Review: aerobic exercise improves cardiovascular fitness and tender points in fibromyalgia.

QUESTION: In patients with fibromyalgia, is exercise training effective for improving symptoms such as physical function, pain, and tender points?Data sources:Studies were identified by searching Medline (1966-2000), CINAHL (1982-2000), EMBASE/Excerpta Medica (1974-2000), HealthSTAR (1990-2000), Sports Discus (1975-2000), the Cochrane Controlled Trials Register (2000, Issue 4), and reviewing bibliographies of relevant articles.Study selection:Studies published in any language were selected if they were randomised controlled trials (RCTs) comparing an intervention that included an exercise component with an untreated control or other non-exercise interventions and patients had a diagnosis of fibromyalgia based on published criteria.Data extraction:2 reviewers independently extracted data on sample size, details of the intervention, study quality, and outcomes. Main outcomes included pain, tender points, physical function, global wellbeing or perceived improvement, self efficacy, psychological function, fatigue, and sleep.Main results;16 RCTs that evaluated 23 exercise interventions for fibromyalgia met the selection criteria. Types of interventions included aerobic training, flexibility training, strength training, and mixed or composite training. 13 RCTs were of moderate to high methodological quality, and 8 met the American College of Sports Medicine training guidelines. 4 RCTs (also classified as high quality training studies) with similar interventions (cycle ergometry, aerobic dance, whole body aerobics, indoor walking) and similar outcome measures were included in the meta-analysis using a random effects model. The aerobic exercise group showed greater improvement than the control group for cardiovascular fitness (standardised mean difference [SMD] 0.79, 95% CI 0.37 to 1.21) and tender points (SMD 1.19, CI 0.64 to 1.75). The groups did not differ for pain (SMD 0.57, CI -1.20 to 0.06).Conclusion:In patients with fibromyalgia, aerobic exercise training is effective for improving cardiovascular fitness and tender points. [ABSTRACT FROM AUTHOR]