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Authors of a recent systemic review outlined practical recommendations for tailoring home-based exercise protocols for fibromyalgia.

Home-based exercise programs have been investigated to facilitate access to physical exercise programs and active lifestyles across different conditions and populations. However, evidence is limited for patients with rheumatic diseases, especially fibromyalgia.

This led Loiane Cristina de Souza and colleagues to conduct a systematic review to analyze interventions with home-based physical exercise for patients with fibromyalgia. The research was published in Disability and Rehabilitation.

They identified seven studies for the review, which included 491 women diagnosed with fibromyalgia. The analysis showed that aerobic exercise was the most common home-based modality. Among the various modalities used, home-based programs had a maximum duration of 16 weeks and a minimum of 4 weeks. The weekly frequency and length of each session varied considerably between studies.

The studies examined the effects of home-based exercise on the health of patients with fibromyalgia, including pain, quality of life (QOL), depression, anxiety, disease severity, physical function, pain catastrophizing, self-efficacy, psychologic well-being, sleep quality, and somatosensory and temporal discrimination.

The effects of home-based exercise were limited, but improvements in pain and QOL were observed. However, the results were inconclusive for the other outcomes. In most studies, concerns about the risk of bias were presented, according to the researchers.

The authors outlined the following practical recommendations for rehabilitation:

• Combinations of resistance training, aerobic exercise, and stretching are recommended. Resistance training should encompass large muscle groups.
• The frequency should be 2 to 3 times a week, with an average duration of 40 minutes.
• Programs lasting 4 weeks or longer may reduce symptoms, but the practice should be maintained over the long term.

They emphasized that face-to-face physical exercise programs with appropriate professional supervision should be considered the first treatment option.

The researchers also acknowledged that despite the important outcomes, the evidence was limited because of the small number of randomized clinical trials that included large samples and a control group.

“Seven studies met the inclusion criteria, indicating that there is a shortage in the literature on home-based physical exercise for patients with fibromyalgia,” they concluded. “However, the analyzed results indicate that home-based physical exercise could be a viable alternative treatment since significant improvements were reported in some outcomes.”