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Open Access Highly Accessed Research article

Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials

Winfried Häuser12*, Petra Klose3, Jost Langhorst3, Babak Moradi4, Mario Steinbach4, Marcus Schiltenwolf4 and Angela Busch5

Author Affiliations

1 Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany

2 Department of Psychosomatic Medicine, Technische Universität München, Langestr. 3, D-81675 München, Germany

3 Department of Internal Medicine V (Integrative Medicine), University of Duisburg-Essen, Kliniken Essen-Mitte, Am Deimelsberg 34a, D-45276 Essen, Germany

4 Orthopaedic Clinic, University of Heidelberg, Schlierbacher Landstraße 200, D-69118 Heidelberg, Germany

5 School of Physical Therapy, University of Saskatchewan, Saskatoon, 1121 College Drive, Saskatoon SK S7N OW3, Canada

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Arthritis Research & Therapy 2010, 12:R79  doi:10.1186/ar3002

Published: 10 May 2010

Additional files

Additional file 1:

Search strategy for MEDLINE. The file contains the literature search strategy for the database MEDLINE.

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Additional file 2:

Main characteristics of studies with aerobic and mixed exercise in fibromyalgia syndrome. The file contains the main characteristics of studies with aerobic and mixed exercise in fibromyalgia syndrome including outcomes measures.

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Additional file 3:

Main characteristics of studies with head to head comparisons of different types of aerobic and mixed exercise in fibromyalgia syndrome. The file contains the main characteristics of studies with head-to-head comparisons of different types of aerobic and mixed exercise in fibromyalgia syndrome including outcome measures.

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Additional file 4:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on pain at post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 5:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on fatigue and sleep at post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 6:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on depressed mood at post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 7:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on quality of life at post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 8:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on physical fitness at post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 9:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on pain and fatigue at latest follow-up. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 10:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on sleep and depressed mood at latest follow-up. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 11:

Effect estimates (standardised mean differences) of aerobic exercise versus controls on quality of life and physical fitness at latest follow-up. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise groups is lower than in control group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 12:

Effect estimates (standardised mean differences) of moderate versus low intensity on pain and depressed mood post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the exercise group with moderate intensity is lower than in exercise group with low intensity. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 13:

Effect estimates (standardised mean differences) of water versus land-based aerobic exercise on pain and depressed mood post treatment. Forest plots show standardised mean differences (effect sizes) from the random effects model (inverse variance method). A negative effect indicates that the endpoint score of the outcome in the water-based exercise groups is lower than in the land-based exercise group in the study. The pooled (all studies together) effect size is weighted by the inverse variance of each study. IV, inverse variance (method); SD, standard deviation; Std. mean difference, standardised mean differences; random, random effects model; SD, standard deviation; total, number of patients; weight, relative weight (%) of the study in the calculation.

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Additional file 14:

Funnel plot of the comparisons of aerobic exercise versus controls on pain. Scatter plot of the intervention effect estimates (standardised mean differences (SMD)) from individual studies against their standard errors (SE) (on a reversed scale). Publication bias may lead to asymmetry in funnel plots on visual inspection.

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