Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2025-01-13 DOI:10.1002/ejp.4783

David Casanova-Rodríguez, Antonio Ranchal-Sánchez, Rodrigo Bertoletti Rodríguez, Jose Manuel Jurado-Castro

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Abstract

Background and Objective

Fibromyalgia is a condition characterised by disabling levels of pain of varying intensity. Aerobic exercise may play a role in reducing pain in these patients. The aim of this review is to assess the dose of aerobic exercise needed, based on the frequency, intensity, type, time, volume and progression (FITT-VP) model, to obtain clinically relevant reductions in pain.

Databases and Data Treatment

A systematic review and meta-analysis of randomised clinical trials was conducted in the Web of Science (WoS), PEDro, PubMed and Scopus databases, the search having been conducted between July and October of 2023. Risk of bias was assessed with the Cochrane Risk of Bias assessment tool 2.

Results

Seventeen studies were included. The risk of bias varied, with six studies showing low risk; five, some concerns; and six, high risk. Aerobic exercise interventions were analysed using the FITT-VP model. Frequency ranged from 1 to 10 times per week, intensity varied from light to vigorous, and the types of exercise included music-based exercise, interval training, pool-based exercise, stationary cycling, swimming and walking. The intervention durations ranged from 3 to 24 weeks, with session lengths ranging from 10 to 45 min. Most of the studies presented significant differences, favouring aerobic exercise (MD −0.49; CI [−0.90, −0.08; p = 0.02]), with moderate to low heterogeneity in subgroup analyses.

Conclusions

The study findings underscore the efficacy of aerobic exercise in alleviating pain among fibromyalgia patients, advocating for tailored exercise dosing to optimise adherence and outcomes.

Significance Statement

Individuals with fibromyalgia should engage in aerobic exercises two to three times weekly, for twenty-five to forty minutes in each session, aiming for more than a hundred minutes per week. They should start at low intensity, gradually increasing to higher intensities over six to twelve weeks, for optimal pain management. Exercise types should be selected in collaboration with the patient and based on personal preferences and accessibility, such as walking, and swimming, to ensure long-term adherence to the regimen.

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有氧运动处方减轻纤维肌痛：系统回顾和荟萃分析。

背景和目的：纤维肌痛是一种以不同强度的致残疼痛为特征的疾病。有氧运动可能在减轻这些患者的疼痛方面发挥作用。本综述的目的是评估有氧运动所需的剂量，基于频率、强度、类型、时间、体积和进展（FITT-VP）模型，以获得临床相关的疼痛减轻。数据库和数据处理：在Web of Science （WoS）、PEDro、PubMed和Scopus数据库中对随机临床试验进行了系统回顾和荟萃分析，检索时间为2023年7月至10月。采用Cochrane偏倚风险评估工具2评估偏倚风险。结果：纳入17项研究。偏倚风险各不相同，有6项研究显示低风险；五、一些顾虑；第六，高风险。采用FITT-VP模型对有氧运动干预进行分析。频率从每周1到10次不等，强度从轻到剧烈不等，运动类型包括基于音乐的运动、间歇训练、泳池运动、固定自行车、游泳和步行。干预持续时间从3到24周不等，疗程长度从10到45分钟不等。大多数研究存在显著差异，倾向于有氧运动(MD -0.49；Ci [-0.90, -0.08；P = 0.02])，在亚组分析中具有中等到低的异质性。结论：研究结果强调了有氧运动在减轻纤维肌痛患者疼痛方面的功效，提倡定制运动剂量以优化依从性和结果。意义声明：纤维肌痛患者应该每周进行2 - 3次有氧运动，每次25 - 40分钟，目标是每周超过100分钟。他们应该从低强度开始，在6到12周内逐渐增加到高强度，以达到最佳的疼痛管理。运动类型的选择应与患者合作，并根据个人喜好和可及性，如步行，游泳，以确保长期坚持的方案。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.