Introdução O desequilíbrio do sistema nervoso simpático e parassimpático, caracterizado por hiperatividade simpática e redução da atividade parassimpática cardíacas, tem sido associado diretamente com os mecanismos de desenvolvimento de hipertensão arterial sistêmica (HAS). Este desequilíbrio influencia diretamente outros fatores fisiopatogênicos presentes na doença como, por exemplo, disfunção endotelial e remodelamento vascular. O treinamento muscular inspiratório e o treinamento aeróbio demonstram efeitos satisfatórios no tratamento de doenças cardiovasculares, inclusive na HAS. Contudo, não há relatos na literatura sobre a comparação da magnitude dos benefícios de cada uma destas intervenções, tampouco há dados que demonstrem os efeitos da combinação das duas modalidades na HAS. Objetivo Desta forma, com este trabalho, buscamos avaliar os efeitos do treinamento muscular inspiratório e do treinamento aeróbio isoladamente e de maneira combinada sobre: a pressão arterial sistêmica, a capacidade funcional, a função endotelial, o controle autonômico cardiovascular em pacientes com HAS primária. Metodologia Desenvolvemos um ensaio clinico randomizado cego, com a participação de indivíduos com diagnóstico clínico de hipertensão arterial sistêmica primária, a fim de analisar os efeitos de três programas de treinamento, executados por um período de 12 semanas: treinamento muscular inspiratório (TMI: 7 dias por semana, 30 min por dia, com carga de 30%PIMAX), treinamento aeróbio (TA: 2 dias por semana, 1 hora por dia, a 70%FCmáx) e treinamento combinado (TMI+TA: 7 dias por semana divididos em 2 dias de TA e 5 dias de TMI, seguindo as mesmas cargas aplicadas nos grupos isolados). Para avaliação dos objetivos propostos, realizamos, antes e após as intervenções: monitorização ambulatorial da pressão arterial (MAPA) por 24 horas, teste de esforço (ergoespirometria), aquisição dos sinais de pressão arterial (Finometer®) e eletrocardiograma (PowerLab®) de maneira não invasiva, microneuromiografia do nervo peroneo, avaliação da função endotelial através de vasodilatação mediada por fluxo, manovacuometria e aplicação de questionário de qualidade de vida (SF36). Resultados 43 pacientes hipertensos foram randomizados para participação em um dos quatro grupos (TMI, TA, TMI+TA e Controle). 28 pacientes finalizaram o estudo (7 em cada grupo) que teve como principais resultados: redução da pressão sistólica total, de vigília e do sono nos grupos TMI (deltaPAST: -7,85 ± 7,6; deltaPASV: -8,28 ± 9,26; deltaPASS: -5,85 ± 7,1 mmHg) e TMI+TA (?PAST: -6,42 ± 4,42; deltaPASV: -6 ±2 ,76; deltaPASS: -11,42 ± 10,14 mmHg), redução da pressão arterial diastólica total, de vigília e do sono no grupo TMI+TA (deltaPADT: -5,85 ± 3,57; deltaPADV: -5,42 ± 4,72; deltaPADS: -5,85 ± 6,14 mmHg) e redução da pressão diastólica do sono no grupo TMI (deltaPADS: -5,14 ± 5,01 mmHg). Melhora da capacidade funcional, com aumento do VO2MÁX em todos os grupos intervenção (deltaVO2MÁX TMI: 2,11 ± 0,96; TA: 3,31 ± 2,01; TMI+TA: 3.55 ± 2.96 l/min-1) e redução do VE/VCO2slope nos grupos TA (deltaVE/VCO2slope: -1.02 ± 1.31) e TMI+TA (deltaVE/VCO2slope: -2,17 ± 1,49). Além disso, o grupo TMI apresentou redução da modulação simpática cardíaca (BFabs: 241,32 ± 246,74 vs 166.19 ± 178.25) e melhora do balanço simpatovagal (BF/AF: 3.25 ± 2.23 vs 1.33 ± 1.45) após 12 semanas de protocolo. Obervamos ainda, que os três grupos intervenção apresentaram redução da atividade nervosa simpática muscular (deltaANSM TMI: -11,25 ± 13,43; TA: -4,53 ± 2,99; TMI+TA: -6,52 ± 2,05 bursts/min) e melhora da força muscular inspiratória (deltaPIMAX TMI: -35,27 ± 24,06; TA: -17,57 ± 7,25; TMI+TA: -55,28 ± 20,25 cmH2O) e expiratória (deltaPEMAX TMI: 22,04 ± 12,95; TA: 19,28 ± 5,93; TMI+TA: 42,85 ± 15,53 cmH2O) após 12 semanas. Contudo, não observamos alterações na função endotelial ou na qualidade de vida dos participantes após o estudo. Conclusão As três modalidades de treinamento apresentam benefícios no tratamento de pacientes portadores de hipertensão arterial sistêmica. Observamos que os efeitos apresentados através da prática de TMI foram semelhantes àqueles apresentados a partir da prática de TA sobre alguns componentes fisiopatogênicos da HAS e que a prática combinada das duas modalidades agrega em benefícios os efeitos encontrados com a prática isolada. Assim, acreditamos que o TMI é uma alternativa interessante de tratamento ao TA, e que a prática combinada pode ser incentivada nesta população / Introduction Sympathetic and parasympathetic nervous system imbalance, characterized by sympathetic