1. Aerobic exercise seemed to reduce pain perception, depression, improved quality of life as well as mental and physical health-related quality of life.

2. Resistance exercise decreased pain perception and improved quality of life and improved the physical dimension of health-related quality of life. There was a non-significant positive effect on depression and the mental dimension of health-related quality of life.

Evidence Rating Level: 2 (Good)

Exercise plays an important role in the non-pharmacological management of fibromyalgia. Unfortunately, adherence rates to exercise have been low due to the contradictory information regarding the exercise prescription. As a result, the objective of the present systematic review and meta-analysis was to summarize the evidence of different forms of exercise on pain, depression, and quality of life in patients with fibromyalgia.

Of 747 screened records, 18 (n=1184; 97.46% females) were included from database inception to December 2021. Studies were included if they evaluated the effect of either aerobic, resistance, or stretching exercises performed out of the water on pain, depression, or quality of life in patients with fibromyalgia. Interventions that used more than one exercise typology or that were performed in hot water were excluded. Study quality was assessed using the Cochrane Collaboration Risk of Bias Tool. The strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Data analysis was performed through random effect models. Results demonstrated that aerobic exercise seemed to reduce pain perception, depression, improved quality of life as well as mental and physical health-related quality of life. Resistance exercise decreased pain perception, improved quality of life, and the physical dimension of health-related quality of life but had a non-significant positive effect on depression and the mental dimension of health-related quality of life. Stretching exercise reduced pain perception and improved quality of life however there was a non-significant effect on depression.

Despite this, the study was limited by the heterogeneity of the study’s populations, reported outcomes, and interventions. However, the study’s results suggest that exercise should be encouraged in patients with symptomatic fibromyalgia.

Click to read study in: Nature

 Image: PD

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