Table 1
Description of participants by group, indicators and overall results of articles included in the review.
| Authors | Participants | Indicators | EG Programme | Programme description | Results |
| Kümpel et al., 2016 G: 2A | Women with FM from São Paulo (Brazil) EG: n = 20; 54 ± 5.1 years. | VAS Algometry (Somedic Sales AB) FIQ PSQI | F: 2 s/w T: 1 hour D: 15 sessions I: NS Tr: Mat Pilates | Pilates with mat exercises. Participants received individualised guidance, tactile stimulation of the muscle worked on and verbal command. | Improvement in the domains of: pain intensity, fatigue, work absenteeism, sleep quality, depression, anxiety and stiffness (p < .02). Improvement in PSQI score (p = .04). Decrease in FIQ score (p < .01). Pain reduction in the VAS (p = .01). |
| Andrade et al., 2017b G: 1B | Patients with FM from Florianópolis, (Brazil). (96.2% were women). EG: n = 31; 54.42 ± 7.16 years. CG (Control Group): n = 21; 53.10 ± 8 years. | FIQ PSQI | F: 3 s/w T: 1 hour D: 8 wks. I: individualised load Tr: Strength | 10 min warm-up, 40 min main part and 10 min stretching. Exercises: knee extension, knee flexion, bench press, fly, adductors, low rowing, high pulley, elbow extension, lateral raise, push-ups, standing calf raise and crunches. 3 sets of 12 r/ 1 min between sets. | EG: differences in subjective sleep quality, sleep disturbances, daytime dysfunction and total sleep score (p < .05). Association between pain intensity and sleep quality (p < .01). As pain intensity increased, sleep quality worsened. |
| Collado-Mateo et al., 2017 G: 1B | Women with FM from Spain. EG: n = 42; 52.52 ± 9.73 years. CG: n = 41; 52.47 ± 8.75 years. | FIQ EQ-5D-5L VAS | F: 2 s/w T: 1 hour D: 8 wks. I: NS Tr: VirtualEx-FM (exergame) | Warm-up: joint movements of the limbs; dance steps; posture control and ludic coordination, walk following an imaginary footprint track. | EG: improvement in the aspects of mobility, pain and discomfort, anxiety and depression on the EQ-5D-5L (p < .05). Improvement in the pain, stiffness, anxiety and wellness aspects of the FIQ (p < .01). |
| Assumpção et al., 2018 G: 1B | Women with FM from São Paulo (Brazil). EG1: n = 14; 47.9 ± 5.3 years. EG2: n = 16; 45.7 ± 7.7 years. CG: n = 14; 46.9 ± 6.5 years. | VAS FIQ SF-36 Algometry (Fischer) | F: 2 s/w T: 40 min D: 12 wks. EG1 I: Moderate discomfort Tr: Stretching EG2 I: (1-2 wks.) no weight; (3-12 wks.) +0.5 kg per wk. before RPE of 13. Tr: Muscle strength. | EG1: active stretching without assistance. At the beginning, 3 r of 30 seconds; from the fifth week onwards, 4 r; and after the ninth week, 5 r. EG2: dumbbells (upper body) and shin guards (lower body). Series of 8 r. | EG1: improvements in pain threshold (p < .01), FIQ total score (p = .04) and quality of life (p < .05). EG2: improvements in pain threshold (p = .01), number of sensitive spots (p = .03), FM symptoms (p = .01), and quality of life (p < .05). |
| Da Cunha-Ribeiro et al., 2018 G: 2A | Women with FM from São Paulo (Brazil). EG: n = 32; 47.8 ± 13.7 years. | 1RM: leg press and bench press. RPE (CR-10) VAS SF-MPQ POMS FS | F: 1 s/w T: NS D: 8 wks. (4 familiarisation) I: 1) STD: 60% 1RM. 2) SS: self-selected. 3) SS-VM: self-selected intensity. 4) SS-RPE: self-selected load until score 7 RPE is reached. Tr: Strength | Experimental sessions in a randomised crossover fashion: 1) STD: standardised prescription. 