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Cited by 333Fibromyalgia and Chronic Fatigue Syndrome ResearchMusculoskeletal pain and rehabilitationMyofascial pain diagnosis and treatment

Resistance exercise training for fibromyalgia

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Busch, Angela J, Webber, Sandra C, Richards, Rachel S, Bidonde, Julia, Schachter, Candice L, Schafer, Laurel A, Danyliw, Adrienne, Sawant, Anuradha +3 more·2013·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd010884PMC PMC6544808
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Abstract

BACKGROUND: Fibromyalgia is characterized by chronic widespread pain that leads to reduced physical function. Exercise training is commonly recommended as a treatment for management of symptoms. We examined the literature on resistance training for individuals with fibromyalgia. Resistance training is exercise performed against a progressive resistance with the intention of improving muscle strength, muscle endurance, muscle power, or a combination of these. OBJECTIVES: To evaluate the benefits and harms of resistance exercise training in adults with fibromyalgia. We compared resistance training versus control and versus other types of exercise training. SEARCH METHODS: We searched nine electronic databases (The Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, Current Controlled Trials, World Health Organization (WHO) International Clinical Trials Registry Platform, AMED) and other sources for published full-text articles. The date of the last search was 5 March 2013. Two review authors independently screened 1856 citations, 766 abstracts and 156 full-text articles. We included five studies that met our inclusion criteria. SELECTION CRITERIA: Selection criteria included: a) randomized clinical trial, b) diagnosis of fibromyalgia based on published criteria, c) adult sample, d) full-text publication, and e) inclusion of between-group data comparing resistance training versus a control or other physical activity intervention. DATA COLLECTION AND ANALYSIS: Pairs of review authors independently assessed risk of bias and extracted intervention and outcome data. We resolved disagreements between the two review authors and questions regarding interpretation of study methods by discussion within the pairs or when necessary the issue was taken to the full team of 11 members. We extracted 21 outcomes of which seven were designated as major outcomes: multidimensional function, self reported physical function, pain, tenderness, muscle strength, attrition rates, and adverse effects. We evaluated benefits and harms of the interventions using standardized mean differences (SMD) or mean differences (MD) or risk ratios or Peto odds ratios and 95% confidence intervals (CI). Where two or more studies provided data for an outcome, we carried out a meta-analysis. MAIN RESULTS: The literature search yielded 1865 citations with five studies meeting the selection criteria. One of the studies that had three arms contributed data for two comparisons. In the included studies, there were 219 women participants with fibromyalgia, 95 of whom were assigned to resistance training programs. Three randomized trials compared 16 to 21 weeks of moderate- to high-intensity resistance training versus a control group. Two studies compared eight weeks of progressive resistance training (intensity as tolerated) using free weights or body weight resistance exercise versus aerobic training (ie, progressive treadmill walking, indoor and outdoor walking), and one study compared 12 weeks of low-intensity resistance training using hand weights (1 to 3 lbs (0.45 to 1.36 kg)) and elastic tubing versus flexibility exercise (static stretches to major muscle groups).Statistically significant differences (MD; 95% CI) favoring the resistance training interventions over control group(s) were found in multidimensional function (Fibromyalgia Impact Questionnaire (FIQ) total decreased 16.75 units on a 100-point scale; 95% CI -23.31 to -10.19), self reported physical function (-6.29 units on a 100-point scale; 95% CI -10.45 to -2.13), pain (-3.3 cm on a 10-cm scale; 95% CI -6.35 to -0.26), tenderness (-1.84 out of 18 tender points; 95% CI -2.6 to -1.08), and muscle strength (27.32 kg force on bilateral concentric leg extension; 95% CI 18.28 to 36.36).Differences between the resistance training group(s) and the aerobic training groups were not statistically significant for multidimensional function (5.48 on a 100-point scale; 95% CI -0.92 to 11.88), self reported physical function (-1.48 units on a 100-point scale; 95% CI -6.69 to 3.74) or tenderness (SMD -0.13; 95% CI -0.55 to 0.30). There was a statistically significant reduction in pain (0.99 cm on a 10-cm scale; 95% CI 0.31 to 1.67) favoring the aerobic groups.Statistically significant differences were found between a resistance training group and a flexibility group favoring the resistance training group for multidimensional function (-6.49 FIQ units on a 100-point scale; 95% CI -12.57 to -0.41) and pain (-0.88 cm on a 10-cm scale; 95% CI -1.57 to -0.19), but not for tenderness (-0.46 out of 18 tender points; 95% CI -1.56 to 0.64) or strength (4.77 foot pounds torque on concentric knee extension; 95% CI -2.40 to 11.94). This evidence was classified low quality due to the low number of studies and risk of bias assessment. There were no statistically significant differences in attrition rates between the interventions. In general, adverse effects were poorly recorded, but no serious advers

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  • Only five included reviews enforced a minimum intervention period to reduce risk of bias and allow attribution of effects to the intervention.

