Table 36Fibromyalgia: exercise therapies

Author, Year, Followup, Pain Duration, Study QualityInterventionPopulationFunction and Pain OutcomesOther Outcomes

Altan, 2009

3 months

Duration of pain:

Fair

A. Pilates (n=25): 1 hour session 3 times per week for 3 months: Pilates postural education, search for neutral position, sitting, antalgic, stretching and, proproceptivity improvement exercises, and breathing education

B. Attention control (n=25): Instructions in home exercise relaxation/stretching program of 1 hour sessions 3 times per week for 3 months

All patients: Education session about available diagnosis and treatment of

A vs. B

Age: 48 vs. 50 years

Female: 100% vs. 100%

Baseline (0-100): 80.8 vs. 80.1

Baseline pain (0-10): 6.1 vs. 6.3

A vs. B

3 months:

: 69.3 vs. 77.6, difference −8.3 (95% −21.8 to 5.2)

Pain : 5.2 vs. 6.5, difference −1.3 (95% −2.6 to 0.03)

A vs. B

3 months:

(0-100): 224.2 vs. 246.3, difference −22.1 (95% −96.0 to 51.8)

Baptista, 2012

4 months

Duration of pain:

Fair

A. Belly dance (n=40): One hour belly dance classes twice a week for 16 weeks (combination exercise)

B. Waiting list control (n=40): dance offered at end of the study

A vs. B:

Age: 50 vs. 49 years

Female: 100% vs. 100%

Race:

Baseline (0-10): 5.9 vs. 6.3

Baseline pain (0-10): 7.7 vs. 7.5

A vs. B

4 months

: 4.3 vs. 5.9; difference −1.6 (95% −2.5 to −0.8)

Pain : 4.7 vs. 7.3; difference −2.6 (95% −3.6 to −1.6)

A vs. B

4 months

(0-63): 23.1 vs. 23.5; difference −0.40 (95% −7.09 to 6.29)

part 1: 49.4 vs. 51.8; difference −2.40 (95% −6.87 to 2.07)

part 2: 49.8 vs. 54.1; difference −4.3 (95% −8.72 to 0.12)

SF-36 function (0-100): 56.3 vs. 39.1; difference 17.2 (95% 7.55 to 26.85)

SF-36 limitation due to physical aspects (0-100): 36.5 vs. 13.8; difference 22.7 (95% 9.06 to 36.34)

SF-36 pain (0-100): 46.0 vs. 29.1; difference 16.9 (95% 7.62 to 26.18)

SF-36 mental (0-100): 52.3 vs. 46.2; difference 6.1 (95% −3.89 to 16.09)

Buckelew, 1998

3 and 24 months

Duration of symptoms: 11 years

Poor

A. Combination exercise (n=30): included active range of motion exercises, strengthening exercises, low to moderate intensity aerobic exercise, proper posture and body mechanics instruction, and instructions on use of heat, cold, and massage; one 90 minute session per week for 1.5 months and instructions to train 2 additional times independently per week then 24 months of monthly 1-hour groups.

B. Attention control (n=30): one 90-180 minute education session weekly for 1.5 months

A vs. B

Age: 46 vs. 44 years

Female: 93% vs. 90%

Duration of symptoms: 12 vs. 10 years

Duration of diagnosis: 3.0 vs. 2.5 years

Baseline physical activity subscale (0-10): median 4.0 vs. 6.0

Baseline pain (0-10): median 6.3 vs. 5.9

A vs. B

3 months:

physical activity subscale: median 4.0 vs. 6.0; median change from baseline 0 vs. 0

Pain : median 5.4 vs. 5.8, median change from baseline −0.8 vs. −0.5

24 months

physical activity subscale: median 4.0 vs. 6.0, median change from baseline 0 vs. 0

Pain : median 5.5 vs. 5.4, median change from baseline −1.2 vs. −0.6

A vs. B

3 months:

-R Global Severity Index (0-90): median 65.5 vs. 65.0, median change from baseline −3 vs. 0

(0-60): median 13.5 vs. 13.0, median change from baseline −2.5 vs. 3

Sleep scale (0-12), median 8.0 vs. 5.0, median change from baseline 0 vs. 0

24 months

-R Global Severity Index: median 65.5 vs. 67.0, median change from baseline −2.5 vs. −1