hyperactivity and reduction of cardiac parasympathetic activity, has been directly associated with the mechanisms of systemic arterial hypertension development. This imbalance influences directly other pathophysiological factors of the disease, such as endothelial dysfunction and vascular remodeling. Inspiratory muscle training and aerobic training demonstrate satisfactory effects in the treatment of cardiovascular diseases, including hypertension. However, there are no reports in the literature comparing the magnitude of the benefits of each one of these interventions, nor any data demonstrating the effects of the combination of both modalities. Objective In this work, we aimed to evaluate the effects of inspiratory muscle training and aerobic training separately and combined on: blood pressure, functional capacity, endothelial function, and cardiovascular autonomic control in patients with primary hypertension. Methods: We performed a randomized blinded clinical trial including individuals with clinical diagnosis of primary arterial hypertension in order to analyze the effects of three training programs performed over a 12-week period: inspiratory muscle training (IMT: 7 days 30 minutes per day, with 30% PIMAX load), aerobic training (AT: 2 days per week, 1 hour per day, 70% HRmax) and combined training (IMT + AT: 7 days per week divided into 2 days of AT and 5 days of IMT, following the same load applied in the isolated groups). To evaluate the proposed objectives, we performed the following evaluations, before and after the interventions: 24-hour ambulatory blood pressure monitoring (ABPM), exercise test (ergospirometry), noninvasive acquisition of blood pressure signals (Finometer®) and electrocardiogram (PowerLab®), peroneal nerve microneuromyography, evaluation of endothelial function through flow-mediated vasodilation, manovacuometry and application of quality of life questionnaire (SF36). Results 43 hypertensive patients were randomized to participate in one of four groups (IMT, TA, IMT + TA and Control). 28 patients completed the study (7 in each group), with the following results: reduction of systolic blood pressure during 24 hours (SBPT), awake (SBPW) and sleep (SBPS) periods in IMT(deltaSBPT: -7,85 ± 7,6; deltaSBPW: -8,28 ± 9,26; deltaSBPS: -5,85 ± 7,1 mmHg) and IMT+AT groups (deltaSBPT: -6,42 ± 4,42; deltaSBPW: -6 ± 2,76; deltaSBPS: -11,42 ± 10,14 mmHg); reduction of diastolic blood pressure during total (DBPT), awake (DBTW) and sleep (DBPS) periods in IMT+AT group (deltaDBPT: -5.85 v± 3.57; deltaDBTW: -5.42 ± 4.72; deltaDBPS: -5.85±6.14 mmHg) and reduction of diastolic sleep pressure in IMT group (deltaDBPS: -5.14 ± 5.01 mmHg). It was also observed improvement of functional capacity, with increase of VO2MAX in all intervention groups (deltaVO2MAX IMT: 2.11 ± 0.96, AT: 3.31 ± 2.01, IMT+AT: 3.55 ± 2.96 l / min-1) and reduction of VE/VCO2slope in AT (deltaVE/VCO2slope: -1.02 ± 1.31) and IMT+AT groups (deltaVE/VCO2slope: -2.17 ± 1.49). In addition, the IMT group presented reduction of sympathetic cardiac modulation (LFabs: 241.32 ± 246.74 vs 166.19 ± 178.25) and improvement of the sympathovagal balance (LF/HF: 3.25 ± 2.23 vs 1.33 ± 1.45) after 12 weeks of protocol. We also observed that the three intervention groups presented reduction of muscle sympathetic nerve activity (deltaMSNA: IMT: -11.25 ± 13.43, TA: -4.53 ± 2.99, IMT+AT: -6.52 ± 2,05 bursts/min) and improvement of inspiratory muscle strength (deltaPIMAX IMT: -35.27 ± 24.06, AT: -17.57 ± 7.25, IMT+AT: -55.28 ± 20.25 cmH2O), and (deltaPEMAX IMT: 22.04 ± 12.95, AT: 19.28 ± 5.93, IMT+AT: 42.85 ± 15.53 cmH2O) after 12 weeks. However, we did not observe changes on endothelial function or quality of life of participants after the study. Conclusion The three training modalities present benefits in the treatment of patients with systemic arterial hypertension. We observed that the effects presented through the practice of IMT were similar to those presented from the practice of AT on some physiopathology components of hypertension and the combination of the two modalities adds some benefits in the effects found with the isolated practice. Thus, we believe that IMT is an interesting alternative to AT, and that the combined practice can be encouraged in this population

This study addresses the effects of the changing workforce and the physiological and psychological benefits of fitness. The purpose of this experiment is to test the relationship between situational stressors, perceived fitness, exercise locus of control, self-control, and perceived stress.

