Exercise for treating fibromyalgia syndrome

Busch AJ, Barber KAR, Overend TJ, Peloso PMJ, Schachter CL

Summary

Exercise for fibromyalgiaThis summary of a Cochrane review presents what we know from research about the effect of exercise for fibromyalgia. The review shows that in people with fibromyalgia:

• moderate intensity aerobic training for 12 weeks may improve overall well-being and physical function; moderate intensity aerobic exercise probably leads to little or no difference in pain or tender points.
• strength training for 12 weeks may result in large reductions in pain, tender points and depression, and large improvement in overall well-being but may not lead to any difference in physical function.
• the exercise programs that were studied were safe for most. The intensity of aerobic exercise training should be increased slowly aiming for a moderate level. If exercisers experience increased symptoms, they should cut back until symptoms improve. If in doubt about adverse effects, they should check with a health care professional.
• it is not known whether exercise training for more than 12 weeks improves other symptoms such as fatigue, stiffness or poor sleep. Many people with FM do have difficulty staying on an exercise program. Strategies to help individuals exercise regularly were not measured in these studies.
• It is not known whether flexibility training, programs combining types of exercise, and programs combining exercise with non-exercise strategies improve the symptoms of fibromyalgia.

Best estimate of what happens to people with fibromyalgia who take part in aerobic exercise:
In the studies, aerobic exercises were done for at least 20 minutes once a day (or twice for at least 10 minutes), 2 to 3 days a week. Strength training was done 2 to 3 times a week and with at least 8 to 12 repetitions per exercise. The exercise programs lasted between 2 ½ to 24 weeks.

When compared to no exercising, aerobic exercise training may:

• improve overall well-being by 7 points on a scale of 0 to 100.
• improve ability to perform aerobic exercise; by using 2.8 ml/kg/minute more oxygen when walking on a treadmill.
• increase the amount of pressure that can be applied to a tender point by 0.23 kgs/cm² before the onset of pain.
• reduce pain by 1.3 on a scale of 0 to 10.
• have unknown effects on fatigue, depression or stiffness.

Best estimate of what happens to people with fibromyalgia who take part in strength training:
When compared to no exercise, strength training may:

• reduce pain by 49 fewer points on scale of 0 to 100.
• improve overall well-being by 41 points on a scale of 0 to 100.
• lead to 2 fewer active tender points on a scale of 0-18.

The numbers given are our best estimate. When possible, we have also presented a range because there is a 95 percent chance that the true effect of the treatment lies somewhere within that range.