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

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.

Resistance Training Improves Quality of Life and Associated Factors in Patients With Fibromyalgia Syndrome.

BACKGROUND: Patients with primary symptoms of fibromyalgia (FM) have a lower quality of life than healthy people of the same age. The current treatment for FM is palliative, as there is no cure. Therefore, among strategies used to alleviate the symptoms, physical exercise has been recommended. OBJECTIVE: To investigate the effects of a resistance training (RT) program on quality of life and associated factors in patients with FM. DESIGN: Nonrandomized clinical trial. Brazilian Clinical Trials: http://www.ensaiosclinicos.gov.br/ (no. RBR-74pcmw). PARTICIPANTS: Forty-nine women with FM (mean age ± SD: 51.35 ± 9.34 years) allocated to an RT group (n = 26) or control group (CG; n = 23). INTERVENTION: The intervention consisted of 4 weeks of a supervised RT program. Three, 60-minute, training sessions per week were conducted. Participants were evaluated before and after 4 weeks of exercise intervention. MAIN OUTCOME MEASUREMENTS: The Fibromyalgia Impact Questionnaire was used to assess quality of life, and secondary outcomes were assessed with the Pittsburgh Sleep Quality Inventory, Beck Depression Inventory, and Beck Anxiety Inventory. The Wilcoxon test was used to verify the differences after 4 weeks of intervention (12 sessions) and the Mann-Whitney U test was used to compare the results for the RT group and CG. RESULTS: The results demonstrated that 4 weeks of RT reduces the impact of FM on quality of life, depression, and anxiety (P < .05). Higher depression and anxiety scores were related to worsening quality of life. The CG did not show significant changes. CONCLUSIONS: RT reduces the impact of FM on the quality of life, and alleviates symptoms in women with FM. LEVEL OF EVIDENCE: II [Correction added on June 21, 2019, after first online publication: Level of Evidence changed from I to II.].