Title: Comparison of educational and compensation exercise programmes for ankylosing spondylitis patients Objective: The objective of the research was to determine the effect of two educational and compensation exercise programmes on the mobility of the axial system, the functional status and disease activity (including inflammatory process activity) in individuals with ankylosing spondylitis. Methods: The research group included men and women (average age of 35.42 ± 7.15 years), all out-patients of the Institute of Rheumatology in Prague. This characteristic sample (n ═ 38) consisted of respondents who were randomised into three groups: The first experimental group (n ═ 13) attended an educational and compensation exercise programme in a group setting in a gym (twice a week) and an educational and compensation exercise programme in the form of a group exercise in a pool - hydrokinesiotherapy (once a week); the second experimental group (n ═ 13) attended the same educational and compensation exercise programme in a group setting in a gym (twice a week); the control group educational and compensation exercise programme in a group setting in a gym (twice a week) received no exercise intervention but its members were allowed to use "passive" physiotherapeutic procedures (e.g. hydrotherapy or...

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022 / Students who transition from school to tertiary institutions can experience stressors which lead to anxiety and depression. This can be alleviated by exercise. Limited research has been undertaken about exercise and the alleviation of depression amongst tertiary education students in South Africa. The aim of the study was to investigate the impact of exercise on depression, anxiety, and self-esteem on first-year students registered at the University of Venda (UNIVEN). A quantitative approach using a cross-sectional survey design was used. The study sample consisted of 320 randomly selected first-year students, 160 students who exercised regularly and 160 students who did not exercise at all. Data was collected using the Rosenberg Self-Esteem Scale (RSE), The Becks Anxiety Inventory (BAI), and the Becks Depression Inventory-11 (BDI-11). The study was theoretically underpinned by the trans theoretical model (TTM). Data analysis used both non-inferential and inferential statics that is, descriptive statistics, multivariate analysis of variance (MANOVA) and logistic regression analysis. The findings supported those found in previous research, both locally and internationally. The hypotheses of this study were fully supported by the results. Results pertaining to age and gender in this study revealed that there were no significant differences in scores. Additionally, respondents that had higher levels of anxiety, due to not exercising, were linked to pre-contemplation in the TTM. It was determined that these respondents were not aware of exercise as an intervention to enhance their overall well-being and mental health. Generally, the research contributes to understandings of the impact of exercise as an intervention in mental health challenges in first year tertiary education students. The exercise guidelines developed out of this research will help the Department of Education (DoE), UNIVEN and tertiary institutions generally in providing exercise interventions to undergraduate students in the tertiary education sector / National Research Foundation (NRF)

Ten caucasian male quadriplegics were compared with eight sedentary caucasian male controls in regards to left ventricular dimensions and mass obtained from echocardiograrns. The interventricular septum (IVS), left ventricular posterior wall (LVPW) and left ventricular internal diameter (LVII) were within normal limits for both groups. However, the INS in the SCI were significantly thicker than controls (p <0.05). Myocardial thickness was larger in SCI subjects (p <0.05). Absolute left ventricular mass (LVM) and total left ventricular volume was not different ( p > 0.05), but SCI subjects had significantly greater LVM to lean body mass ratios. Echocardiographically, SCI patients demonstrate concentric hypertrophy. This suggests adaptive response to chronic increase in afterload pressure secondary to their daily activities and muscle spasticity.

