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BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis

Authors: George A Kelley, Kristi S Kelley, Jennifer M Hootman, Dina L Jones

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Exercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.

Methods

Studies were derived from six electronic sources, cross-referencing from retrieved studies and expert review. Dual selection of randomized controlled exercise training studies published between January 1, 1980 and January 1, 2008 and in which global well-being was assessed using the Fibromyalgia Impact Questionnaire (FIQ) were included. Dual abstraction of data for study, subject and exercise program characteristics as well as assessment of changes in global well-being using the total score from the FIQ was conducted. Risk of bias was assessed using the Cochrane bias assessment tool. Random-effects models and Hedge's standardized effect size (g) were used to pool results according to per-protocol and intention-to-treat analyses.

Results

Of 1,025 studies screened, 7 representing 5 per-protocol and 5 intention-to-treat outcomes in 473 (280 exercise, 193 control) primarily female (99%) participants 18-73 years of age were included. Small, statistically significant improvements in global well-being were observed for per-protocol (g and 95% confidence interval, -0.39, -0.69 to -0.08) and intention-to-treat (-0.34, -0.53 to -0.14) analyses. No statistically significant within-group heterogeneity was found (per-protocol, Qw = 6.04, p = 0.20, I 2 = 33.8%; intention-to-treat, Qw = 3.19, p = 0.53, I 2 = 0%) and no between-group differences for per-protocol and intention-to-treat outcomes were observed (Qb = 0.07, p = 0.80). Changes were equivalent to improvements of 8.2% for per-protocol analyses and 7.3% for intention-to-treat analyses.