: median 11.5 vs. 12.0, median change from baseline −3.5 vs. −2

Sleep scale: median 7.5 vs. 6.0, median change from baseline 0 vs. 0

Clarke-Jenssen, 2014

3 and 12 months

Duration of symptoms: 14 years

Fair

A. Aerobic exercise (n=44): conducted on land and in warm water provided in a warm climate; also stretching, relaxation, and education; provided in groups 5 days per week for 4 weeks

B. Aerobic exercise (n=44): on land and in warm water provided in a cold climate; also stretching, relaxation, education, provided in groups 5 days per week for 4 weeks

C. Usual Care (n=44): no intervention

A vs. B vs. C:

Age: 46 vs. 46 vs. 45 years

Female: 88% vs. 93% vs. 96%

Symptom duration: 17 vs. 13 vs.12 years

Baseline pain (mean, 0-10): 6.6 vs. 6.9 vs. 6.6

A vs. C, between-group difference in change from baseline:

3 months

: data , p=

Pain : −1.2 (95% −2.2 to −0.1)

12 months

data , p=

Pain : 0.1 (95% −0.9 to 1.1)

B vs. C, between-group difference in change from baseline:

3 months

: data , p=

Pain : −0.9 (95% −1.9 to 0.2)

12 months

: data , p=

Pain : 0 (95% −1 to 1)

A vs. C, between-group difference in change from baseline:

3 months

: data , p=

SF-36 Physical: data , p=

SF-36 Mental: data , p=

12 months

: data , p=

SF-36 Physical: data , p=

SF-36 Mental: data , p=

B vs. C, between-group difference in change from baseline:

3 months

: data , p=

SF-36 Physical: data , p=

SF-36 Mental: data , p=

12 months

: data , p=

SF-36 Physical: data , p=

SF-36 Mental: data , p=

Da Costa, 2005

3 and 9 months

Duration of symptoms: 11 years

Fair

A. Combination Exercise (n=39): aerobic exercise, stretching, and strength exercises; 4 visits (initial 90 minutes, others 30 minutes) over 12 weeks with exercise physiologist; individualized home-based program.

B. Usual care (n=41): subjects asked to record exercise activity weekly during the 12-week intervention phase and monthly thereafter.

A vs. B

Age, years: 49 vs. 52

Female: 100% vs. 100%

Symptom duration: 10.5 vs. 11.2 years

Baseline (0-100): 55.1 vs. 48.6

Baseline upper body pain (0-100): 49.5 vs. 47.4

Baseline lower body pain (0-100): 47.0 vs. 47.0

A vs. B, mean change from baseline

3 months:

: −7.8 (95% −13.9 to −1.7) vs. −0.04 (95% CI −5.2 to 5.1), p=0.05

Pain , upper body: −10.6 (95% −17.8 to −3.4) vs. −1.9 (95% CI −6.9 to 3.2), p=0.048

Pain , lower body: −8.21 (95% −15.7 to −0.74) vs. −2.0 (95% CI −9.4 to 5.4), p=0.24

9 months:

: −10.1 (95% −16.1 to −4.0) vs. −0.024 (95% CI −4.4 to 3.9), p=0.009

Pain , upper body: −7.9 (95% −14.3 to −1.4) vs. 2.4 (95% CI 3.7 to 8.5), p=0.02

Pain , lower body: −5.6 (95% −13.3 to 2.2) vs. −0.29 (95% CI −8.6 to 8.0), p=0.35

A vs. B, mean change from baseline

3 months:

SCL 90-R (30−81): −0.02 (95% −0.3 to −0.04) vs. −0.07 (95% CI −0.2 to 0.05), p=0.26

9 months:

SCL 90-R (30-81): −0.16 (95% −0.28 to 0.35) vs. −0.09 (95% CI −0.21 to 0.03), p=0.39

Fontaine, 2010, 2011,

6 and 12 months

Duration of fibromyalgia: Mean 7.4 years

Fair

A. Aerobic Exercise (n=30): Lifestyle Physical Activity; 6, 60-minute group sessions over 3 months with the goal to increase moderate-intensity physical exercise by accumulating short bursts of physical activity throughout the day to 30 minutes 5-7 days per week.