A back injury prevention program was developed, implemented and evaluated for employees at Corning Corporation. Subjects included 38 manufacturing employees; 21 in the intervention group and 17 in the control group. The subjects included slightly more males (62%) than females (37%), significantly more whites (87%) than African Americans or other minorities (13%), and an average age of 30-39 years. The intervention involved frequent stretching exercises done throughout the 12 hour workday. A two-way ANOVA was used to access self-reported back discomfort reported by a questionnaire during pre- and post- intervention periods. Although no significant interactions between groups across time occurred, there was a decline in discomfort for both groups. A correlational analyses was used to study the relationship between participation in the stretching exercises and discomfort. The correlation coefficient for the frequency of discomfort variable reached significance and the region of discomfort approached statistical significance. Statistical significance was not evident for intensity, duration and level of discomfort variables. Except for the relationship between increased participation in the intervention program and a increased reduction in frequency of discomfort, statistical evidence is absent regarding the benefit of the intervention. However, other positive results support the possibility of program continuation. / Master of Science

Die doel van hierdie ondersoek was om vas te stel of Opvoedkundige Kinesiologie deur die Opvoedkundige Sielkundige gebruik sou kan word as 'n psigoterapeutiese benadering ten einde emosionele welsyn te verhoog. Volgens Edu-K is die brein-liggaam sisteem onlosmaak:lik verbind en emosionele blokkerings is nie slegs in die denke en intellek van die mens gelee nie, maar ook op sellulere vlak vasgele. Navorsing aan die hand van die idiografiese benadering is gedoen. Vyf proe:tpersone, wat aangemeld is met emosionele probleme, het elkeen 'n reeks Edu-K balanserings ontvang volgens individuele behoeftes. Die doel daarvan was om te bepaal ofEdu-K balanserings sou lei tot verhoogde welsyn. Na die reeks balanserings is daar beduidende positiewe veranderinge waargeneem ten opsigte van emosionele probleme, sowel as verbeteringe in ak.ademiese prestasie. Daar is ook algemene prak.tiese riglyne gegee vir ouers, onderwysers en Opvoedkundige Sielkundiges. / The aim of this investigation was to ascertain whether Educational Kinesiology could be applied by the Educational Psychologist as a psychotherapeutic tool in order to enhance emotional wellbeing. According to Edu-K the mind-body system is inseperably one: emotional blocks are not only situated in the mind and intellect of a person, but are recorded on cellular level as well. Research was done by way of an idiographic approach. Five subjects with emotional problems received a series of balances according to their individual needs. The aim was to ascertain whether Edu-K balances could enhance emotional wellbeing. A significant positive improvement in emotional problems as well as in academic performance were noted. General guidelines for parents, teachers and Educational psychologists are also given. / Psychology of Education / M. Ed. (Voorligting)

Aging, obesity and increased waist circumference (WC) increases risk for metabolic syndrome (MetS). MetS is a cluster of symptoms (elevated WC, triglycerides, blood pressure, fasting glucose, and decreased high-density lipoprotein cholesterol [HDL-C]) increasing risk for chronic disease. Low-energy dense (LED) diets, emphasizing whole food eating patterns, have not been examined in combination with moderate (mod)/high-intensity physical activity (PA) or dietary protein levels to determine their impact on changes in body weight (BW) and WC in premenopausal, abdominally obese women. PURPOSE: To determine the effect of two 16-wk diet and PA interventions, differing in protein intake, on BW, WC, MetS risk factors, dietary patterns, energy density (ED), and min of Mod-Hi PA. METHODS: Healthy, abdominally obese (WC≥80cm) women (n=38; 34±10y) were randomly assigned to either a 15 or 25% (+18 g/d whey protein) en from protein diet. Individualized LED diets plans decreased energy intake (EI) by ~300kcal/d; PA 5 d/wk (30-60 min/d) consisted of supervised, high-intensity Zumba classes 3d/wk (≥65%HRmax; ≥6METs) and self-selected mod-intensity PA (≥3METs) 2d/wk. Servings of fruits/vegetables, whole grains, and low-fat/fat-free dairy (LFD), fiber, high calorie beverages (BEV), ED, and PA were monitored before (T1), during (T2) and after (T3) the intervention using repeated measures ANOVA. Bonferroni simultaneous testing procedure was used in analysis of multiple comparisons. RESULTS: At T1, groups did not differ in dietary patterns, PA, BW, WC, or MetS risk. Groups responded similarly to the interventions so data were combined, with BW and WC decreasing (p<0.0001) by -4.8±2.7kg and -7.1±3.6cm, respectively. Comparing T1 vs. T2, there were increases (p<0.0001) in fruits/vegetables, (Δ=+1.5 ser/d), whole grains (Δ=+1.0 