The Effects of Non-Pharmacological Interventions in Fibromyalgia: A Systematic Review and Metanalysis of Predominants Outcomes

Abstract

(1) Fibromyalgia (FM) is a chronic musculoskeletal condition with multiple symptoms primarily affecting women. An imbalance in cytokine levels has been observed, suggesting a chronic low-grade inflammation. The main aim of the meta-analysis was to examine the effect of multimodal rehabilitation on cytokine levels and other predominant variables in patients with FM. Furthermore, to examine which non-pharmacological tools have been used to investigate the effects that these can have on cytokines in FM patients. (2) Methods: Searches were conducted in PubMed, Scopus, Web of Science, Cochrane, and ScienceDirect databases. This systematic review and metanalysis followed the PRISMA statement protocol. The methodological quality of the studies was assessed using the PEDro scale, the risk of bias followed the Cochrane Manual 5.0.1, and the GRADE system was used for rating the certainty of evidence. (3) Results: Of 318 studies found, eight were finally selected, with a sample size of 320 women with a mean age of 57 ± 20. The proinflammatory cytokines IL-1β, IL-6, IL-8 and TNF-α were the most studied. Resistance exercise, aquatic exercise, dynamic contractions, cycling, treadmill, and infrared therapy were the main non-pharmacological tools used. (4) Conclusions: The systematic review with meta-analysis found evidence of elevated cytokine levels in patients with FM, suggesting low chronic inflammation and a possible contribution to central sensitization and chronic pain. However, the effects of physiotherapeutic interventions on cytokine levels are variable, highlighting the importance of considering different factors and the need for further research.

Effects of exercise-based interventions on inflammatory markers in patients with fibromyalgia: A systematic review and meta-analysis

“…Bidonde et al found that aerobic exercise can reduce inflammation in FM patients [58]. Similarly, exercise interventions, including aerobic exercise, can reduce pro-inflammatory cytokines such as TNF-α, IL-1RA, IL-6 and IL-8 in FM patients, according to a systematic review and meta-analysis [59]. Aerobic exercise can also improve cardiovascular fitness, which may indirectly help to reduce inflammation.…”

“…In this regard, exercise can provide a non-pharmacological approach to managing the symptoms of FM through its anti-inflammatory effects [59]. However, it is important to note that exercise should be tailored to the needs and abilities of the individual and supervised by a healthcare professional.…”