Fibromyalgia & musculoskeletal pain
Effectiveness of non-pharmacological interventions for fibromyalgia and quality of review methods: an overview of Cochrane Reviews
Authors' conclusion
There is low certainty evidence of clinically relevant reduction of mobility difficulties and of improvement of HRQoL among individuals with FMS by aerobic and mixed exercise training and by CBTs at the end of the intervention. There is low certainty evidence that CBTs and mixed exercise training reduces mobility difficulties post-treatment and that mixed exercise training improves HRQoL at follow-up by clinically meaningful scores.
Study context
- Population
- Adults with fibromyalgia syndrome; Cochrane reviews of RCTs of non-pharmacological interventions (CDSR 2022 Issue 3 and CDSR 2023 Issue 6)10 reviews
- Participants
- 11,917 adults181 trials
- Comparison
- Non-pharmacological interventions vs controls
- Primary endpoint
- Clinically relevant pain relief, improvement in HRQoL, acceptability, safety, and reduction of mobility difficulties as reported by participants (MCID 15%, SMD >0.2 or MD >0.5 on 0–10 scale)
Methodological detailsAMSTAR-2 quality assessment, no pooled analyses
- AMSTAR-2 quality assessment
- No pooled analyses
Primary result
As reported in the abstract
NNTB for minimal clinically important difference (MCID) of 15%
between 4 and 9
Further findings
Mobility difficulties and health-related quality of life (HRQoL) at follow-up · average follow up of 24 weeks
- NNTB for MCID of 15%
- from 5 to 11
- Low certainty evidence, clinically relevant, for mixed exercise and cognitive behavioural therapies (CBTs) for reducing mobility difficulties
- Low certainty evidence of clinically relevant positive effects of mixed exercise on HRQoL
Methodological quality of reviews (AMSTAR 2)
- Rated moderate
- 1
- Rated low
- 7
- Rated critically low
- 2
Acceptability (dropouts for any reason)
- Dropout rate did not differ across interventions or controls, except biofeedback and movement therapies (very low to moderate certainty)
Safety
- Reporting of adverse events inconsistent in the studies analysed (very low certainty evidence)
Original publication
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