation. These sessions will be carried out 3 times a week for 3 months. Primary outcomes are balance (static
and dynamic) and pain (intensity and threshold). Secondary outcomes include functional balance, quality of life, quality
of sleep, fatigue, self-confidence in balance and physical ability. Outcome measures will be evaluated at baseline, at the
end of the 3-month intervention period, and 6-weeks post-treatment. Statistical analysis will be carried out using the
SPSS 21.0 program for Windows and a significance level of p ≤ 0.05 will be used for all tests.

Discussion: This study protocol details two physiotherapy interventions in women with fibromyalgia to improve balance
and decrease pain: aquatic therapy and land-based therapy. In current literature there is a lack of methodological rigour
and a limited number of studies that describe physiotherapy protocols to manage fibromyalgia symptoms. High-quality
scientific works are required to highlight physiotherapy as one of the most recommended treatment options for this

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