Effects of training and albuterol on pain and fatigue in facioscapulohumeral muscular dystrophy.
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.
van der Kooi
E L
EL
Neuromuscular Center Nijmegen, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, The Netherlands. e.vanderkooi@neuro.umcn.nl.
Kalkman
J S
JS
Lindeman
E
E
Hendriks
J C M
JC
van Engelen
B G M
BG
Bleijenberg
G
G
Padberg
G W
GW
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
D000318:Adrenergic beta-Agonists; D000420:Albuterol