線維筋痛症患者における運動の知覚と実体験:メタシンセシスとメタサマリーを伴う質的系統的レビュー
Matteo Cioeta1, Martina Sitzia2, Michele Marelli3
1Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy. matteocioeta@gmail.com.
Objective:
To systematically synthesize and summarize qualitative findings on how adults with fibromyalgia perceive, negotiate, and sustain exercise and everyday movement.
Design:
Systematic review of qualitative studies with meta-synthesis and meta-summary.
Literature Search:
We searched CINAHL, EMBASE, PsycINFO, MEDLINE, Scopus, SPORTDiscus, and Web of Science until October 2025, supplemented by berry-picking techniques and gray literature.
Study Selection Criteria:
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.
Data Synthesis:
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.
Results:
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.
Conclusion:
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.
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