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Background:  Different treatments have been proposed for Fibromyalgia, but only few studies have compared their effects on multiples outcomes over time.  Objective:  The objective of this study was to investigate the effects of aquatic physiotherapy (AP) or a health education program (HEP) in a sample of women with Fibromyalgia (FM).  Methods:  Forty-six women with FM, aged between 25 and 60 years old, whose BMI was less than 30, were assigned to either AP (27 women) or HEP (19 women) groups in a blind randomized clinical trial lasting eleven weeks. Pain (McGill Pain questionnaire), fatigue (Piper Fatigue Scale-Revised), functional capability (Fibromyalgia Impact questionnaire), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory) and quality of sleep (Pittsburgh Sleep Quality Index) data were collected at baseline, after six weeks and post intervention. Two-factor mixed-model analysis of variance (ANOVAs) were used to examine the effects of the treatment on each outcome variable.  Results:  The AP and HEP interventions showed statistically significant within-group differences on all outcome measures except reducing the pain. Between-group differences was statistically significant only for impact of FM on the participant's life [ F (1.82,80.41)  = 31,99; p ≤ 0.01] indicating that patients receiving HEP experienced a greater decrease in FIQ than those treated with AP.  Conclusion:  The findings do not allow to affirm that one intervention is superior to the other for the treatment of people with FM. Future studies should investigate whether the combination of HEP and PA can be effective and long-lasting.

Our objective was to test the hypothesis that pain beliefs are mediators of disability in a population of workers with chronic pain. A cross-sectional study composed of 115 workers with work-related musculoskeletal disorders (WRMD) whose symptoms appeared 6 months before the beginning of the study was conducted. Outcome measures included questionnaires on pain, pain beliefs, physical disability, and depression. Almost half of the sample (42%) reported moderate pain; the mean disability score was 11.5. Assessment of pain beliefs revealed that only the emotion domain was "more adaptive." Thirty-eight workers presented depressive symptoms (33%), with a mean score of 18. A multiple linear regression analysis identified the best predictors associated with disability in sample. The variables that remained in the model were intensity of pain, domains solicitude, and disability from the survey of pain attitudes, physical disability, and depression. Results showed that pain beliefs are partial mediators of the relation between chronic pain and disability. When depression was added to the model, there was a significant increase in the explanation of disability variance, indicating that this variable is an important factor associated with functional limitation. Disability associated with chronic pain is a multidimensional experience, affected by the interaction of social and psychological factors.