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
Fecha de publicación:2026
País:España
Institución:Universidad de Huelva (UHU)
Repositorio:Arias Montano. Repositorio Institucional de la Universidad de Huelva
Idioma:inglés
OAI Identifier:oai:dnet:ariasmontano::ea7c778db0e39c7f3b3a668893c27b49
Acceso en línea:https://hdl.handle.net/10272/28131
Access Level:acceso abierto
Palabra clave:Exercise therapy
Fibromyalgia
Fibromyalgia impact questionnaire
Pain
32 Ciencias Médicas
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 interventions reporting Fibromyalgia Impact Questionnaire outcomes. Data synthesis followed PRISMA-NMA guidelines, using a frequentist network meta-analysis to estimate effect sizes and clinically important differences 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.