Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis

Abstract

BackgroundExercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.MethodsStudies were derived from six electronic sources, cross-referencing from retrieved studies and expert review. Dual selection of randomized controlled exercise training studies published between January 1, 1980 and January 1, 2008 and in which global well-being was assessed using the Fibromyalgia Impact Questionnaire (FIQ) were included. Dual abstraction of data for study, subject and exercise program characteristics as well as assessment of changes in global well-being using the total score from the FIQ was conducted. Risk of bias was assessed using the Cochrane bias assessment tool. Random-effects models and Hedge's standardized effect size (g) were used to pool results according to per-protocol and intention-to-treat analyses.ResultsOf 1,025 studies screened, 7 representing 5 per-protocol and 5 intention-to-treat outcomes in 473 (280 exercise, 193 control) primarily female (99%) participants 18-73 years of age were included. Small, statistically significant improvements in global well-being were observed for per-protocol (g and 95% confidence interval, -0.39, -0.69 to -0.08) and intention-to-treat (-0.34, -0.53 to -0.14) analyses. No statistically significant within-group heterogeneity was found (per-protocol, Qw = 6.04, p = 0.20, I2 = 33.8%; intention-to-treat, Qw = 3.19, p = 0.53, I2 = 0%) and no between-group differences for per-protocol and intention-to-treat outcomes were observed (Qb = 0.07, p = 0.80). Changes were equivalent to improvements of 8.2% for per-protocol analyses and 7.3% for intention-to-treat analyses.ConclusionsThe results of this study suggest that exercise improves global well-being in community-dwelling women with fibromyalgia. However, additional research on this topic is needed, including research in men as well as optimal exercise programs for improving global well-being in adults.

Personality and fibromyalgia: Relationships with clinical, emotional, and functional variables

“…Greater use of the ''catastrophizing'' strategy by FMS patients accords with studies showing greater use of poor coping strategies in response to stressors in FMS Houdenhove & Luyten, 2006), and a higher degree of pain catastrophizing among FMS patients compared with patients suffering from other rheumatologic conditions (Börsbo, Gerdle, & Peolsson, 2010;Hassett et al, 2000). Elevated pain catastrophization in FMS would lead to fear-avoidance behaviors that often result in physical inactivity (Hassett et al, 2000), which in turn frequently leads to further complications such as weakening of the musculoskeletal system, increased pain, fatigue and functional disability (Kelley, Kelley, Hootman, & Jones, 2010). The coping strategy of ''ignoring pain sensations'', related to superior psychological functioning in the context of chronic pain (Jensen & Karoly, 1991), is used less by FMS patients.…”

Physical exercise as non-pharmacological treatment of chronic pain: Why and when

“…(37-46) Further, physical activity positively influences quality of life, activities of daily living, emotional affect, overall physical function and independence. At the same time, physical activity reduces disability and risk of developing comorbid illnesses including hypertension, cardiovascular disease, type 2 diabetes, osteoporosis and obesity.…”

Objectively measured sedentary time and physical activity in women with fibromyalgia: a cross-sectional study

“…1 2 Fibromyalgia is becoming a common syndrome in Western European countries, and estimates indicate a point prevalence of 2.9%, which translates to approximately six million people with fibromyalgia. 3 There is increasing evidence about the potential benefits of regular physical activity on fibromyalgia-related symptoms, [4][5][6][7] and international organisations support the use of physical activity-based interventions as a complementary tool in the therapeutic armamentarium against fibromyalgia. 8 Physical inactivity is one of the major public health problems of the 21st century, 9 and several longitudinal studies have shown the negative consequences on health through a sedentary lifestyle.…”