6 series of 10 r. 2) SS: fixed number of series and r. 6 series of 10 r. 3) SS-VM: with volume load (r x series x intensity) adapted for STD. 4) SS-RPE: free number of r until score 7 (very difficult) is reached in RPE. | The load was lower in SS, SS-VM, SS-RPE than in STD, considering that the perceived exertion and volume load were comparable between sessions. Increase in VAS scores at beginning (p < .01), and decrease after 48h, 72h and 96h (p < .01), remaining elevated compared to previous values. Increase in SF-MPQ values after all exercise sessions (p = .025), with gradual decrease over time, reaching baseline levels at 24h. There were no differences between sessions. |
| Wong et al., 2018 1A | Women with FM from Busan (Korea). EG: n = 17; 51 ± 2 years. CG: n = 14; 51 ± 2 years. | Autonomous heart modulation using heart rate variability (SA-2000E Medicore) VAS SART 1RM | F: 3 s/w T: 55 min D: 12 wks. I: 40-50% HRR Tr: Tai Chi | 10 min warm up, 40 min main part and 5 min cool-down. 10 forms of the classic Yang style. | Decrease in sympathetic balance (LnLF/LnHF), sympathetic tone (LnLF, nLF), pain and fatigue (p < .05). Increase in parasympathetic tone (LnHF, nHF), strength and flexibility compared to no change in the control group (p < .05). No change in HR and sleep quality. |
| Marín-Mejía et al., 2019 G: 2A | Women with FM in Colombia. EG: n = 18; 48.4 ± 10.1 years. CG: n = 19; 46.6 ± 6.7 years. | GPI SSS | F: 2 s/w T: 1 hour D: 12 wks. I: 45-75% HRmax; 0-6 RPE. Tr: Therapeutic dance | Cardiovascular stimulation, coordination and flexibility with different types of recreational dance. The strength stimuli were applied through a combination of muscle strengthening exercises. Adjustment of musical speed and motor patterns every 4 weeks. | Decrease in the number of painful spots (p < .01) and symptoms associated with FM (p < .01). |
| Silva et al., 2019 G: 1A | Women with FM from Santa Cruz (Brazil) EG: n = 30; 49.40 ± 8.30 years. CG: n = 30; 44.93 ± 10.30 years. | VAS 1RM FIQ SF-36 6MWT TUG | F: 2 s/w T: 40 min D: 12 wks., I: NS Tr: Sophrology | The patients lying on mats were guided by a physiotherapist through a series of phrases such as: “close your eyes”, “analyse your breathing and heartbeat to slow it down”, etc. Once in a relaxed state, they were asked to think about the negative aspects of their illness and try to see the positive aspects. At the end, they were guided back from the relaxation phase by a set of instructions. | CG: reduction of pain during the assessments (p < .05) and increased strength in the tested muscles (p < .05). EG: reduction in pain (p < .05). Differences with better 6MWT and SF-36 rates for CG only (p < .05). |
| Villafaina et al., 2019 G: 1B | Women with FM from Spain. EG: n = 22; 54.27 ± 9.29 years. CG: n = 15; 53.44 ± 9.47 years. | CST 10-SST 6MWT FIQ-r IPAQ | F: 2s/w T: 1 hour D: 24 wks. I: NS Tr: VirtualEx-FM (exergame) | 1) Warm-up: joint movements of the limbs; 2) Aerobic component: dance steps; 3) Postural control and ludic coordination; 4) Walk following an imaginary path with different types of steps. | Exergame: improved CST performance (p = .003) and the 6MWT (p = .003), with no difference found in the 10-SST. Fitness was maintained in the follow-up assessment (six months; p = .013), however, lower body strength and agility showed no residual effect (p > .05). |
