Evidence Summary (Updated 2022)
A Cochrane review identified a significant improvement in fatigue in those with fibromyalgia undertaking resistance exercise interventions (1). Their meta-analysis of two RCTs demonstrated a large improvement in the intervention group, with the Mean Difference -14.66 on a 0-100 scale (-20.55 to -8.77).
A review of over 1000 participants found that exercise compared to usual care was effective in reducing fatigue (pooled SMD -0.47; 95%CI -0.67 to -0.27, I2=51%) and also had a small positive effect on improved sleep quality (2). Strength training interventions in females with fibromyalgia improved sleep quality but the evidence was overall of low quality (3).
Quality of Evidence
Grade B – moderate quality
Strength of recommendation
Grade 1 – strong recommendation
Conclusion
Regular physical activity that includes a degree of resistance exercise is likely to improve fatigue in those with chronic musculoskeletal pain. There is no evidence to suggest that regular physical activity has a negative impact on fatigue in this population
References
1. Busch AJ, Barber KAR, Overend TJ, Peloso PMJ, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev [Internet]. 2007 [cited 2022 Aug 24];(4). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003786.pub2/full
2. Estévez-López F, Maestre-Cascales C, Russell D, Álvarez-Gallardo IC, Rodriguez-Ayllon M, Hughes CM, et al. Effectiveness of Exercise on Fatigue and Sleep Quality in Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Trials. Arch Phys Med Rehabil [Internet]. 2021 Apr 1 [cited 2022 Jul 8];102(4):752–61. Available from: https://pubmed.ncbi.nlm.nih.gov/32721388/
3. Andrade A, de Azevedo Klumb Steffens R, Sieczkowska SM, Peyré Tartaruga LA, Torres Vilarino G. A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations. Adv Rheumatol (London, England) [Internet]. 2018 Oct 22 [cited 2022 Jul 11];58(1):36. Available from: https://pubmed.ncbi.nlm.nih.gov/30657077/