    “Only five reviews enforced a minimum intervention period to reduce risk of bias, and were able to attribute any effects to the intervention (Brown 2010;Busch 2013;Gross 2015a;Hurkmans 2009;Silva 2010).”

    From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Busch 2013

  • Physical activity and exercise programmes are increasingly promoted and offered in healthcare systems for various chronic pain conditions.

    “Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions.”

    From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Busch 2013

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Research works printed but not linked: 6

  1. Bailey 1999 {published data only} Bailey A, Starr L, Alderson M, Moreland J. A comparative evaluation of a fibromyalgia rehabilitation program. Arthritis Care & Research 1999;12(5):336-40.
  2. Kendall 2000 {published data only} Kendall SA, Brolin MK, Soren B, Gerdle B, Henriksson KG. A pilot study of body awareness programs in the treatment of fibromyalgia syndrome. Arthritis Care and Research 2000;13:304-11.
  3. Oncel 1994 {published data only} Oncel A, Eskiyurt N, Leylabadi M. The results obtained by different therapeutic measures in the treatment of generalized fibromyalgia syndrome. Tip Fakultesi Mecmuasi 1994;57(4):45-9.
  4. Winkelmann A, Hauser W, Friedel E, Moog-Egan M, Seeger D, Settan M, et al. Physiotherapy and physical therapies for fibromyalgia syndrome: systematic review, meta-analysis and guideline [in German]. Schmerz 2012;26 (3):276-86.
  5. Yuruk OB, Gultekin Z. Comparison of two different exercise programs in women with fibromyalgia syndrome [in Turkish]. Fizyoterapi Rehabilitasyon 2008;19(1):15-23. References to other published versions of this review Busch 2001
  6. Busch AJ, Schachter CL, Peloso P, Bombardier C. Exercise for treating fibromyalgia syndrome. Cochrane Database of Systematic Reviews 2002, Issue 3. DOI: 10.1002/ 14651858.CD003786 Busch 2007 · DOI

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Authors
Busch, A. J., Webber, S. C., Richards, R. S., Bidonde, J., Schachter, C. L., Schafer, L. A., Danyliw, A., Sawant, A., Dal Bello-Haas, V., Rader, T., & Overend, T. J.
Affiliations
  • University of Saskatchewan (CA)
  • University of Manitoba (CA)
  • 3355 Robinson Rd North Vancouver BC Canada V7J 3P7
  • 637 Lisa Court Windsor ON Canada N9G 2N1
  • Central Avenue Physiotherapy; 302 Central Ave. N Swift Current SK Canada S9H 0L4
  • 218 Buckwold Cove Saskatoon SK Canada S7N 4V9
  • London Health Sciences Centre (CA)
  • McMaster University; School of Rehabilitation Science; 1400 Main Street West, 403/E Hamilton ON Canada L8S 1C7
  • University of Ottawa (CA)
  • Western University (CA)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2013-12-20
Volume
2014
Issue
7
Pages
CD010884-CD010884
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd010884
PMC
PMC6544808
OpenAlex
W1582349367
Cited by
333
References
251
Citations by year
2026: 12 · 2025: 17 · 2024: 36 · 2023: 27 · 2022: 40 · 2021: 29 · 2020: 35 · 2019: 31 · 2018: 24 · 2017: 29 · 2016: 28 · 2015: 17 · 2014: 8
FWCI
2.41
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
Keywords
fibromyalgia, resistance training, progressive resistance training, chronic widespread pain, physical function, muscle strength, pain, tenderness, attrition, adverse effects, exercise therapy, women, low back pain, neck pain, knee osteoarthritis
MeSH terms
Adult, Female, Fibromyalgia, Humans, Exercise, Randomized Controlled Trials as Topic, Resistance Training

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