Flexibility exercise training for adults with fibromyalgia.

Area of Science:

• Rheumatology
• Exercise Science
• Evidence-Based Medicine

Background:

• Exercise training is a common recommendation for managing fibromyalgia.
• Flexibility exercise involves moving joints through a complete range of motion.
• This review updates previous findings on flexibility training for fibromyalgia.

Purpose of the Study:

• To evaluate the benefits and harms of flexibility exercise training in adults diagnosed with fibromyalgia.
• To assess the impact on health-related quality of life, pain, stiffness, fatigue, and physical function.
• To determine the incidence of trial withdrawals and adverse events associated with flexibility training.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) including adults with fibromyalgia.
• Searched multiple databases (Cochrane Library, MEDLINE, Embase, etc.) up to December 2017.
• Assessed risk of bias and certainty of evidence using the GRADE approach.

Main Results:

• 12 RCTs (743 participants) were included, comparing flexibility training to various interventions, including aerobic training.
• Very low-certainty evidence suggests flexibility training provides no clinically important benefits over aerobic training for quality of life, pain, fatigue, stiffness, or physical function.
• Low-certainty evidence indicates no significant difference in withdrawals between flexibility and aerobic training groups; adverse event data is scarce.

Conclusions:

• The certainty of evidence is very low, making it uncertain whether flexibility exercise improves key outcomes in fibromyalgia compared to aerobic training.
• Flexibility exercise training may result in minimal differences in all-cause withdrawals.
• The safety and long-term effects of flexibility exercise training for fibromyalgia remain uncertain due to limited and low-certainty evidence.