{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:18:08Z","timestamp":1760145488436,"version":"build-2065373602"},"reference-count":69,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Foundation for Science and Technology","doi-asserted-by":"publisher","award":["UIDP\/04923\/2020"],"award-info":[{"award-number":["UIDP\/04923\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Fibromyalgia is a chronic disorder marked by widespread muscle and joint pain, persistent fatigue, sleep disturbances, and irregularities in the autonomic nervous system (ANS). Methods: This study compared the effectiveness of neuromodulation using the EXOPULSE Mollii suit with a structured exercise program in regulating ANS function in fibromyalgia patients. In this randomized, longitudinal crossover study, 10 female patients were randomly assigned to either the Suit + Exercise group or the Exercise + Suit group. Each group participated in two sessions per week for eight weeks, followed by a two-week washout period before switching to the other intervention. We measured cortical arousal, microcirculation, and heart rate variability (HRV) before and after the 1st, 8th, and 16th sessions. Results: The results showed significant improvements in cortical arousal, HRV, and microcirculation with the neuromodulation treatment whereas the exercise program only produced short-term improvements in cortical arousal. Conclusion: The EXOPULSE Mollii suit exhibited cumulative benefits on ANS modulation over time, suggesting potential long-term advantages for managing fibromyalgia. However, further research is needed to explore the delayed effects of both treatments on ANS modulation.<\/jats:p>","DOI":"10.3390\/jcm13154288","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T11:40:36Z","timestamp":1721734836000},"page":"4288","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Efficacy of Neuromodulation and Structured Exercise Program on Autonomic Modulation in Fibromyalgia Patients: Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3616-7799","authenticated-orcid":false,"given":"Alejandro","family":"Rubio-Zarapuz","sequence":"first","affiliation":[{"name":"Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s\/n, 28670 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8347-7589","authenticated-orcid":false,"given":"Mar\u00eda Dolores","family":"Apolo-Arenas","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Universidad de Extremadura, 06006 Badajoz, Spain"},{"name":"Research Group PhysioH, University of Extremadura, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-8774","authenticated-orcid":false,"given":"Orlando","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Departamento de Desporto e Sa\u00fade, Escola de Sa\u00fade e Desenvolvimento Humano, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), University of \u00c9vora, 7004-516 \u00c9vora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-8133","authenticated-orcid":false,"given":"Jos\u00e9 Francisco","family":"Tornero-Aguilera","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s\/n, 28670 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2397-2801","authenticated-orcid":false,"given":"Vicente J.","family":"Clemente-Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s\/n, 28670 Madrid, Spain"},{"name":"Grupo de Investigaci\u00f3n en Cultura, Educaci\u00f3n y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-7409","authenticated-orcid":false,"given":"Jose A.","family":"Parraca","sequence":"additional","affiliation":[{"name":"Departamento de Desporto e Sa\u00fade, Escola de Sa\u00fade e Desenvolvimento Humano, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), University of \u00c9vora, 7004-516 \u00c9vora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ITC33","DOI":"10.7326\/AITC202003030","article-title":"Fibromyalgia","volume":"172","author":"Bair","year":"2020","journal-title":"Ann. 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