Which exercise is most beneficial for treating women with fibromyalgia? A systematic review and network meta-analysis

Background: Therapeutic exercise is the only intervention with strong evidence for fibromyalgia, yet the most effective modality remains uncertain. Objective: To determine which modality of therapeutic exercise is the most effective in reducing the impact of fibromyalgia in women, as assessed by the...

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Detalles Bibliográficos
Autores: Rodríguez-Domínguez, Álvaro-José, Jiménez Rejano, José Jesús, Cardellat González, Melania, Rosales Tristancho, Abel, Arana-Rodríguez, Andrés, Rebollo Salas, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:dnet:idus________::b2765094c06169aecdcee467eccd63ac
Acceso en línea:https://hdl.handle.net/11441/186896
https://doi. org/10.1016/j.msksp.2026.103515
Access Level:acceso abierto
Palabra clave:Exercise therapy
Fibromyalgia
Fibromyalgia impact questionnaire
Pain
Descripción
Sumario:Background: Therapeutic exercise is the only intervention with strong evidence for fibromyalgia, yet the most effective modality remains uncertain. Objective: To determine which modality of therapeutic exercise is the most effective in reducing the impact of fibromyalgia in women, as assessed by the Fibromyalgia Impact Questionnaire (FIQ/FIQR). Design: Systematic review with a network meta-analysis of randomized controlled trials. Methods: A comprehensive search was performed in MEDLINE, Cochrane Library, Scopus, Web of Science, and CINAHL from inception to March 2025. Eligible randomized controlled trials involved therapeutic exercise in terventions reporting Fibromyalgia Impact Questionnaire outcomes. Data synthesis followed PRISMA-NMA guidelines, using a frequentist network meta-analysis to estimate effect sizes and clinically important differ ences in the short term (≤3 months) and long term (>3 months). Certainty of evidence was assessed with CINeMA. Results: Sixty-four studies were identified, of which 59 were included in the quantitative synthesis (n = 3256). Fourteen modalities of therapeutic exercise and seven comparison interventions (comparators) were identified. In the short term, Pilates, Aquatic Exercise, and Resistance Exercise ranked highest. In the long term, Dance and Mixed Exercise ranked highest. Certainty of evidence was mostly low to moderate (CINeMA), mainly limited by imprecision and heterogeneity. Conclusions: Pilates, Aquatic Exercise, and Resistance Exercise ranked highest in the short term, while Dance and Mixed Exercise ranked highest in the long term. However, findings should be interpreted with caution due to substantial heterogeneity and mostly low-to-moderate certainty of evidence