OBJECTIVE: The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia.
DATA SOURCES: Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024.
STUDY SELECTION: Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included.
DATA EXTRACTION: Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model.
DATA SYNTHESIS: Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = -0.67; 95% CI = -0.70 to -0.65) and a total duration of 600 min (SMD = -0.65; 95% CI = -0.69 to -0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = -1.14; 95% CI = -1.19 to -1.09) and 1200 min total duration (SMD = -1.08; 95%CI = -1.13 to -1.02). Additionally, a minimum dose of 65 min per week (SMD = -0.62; 95% CI = -0.6 to -0.69) and a total duration of 950 min (SMD = -0.61; 95% CI = -0.60 to -0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = -1.77; 95% CI = -1.89 to -1.65) and 3000 min of total duration (SMD = -1.43; 95% CI = -1.54 to -1.31).
CONCLUSION: These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia.
| Discipline Area | Score |
|---|---|
| Physician |  |
| Rehab Clinician (OT/PT) | |
Physician rater
Moderate-intensity personalised aerobic exercise reduces pain in fibromyalgia patients, as excessive intensity or volume may worsen symptoms. Despite some limitations due to study heterogeneity and bias risk, the evidence generally supports aerobic exercise as a safe, accessible, and beneficial intervention to lessen fibromyalgia pain and enhance quality of life.
Physician rater
A useful synthesis of evidence with key points. Prescribing aerobic exercise is essential in fibromyalgia management to reduce pain and improve function - about 50–65 minutes weekly, gradually increasing towards 90–150 minutes per week based on patient tolerance and goals. Include patient education on benefits and promote adherence with personalised exercises. Consider aquatic exercise as an alternative, especially for those with severe symptoms or comorbidities that limit land-based activity. Monitor for signs of overexertion and adverse reactions, adjusting the exercise dose as necessary.
, McMaster University