ser/d), LFD (Δ=+0.5 ser/d), fiber (Δ=+5.7g/1000 kcal), and decreases in BEV (Δ=-165 kcal/d) and ED (Δ=-0.55 kcal/g). During the intervention high-intensity Zumba PA was 87min/wk; total min of all mod-intensity PA increased by 75 min/d (p<0.0001); VO2max improved from 29.3±4.7 (T1) to 34.4±5.3 (T3) mL/kg/min (p<0.0001). Triglycerides significantly decreased (-24±52 mg/dl; p=0.006), no other significant changes occurred in MetS risk factors. Exploratory analysis indicated that increases in fruits/vegetables and LFD, and decreases ED were associated with BW loss, while increases in whole grains, fiber, LFD, and min/wk of high-intensity PA (Zumba) were associated with WC reductions. CONCLUSION: For abdominally obese women, an intervention focused on LED foods and high-intensity PA significantly reduced BW and WC and improved dietary patterns regardless of protein intake. Helping clients identify a few key factors that positively promote reductions in BW and WC may improve weight loss success, while reducing MetS risk factors. / Graduation date: 2012

Treningsterapi som en del av tverrfaglig spesialisert rusbehandling. Formålet med studiet er å undersøke hvordan en gruppe pasienter med rusmiddelavhengighet og psykiske lidelser opplever og beskriver sine erfaringer med treningsterapi som en del av behandlingen ved Stiftelsen Bergensklinikkene. Dette sett i lys av Self-Determination Theory (SDT) - selvbestemmelsesteorien.    Studiet har en kvalitativ tilnærming hvor det empiriske materialet er basert på forskningsintervju. Det er blitt gjennomført intervjuer av syv pasienter med rusmiddelavhengighet alle med erfaring med bruk av treningsterapi ved Bergensklinikkene. Treningsterapi vil si planlagte og strukturerte fysiske aktiviteter. Empirien i dette studiet er analysert ved bruk av tradisjonell kvalitativ tilnærming og meningskonsentrering. Hovedfunnene viser at et autonomistøttende miljø er en forutsetning for å bli motivert for behandling. Brukermedvirkning og selvbestemmelse er faktorer som styrker motivasjonen for endring.   Økt kompetanse blant pasientene gjennom nye erfaringer og økt innsikt i treningsterapi, ga grunnlag for en autonomistyrt behandling.  Relasjon til treningsterapeutene var viktig for at pasientene opplevde terapeutens informasjon og veiledning som nyttig. Opplevelsen av et inkluderende felleskap med behandlere og medpasienter var av stor betydning for informantene. I studien kom det frem at behovet for tettere oppfølging i overgangen fra institusjon til hjem var nødvendig.     Opplevelse av bedre rusmestring, bedre søvn, mindre angst og depresjon og mindre ADHD-symptomer var viktige motivasjonsfaktorer. Dessuten ga fysiske effekter både indre og ytre motivasjon til bruk av treningsterapi. Gjennom studien kan en ut fra resultatene konkludere med at informantene blant annet vektlegger en autonomistøttende struktur, økt kompetanse, opplevelse av fellesskap og motivasjon som viktig og nødvendig i treningsterapi. / Excercise as therapy  Exercise as therapy as part of multidisciplinary specialized treatment. The purpose of the study is to understand how a group of patients with substance use disorders and mental illness experience and describe their experiences with exercise therapy as part of treatment at the Bergen Clinics Foundation. The thesis uses a framework of self-determination theory (SDT).   The study has a qualitative approach where the empirical material is based on research interviews. Seven patients were strategically selected to undertake semi-structured interviews regarding their experience with exercise as therapy as part of multidisciplinary specialized treatment in The Bergen Clinics Foundation. Exercise as therapy is physical activity that is planned and structured. The empirical data in this study is analyzed using the traditional qualitative approach.    The results show that an autonomy supportive environment is a prerequisite for being motivated for treatment. User involvement and self-determination are factors that strengthen the motivation for change.   Increased competence among patients through new experiences and greater insight into exercise as therapy, provided the basis for an autonomy-guided therapy. The patients´ relationship with the therapists was important: in case this relationship was deficient, they wouldn´t experience the information and guidance as helpful.   The experience of an inclusive community of practitioners and fellow patients was of great significance for patients. The study revealed that the need for closer monitoring of the transition from institutional to home was necessary.    Experience of better control of drug dependence, better sleep, less anxiety and depression and less ADHD symptoms were important motivators. Besides giving physical effects both intrinsic and extrinsic motivation for use of exercise as therapy.   One can conclude from the study that in the patients´ view an autonomy supportive structure, increased expertise, experience of community and motivation represented the most important and indispensable factors in exercise therapy.