| Izquierdo-Alventosa et al., 2020 G: 1A | Women with FM from Spain. EG: n = 16; 53.06 ± 8.4 years. CG: n = 16; 55.13 ± 7.35 years. | PCS HADS BDI-II PSS-10 CPAQ-FM Algometry (WAGNER Force Dial TM FDK20) FIQr-PF 6MWT 5STST | F: 2 s/w T: 1 hour D: 8 wks. I: Sessions 1-4 were run at 1-2 RPE; sessions 5-16 were set at 3-4 RPE of the CR-10 scale Tr: Strength. | Warm-up: walking at a slow pace and mobilising the main joint structures. Training: sessions 1-4: walking at a comfortable speed for 15 min, 10-exercise circuit for 25 min, and cool-down for 20 min. Sessions 5-16: perform as many r as possible in 1 min during the 10-station circuit exercises for 40 min, and cool-down for 10 min, r between 15 and 25. Load between 0.5 and 2 kg for the upper body, and between 1 and 3 kg for the lower body; a light elastic band and ball were also used. | EG: improvement in all variables studied post-intervention (p < .05). CG: showed no significant change in pain threshold, but rather worsened (p < .05). |
| Ernberg et al., 2016 G: 2A | Women with FM from Sweden *L. EG: n = 24; 57 ± 9 years. Healthy women CG: n = 27; 57 ± 9 years. | HADS SF-36 IEFS (Isobex Dynamometer) KEIS (Steve Strong Dynamometer) 6MWT Algometry (Somedic Sales AB) VAS RPE (Borg Scale 6-20) Vastus lateralis micro dialysis Blood cytokines | *PL | *PL Further intramuscular micro dialysis of the vastus lateralis was applied 220 min before and after training; including 20 min of dynamic muscle contraction exercises in micro dialysis. | EG and CG: dynamic contractions increased pain and fatigue (p < .01). Increased levels of IL-6 and IL-8 following dynamic contractions (p < .01). TNF-α levels were lower in the EG than in the CG in both sessions (p < .05). EG: reduction in pain intensity (p < .05); no change in fatigue and cytokine levels. CG: increase in TNF-α (p < .05), but no change in IL-1β levels. |
| Palstam et al., 2016 G: 2A | Women with FM from Gothenburg, Stockholm and Linköping (Sweden) *L. EG: n = 67; 51 ± 9.1 years. Secondary analysis | PDI VAS KEIS (Steve Strong Dynamometer) Grip strength (Grippit) LTPAI FABQ physical | *PL F: 2 s/w T: 60 min D: 15 wks. I: Initial load of 40% 1RM and progressively increased to 70-80% 1RM Tr: Based on Programme by Larsson et al., 2015 (*PL) | *PL Individualised programme: 10 min warm-up, followed by resistance exercises for legs, arms, hands and abdominal stability; ending with stretching. Explosive leg strength exercises were included in the 5th and 8th week. For load progression, they were evaluated every 3-4 wks. | Reduction in disability caused by pain compared to initial values (p = .006). Decrease in post-intervention pain intensity (p = .002). Increase in KEIS and the amount of physical activity (p < .01); as well as PDI and the domains of recreation, social activity and occupation (p = .001). |
| Ericsson et al., 2016 G: 2A | Women with FM from Sweden *L. EG: n = 67; 50.81 ± 9.05 years. CG: n = 63; 52.10 ± 9.78 years. | MFI-20 VAS PSQI PCS HADS LTPAI 6MWT | *PL | *PL | EG: greater improvement than CG on the physical fatigue subscale of the MFI-20 (p = .013). Sleep efficiency was the best predictor of change in the general fatigue subscale of the MFI-20 (p = .031). Participating in a strength programme (p = .01) and working few hours per week (p = .005) were independent predictors of change in physical fatigue. |
| Bjersing et al., 2017 G: 2A | Women with FM from Sweden *L. Total: n = 43; 51 (25 to 64) years. Lean: n = 18; 50 (25 to 63) years. Overweight: n = 17; 53 (34 to 64) years. Obesity: n = 8; 51 (25 to 63) years. | VAS MFI-20 KEIS IEFS Grip strength (Grippit) Blood Cytokines and leptin | *PL | *PL | The levels of free IGF-1 (p = .047), IGFBP3- (p = .025) and leptin (p = .008) decreased in lean women, but not in overweight or obese women. Lean women showed improvement in current pain (p = .039), general fatigue (p = .022) and IEFS (p = 017). Participants who were overweight or obese had improved IEFS (p = .049). |
