Optimal Dose of Aerobic Exercise Programs to Reduce Pain Intensity and Improve Health Status in Patients With Fibromyalgia: A Dose-Response Meta-Analysis

Abstract

Objective: The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia.

Data sources: Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024.

Study selection: Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included.

Data extraction: Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model.

Data synthesis: Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = -0.67; 95% CI = -0.70 to -0.65) and a total duration of 600 min (SMD = -0.65; 95% CI = -0.69 to -0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = -1.14; 95% CI = -1.19 to -1.09) and 1200 min total duration (SMD = -1.08; 95%CI = -1.13 to -1.02). Additionally, a minimum dose of 65 min per week (SMD = -0.62; 95% CI = -0.6 to -0.69) and a total duration of 950 min (SMD = -0.61; 95% CI = -0.60 to -0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = -1.77; 95% CI = -1.89 to -1.65) and 3000 min of total duration (SMD = -1.43; 95% CI = -1.54 to -1.31).

Conclusion: These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia.

Keywords: Chronic Pain; Dose-Response Relationship; Exercise; Fibromiositis; Muscular Rheumatism; Physical Activity.