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. 2011:2011:125485.
doi: 10.1155/2011/125485. Epub 2011 Oct 9.

Efficacy and effectiveness of exercise on tender points in adults with fibromyalgia: a meta-analysis of randomized controlled trials

George A Kelley  1 , Kristi S Kelley, Dina L Jones
Affiliations

Efficacy and effectiveness of exercise on tender points in adults with fibromyalgia: a meta-analysis of randomized controlled trials

George A Kelley et al. Arthritis. 2011.

Abstract

Fibromyalgia is a major public health problem affecting an estimated 200 to 400 million people worldwide. The purpose of this study was to use the meta-analytic approach to determine the efficacy and effectiveness of randomized controlled exercise intervention trials (aerobic, strength training, or both) on tender points (TPs) in adults with fibromyalgia. Using random effects models and 95% confidence intervals (CI), a statistically significant reduction in TPs was observed based on per-protocol analyses (8 studies representing 322 participants) but not intention-to-treat analyses (5 studies representing 338 participants) (per-protocol, g, -0.68, 95% CI, -1.16, -0.20; intention-to-treat, g, -0.24, 95% CI, -0.62, 0.15). Changes were equivalent to relative reductions of 10.9% and 6.9%, respectively, for per-protocol and intention-to-treat analyses. It was concluded that exercise is efficacious for reducing TPs in women with FM. However, a need exists for additional well-designed and reported studies on this topic.

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Figures

Figure 1
Figure 1
Flow diagram for the selection of studies. Stepwise procedures used for the selection of tender point studies. Note that RCT means randomized controlled trial.
Figure 2
Figure 2
Risk of bias assessment. Percentage of studies classified as having a low, high, or unclear risk of bias for the seven listed categories. Note that TP means tender points.
Figure 3
Figure 3
Forest plot for changes in tender points according to per-protocol analysis. The black squares represent the standardized mean difference (Hedge's g), while the left and right extremes of the squares represent the corresponding 95% confidence intervals. The middle of the black diamond represents the overall standardized mean difference (Hedge's g), while the left and right extremes of the diamond represent the corresponding 95% confidence intervals.
Figure 4
Figure 4
Forest plot for changes in tender points according to intention-to-treat analysis. The black squares represent the standardized mean difference (Hedge's g), while the left and right extremes of the squares represent the corresponding 95% confidence intervals. The middle of the black diamond represents the overall standardized mean difference (Hedge's g), while the left and right extremes of the diamond represent the corresponding 95% confidence intervals.
See this image and copyright information in PMC

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