B. Attention control (n=23): education, monthly sessions for 3 months. Included education about FM and social support.

A vs. B

Age: 46 vs. 49 years

Female: 94% vs. 100%

Race, white: 78% vs. 82%

Years since diagnosis: 5.9 vs. 9.6

Baseline (scale ): 67.5 vs. 69.7

Baseline pain (0-100): 54.6 vs. 58.9

A vs. B

6 months:

: 65.3 vs. 63.9, difference 1.4 (95% −10.0 to 12.8)

Pain : 54.9 vs. 49.4, difference 5.5 (95% −7.8 to 18.8)

12 months:

: 64.4 vs. 65.1, difference −0.7 (95% −13.6 to 12.2)

Pain : 51.6 vs. 50.9, difference 0.7 (95% −12.9 to 14.3)

A vs. B

6 months:

(scale ): 18.1 vs. 19.9, difference −1.8 (95% −7.5 to 3.9)

12 months:

: 19.8 vs. 20.6, difference −0.8 (95% −7.1 to 5.5)

Giannotti, 2014

1 and 6 months

Duration of pain:

Poor

A. Combination exercise (n=21): stretching, strengthening, active and passive mobilization, spine flexibility, and aerobic training plus education 2 days a week (60 minutes per session) for 10 weeks; instructions to perform at home the exercise program at least 3 times per week.

B. No intervention (n=20)

A vs. B

Age: 53 vs. 51 years

Female: 95% vs. 92%

Baseline (0-100): 62.7 vs. 59.1

Baseline pain (0-10): 6.1 vs. 6.1

A vs. B

1 month:

: 55.5 vs. 50.9, difference 4.6 (95% −6.38 to 15.58)

Pain : 5.3 vs. 5.5, difference −0.20 (95% −1.87 to 1.47)

6 months

: 48.8 vs. 56.9, difference −8.1 (95% −20.33 to 4.13)

Pain : 5.8 vs. 5.4, difference 0.4 (95% −1.4 to 2.2)

A vs. B

1 month

Sleep (0-10): 4.6 vs. 5.0, difference −0.40 (95% −2.51 to 1.71)

6 months

Sleep (0-10): 6.3 vs. 6.1, difference 0.20 (95% −2.15 to 2.55)

Gowans, 2001

6 months

Duration of symptoms: 9 years

Poor

A. Aerobic exercise (n=30): 3 pool and walking exercise classes (plus stretching) per week for 6 months

B. Control group (n=27): continued ad libitum activity

A vs. B

Age: 45 vs. 50 years

Female: 89% vs. 87%

Baseline (0-80): 57.7 vs. 56.6

A vs. B

6 months:

: 48.6 vs. 54.9, p**<0.05; difference −6.3 (95% −14.8 to 2.2)

A vs. B

6 months:

(0-63): 16.9 vs. 21.3, p**<0.05 difference −4.4 (95% −10.4 to 1.6), p=0.15

(20-80): 41.3 vs. 51.7, P**<0.05; difference −10.4 (95% −18.2 to −2.6), p=0.01

Gusi, 2006

3 months

Duration of symptoms: 22 years

Poor

A. Combination exercise (n=18): 1-hour pool exercise (warm up, aerobic exercise, mobility and lower-limb strength exercises, cool down) 3 times per week for 12 weeks (subjects instructed to avoid physical exercise for the next 12 weeks)

B. Control (n=17): Normal daily activities, which did not include any exercise related to those in the therapy.

A vs. B

Age, years: 51 vs. 51

Female: 100% vs. 100%

Baseline pain (0-100): 63.1 vs. 63.9

A vs. B

Change from baseline

3 months

Pain : −1.6 (95% −12.7 to 0.9) vs. 0.9 (95% CI −7.3 to 9.2), p=0.69

A vs. B

Change from baseline

3 months

(0-1): 0.14 (95% −0.03 to 0.32) vs. −0.02 (−0.17 to 0.13), p=0.14

Pain/discomfort (1-3): −0.1 (95% −0.4 to 0.3) vs. 0 ((95% CI −0.3 to 0.3), p=0.79

Anxiety/depression (1-3): −0.5 (95% −0.8 to −0.1) vs. 0 (95% CI −0.2 to 0.2), p=0.01

