Perception and lived experience of movement in patients with fibromyalgia: a qualitative systematic review with...

To systematically synthesize and summarize qualitative findings on how adults with fibromyalgia perceive, negotiate, and sustain exercise and everyday movement.

Systematic review of qualitative studies with meta-synthesis and meta-summary.

We searched CINAHL, EMBASE, PsycINFO, MEDLINE, Scopus, SPORTDiscus, and Web of Science until October 2025, supplemented by berry-picking techniques and gray literature.

We included qualitative primary studies or mixed-methods studies that clearly reported qualitative data; involved adults (≥ 18 years) with fibromyalgia; and explored experiences of movement, physical activity, or exercise.

Sandelowski and Barroso's methodology was used for study classification, meta-synthesis, and meta-summary. Methodological quality was appraised with Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool. The Confidence in the Evidence from Reviews of Qualitative Research approach evaluated certainty.

Thirteen studies (N = 213, 204 women; 19-82 years) were included. Four hundred thirty-two statements were extracted, synthesized into 15 categories, and grouped into four themes: (1) past experiences of movement; (2) movement during daily life: strategies, adaptations, and effects; (3) barriers to movement: personal, environmental, and relational; (4) facilitators to movement: peer support, empathic relationships, and f guide. Inter-study frequency effect sizes were highest for "Positive effects" (77%) and "Altered body perception" (69%) and lowest for "Standardized, not personalized plan" (31%). Overall confidence in the findings was moderate.

For individuals with fibromyalgia, movement is experienced as both beneficial and risky. Patient-centered rehabilitation could validate pacing, formalize existing self-management strategies, and offer tailored, supported pathways to sustainable activity.