Conclusions

The results of this study suggest that exercise improves global well-being in community-dwelling women with fibromyalgia. However, additional research on this topic is needed, including research in men as well as optimal exercise programs for improving global well-being in adults.
Appendix
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Literature
1.
2.
Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, et al: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008, 58: 26-35. 10.1002/art.23176.CrossRefPubMedPubMedCentral
3.
Berger A, Dukes E, Martin S, Edelsberg J, Oster G: Characteristics and healthcare costs of patients with fibromyalgia syndrome. Int J Clin Pract. 2007, 61: 1498-1508. 10.1111/j.1742-1241.2007.01480.x.CrossRefPubMedPubMedCentral
4.
White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, Robinson RL: Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. J Occup Environ Med. 2008, 50: 13-24. 10.1097/JOM.0b013e31815cff4b.CrossRefPubMed
5.
Schlenk EA, Erlen JA, Dunbar-Jacob J, McDowell J, Engberg S, Sereika SM, Rohay JM, Bernier MJ: Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36. Qual Life Res. 1998, 7: 57-65. 10.1023/A:1008836922089.CrossRefPubMed
6.
Laas K, Roine R, Rasanen P, Sintonen H, Leirisalo-Repo M: Health-related quality of life in patients with common rheumatic diseases referred to a university clinic. Rheumatol Int. 2009, 29: 267-273. 10.1007/s00296-008-0673-x.CrossRefPubMed
7.
Busch AJ, Schachter CL, Overend TJ, Peloso PM, Barber KA: Exercise for fibromyalgia: a systematic review. J Rheumatol. 2008, 35: 1130-1144.PubMed
8.
DaCosta D, Abrahamowicz M, Lowensteyn I, Bernatsky S, Dritsa M, Fitzcharles MA, Dobkin PL: A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia. Rheumatology (Oxford). 2005, 44: 1422-1427. 10.1093/rheumatology/kei032.CrossRef
9.
Gowans SE, deHueck A, Voss S, Silaj A, Abbey SE, Reynolds WJ: Effect of a randomized, controlled trial of exercise on mood and physical function in individuals with fibromyalgia. Arthritis Rheum. 2001, 45: 519-529. 10.1002/1529-0131(200112)45:6<519::AID-ART377>3.0.CO;2-3.CrossRefPubMed
10.
King SJ, Wessel J, Bhambhani Y, Sholter D, Maksymowych W: The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol. 2002, 29: 2620-2627.PubMed
11.
Kingsley JD, Panton LB, Toole T, Sirithienthad P, Mathis R, McMillan V: The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia. Arch Phys Med Rehabil. 2005, 86: 1713-1721. 10.1016/j.apmr.2005.04.014.CrossRefPubMed
12.
Munguia-Izquierdo D, Legaz-Arrese A: Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol. 2007, 25: 823-830.PubMed
13.
Schachter CL, Busch AJ, Peloso PM, Sheppard MS: Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther. 2003, 83: 340-358.PubMed
14.
Tomas-Carus P, Hakkinen A, Gusi N, Leal A, Hakkinen K, Ortega-Alonso A: Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc. 2007, 39: 1044-1050. 10.1249/01.mss.0b0138059aec4.CrossRefPubMed
15.
Buckelew SP, Conway R, Parker J, Deuser WE, Read J, Witty TE, Hewett JE, Minor M, Johnson JC, Van ML, et al: Biofeedback/relaxation training and exercise interventions for fibromyalgia: a prospective trial. Arthritis Rheum. 1998, 11: 196-209. 10.1002/art.1790110307.CrossRef
16.
Hakkinen A, Hakkinen K, Hannonen P, Alen M: Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia: comparison with healthy women. Ann Rheum Dis. 2001, 60: 21-26. 10.1136/ard.60.1.21.CrossRefPubMedPubMedCentral
17.
Valkeinen H, Alen M, Hannonen P, Hakkinen A, Airaksinen O, Hakkinen K: Changes in knee extension and flexion force, EMG and functional capacity during strength training in older females with fibromyalgia and healthy controls. Rheumatology (Oxford). 2004, 43: 225-228. 10.1093/rheumatology/keh027.CrossRef
18.
Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for shoulder pain. Phys Ther. 2001, 81: 1719-1730.
19.
Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole RM: Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001, 94: 149-158. 10.1016/S0304-3959(01)00349-9.CrossRefPubMed
20.
Puhan MA, Soesilo I, Guyatt GH, Schunemann HJ: Combining scores from different patient reported outcome measures in meta-analyses: when is it justified?. Health Qual Life Outcomes. 2006, 4: 94-10.1186/1477-7525-4-94.CrossRefPubMedPubMedCentral
21.
Nuesch E, Trelle S, Reichenbach S, Rutjes AW, Burgi E, Scherer M, Altman DG, Juni P: The effects of excluding patients from the analysis in randomised controlled trials: meta-epidemiological study. BMJ. 2009, 339: b3244-10.1136/bmj.b3244.CrossRefPubMedPubMedCentral
22.
Bennett R: The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol. 2005, 23: S154-S162.PubMed
23.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: Updated recommendation for Adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
24.
Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C: Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1435-1445. 10.1249/mss.0b013e3180616aa2.CrossRefPubMed
25.
Physical Activity Guidelines Advisory Committee: Physical Activity Guidelines Advisory Report. 2008, Washington, DC
26.
Sacks HS, Chalmers TC, Smith H: Randomized versus historical controls for clinical trials. Am J Med. 1982, 72: 233-240. 10.1016/0002-9343(82)90815-4.CrossRefPubMed
27.
Schulz KF, Chalmers I, Hayes R, Altman DG: Empirical evidence of bias: Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995, 273: 408-412. 10.1001/jama.273.5.408.CrossRefPubMed
28.
Cohen J: Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull. 1968, 70: 213-220. 10.1037/h0026256.CrossRefPubMed
29.
Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics. 1977, 33: 159-174. 10.2307/2529310.CrossRefPubMed
30.
Emerson JD, Burdick E, Hoaglin DC, Mosteller F, Chalmers TC: An empirical study of the possible relation of treatment differences to quality scores in controlled randomized clinical trials. Control Clin Trials. 1990, 11: 339-352. 10.1016/0197-2456(90)90175-2.CrossRefPubMed
31.
Juni P, Witschi A, Bloch R, Egger M: The hazards of scoring the quality of clinical trials for meta-analysis. JAMA. 1999, 282: 1054-1060. 10.1001/jama.282.11.1054.CrossRefPubMed
32.
33.
Hartling L, Ospina M, Liang Y, Dryden DM, Hooton N, Krebs SJ, Klassen TP: Risk of bias versus quality assessment of randomised controlled trials: cross sectional study. BMJ. 2009, 339: b4012-10.1136/bmj.b4012.CrossRefPubMedPubMedCentral
34.
Hedges LV, Olkin I: Statistical methods for meta-analysis. 1985, San Diego, CA: Academic Press
35.
Follmann D, Elliot P, Suh I, Cutler J: Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992, 45: 769-773. 10.1016/0895-4356(92)90054-Q.CrossRefPubMed
36.
37.
Higgins JPT, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. Br Med J. 2003, 327: 557-560. 10.1136/bmj.327.7414.557.CrossRef
38.
McGraw KO, Wong SP: A common language effect size statistic. Psychol Bull. 1992, 111: 361-365. 10.1037/0033-2909.111.2.361.CrossRef
39.
Duval S, Tweedie R: Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000, 56: 455-463. 10.1111/j.0006-341X.2000.00455.x.CrossRefPubMed
40.
Lau J, Schmid CH, Chalmers TC: Cumulative meta-analysis of clinical trials builds evidence for exemplary medical care: The Potsdam International Consultation on Meta-Analysis. J Clin Epidemiol. 1995, 48: 45-57. 10.1016/0895-4356(94)00106-Z.CrossRefPubMed
41.
SPSS: SPSS for Windows. (16.0). 2008, Chicago, IL, SPSS, Inc
42.
Biostat: Comprehensive meta-analysis (version 2.2). 2006, Englewood, New Jersey
43.
Linde K, Willich SN: How objective are systematic reviews? Differences between reviews on complementary medicine. J R Soc Med. 2003, 96: 17-22. 10.1258/jrsm.96.1.17.CrossRefPubMedPubMedCentral
44.
Bennett RM, Bushmakin AG, Cappelleri JC, Zlateva G, Sadosky AB: Minimal clinically important difference in the fibromyalgia impact questionnaire. J Rheumatol. 2009, 36: 1304-1311. 10.3899/jrheum.081090.CrossRefPubMed
45.
Pedersen BK, Saltin B: Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006, 16: 3-63. 10.1111/j.1600-0838.2006.00520.x.CrossRefPubMed
46.
Littell JH, Corcoran J, Pillai V: Systematic reviews and meta-analysis. 2008, New York: Oxford University PressCrossRef
47.
Borenstein M, Hedges LV, Higgins JPT, Rothstein HR: Introduction to Meta-Analysis. 2009, West Sussex: John Wiley & SonsCrossRef
Metadata
Title
Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis
Authors
George A Kelley
Kristi S Kelley
Jennifer M Hootman
Dina L Jones
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-198

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