Kayo, 2012

3 months

Duration of symptoms: 5 years

Fair

A. Aerobic exercise (n=30): Walking program, 60 minutes 3 times per week for 16 weeks, supervised by physical therapist.

B. Muscle strengthening exercise (n=30): 60 minutes 3 times per week for 16 weeks, supervised by physical therapist.

C. No treatment (n=30)

A vs. B:

Age: 48 vs. 47 vs. 46 years

Symptom duration: 4.0 vs. 4.7 vs. 5.4

Baseline total (0-100): 63.1 vs. 67.3 vs. 63.8

Baseline pain (0-10): 8.6 vs. 8.7 vs. 8.4

A vs. C

3 months

: 38.5 vs. 57.7; overall group X time interaction p=

Pain : 4.8 vs. 6.7; overall group X time interaction p=

B vs. C

3 months

: 50.5 vs. 57.7; overall group X time interaction p=

Pain : 5.9 vs. 6.7; overall group X time interaction p=

King, 2002

3 months

Duration of symptoms: 8.5 years

Poor

A. Aerobic exercise (n=30): aerobic land and water activities; three, 10-40 minute supervised exercise sessions per week for 3 months

B. Control (n=18): instructions on stretches and coping strategies and contacted 1-2 times during the 3 month treatment period to answer any questions

A vs. B

Age: 45 vs. 47 years

Female: 100% vs. 100%

Duration of symptoms: 7.8 vs. 9.6 years

Baseline (0-80): 52.4 vs. 55.2

A vs. B

3 months

: 47.5 vs. 51.5, difference −4.0 (95% −12.2 to 4.2)

Mannerkorpi, 2009

6-7 months

Duration of pain:

Fair

A. Aerobic exercise (n=81): One 45 minute pool aerobic exercise session per week for 20 weeks, stretching exercise also, plus six 1 hour weekly sessions of strategies to cope with symptoms, plan for physical activity for the following week and short relaxation exercise

B. Education control (n=85): six 1 hour weekly sessions of strategies to cope with symptoms, plan for physical activity for the following week and short relaxation exercise

A vs. B

Age: 45 vs. 47 years

Female: 100% vs. 100%

Baseline (0-100): 61.6 vs. 66.6

Baseline pain subscale (0-100): 67.7 vs. 70.4

A vs. B

6-7 months

: mean change from baseline: −3.9 vs. −4.5, p=0.04

pain: mean change from baseline: −6.5 vs. −2.5, p=0.018

A vs. B

6-7 months

depression scale (0-21): mean change from baseline −0.4 vs. 0.0, p=0.99

anxiety scale (0-21): mean change from baseline −0.7 vs. 0.4, p=0.15

SF-36 PCS (0-100): mean change from baseline 2.9 vs. 1.3, p=0.13

SF-36 MCS (0-100): mean change from baseline 0.5 vs. 1.3, p=0.15

SF-36 physical functioning (0-100): mean change from baseline 2.2 vs. 1.3, p=0.70

SF-36 role-physical (0-100): mean change from baseline 12.1 vs. 9.3, p=0.72

SF-36 bodily pain (0-100): mean change from baseline 5.0 vs. 3.6, p=0.24

Paolucci, 2015

3 months

Duration of symptoms:

Fair

A. Combination exercise (n=19): Low-impact aerobic training, agility training balance and postural exercises, hip flexor strengthening, static stretching, diaphragmatic breathing, and relaxation; 10, 60-minute sessions, twice a week for 5 weeks

B. Control (n=18): No rehabilitation interventions, continued normal activities

A vs. B

Age: 50 vs. 48 years

Female: 100% vs. 100%

Baseline total (0-100): 64.8 vs. 63.9

A vs. B

3 months:

total: 53.8 vs. 64.3, difference −10.5 (95% −17.8, −3.2)

Sanudo, 2010

6 months

Duration of pain:

Fair

A. Combination exercise (n=21): supervised aerobic, muscle strengthening, and flexibility exercises; twice-weekly sessions for 24 weeks

B. Aerobic exercise (n=22): warm-up, aerobic exercise, cool down; two, 45-60 minute sessions/week for 6 months

C. Usual care control (n=21): medical treatment for and continued normal daily activities, which did not include aerobic exercise.

