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Efficacy of different types of aerobic exercise in fibromyalgia syndrome a systematic review and meta-analysis of randomised controlled trials.doc

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Efficacy of different types of aerobic exercise in fibromyalgia syndrome a systematic review and meta-analysis of randomised controlled trials

H?user et al. Arthritis Research Therapy 2010, 12:R79 /content/12/3/R79 RESEARCH ARTICLE Open Access Efficacy of different types of aerobic exercise in Research article fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials Winfried H?user*1,2, Petra Klose3, Jost Langhorst3, Babak Moradi4, Mario Steinbach4, Marcus Schiltenwolf4 and Angela Busch5 Abstract Introduction: The efficacy and the optimal type and volume of aerobic exercise (AE) in fibromyalgia syndrome (FMS) are not established. We therefore assessed the efficacy of different types and volumes of AE in FMS. Methods: The Cochrane Library, EMBASE, MEDLINE, PsychInfo and SPORTDISCUS (through April 2009) and the reference sections of original studies and systematic reviews on AE in FMS were systematically reviewed. Randomised controlled trials (RCTs) of AE compared with controls (treatment as usual, attention placebo, active therapy) and head- to-head comparisons of different types of AE were included. Two authors independently extracted articles using predefined data fields, including study quality indicators. Results: Twenty-eight RCTs comparing AE with controls and seven RCTs comparing different types of AE with a total of 2,494 patients were reviewed. Effects were summarised using standardised mean differences (95% confidence intervals) by random effect models. AE reduced pain (-0.31 (-0.46, -0.17); P 0.001), fatigue (-0.22 (-0.38, -0.05); P = 0.009), depressed mood (-0.32 (-0.53, -0.12); P = 0.002) and limitations of health-related quality of life (HRQOL) (-0.40 (- 0.60, -0.20); P 0.001), and improved physical fitness (0.65 (0.38, 0.95); P 0.001), post treatment. Pain was significantly reduced post treatment by land-based and water-based AE, exercises with slight to moderate intensity and frequency of two or three times per week. Positive effects on depressed mood, HRQOL and physical fitness could be maintained at follow-up. Continuing exercise wa