Fibromialgia é uma síndrome de etiologia desconhecida e caracterizada pela presença de dor difusa e crônica e pelo menos 11 dos 18 tender points específicos. É fundamental encontrar alternativas eficazes de tratamento que objetivem minimizar o impacto da fibromialgia (FM) sobre a qualidade de vida dos pacientes. O objetivo deste estudo foi avaliar a eficácia de um tratamento fisioterapêutico composto de terapia a laser nos tender points e exercícios de alongamento muscular sobre a qualidade de vida de pacientes com FM. Participaram do estudo 28 pacientes com FM que foram divididos em três grupos: GLA (n=10) que realizou 10 sessões de terapia a laser nos tender points e exercícios de alongamento; GA (n=10) que realizou 10 sessões de alongamento muscular e; GC (n=8) que realizou uma sessão educativa. Foram utilizadas as medidas da escala analógica visual da dor (VAS), dolorimetria dos tender points, Fibromyalgia Impact Questionnaire (FIQ) e SF-36. Os resultados mostraram que os grupos GLA e GA, quando comparadas as avaliações inicial e final, apresentaram diferença significante na VAS (p=0,006 e p=0,002; respectivamente); no limiar de dor dos tender points (p=0,001 e p=0,007; respectivamente); no FIQ (p=0,04 e p=0,006; respectivamente) e no SF-36 (p=0,001 e p=0,000; respectivamente). O grupo GC não apresentou diferença significante em nenhuma das medidas. Não houve diferença significante entre os grupos GLA e GA, mas houve diferença destes com o grupo GC nas medidas da VAS e do limiar de dor nos tender points. Neste estudo, conclui-se que os exercícios de alongamento são eficazes na melhora da dor, sensibilidade dolorosa dos tender points e qualidade de vida dos pacientes. Devem ser revistos alguns parâmetros da terapia a laser de baixa potência no tratamento desses pacientes, como o intervalo entre as sessões e o comprimento de onda do laser adotados. Sugere-se ainda que a abordagem educativa seja empregada como parte integrante do tratamento e que a relação fisioterapeuta-paciente deva ser valorizada, pois são aspectos importantes que podem contribuir para a melhora da qualidade de vida dos pacientes com FM. / Fibromyalgia is a syndrome of unknown etiology characterized by the presence of chronic and diffuse pain, and at least 11 of the 18 specific tender points. Its fundamental to find effective options of treatment that look for minimize the impact of fibromyalgia (FM) in the patients quality of life. The purpose of this study was to evaluate the efficacy of a physical therapy treatment compounded of laser therapy in the tender points and stretching exercises, in quality of life of patients with FM. Twenty-eight patients with FM participated of this study were divided in three groups: GLA (n=10) performed 10 sessions of laser therapy in the tender points and stretching exercises; GA (n=10) performed 10 sessions of stretching exercises and; GC (n=8) performed a single session of an educational approach. Measures of visual analogue scale of pain (VAS), dolorimetry of the tender points, Fibromyalgia Impact Questionnaire (FIQ) and SF-36 were assessed. The results showed, comparing initial and final assessments, the groups GLA and GA presented significant differences of VAS (p=0.006 and p=0.002; respectively); pain threshold of tender points (p=0.001 and p=0.007; respectively); FIQ (p=0.04 and p=0.006; respectively) and SF-36 (p=0.001 and p=0.000; respectively). There was no significant difference in any of the measures in the GC group. No significant groups GLA and GA differences were found, but compared with the controls (GC) the measures of VAS and pain threshold were significant different. In conclusion, in this study the stretching exercises were effective in the improvement to pain, tenderness threshold of the tender points and quality of life of patients with FM. Some parameters should be reviewed about low-power laser therapy in the treatment of patients with FM, as treatment intervals and laser wavelength. This study suggests that an educational approach could be employed as an integrant part of the treatment, and the relationship between physical therapist and patient plays an essential role in the treatment, since they are important aspects that contribute to the improvement in quality of life of patients with FM.