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Meta-Analysis
. 2025 Feb;29(2):e4783.
doi: 10.1002/ejp.4783.

Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis

David Casanova-Rodríguez  1   2   3 , Antonio Ranchal-Sánchez  1   4 , Rodrigo Bertoletti Rodríguez  2   5 , Jose Manuel Jurado-Castro  4   6   7
Affiliations
Meta-Analysis

Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis

David Casanova-Rodríguez et al. Eur J Pain. 2025 Feb.

Erratum in

Abstract

Background and objective: Fibromyalgia is a condition characterised by disabling levels of pain of varying intensity. Aerobic exercise may play a role in reducing pain in these patients. The aim of this review is to assess the dose of aerobic exercise needed, based on the frequency, intensity, type, time, volume and progression (FITT-VP) model, to obtain clinically relevant reductions in pain.

Databases and data treatment: A systematic review and meta-analysis of randomised clinical trials was conducted in the Web of Science (WoS), PEDro, PubMed and Scopus databases, the search having been conducted between July and October of 2023. Risk of bias was assessed with the Cochrane Risk of Bias assessment tool 2.

Results: Seventeen studies were included. The risk of bias varied, with six studies showing low risk; five, some concerns; and six, high risk. Aerobic exercise interventions were analysed using the FITT-VP model. Frequency ranged from 1 to 10 times per week, intensity varied from light to vigorous, and the types of exercise included music-based exercise, interval training, pool-based exercise, stationary cycling, swimming and walking. The intervention durations ranged from 3 to 24 weeks, with session lengths ranging from 10 to 45 min. Most of the studies presented significant differences, favouring aerobic exercise (MD -0.49; CI [-0.90, -0.08; p = 0.02]), with moderate to low heterogeneity in subgroup analyses.

Conclusions: The study findings underscore the efficacy of aerobic exercise in alleviating pain among fibromyalgia patients, advocating for tailored exercise dosing to optimise adherence and outcomes.

Significance statement: Individuals with fibromyalgia should engage in aerobic exercises two to three times weekly, for twenty-five to forty minutes in each session, aiming for more than a hundred minutes per week. They should start at low intensity, gradually increasing to higher intensities over six to twelve weeks, for optimal pain management. Exercise types should be selected in collaboration with the patient and based on personal preferences and accessibility, such as walking, and swimming, to ensure long-term adherence to the regimen.

Keywords: chronic pain; endurance training; exercise therapy; fibromyalgia; pain intensity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Prisma flow chart.
FIGURE 2
FIGURE 2
Aerobic exercise versus comparation. A minus sign signifies an effect in favour of the aerobic intervention.
FIGURE 3
FIGURE 3
Pre/Post comparison of the frequency domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 4
FIGURE 4
Pre/Post comparison of the intensity domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 5
FIGURE 5
Pre/Post comparison of the type domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 6
FIGURE 6
Pre/Post comparison of the time domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 7
FIGURE 7
Pre/Post comparison of the daily volume domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 8
FIGURE 8
Pre/Post comparison of the weekly volume domain. A positive sign signifies an effect of favour of post intervention.
FIGURE 9
FIGURE 9
Pre/Post comparison of the progression domain. A positive sign signifies an effect of favour of post intervention.
See this image and copyright information in PMC

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