A vs. B vs. C

Age: 56 vs. 56 vs. 57 years

Baseline (0-100): 62.2 vs. 60.9 vs. 60.5

A vs. C

6 months

: mean change from baseline −8.8 vs. ; p<0.01

B vs. C

6 months

: mean change from baseline −8.8 vs. ; p<0.05

A vs. C

6 months

(0-63): mean change from baseline −6.4 vs. ; p<0.01

SF-36 total (0-100): mean change from baseline 8.4 vs. ; p<0.01

B vs. C

6 months

: −8.5 vs. ; p<0.01

SF-36 total: 8.9 vs. ; p<0.05

Sanudo, 2012

6, 18 and 30 months

Duration of pain:

Poor

A. Combination exercise (n=21): Twice-weekly 45- to 60-minute sessions of exercise (warm up, aerobic exercise, muscle strengthening exercise, flexibility exercises) for 6 months.

B. Usual care (n=20): alternated between 6 months of training and 6 months with no exercise intervention (asked not to participate in any structured exercise program) for 30 months.

A vs. B

Female: 100% vs. 100%

Baseline (0-80): 58.6 vs. 55.6

A vs. B

6 months:

: 48.5 vs. 55.4, p<0.0005; difference −6.9 (95% −14.4 to 0.6), p=0.07

18 months:

: 45.6 vs. 51.3, p=; difference −5.7 (95% −14.6 to 3.2), p=0.20

30 months

: 38.5 vs. 49.5, p ; difference −11.0 (95% −19.9 to −2.1), p=0.02

A vs. B

6 months:

SF-36 (0-100): 49.5 vs. 37.9, p=0.13; difference 4.68 (95% .096 to 21.104), p=0.02

(0-63): 14.7 vs. 16.6, p=0.18; difference −1.9 (95% −6.5 to 2.7), p=0.41

18 months:

SF-36: 51.8 vs. 41.3, p=; difference 10.5 (95% 0.5 to 20.5), p=0.04

: 14.3 vs. 14.2, p=; difference 0.10 (95% −5.4 to 5.6), p=0.97

30 months

SF-36: 60.5 vs. 42.0, p=

: 9.7 vs. 17.9, p=

Sanudo, 2015

6 months

Duration of pain:

Poor

A. Aerobic exercise (n=16): consisted of warm up, steady state exercise at 60-65% of predicted maximum heart rate, interval training at 75-80% of predicted maximum heart rate, and cool-down; 2, 45-60 minute sessions per week for 6 months

B. Usual care (n=16): normal activities, which did not include structured exercise.

A vs. B

Age: 55 vs. 58 years

Female: 100% vs. 100%

Baseline pain (0-10): 7.4 vs. 7.2

A vs. B

6 months:

Pain : 6.7 vs. 7.0, difference −0.3 (95% −6.3 to 5.7),

A vs. B

6 months

Anxiety (0-10): 5.7 vs. 7.5, difference −1.8 (95% −10.8 to 7.2)

Depression (0-10): 5.6 vs. 6.7 (2.2), difference −1.1 (95% −10.1 to 7.9)

Sleep disturbance (0-10): 7.2 vs. 8.6 (1.9), difference −1.4 (95% −8.9 to 6.1)

Sencan, 2004

6 months

Duration of pain: 5.4 years

Poor

A. Exercise group (n=14): 3 40-minute aerobic exercise sessions per week for 6 weeks

B. Paroxetine (n=18): 20/mg paroxetine/day for 6 weeks

C. Sham (n=20): placebo with electrodes applied to two most painful tender points for 20 minutes, 3 times/week for 6 weeks.

All patients instructed to take paracetamol as a rescue medication throughout the study.

A vs. B vs. C

Age: 35 vs. 36 vs. 36 years

Female: 100% vs. 100% vs. 100%

: 24 vs. 24 vs. 15

Duration of symptoms: 4.7 vs. 6.5 vs. 5.1 years

Baseline (0-10): 6.85 vs. 6.62 vs. 7.70

Baseline Beck Depression Index ( 0-60): 16.20 vs. 20.80 vs. 18.50

A vs. C

6 months

: 4.75 vs. 5.01, difference −0.3 (95% −1.5 to 0.9)

A vs. B

6 months

:4.75 vs. 5.84, difference −1.1 (95% −2.4 to 0.2)

A vs. C

6 months

: 9.95 vs. 15.15, difference −5.2 (95% −7.41 to −2.99)

