Mixed exercise training for adults with fibromyalgia (original) (raw)

Cochrane Database of Systematic Reviews

Abstract

What is fibromyalgia and what is mixed exercise? Fibromyalgia is a condition causing chronic pain and soreness throughout the body. People with this condition often feel depressed, tired, and stiff, and have difficulty sleeping. Mixed exercise is defined as regular sessions of two or more types of exercise including aerobic (walking or cycling), strengthening (lifting weights or pulling against resistance bands), or flexibility (stretching) exercise. Study characteristics Reviewers searched for studies until December 2017, and found 29 studies (2088 people) conducted in 12 different countries. The average age of study participants was 51 years, and 98% were female. The average exercise programme was 14 weeks long with three sessions of 50 to 60 minutes per week. All exercise programmes were fully or partially supervised. Reviewers were most interested in comparing mixed exercise groups to control groups (19 studies; 1065 people). People in control groups either received no treatment or continued their usual care. Key results - mixed exercise vs control Each outcome below is measured on a scale that goes from 0 to 100, where lower scores are better. Health-related quality of life (HRQL) After 5 to 26 weeks, people who exercised were 7% better (3% better to 11% better) or improved by 7 points on a 100 point scale. People who exercised rated their HRQL at 49 points. People in the control group rated their HRQL at 56 points. Pain After 5 to 26 weeks, people who exercised had 5% less pain (1% better to 9% better) or improved by 5 points on a 100 point scale. People who exercised rated their pain at 53 points. People in the control group rated their pain at 58.6 points. Tiredness After 14 to 24 weeks, people who exercised were 13% less tired (8% better to 18% better) or improved by 13 points on a 100 point scale People who exercised rated their tiredness at 59 points. People in the control group rated their tiredness at 72 points. Stiffness After 16 weeks, people who exercised were 7% less stiff (1% better 1 to 12% better) or improved by 7 points on a 100 point scale. People who exercised rated their stiffness at 61 points. People in the control group rated their stiffness at 68 points. Ability to do daily activities (physical function) After 8 to 24 weeks, people who exercised were 11% better (7% to 15%) or improved by 11 points on a 100 point scale. People who exercised rated their physical function at 38 points. People in the control group rated their physical function at 49 points. Harms - Some participants experienced increased pain, soreness, or tiredness during or after exercise. Studies reported no injuries or other harms. However, reporting of harms was missing or incomplete in many studies. We are uncertain whether risk is increased with exercise. Leaving the study early - 11% of control participants left the study early compared with 12% of exercisers. Long-term effects - Analysis of long-term effects of HRQL showed maintenance of mixed exercise effects at 6 to 12 weeks and at 13 to 26 weeks but not at 27 to 52 weeks. Very low-quality evidence suggests that it is uncertain whether mixed exercises improve HRQL in the long term. Withdrawals and adverse events were not measured. Other - Reviewers found no evidence that the benefits and harms of mixed exercise were any different from education programmes, cognitive-behavioural training, biofeedback, medication, or other types of exercise. Conclusions and quality of evidence Mixed exercise may improve HRQL and the ability to do daily activities, may decrease pain and tiredness, and may be acceptable to individuals with fibromyalgia. Low-quality evidence suggests that mixed exercise may slightly improve stiffness. When compared to other exercise or non-exercise interventions, we are uncertain about the effects of mixed exercise. Although mixed exercise appears to be well tolerated (similar numbers of people leaving the study across groups), evidence on harms was scarce, so we are uncertain about its safety. Reviewers considered the quality of evidence to be low to moderate because of small numbers of people in the studies, some issues involving study design, and the low quality of results.

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