Table 1: General characteristics of included studies.

Author/yearDesignParticipantsIntervention/comparisonOutcomesConclusions

Wigers et al. 1996 [19]RCTAE: 18 women and 2 men
() with FMS
SMT: 18 women and 2 men
() with FMS
CG: 19 women and 1 man
() with FMS
Intervention: aerobic exercise (AE) and stress management treatment (SMT)
Comparison: usual care (CG)
Duration: AE: 3 days a week (45 minutes) for 14 weeks. SMT: 2 days a week (90 minutes) for 6 weeks and 1 day a week (90 minutes) for 8 weeks
(i) Pain
(ii) Symptoms of depression
Aerobic exercise was the overall most effective treatment.

Jones et al. 2001 [27]RCTEG: 28 women with FMS
CG: 28 women with FMS
Intervention: muscle strengthening (EG)
Comparison: stretching exercises (CG)
Duration: 2 days a week (60 minutes) for 12 weeks
(i) Pain
(ii) FMS impact
Muscle strengthening produces an improvement in overall disease activity.

Richards and Scott 
2002 [20]
RCTEG: 62 women and 5 men
() with FMS
CG: 64 women and 5 men
() with FMS
Intervention: aerobic exercise (EG)
Comparison: relaxation (CG)
Duration: EG: 2 days a week (12–50 minutes) for 12 weeks. CG: 2 days a week (60 minute) for 12 weeks
(i) FMS impactAerobic exercise is an effective treatment for FMS.

Rooks et al. 2007 [28]RCTAE: 35 women with FMS
ST: 35 women with FMS
FSHC: 27 women with FMS
ST-FSHC: 38 women with
FMS
Interventions: aerobic exercise (AE), strength training, aerobic exercise and stretching (ST), fibromyalgia self-help course (FSHC), and a combination of ST and FSHC (ST-FSHC)
Duration: AE and ST: 2 days a week (60 minutes) for 16 weeks. FSHC: 120 minutes every two weeks
(i) Pain
(ii) FMS impact
Progressive walking, simple strength training movements, and stretching activities improve functional status, key symptoms, and self-efficacy in women with FMS.

Bircan et al. 2008 [33]RCTAE: 13 women with FMS
SE: 13 women with FMS
Interventions: aerobic exercise (AE) and strengthening exercise (SE)
Duration: 3 days a week (30–40 minutes) for 8 weeks
(i) Pain
(ii) Symptoms of depression
AE and SE are similarly effective at improving symptoms, depression, and quality of life in FMS.

García-Martínez et al. 2010 [23]RCTEG: 14 women with FMS
CG: 14 women with FMS
Intervention: exercise combined protocol
(aerobic, strengthening, and stretching exercises)
(EG)
Comparison: normal daily activities (CG)
Duration: 3 days a week (60 minutes) for 12
weeks
(i) Pain
(ii) HRQOL
(iii) FMs impact
The GE improved quality of life, psychological state, and physical functioning.

Sañudo et al. 2010 [24]RCTEG1: 22 women with FMS
EG2: 21 women with FMS
CG: 20 women with FMS
Interventions: aerobic exercise and combined exercise (EG1 and EG2)
Comparison: Normal daily activities (CG)
Duration: GE1: 2 days a week (45–60 minutes)
GE2: 2 days a week (35–45 minutes), 24 weeks
(i) FMS impact
(ii) HRQOL
(iii) Symptoms of depression
(iv) Pain
An improvement from baseline in total FIQ score was observed in the exercise groups and was accompanied by decreases in BDI scores. Relative to nonexercising controls, CE evoked improvements in the SF-36 physical functioning and bodily pain domains and was more effective than AE for evoking improvements in the vitality and mental health.

Mannerkorpi et al.
2010 [30]
RCTEG: 34 women with FMS
CG: 33 women with FMS
Intervention: Nordic walking moderate to high intensity (EG)
Comparison: low intensity walking (CG)
Duration: EG: 2 days a week (10–20 minutes), 15 weeks. CG: 1 day a week
(i) Pain
(ii) FMS impact
The Nordic walking group had better FIQ physical scores.

Sañudo et al. 2011 [25]RCTEG: 18 women with FMS
CG: 20 women with FMS
Intervention: combined exercise (aerobic, strength, and flexibility) (EG)
Comparison: routine care (CG)
Duration: 2 days a week (45–60 minutes) for 24
weeks
(i) HRQOL
(ii) FMS impact
(iii) Symptoms of depression
A combined program of long-term exercise improves psychological and health status by increasing the quality of life.

Kayo et al. 2012 [21]RCTWPG: 30 women with FMS
SMG: 30 women with FMS
GC: 30 women with FMS
Interventions: walking program (WPG) and muscle strengthening (SMG) exercises
Comparison: medication only or conventional treatment (CG)
Duration: WPG and SMG: 3 days a week (60 minutes) for 16 weeks
(i) Pain
(ii) FMS impact
(iii) HRQOL
(iv) Use of drugs
Both modalities (WP and PSM) provided better pain relief for people with FMS than medication only or conventional treatment.

Hooten et al. 2012 [26]RETAE: 32 women and 4 men
() with FMS
SE: 33 women and 3 men
() with FMS
Intervention: aerobic exercise (AE) and strengthening exercise (SE)
Duration: AE: 10–30 minutes each day for 3 weeks SE: 25–30 minutes each day for 3 weeks
(i) Pain severityStrengthening exercises and aerobic exercise are similarly effective in reducing pain intensity.

Gavi et al. 2014 [22]RCTMSE: 35 women with FMS
SE: 31 women with FMS
Intervention: muscle strengthening exercise
(MSE) and stretching exercises (SE)
Duration: 2 days a week (45 minutes) for 16 weeks
(i) Pain
(ii) HRQOL
(iii) FMS impact
(iv) Symptoms of depression
Both groups experienced a reduction in pain, which was more noticeable and had an earlier onset in the strengthening exercise group. Both groups experienced improvements in functionality, depression, and quality of life.

Duruturk et al. 2015 [32]RCTBE: 12 women with FMS
AE: 14 women with FMS
Intervention: balance exercise (BE) and aerobic exercise (AE)
Duration: 3 days a week (20–45 minutes) for 6 weeks
(i) Pain
(ii) FMS impact
Both groups showed an improvement in pain intensity and FIQ functionality; there was no group difference on either measure.

Larsson et al. 2015 [29]RCTRE: 67 women with FMS
CG: 63 women with FMS
Intervention: resistance exercise (RE)
Comparison: relaxation exercises (CG)
Duration: RE: 2 days a week (60 minutes) for 15 weeks. CG: 2 days a week (25 minute) for 15 weeks
(i) HRQOL
(ii) Pain intensity
(iii) FMS impact
Resistance exercise group reduced pain intensity.

Ericsson et al. 2016 [31]RCTEG: 67 women with FMS
CG: 63 women with FMS
Intervention: resistance exercise (EG)
Comparison: relaxation therapy (CG)
Duration: 2 days a week (60 minutes) for 15
weeks
(i) Pain
(ii) Symptoms depression
Resistance exercise improves some symptoms in women with FMS.

RCT: randomized clinical trial; RET: randomized equivalence trial; EG: exercise group; CG: control group; FMS: Fibromyalgia Syndrome.