Short-term effects of pilates and aerobic exercise on cognitive functions and biochemical factors in women with fibromyalgia: a randomized controlled trial.

OBJECTIVE: This study aimed to compare the effects of eight-week Pilates and aerobic exercise programs on clinical symptoms, cognitive functions, and serum levels of irisin, BDNF, VEGF, and IGF-1 in female patients diagnosed with Fibromyalgia Syndrome (FMS).

METHODS: Forty-six women with FMS, aged 18-55, were included in the study. Participants were randomly assigned to the Pilates group (n = 23) or the Aerobic Exercise group (n = 23). Both groups received exercise training three days in a week for eight weeks. Clinical assessments included the Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), and Tampa Scale for Kinesiophobia (TSK). Cognitive functions were measured using Verbal Memory Processes Test (VMPT), Stroop test, and Verbal Fluency Test (VFT). Additionally, serum irisin and neurotrophic factor levels were analyzed using the ELISA method from blood samples collected before and after the intervention.

RESULTS: Both groups showed statistically significant improvements in pain (VAS), disease severity (FIQ), and kinesiophobia scores (p < 0.05). Regarding cognitive functions, a more pronounced increase in attention, executive functions, and short-term memory performance was observed in the aerobic exercise group compared to the Pilates group. Biochemical analysis revealed significant increases in serum irisin and BDNF levels in the aerobic exercise group (p < 0.05), while changes in the Pilates group did not reach statistical significance. Regression analysis indicated that increased irisin levels were positively correlated with cognitive improvement.

CONCLUSION: Both Pilates and aerobic exercises are effective in the clinical management of FMS. However, it was concluded that aerobic exercise is a superior therapeutic option for reducing fibrofog symptoms by more strongly triggering the synthesis of neurotrophic factors over 8 weeks. Further studies should investigate the persistence of these effects. Key Points • Eight weeks of Pilates and aerobic exercises both significantly improve clinical symptoms in female patients with fibromyalgia. • Aerobic exercise provides more comprehensive improvements in cognitive performance, attention, and memory compared to Pilates. • Significant increases in serum irisin, BDNF, and IGF-1 levels are induced exclusively by the aerobic exercise program. • Elevated serum irisin and neurotrophic factor levels positively correlate with the regression of "fibrofog" symptoms.