To meta-analyse the prevalence and predictors of dropout rates among adults with fibromyalgia participating in exercise randomized controlled trials (RCTs).
Two authors searched Embase, CINAHL, PsycARTICLES, and Medline up to 01/21/2023.
We included RCTs of exercise interventions in people with fibromyalgia that reported dropout rates.
Dropout rates from exercise and control conditions and exerciser/participant, provider, and design/implementation related predictors.
A random effects meta-analysis and meta-regression were conducted. In total 89 RCTs involving 122 exercise arms in 3.702 people with fibromyalgia were included. The trim-and-fill-adjusted prevalence of dropout across all RCTs was 19.2% (95%CI=16.9%-21.8%), which is comparable to the dropout observed in control conditions with the trim-and-fill-adjusted odds ratio being 0.31 (95%CI = 0.92 to 1.86, P=0.44). Body mass index (R²=0.16, P=0.03) and higher impact of illness (R²=0.20, P=0.02) predicted higher dropout. The lowest dropout was observed in exergaming, compared to other exercise types (P=0.014), and in lower-intensity exercises, compared with high intensity exercise (P=0.03). No differences in dropout were observed for the frequency or duration of the exercise intervention. Continuous supervision by an exercise expert (e.g., physiotherapist) resulted in the lowest dropout rates (P<0.001).
Exercise dropout in RCTs is comparable to control conditions, suggesting that exercise is a feasible and accepted treatment modality; however, interventions are ideally supervised by an expert (e.g., physiotherapist) to minimize the risk of dropout. Experts should consider a high BMI and the impact of the illness as risk factors for dropout.
Copyright © 2023. Published by Elsevier Inc.