| Ernberg et al., 2018 G: 2A | Women with FM from Sweden *L. EG: n = 125; 51.2 ± 9.4 years (EG1: n = 67; EG2: n = 58) Healthy women CG: n = 130; 48.2 ± 11.4 years. | VAS PDI SF-36 MFI FIQ HADS PCS IEFS KEIS Grip strength (Grippit) 6MWT Algometry (Somedic Sales AB) Blood cytokines | EG1 *PL | *PL | Baseline IL-2, IL-6, TNF-α, IP-10 and eotaxin values were higher in FM than in CG (p < .041); while those of IL-1β were lower (p < .001). Weak correlations between cytokine levels and clinical variables. After both interventions, IL-1ra increased (p = .004), while IL-1β only increased in the relaxation therapy group (p = .002). Changes in IFN-γ, IL-2, IL-4, IL-6, IL-8, and IL-17A correlated with changes in pain pressure thresholds. |
| Jablochkova et al., 2019 G: 2A | Women with FM from Sweden * L. EG: n = 75; 50.8 ± 9.6 years. (EG: n = 41; EG2: 34). Healthy women CG: n = 25; 47.6 ± 12.8 years. | Algometry VAS PCS HADS SF36-PSC SF36-MSC FIQ MFI | EG1*PL | EG1*PL | The brain neurotrophic factor level increased and the nerve growth factor decreased in women from the EG compared to CG participants (p < .01). Neither exercise nor relaxation interventions affected the levels of brain-derived neurotrophic factor or nerve growth factor. |
| Note. EG: Experimental group; CG: Control group; SD: Standard deviation; NA: Not applicable; NS: Not specified; FM: fibromyalgia; F: Frequency; T: time; D: Duration; I: Intensity; Tr: Training; RPE: Rate of Perceived Exertion; HR: heart rate; HRR: heart rate reserve; maxHR: maximum heart rate; s/w: sessions per week; r: repetitions; VAS: Visual Analogue Scale; FIQ: Fibromyalgia Impact Questionnaire; PSQI: Pittsburgh Sleep Quality Index; EQ-5D-5L: European Quality of life-5 Dimensions-5 Levels; 1RM: one repetition maximum; SF-MPQ: Short-Form McGill Pain Questionnaire; POMS: Profile of Mood States; FS: Feeling Scale; SSS: Symptom Severity Scale; GPI: Generalised Pain Index; SART: Sit-and-Reach Test; 6MWT: Six-minute Walk Test; TUG: Timed Up and Go; CST: Chair-stand Test; 10-SST: 10 Step Stair Test; FIQ-r: FIQ revised version; IPAQ: International Physical Activity Questionnaire; PCS: Pain Catastrophizing Scale; HADS: Hospital Anxiety and Depression Scale; BDI-II: Beck Depression Inventory-Second Edition; CPAQ-FM: Chronic Pain Acceptance Questionnaire; FIQr-PF: FIQR subscale “Physical Function”; 5STST: Five-Repetition Sit-to-Stand Test; IEFS: Isometric elbow flexion strength; TNF-α: Tumour necrosis factor alpha; IL-6: Interleukin-6; IL-8: Interleukin-8; IL-1β: Interleukin-1 Beta; PDI: Pain Disability Index; KEIS: Knee extension isometric strength; LTPAI: Leisure Time Physical Activity Instrument; FABQ physical: Fear Avoidance Beliefs Questionnaire physical subscale; MFI-20: Multidimensional Fatigue Inventory; IGFBP3: insulin-like growth factor binding protein 3; IGF-1: Insulin-like Growth Factor; IP-10: IFN-γ inducible protein 10; IFN-γ: Interferon gamma; IL-1ra: IL-1 receptor antagonist; SF-36: Short Form-36 Health Survey; SF36-PSC: SF-36 physical component; SF-36 mental component SF36-MSC; *L: Project by Larsson et al., 2015; *PL: Experimental protocol of the project by Larsson et al., 2015; *PLC: “Active control” protocol of the project by Larsson et al., 2015. | |||||
