Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia; A randomized controlled trial

Background: Aquatic physical training (APT) has been strongly recommended to improve symptoms in fibromyalgia syndrome (FMS).
However, its effects on body composition and whether lean body mass (LBM) directly influences the aerobic functional capacity of this population
are still not clear.

Aim: To investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and
whether oxygen uptake (VO2) related to LBM can better quantify the functional capacity of this population.

Design: Randomized controlled trial.

Setting: The Federal University of São Carlos, São Paulo, Brazil.

Population: Fifty-four women with FMS were randomly assigned to trained group (TG, N.=27) or control group (CG, N.=27).

Methods: All women underwent cardiopulmonary exercise test (CPET) to assess oxygen consumption at ventilatory anaerobic threshold
(VAT ) and at peak exercise, and also to assess body composition. The TG was submitted to APT program, held twice a week for 16 weeks. The
exercise intensity was adapted throughout the sessions in order to keep heart rate and ratings of perceived exertion achieved at VAT .

Results: After APT, body composition was not significantly different between groups (TG and CG). In VAT only TG showed increased VO2
related to LBM, since in peak CPET, VO2 in absolute units, VO2 related to total body mass (TBM), VO2 related to LBM and power showed
significant differences. Significant difference between VO2 related to TBM and VO2 related to baseline LBM and after 16 weeks of follow-up,
both in VAT as in peak CPET in both groups. Significant difference between VO2 related to TBM and VO2 related to LBM at VAT and at peak
CPET in both groups at baseline and after 16 weeks of follow-up was observed.

Conclusions: APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased
VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity
at VAT level after to APT.

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