title: Effects of training and albuterol on pain and fatigue in facioscapulohumeral muscular dystrophy.
abstract: BACKGROUND
  We recently reported a randomised controlled trial on the efficacy of strength training and the beta2-adrenergic agonist albuterol in patients with facioscapulohumeral muscular dystrophy (FSHD). Strength training and albuterol appeared safe interventions with limited positive effect on muscle strength and volume. We concurrently explored the prevalence and the characteristics of pain and fatigue in the participating FSHD patients, because these are probably underreported but clinically relevant symptoms in this disorder. Next, we studied the effects of albuterol and strength training on pain, experienced fatigue, health-related functional status and psychological distress.
  
  
  METHODS
  Sixty-five patients were randomised to strength training of elbow flexors and ankle dorsiflexors or non-training. After 26 weeks, albuterol (sustained-release, 8 mg bid) was added in a randomised, double-blind, placebo-controlled design. Outcomes comprised self-reported pain, experienced fatigue, functional status and psychological distress obtained with validated questionnaires at 52 weeks.
  
  
  RESULTS
  Eighty percent of patients reported chronic persistent or periodic, multifocal pains. Thirty-four percent of the participants were severely fatigued. Strength training and albuterol failed to have a significant effect on all outcomes.
  
  
  CONCLUSIONS
  Pain and fatigue are important features in FSHD. Strength training and albuterol do not have a positive or negative effect on pain, experienced fatigue, functional status and psychological distress.
authors.affiliation: Neuromuscular Center Nijmegen, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, The Netherlands. e.vanderkooi@neuro.umcn.nl.
authors.forename: E L
authors.initials: EL
authors.lastname: van der Kooi
authors.forename: J S
authors.initials: JS
authors.lastname: Kalkman
authors.forename: E
authors.initials: E
authors.lastname: Lindeman
authors.forename: J C M
authors.initials: JC
authors.lastname: Hendriks
authors.forename: B G M
authors.initials: BG
authors.lastname: van Engelen
authors.forename: G
authors.initials: G
authors.lastname: Bleijenberg
authors.forename: G W
authors.initials: GW
authors.lastname: Padberg
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D015444:Exercise; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000150:complications / Q000628:therapy; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods; D010809:Physical Fitness; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol