Exercise for treating fibromyalgia syndrome
Bibliographic record
Abstract
BACKGROUND: Fibromyalgia (FMS) is a syndrome expressed by chronic widespread body pain which leads to reduced physical function and frequent use of health care services. Exercise training is commonly recommended as a treatment. OBJECTIVES: The objective of this systematic review was to examine the efficacy of exercise training as an treatment for FMS. SEARCH STRATEGY: We searched 6 electronic bibliographies for studies of exercise training in FMS: MEDLINE (1966-12/2000), CINAHL (1982-12/2000), HealthSTAR (1990-12/2000), Sports Discus (1975-05/2000), EMBASE (1974-05/2000) and the Cochrane Controlled Trials Register (2000, issue 4). We also reviewed the reference lists from identified articles including reviews and meta-analyses of treatment studies. SELECTION CRITERIA: Randomized trials focused on cardiorespiratory endurance, muscle strength and/or flexibility as treatment for FMS were selected. DATA COLLECTION AND ANALYSIS: Two reviewers independently identified trials meeting inclusion criteria, rated the methodologic quality using 2 standardized validated instruments, evaluated the adequacy of the exercise training stimulus using the American College of Sports Medicine (ACSM) criteria and evaluated the results. Disagreements were resolved through active discussion and consensus. High quality training studies had scores of 50% or greater on van Tulder methodologic criteria and met the minimum training standards of ACSM. Outcome variables were grouped into 7 constructs: pain, tender points, physical function, global well being, self efficacy, fatigue & sleep, and psychological function. Two reviewers independently extracted data on study characteristics, results and point estimates for selected variables, and used consensus to address discrepancies. MAIN RESULTS: Sixteen trials involving a total of 724 participants were assigned at random to: exercise intervention groups (n=379), control groups (n=277), or groups receiving an alternate treatment (n=68). Seven studies were high quality training studies: 4 aerobic training, 1 a mixture of aerobic, strength and flexibility training, 1 strength training and 2 with exercise training as part of a composite treatment. Flexibility protocols were never described in sufficient detail to allow evaluation. The four high quality aerobic training studies reported significantly greater improvements in the exercise groups versus control groups in aerobic performance (17.1% increase in aerobic performance with exercise versus 0.5% increase in the control groups), tender point pain pressure threshold (28.1% increase versus 7.0% decrease) and improvements in pain (11.4% decrease in pain versus 1.6% increase). Poor description of exercise protocols was common, with insufficient information on intensity, duration, frequency and mode of exercise. Adverse events were also poorly reported. REVIEWER'S CONCLUSIONS: Supervised aerobic exercise training has beneficial effects on physical capacity and FMS symptoms. Strength training may also have benefits on some FMS symptoms. Further studies on muscle strengthening and flexibility are needed. Research on the long-term benefit of exercise for FMS is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".