Effects of different protocols of physical exercise on fibromyalgia syndrome treatment: systematic review and meta-analysis of randomized controlled trials

Abstract

Physical exercise has been used as a form of treatment for fibromyalgia, however, the results indicate the need for further investigations on the effect of exercise on different symptoms. The aim of the study was to synthesize and analyse studies related to the effect of exercise in individuals with fibromyalgia and provide practical recommendations for practitioners and exercise professionals. A search was carried out in the Web of Science, PubMed, and Scopus databases in search of randomized clinical trials (RCT) written in English. A meta-analysis was performed to determine the effectiveness of different types of exercise on the fibromyalgia impact questionnaire (FIQ), and the protocol period and session duration on the pain outcome. Eighteen articles were eligible for a qualitative assessment and 16 were included in the meta-analysis. The exercise showed large evidence for the association with a reduction in the FIQ (SMD − 0.98; 95% CI − 1.49 to − 0.48). Protocols between 13 and 24 weeks (SMD − 1.02; 95% CI − 1.53 to − 0.50), with a session time of less than 30 min (SMD − 0.68 95% CI − 1.26 to − 0.11) or > 30 min and < 60 min (SMD − 1.06; 95% CI − 1.58 to − 0.53) presented better results. Better results were found after combined training protocols and aerobic exercises. It is suggested that exercise programs lasting 13-24 weeks should be used to reduce pain, and each session should last between 30 and 60 min. In addition, the intensity should always be carried out gradually and progressively. PROSPERO registration number CRD42020198151.

The vicious cycle of physical inactivity, fatigue and kinesiophobia in patients with fibromyalgia syndrome

“…The results of another recent metaanalysis show that especially resistance exercises are effective on pain and fatigue in patients with FMS (34). In addition, in terms of physical exercise intensity, it has been reported that the exercise intensity should be light at the beginning and increased over time to not aggravate the symptoms of FMS patients (10). The results of this study showed that the kinesiophobia levels of FMS patients were high.…”

“…On the other hand, Sieczkowska et al showed that physically active patients with FMS had better quality of life and less depressive symptoms (28). In a recent meta-analysis, it has been reported that the intervention of physical exercises was effective on the symptoms and physical well-being of FMS patients (10). The results of another recent metaanalysis show that especially resistance exercises are effective on pain and fatigue in patients with FMS (34).…”

“…The positive effect of exercise on the psychological state and quality of life in fibromyalgia is also mentioned (9). Recent meta-analyses have found that combined exercise programs and aerobic exercises are effective in the treatment of FMS (10). On the other hand, according to the results of some studies on exercise compliance of FMS patients, it has been reported that patients with FMS need help from health professionals for par-ticipation and adherence in exercise (11).…”

Effects of resistance training on sleep of patients with fibromyalgia: A systematic review

“…The recommendation for exercise is due to its ability to increase slow-wave sleep, which helps thermoregulation (Youngstedt, 2005), alters the circadian cycle and alters levels of neuropeptides and neurotransmitters in the brain that play important roles in sleep (Buman and King, 2010). Furthermore, exercise has shown to improve general health, symptoms of the disease and physical function (Busch et al, 2011) and in general, the recommendations are aimed at aerobic exercise and resistance training (RT) (Albuquerque et al, 2022; Macfarlane et al, 2017).…”

On the superiority of a combination of aerobic and resistance exercise for fibromyalgia syndrome: A network meta-analysis

“…For example, aerobic exercise can improve the quality of life and relieve muscle pain in FMS (Busch et al, 2007 ), while resistance exercise can significantly improve physical function in FMS (Busch et al, 2013 ). However, most current clinical studies only analyze the efficacy of two exercise programs by comparing each other (Rooks et al, 2007 ; Alentorn-Geli et al, 2008 ), and most meta-analyses start with only a few outcome indicators, for example, quality of life, fatigue, and sleep quality (Estévez-López et al, 2021 ; Albuquerque et al, 2022 ). The extant studies lack a comparison of the three common exercise programs from the three perspectives of improving quality of life, relieving muscle pain, and simultaneously enhancing physical function in patients with fibromyalgia.…”