Efficacy of rehabilitation treatments in improving functioning in patients with fibromyalgia: A systematic review and meta-analysis of randomized controlled trials

Article type: Review Article

Authors: de Sire, Alessandro^{a; b; c; *} | Marotta, Nicola^{b; d} | Prestifilippo, Emanuele^a | Zito, Roberta^a | Bartalotta, Isabella^a | Lippi, Lorenzo^e | Mezian, Kamal^f | Vecchio, Michele^{g; h} | Invernizzi, Marco^{i; j} | Ammendolia, Antonio^{a; b}

Affiliations: [a] Department of Medical and Surgical Sciences, Physical and Rehabilitative Medicine Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy | [b] Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, Catanzaro, Italy | [c] Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic | [d] Department of Experimental and Clinical Medicine, Physical and Rehabilitative Medicine Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy | [e] Department of Scientific Research, Campus LUdeS, Off-Campus Semmelweis University of Budapest, Budapest, Hungary | [f] Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic | [g] Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy | [h] Unit of Rehabilitation, AOU Policlinico G. Rodolico S.Marco, Catania, Italy | [i] Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy | [j] Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

Correspondence: [*] Corresponding author: Alessandro de Sire, Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences University of Catanzaro “Magna Graecia”, Catanzaro, Italy. E-mail: alessandro.desire@unicz.it.

Abstract: BACKGROUND: Fibromyalgia is a debilitating condition marked by persistent pain and reduced functionality. Various therapeutic methods have been suggested to alleviate symptoms in individuals with fibromyalgia, yet the impact of diverse rehabilitation strategies remains unclear. OBJECTIVE: This systematic review and meta-analysis aimed at assessing the efficacy of rehabilitation interventions in improving functioning in fibromyalgia patients. METHODS: We conducted a comprehensive literature search of multiple international databases (PubMed, Scopus, and Web of Science) from their inception until November 22nd, 2023. We identified 23 randomized controlled trials (RCTs) assessing multiple rehabilitation strategies. The primary outcome was the Fibromyalgia Impact Questionnaire (FIQ). Study quality was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). The study protocol was registered in PROSPERO (CRD42020197666). RESULTS: Our meta-analysis rehabilitation interventions significantly reduce FIQ scores (MD =-11.74, 95% CI: -16.88 to -6.59, p< 0.0001). Notably, the subgroup analysis showed that different rehabilitation modalities seem to induce different therapeutic responses. CONCLUSIONS: Rehabilitation strategies hold promise in addressing the functional impairments and improving the overall well-being of individuals with fibromyalgia. The study underscores the need for further research to determine the optimal rehabilitation approach and its potential impact on the multilevel disability characterizing patients with fibromyalgia.

Keywords: Fibromyalgia, rehabilitation, pain management, physical therapy, functioning

DOI: 10.3233/BMR-230382

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 5, pp. 1103-1129, 2024