Effectiveness of exercise interventions for fibromyalgia syndrome:a Meta-analysis

Jinpu ZHANG; Junli WANG; Siqi ZHANG; Jiahao CHEN; Qiushi YANG

ABSTRACT

OBJECTIVE:

Exercise intervention is one of the main treatments for fibromyalgia,but there is no consistent conclusion on the choice of different exercise modalities.In this article,a network Meta-analysis was used to comprehensively and quantitatively evaluate the effects of different exercise modalities on fibromyalgia syndrome.

METHODS:

PubMed,EMbase,Scoups,The Cochrane Library,Web of Science,CNKI,WanFang Database,and China Biomedical Literature Database were searched for relevant literature,with a search timeframe from the establishment of each database to June 2023.The outcome indicators included five continuous variables,including fibromyalgia impact questionnaire-revised(FIQ)scores,visual analogue scale(VAS)scores,quality of life,quality of sleep,and depression.The Cochrane Risk of Bias Assessment Tool was used to evaluate the quality of the included literature.RevMan 5.4 software was used to perform effect sizes,subgroup analyses,and sensitivity analyses of the data.Stata 17 software was used to perform reticulation and network Meta-analysis of the data.

RESULTS:

A total of 13 articles with 14 randomized controlled trials were finally included.The overall methodological quality of the literature was high.The results of traditional Meta-analysis showed that,compared with the control group,exercise therapy significantly improved the FIQ score[standardized mean difference(SMD)=-0.67,95％confidence interval(CI)-0.83 to-0.50,P<0.01],VAS score(SMD=-0.72,95％CI-0.90 to-0.54,P<0.01),quality of life(SMD=1.03,95％CI0.45 to 1.61,P=0.000 5),sleep quality(SMD=-0.62,95％CI-0.98 to-0.25,P=0.001),and depression(SMD=-0.63,95％CI-1.09 to-0.18,P=0.007).Network Meta-analysis showed that the probability of optimal intervention effect of exercise modalities on FIQ scores was ranked asmind-body exercise(86.5)>resistance exercise(70.5)>aerobic exercise(41.7);the probability of optimal intervention effect of exercise modalities on VAS scores was ranked asresistance exercise(85.3)>mind-body exercise(74.3)>aerobic exercise(34.5).

CONCLUSION:

Exercise therapy significantly improves FIQ scores,VAS scores,quality of life,sleep quality,and depression in patients with fibromyalgia syndrome.Mind-body exercise and resistance exercise are the most effective exercise modalities to reduce FIQ scores and VAS scores in patients with fibromyalgia syndrome.