John: Hello, I'm John Hilton, editor of the Cochrane Editorial unit. The Cochrane Musculoskeletal Group is producing a series of reviews of exercise interventions for people with the painful condition, fibromyalgia. One of these, published in June 2017, examines the effects of aerobic exercise training. In this podcast, Hayley Hassan, on behalf of the authors, describes the findings.

Hayley: Fibromyalgia is a common painful and fatiguing condition which is puzzling in many aspects. Exercise is an important part of fibromyalgia management. And many studies have shown that people with fibromyalgia can successfully perform different types of exercise without long term exacerbation of fibromyalgia symptoms. Regular exercise is also an important factor in countering age-related loss of muscle and bone mass, and helps functional independence in the general population. Therefore, we did this review to clarify the benefits and harms of aerobic exercise training for adults with fibromyalgia. Placing the review in a wider context, it’s the third in a series of systematic reviews our team is producing on exercise and fibromyalgia. The first, on resistance exercise training, was published in 2013 and the second on aquatic exercise appeared in 2014. More will follow over the next few years.
Returning to this review, in simple terms, aerobic exercise causes breathing and heart rate to increase over resting levels. It covers a broad range of physical activities such as walking, jogging, cycling, and dancing performed at submaximal intensities that can be sustained from minutes to hours, depending in part on the fitness level of the individual and the intensity of the exercise.
For our review, we searched for studies published up to June 2016, and found 13 randomised trials including a total of more than 800 individuals. On average, participants in the aerobics group exercised two to three times per week for 35 minutes per session; doing things such as walking, cycling, running, low-impact aerobics and aquacise.
Comparing people who did aerobic exercise with others who did not exercise, there was moderate-quality evidence that aerobic exercise improved Heath Related Quality of Life, and low-quality evidence for improvement in physical function and decreased pain, fatigue, and stiffness. Only minor adverse events were reported, but reporting was inconsistent in these studies.
Four studies explored long-term effects at 24 to 208 weeks after the intervention ended. These found that benefits of exercise on pain and function persist in the long term.
One of the challenges when using research into the effects of interventions such as exercise is knowing exactly what the program consisted of and so we took great care to examine the exercise programs. We carefully noted the specific exercises, the frequency, intensity, and duration, and included this information in the review, to make it easiers for patients and their carers to make decisions about an appropriate regimen for them.

John: If you would like to see that detail on the different exercise programmes or to look in more depth at the review as a whole, you can find it online with a search for 'aerobic exercise and fibromyalgia' at Cochrane Library dot com. While a simple search for 'exercise and fibromyalgia' will pick up all the reviews in this series.