Effectiveness of Therapeutic Exercise in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Objective The aim of this study was to summarize evidence on the effectiveness of therapeutic exercise in Fibromyalgia Syndrome. Design Studies retrieved from the Cochrane Plus, PEDro, and Pubmed databases were systematically reviewed. Randomized controlled trials and meta-analyses involving adults with fibromyalgia were included. The primary outcomes considered in this systematic review were pain, global well-being, symptoms of depression, and health-related quality of life. Results Effects were summarized using standardized mean differences with 95% confidence intervals using a random effects model. This study provides strong evidence that physical exercise reduces pain (−1.11 [95% CI] −1.52; −0.71; overall effect p < 0.001), global well-being (−0.67 [95% CI] −0.89, −0.45; p < 0.001), and symptoms of depression (−0.40 [95% CI] −0.55, −0.24; p < 0.001) and that it improves both components of health-related quality of life (physical: 0.77 [95% CI] 0.47; 1.08; p < 0.001; mental: 0.49 [95% CI] 0.27; 0.71; p < 0.001). Conclusions This study concludes that aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global well-being in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life. In addition, combined exercise produces the biggest beneficial effect on symptoms of depression.

Effects of a functional training program in patients with fibromyalgia: A 9‐year prospective longitudinal cohort study

“…The treatment of pain in FM has focussed on pharmacotherapy and non‐pharmacological treatments such as educating the patients, PA, and educational‐psychological programs shown to be effective in the relief of the symptoms of FM . There are enough evidences that physical exercise is an effective instrument for improving physical fitness, health, and quality of life and causes beneficial effects on the symptoms of FM patients . Overall, studies have reported short‐term improvements in pain, quality of life, and physical fitness, although more studies are needed about the long‐term effects.…”

“…12 There are enough evidences that physical exercise is an effective instrument for improving physical fitness, health, and quality of life and causes beneficial effects on the symptoms of FM patients. [13][14][15][16][17] Overall, studies have reported short-term improvements in pain, quality of life, and physical fitness, 18 although more studies are needed about the long-term effects. However, despite these benefits, a high dropout rate in PA programs is commonly observed among the patients with FM, and a low percentage of patients comply with the weekly PA recommendations.…”

Management of functional neurological disorder

“…FM is characterized by widespread pain, along with multiple other symptoms including fatigue and cognitive fog [53][54][55][56][57]. As in CFS, a multidisciplinary approach to management is recommended, often accessed through chronic pain clinics.…”

“…As in CFS, a multidisciplinary approach to management is recommended, often accessed through chronic pain clinics. This approach may include non-pharmacologic management including education around pacing, CBT and exercise [53,54].…”

Efficacy of a Multicomponent Intervention for Fibromyalgia Based on Pain Neuroscience Education, Exercise Therapy, Psychological Support, and Nature Exposure (NAT-FM): Study Protocol of a Randomized Controlled Trial

“…Randomized controlled trials (RCTs), testing for the simultaneous combination of ET and CBT, have been shown to be the most effective non-pharmacological treatments for FM [13]. Treatments based exclusively on ET have contributed to the reduction of symptoms of pain, fatigue, and depression, as well as to the improvement of mental health, psychological well-being, and physical function [14,15]. CBT-based treatments have favoured the acceptance of FM, strengthening of self-efficacy, development of coping strategies, and the reduction in depressive moods [16].…”