Analgesic Consumption: 1.15 vs. 4.35, difference −3.17 (95% −3.79 to −2.55)

A vs. B

6 months

: 9.95 vs. 10.12, difference −0.17 (95% −2.09 to 1.75)

Analgesic Consumption: 1.15 vs. 2.40, difference −1.25 (95% −1.39 to −1.11)

Tomas-Carus, 2008/2009,

8 months

Duration of symptoms: 20 years

Poor

A. Combination exercise (n=17): Pool exercise in 1 hour sessions 3 times per week for 8 months (warm up, aerobic exercise, mobility and lower limb strength exercises using water resistance and upper limb strength exercises without water resistance, cool down)

B. Control (n=16): normal activities for 8 months, which did not include exercise similar to that in group A.

A vs. B

Age: 51 vs. 51 years

Female: 100% vs. 100%

Baseline Total (0-10): 6.1 vs. 6.3

Physical Baseline Function (0-10): 3.0 vs. 3.7

Baseline Pain (0-10): 5.6 vs. 6.4

A vs. B

8 months

Total: 5.2 vs. 6.5, difference −1.3 (95% −0.23 to −0.3)

Physical Function: 2.4 vs. 3.7, difference −1.3 (95% −2.7 to 0.09)

Pain: 5.3 vs. 6.6, difference −1.3 (95% −2.5 to −0.09)

A vs. B

8 months

Anxiety (0-10): 4.7 vs. 6.6, difference −1.9 (95% −3.7 to −0.1)

Depression (0-10): 4.0 vs. 6.1, difference −2.1 (95% −4.1 to −0.1)

State Anxiety (20-80): 37.5 vs. 44.4, difference −6.9 (95% −13.2 to −0.6)

SF-36 physical function (0-100): 54.1 vs. 36.6, difference 17.5 (95% 3.4 to 31.6)

SF-36 bodily pain (0-100): 51.7 vs. 27.1, difference 24.6 (95% 11.6 to 37.6)

SF-36 Mental Health (0-100): 67.3 vs. 49, difference 18.3 (95% 2.5 to 34.0)

van Eijk-Hustings, 2013

18 months

Duration of pain:

Fair

A. Aerobic exercise (n=47): two group sessions per week for 12 weeks (warm up, aerobic exercise, resistance training to strengthen muscles, cool down). Subjects were asked to practice exercises at home with videodisc once a week.

B. Usual care (n=48): individualized education and lifestyle advice within 1-2 consultations, plus care as usual

A vs. B

Age: 44 vs. 43 years

Female: 100% vs. 98%

Baseline total (0-100): 60.0 vs. 55.4

Baseline physical function (0-10): 3.6 vs. 3.4

Baseline Pain (0-10): 6.2 vs. 5.5

A vs. B

18 months:

total: 52.0 vs. 56.2, ES=0.22 (95% −0.20 to 0.61)

physical function: 3.6 vs. 3.9, ES=0.11 (95% −0.29 to 0.52)

pain: 5.2 vs. 5.3, ES=0.05 (95% −0.36 to 0.44)

A vs. B

18 months:

Depression (0-10): 5.0 vs. 4.2, ES=0.09 (95% −0.31 to 0.49)

Anxiety (0-10): 5.0 vs. 4.8, ES=−0.06 (95% −0.46 to 0.34)

(−0.59 to 1): 0.54 vs. 0.51, ES=0.10 (95% −0.31 to 0.50)

GP consultations: 1.0 vs. 0.7, ES=−0.10 (95% −0.48 to 0.32)

Medical specialist consultations: −0.4 vs. 0.2, ES=−0.29 (95% −0.58 to 0.22)

Physiotherapist consultations: 0.4 vs. 2.8, ES=−0.29 (−0.58 to 0.22)

Other paramedical professional consultations: 2.1 vs. 0.2, ES=−0.68 (95% −1.00 to −0.18)

van Santen, 2002

6 months

Duration of symptoms: 12 years

Poor

A. Combination exercise (n=58): group sessions (60 minutes) twice a week for 24 weeks (aerobic exercises, stretching, general flexibility and balance exercises, and isometric muscle strengthening); encouraged to attend a third, unsupervised, 60 minute session weekly and to use sauna or swimming pool after all sessions.

