Optimal Dose of Aerobic Exercise Programs to Reduce Pain Intensity and Improve Health Status in Patients With Fibromyalgia: A Dose-Response Meta-Analysis

ABSTRACT Objective The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia. Data Sources Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024. Study Selection Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included. Data Extraction Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model. Data Synthesis Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = −0.67; 95% CI = −0.70 to −0.65) and a total duration of 600 min (SMD = −0.65; 95% CI = −0.69 to −0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = −1.14; 95% CI = −1.19 to −1.09) and 1200 min total duration (SMD = −1.08; 95%CI = −1.13 to −1.02). Additionally, a minimum dose of 65 min per week (SMD = −0.62; 95% CI = −0.6 to −0.69) and a total duration of 950 min (SMD = −0.61; 95% CI = −0.60 to −0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = −1.77; 95% CI = −1.89 to −1.65) and 3000 min of total duration (SMD = −1.43; 95% CI = −1.54 to −1.31). Conclusion These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia.