Extract

Background: Objective: To evaluate the effectiveness of exercise in the management of fatigue and sleep dysfunction in fibromyalgia syndrome (FMS) and to identify the type, intensity, frequency and duration of exercise therapy most effective in FMS.

Methods: This review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered with the PROSPERO database (CRD42013004439). Ten electronic databases were searched using a Cochrane style search strategy. Only randomized controlled trials published in English, French or Spanish were included in this review. All studies must also have included an exercise component which had to comprise at least 50% of the intervention. The main outcome of interest was fatigue; the secondary outcome was sleep dysfunction. Methodological quality was assessed using the van Tulder scale and the Cochrane Risk of Bias tool. Studies were deemed high quality if they scored ≥6/12 on the van Tulder scale and major risks of bias were: inadequate randomization, inadequately concealed treatment allocation and non-blinding of outcome assessors. Data were summarized qualitatively using a best evidence synthesis and were possible effect sizes were calculated using Cohen’s d.

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