B. Usual care (n=29): analgesics NSAIDs, or tricyclic antidepressants, if appropriate; GPs informed that aerobic exercises and relaxation should not be prescribed or encouraged

A vs. B

Age: 46 vs. 43 years

Female: 100% vs. 100%

Duration of symptoms: 9.7 vs. 15.4 years

Baseline physical score (mean, 0-100): 11.3 vs. 9.8

Baseline total score (mean, 0-100): 14.4 vs. 11.4

Baseline (mean, 0-10): 1.9 vs. 5.4

Baseline Pain (mean, 0-100): 66.8 vs. 62.4

A vs. B, mean change from baseline

6 months:

physical score: −1.7 (95% −3.7 to 0.3) vs. −0.6 (95% CI −2.9 to 1.7), p=

total score: −1.9 (95% −3.9 to 0.1) vs. −1.4 (95% CI −3.4 to 0.6) p=

: 0.1 (95% −0.6 to 0.8) vs. 0.8 (95% CI −1.8 to −0.2), p=

Pain : −5.5 (95% −10.9 to −0.1) vs. 1.3 (95% CI −4.5 to 7.1), p=

A vs. B, mean change from baseline

6 months:

-R Global Severity Index (scale unclear): −6.8 (95% −20.1 to 6.5) vs. −8.1 (95% CI −19.8 to 3.6), p=

psychosocial score (0-100): −3.2 (95% −6.2 to 0.2) vs. −3.5 (95% CI −7.0 to 0.0), p=

Patient global assessment (1-5): 0.5 (95% 0.2 to 0.8) vs. 0.5 (95% CI 0.2 to 0.8), p=

Villafaina, 2019

6 months (Immediately postintervention)

Duration of symptoms:

Fair

[New trial]

A. Exercise via an exergame specifically designed for patients with (n=28): 2, 1-hour sessions per week for 24 weeks; exercises targeting aerobic fitness, strength, mobility, postural control, and corrdination of the upper and lower limb.

B. Usual Care (n=27): continued with their usual daily activities.

A vs. B

Age: 54 vs. 53 years

% Female: 100% vs. 100%

Baseline -pain: 62.14 vs. 60.37

A vs. B

6 months

-pain: 58.88 vs. 68.20, effect size 0.076, p=0.04

A vs. B

6 months

-EQ 5D health perception (0-100): 52.30 vs. 45.88, effect size 0.113, p=0.01

-5L utility (0-1): 0.56 vs. 0.52, effect size 0.04, p=0.12

Wigers, 1996

48 months

Duration of symptoms: 10 years

Fair

A. Aerobic exercise (n=20): sessions consisted of training to music (further details not given) and aerobic games; 45 minute group sessions 3 times a week for 14 weeks

B. Treatment as usual (n=20)

A vs. B

Age: 43 vs. 46 years

Female: 90% vs. 95%

Duration of symptoms: 9 vs. 11 years

Baseline pain (0-100): 72 vs. 65

A vs. B

48 months:

Pain : 68 vs. 69, difference −1.0 (95% −16.3 to 14.4)

A vs. B

48 months

Depression (0-100): 32 vs. 30, difference 2.0 (95% −18.8 to 22.8)

Global subjective improvement: 75% vs. 12%, 5.9 (95% 1.5 to 22.2)

= Arthritis Impact Measurement Scale; = Beck Depression Inventory; : Center for Epidemiologic Studies Depression Scale Revised; = confidence interval; EQ5D = EuroQoL 5 Dimensions; ES = effect size; = Fibromyalgia Impact Questionnaire; = fibromyalgia; GP = general practitioner; – Global Severity Index; = Hospital Anxiety and Depression Scale; = Nottingham Health Profile; = not reported; = not statistically significant; = nonsteroidal anti-inflammatory drug; -R = Symptom Checklist-90-Revised; SF-36 = Short-Form 36 Questionnaire; = Sickness Impact Profile; = State-Trait Anxiety Inventory; = visual analog scale

a

Unless otherwise noted, followup time is calculated from the end of the treatment period

b

Total number of consultations over a period of 2 months prior to measurement

From: Results

Cover of Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update
Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update [Internet].
Comparative Effectiveness Review, No. 227.
Skelly AC, Chou R, Dettori JR, et al.

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