title: Exercise for adults with fibromyalgia: an umbrella systematic review with synthesis of best evidence.
abstract: The objective of this umbrella systematic review was to identify, evaluate, and synthesize systematic reviews of physical activity interventions for adults with fibromyalgia (FM) focussing on four outcomes: pain, multidimensional function (wellness or quality of life), physical function (self-reported physical function or measured physical fitness) and adverse effects. A further objective was to link these outcomes with details of the interventions so as to guide and shape future practice and research. Electronic databases including Medline, EMBASE, CINAHL, AMED, the Cochrane Library, and DARE, were searched for the January 1(st) 2007 to March 31(st) 2013 period. Nine systematic reviews (60 RCTs with 3816 participants) were included. Meta-analysis was not conducted due to the heterogeneity of the sample. We found positive results of diverse exercise interventions on pain, multidimensional function, and self-reported physical function, and no supporting evidence for new (to FM) interventions (i.e., qigong, tai chi). There were no serious adverse effects reported. The variability of the interventions in the reviews prevented us from answering important clinical questions to guide practical decisions about optimal modes or dosages (i.e., frequency, intensity, duration). Finally, the number of review articles is proliferating, leading researchers and reviewers to consider the rigor and quality of the information being reviewed. As well, consumers of these reviews (i.e., clinicians, individuals with FM) should not rely on them without careful consideration.
authors.forename: Julia
authors.initials: J
authors.lastname: Bidonde
authors.forename: Angela Jean
authors.initials: AJ
authors.lastname: Busch
authors.forename: Brenna
authors.initials: B
authors.lastname: Bath
authors.affiliation: School of Physical Therapy, 1121 College Drive, Saskatoon, SK S7N 0W3 Canada. angela.busch@usask.ca.
authors.forename: Stephan
authors.initials: S
authors.lastname: Milosavljevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005356:Fibromyalgia / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D011788:Quality of Life; D012196:Review Literature as Topic; D016896:Treatment Outcome; D055815:Young Adult