Pool-based exercise for amelioration of pain in adults with fibromyalgia syndrome: A systematic review and meta-analysis

Abstract

Objective

To evaluate the effects of pool-based exercises on pain symptomatology among adults with fibromyalgia syndrome.

Methods

A systematic review and meta-analysis were carried out using PRISMA guidelines. Database search was conducted by two independent reviewers. For meta-analysis, the visual analogue scale (VAS) score for pain was used as the primary outcome and the Fibromyalgia Impact Questionnaire (FIQ) score was utilized as the secondary outcome.

Results

A total of 42 out of 292 potentially eligible studies were selected for being read in full by reviewers, 14 of which were included in meta-analysis, being 10 of them used in sensitivity analysis of either the primary or secondary outcome. Data pooled from 10 randomized controlled trials (n = 508) revealed that patients who underwent pool-based exercises exhibited a significantly lower mean in VAS score as compared to controls (SMD = −0.27, 95% CI: −0.45 to −0.09). Regarding FIQ scores, data from 10 randomized controlled trials were pooled (n = 578) and a lower mean score was also shown in the group that underwent a pool-based exercise program (SMD = −0.29, 95% CI: −0.49 to −0.09). Limitations of this study include the small sample size and moderate dropout rates in currently available clinical trials.

Conclusion

Pool-based exercise may provide some additional benefit for pain relief in adults with fibromyalgia as compared to either land-based or no physical exercise.

Implications of key findings

Collectively, these findings suggest that pool-based exercise deserves further attention as a potential adjuvant therapeutic option for adults with fibromyalgia. PROSPERO registration number: CRD42019136755.

Keywords:

• Fibromyalgia
• pain
• exercise therapy
• hydrotherapy

Conflict of interest

None.

Additional information

Funding

The authors thank the Foundation for Research and Scientific and Technological Development of Maranhão (FAPEMA, Brazil) for the financial support provided to P.C. Leal (grant 01350/17). The funding agency had no role in the study conception and design, collection and interpretation of data, writing of the manuscript, or approval of the final version to be published.