Mind-body exercise interventions best improved health-related quality of life (HRQOL) outcomes among patients with fibromyalgia, according to the results of a systematic review and meta-analysis published in the Journal of Pain Research.
Investigators from Qilu Hospital of Shandong University in China searched publication databases through April 2022 for randomized clinical trials that evaluated exercise interventions in the setting of fibromyalgia. A total of 57 studies published between 1996 and 2021 were included in this analysis.
Of the study population of 3319 patients, 2961 patients had sufficient data to be included in the analysis. The patients were mostly women (93.8%) with an average age between 35 and 59.3 years.
Exercise interventions included land-based aerobic exercise (n=772), mind-body exercise (n=348), stretching exercise (n=316), strength or resistance exercise (n=303), pool-based aerobic exercise (n=303), sensorimotor training exercise (n=260), and whole body vibration (n=78). Patients in the comparator groups received noninterventional (n=776) or active (n=163) control treatments.
In the network analysis focusing on HRQOL outcomes, mind-body exercise was most favored over noninterventional control (standardized mean difference [SMD], -12.12), followed by whole body vibration (SMD, -9.23), strength or resistance exercise (SMD, -7.19), land-based aerobic exercise (SMD, -6.49), pool-based aerobic exercise (SMD, -6.48), stretching exercise (SMD, -3.78), and sensorimotor training exercise (SMD, -3.04).
Compared with noninterventional control, for the outcome of pain, sensorimotor training exercise (standardized mean difference [SMD], -1.81), strength or resistance exercise (SMD, -1.73), mind-body exercise (SMD, -1.65), PAE (SMD, 1.28), and land-based aerobic exercise (SMD, -0.87) interventions were favored; for sleep, whole body vibration (SMD, -6.95) and strength or resistance exercise (SMD, -2.38) were favored; for anxiety, pool-based aerobic exercise (SMD, -4.83), land-based aerobic exercise (SMD, -2.87), active control (SMD, -2.48), mind-body exercise (SMD, -2.13), and sensorimotor training exercise (SMD, -1.90) were favored; and for depression, sensorimotor training exercise (SMD, -6.33) was favored.
Little evidence of publication bias, except for the outcome of pain, was reported. In a netsplit analysis, 4 comparisons had evidence of indirect and direct evidence divergence.
This analysis may have been biased by the fact that exercise frequency, intensity, and duration data were not considered.
According to the study authors, “[O]ur results indicate that [mind-body exercise], including yoga and tai chi, is associated with lower FIQ (or FIQR) scores in patients with [fibromyalgia] compared with treatment as usual, contributing to reduced symptom severity and enhance overall quality of life.” These data suggest that among patients with fibromyalgia, mind-body exercise interventions were also preferred over noninterventional control for pain and anxiety outcomes.
Zhang K-D, Wang L-Y, Zhang Z-H, et al. Effect of exercise interventions on health-related quality of life in patients with fibromyalgia syndrome: a systematic review and network meta-analysis. J Pain Res. 2022;15:3639-3656. doi:10.2147/JPR.S384215