Effect of Physical Activity on Chronic Widespread Pain: Insights From Meta-Analysis and Two-Sample Mendelian Randomization
Bibliographic record
Abstract
Chongjie Yao,1– 3,* Yuchen Zhang,2,3,* Sizheng Steven Zhao,4 Jun Ren,3 Pingping Sun,5 Lingjun Kong,3 Jiming Tao,3 Jingxian Li,6 Min Fang,3,7 Qingguang Zhu1,7 1Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China; 2School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China; 3Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China; 4Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biological Medicine and Health, the University of Manchester, Manchester, UK; 5School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China; 6School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, K1N 6N5, Canada; 7Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qingguang Zhu; Min Fang, Email zhuqingguang@126.com; fm-tn0510@shutcm.edu.cnBackground: Chronic widespread pain (CWP) is a core symptom of fibromyalgia that is associated with significant morbidity and mortality. Despite the widespread recommendation for physical activity (PA) in management, the heterogeneity of PA prescriptions limits the in-depth evaluation of its efficacy. By triangulating clinical interventional evidence with human genetic evidence, the aim of this study was to investigate the role of influencing factors such as PA mode, course of treatment, and intensity on PA in the prevention and treatment of CWP.Methods: Ten international and regional databases were searched for articles published between January 2014 and July 2024. Randomized control trials with CWP or fibromyalgia as an entry criterion and PA as an intervention were included. Meta-analyses were performed using fixed- or random-effects models based on heterogeneity, and subgroup analyses were conducted. Mendelian randomization (MR) was used to estimate the effects of the genetic variants linked to PA intensity on CWP risk.Results: The analysis included 11 studies with 540 participants. PA effectively improved pain perception (MD: − 1.47; 95% CI: − 2.23, − 0.72), depression (MD: − 4.77; 95% CI: − 7.40, − 2.14), and overall quality of life (SMD: − 1.43; 95% CI: − 2.16, − 0.69). MR analysis revealed that several PA intensities were associated with reduced susceptibility to CWP: walking for pleasure (OR: 0.950; 95% CI: 0.934– 0.966), light do-it-yourself (DIY) (OR: 0.976; 95% CI: 0.961– 0.992), strenuous sports (OR: 0.923; 95% CI: 0.880– 0.967), and other exercises (OR: 0.957; 95% CI: 0.942– 0.973).Conclusion: PA interventions are beneficial for reducing pain perception and mood disorders and enhancing the quality of life of patients with CWP. A treatment course of approximately three months is preferable, with Ba-Duan-Jin potentially more effective than other PAs, and high-intensity PA offers the most significant protective effect against CWP.Keywords: chronic widespread pain, fibromyalgia, physical activity, exercise
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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 | 0.063 | 0.120 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.015 | 0.032 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
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".