A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

Table 1

Characteristics of included systematic reviews.

Reference	Year	Meta-analysis	Intervention	Comparator groups	Types of included studies	Number of studies; Number of patients	Risk of bias assessment?; Grade of Recommendation?	Safety (AE/SAE)
CAM interventions in general
Baranowsky et al. [50]	2009	No	CAM therapies as defined by the NIH, with the exception of dietary, nutritional, herbal, and hormonal supplements	Any	RCT	24; 1466	Adapted instrument	Not assessed; not reported
De Silva et al. [51]	2010	No	CAM therapies (oral or topical application)	Placebo or other treatments	RCT	7; 267	Jadad scale	Minor AE; No SAE
Holdcraft; et al. [52]	2003	No	CAM therapies according to NIH scheme	Any	RCT, non-RCT	22; 1091	Consort rating system	Not assessed; not reported
Terhorst et al. [53]	2011	Yes	CAM therapies according to NIH scheme	Any	RCTs	60; 2897	Adapted GRADE system (random sequence generation and allocation concealment; incomplete outcome data; selective reporting; other)	Not assessed; not reported
Exercise-based CAM
Chan et al. [54]	2012	No	Qigong	Any	RCT, CT	4; 251	Jadad scale	Not assessed; not reported
Langhorst; et al. [55]	2013	Yes	Meditative movement therapies (yoga, qigong, tai chi)	Any control	RCT	7; 362	Randomization, allocation concealment, blinding of outcome assessment, adequacy of data analysis (intention-to-treat analysis)	3.1% AE; No SAE
Lauche et al. [56]	2013	Yes	Qigong	Any control	RCT	7; 395	Cochrane risk of bias assessment; GRADE	Minor AE; No SAE
Mist et al. [57]	2013	Yes	Complementary and alternative exercise	Any	Any	16; 832	Jadad score	No SAE
Manipulative therapies
Ernst [58]	2009	No	Chiropractic treatment	Any	RCT	4; 108	Jadad score	Not assessed; not reported
Kalichman [59]	2010	No	Massage therapy	Any	Any, with an emphasis on RCTs	8; 235	None	Not assessed; not reported
Schneider et al. [60]	2009	No	Chiropractic treatment	Any	RCTs, systematic reviews, meta-analyses, guidelines consensus documents, RCTs, clinical trials, case reports, case-control studies, surveys	8 systematic reviews, 3 meta-analyses, 5 practice guidelines, 44 RCTs, 17 clinical trials, 17 case reports, 2 case-control studies, 2 surveys	Oxford rating scale; Scottish Intercollegiate Guidelines Network evidence rating checklist	Not assessed; not reported
Mind/Body interventions
Bernardy; et al. [61]	2011	Yes	Hypnosis, guided imagery	Any	CT; quasi-RCT; RCT	6; 239	Scale for rating the quality of psychological trials in pain [40]	Minor AE; No SAE
Glombiewski; et al. [62]	2013	Yes	EMG and EEG biofeedback	Any	RCT	7; 321	Randomization, allocation concealment, blinding of outcome assessor, adequate data analysis, intention-to-treat analysis	Minor AE; No SAE
Hadhazy; et al. [63]	2000	No	Mind-Body therapies (education, cognitive therapy, movement therapy, dance, meditation, relaxation, hypnosis, guided imagery, biofeedback)	Any	RCT, quasi-RCT	13; 802	Jadad criteria	No AE reported
Kozasa et al. [64]	2012	No	Meditation-based interventions	Any	RCT	4; 449	Jadad score	Not assessed; not reported
Lauche et al. [65]	2013	Yes	Mindfulness-based stress reduction (MBSR)	Any control	CT; RCT	6; 674	Cochrane risk of bias assessment; GRADE	No AE/SAE reported
Acupuncture
Deare et al. [66]	2013	Yes	Acupuncture (invasive acupuncture only) as standalone or adjunct	Any (nonacupuncture treatments, placebo, sham-acupuncture)	RCT	9; 395	Cochrane risk of bias assessment	0–53% AE; No SAE
Langhorst et al. [67]	2010	Yes	Acupuncture	Sham-acupuncture, simulated acupuncture	RCT, quasi-RCT	7; 385	van Tulder score	3–70% AE; No SAE
Martin-Sanchez; et al. [68]	2009	Yes	Acupuncture	Sham-acupuncture	RCT	6; 323	None	Not assessed; not reported
Mayhew and; Ernst [69]	2007	No	Acupuncture	Any	RCT	5; 316	Jadad score	Not assessed; not reported
Balneotherapy/hydrotherapy
Fraioli et al. [70]	2013	No	Spa therapy	Unclear	RCTs, observational studies	7; 303	Value of the international journals that published these researches, the number of patients included in the studies, the methods used to study the patients, and the possibility of exclusion of more frequent studies bias	Not assessed; not reported
Langhorst et al. [71]	2009	Yes	Hydrotherapy	Any	RCT	13; 446	van Tulder score	Not assessed; not reported
McVeigh; et al. [72]	2008	No	Hydrotherapy	Any	RCT	10; 571	van Tulder score	Not assessed; not reported
Phytotherapy
de Souza Nascimento; et al. [73]	2013	No	Medicinal plants or related natural products	Placebo, other drugs	RCTs	8; 475	Jadad score	Minor AE; No SAE
Homeopathy
Perry et al. [74]	2010	No	Homeopathy	Any	RCTs	4; 163	Jadad score; recommendations from the Cochrane Handbook	Not assessed; not reported

AE: adverse event; CAM: complementary and alternative medicine; CONSORT: Consolidated Standards of Reporting Trials; CT: controlled trial; GRADE: Grading of Recommendations Assessment, Development, and Evaluation; RCT: randomized controlled trial; SAE: serious adverse event.