Clinical Report: Movement Perception and Experiences in Fibromyalgia Patients

Overview

This qualitative systematic review synthesizes adult fibromyalgia patients' perceptions and experiences of movement and exercise. It identifies key barriers such as pain and fatigue, alongside facilitators including professional guidance and social support, which influence adherence to physical activity.

Background

Fibromyalgia (FM) is a chronic syndrome marked by widespread musculoskeletal pain, fatigue, sleep disturbances, mood disorders, and cognitive difficulties, affecting 1.3% to 8% of the global population, predominantly women aged 20–55. Central sensitization contributes to pain variability, while comorbid anxiety and depression exacerbate symptoms and cognitive impairment. Current management emphasizes a personalized, multimodal approach incorporating education, cognitive-behavioral therapy, exercise, and pharmacotherapy. Exercise, including aerobic, resistance, flexibility, and mind–body components, is a cornerstone non-pharmacological treatment but is often hindered by fear of symptom exacerbation and fatigue.

Data Highlights

The review included qualitative studies exploring adults with FM and their lived experiences of movement, encompassing structured exercise, incidental physical activity, and daily functional movements. The search spanned seven databases and gray literature up to October 2025, applying rigorous inclusion criteria to ensure FM-specific data extraction. The meta-synthesis approach allowed integration of diverse patient perspectives to identify common themes related to movement perception, barriers, and facilitators.

Key Findings

• Patients with FM exhibit heterogeneous and ambivalent perceptions of movement, ranging from viewing it as disabling to a source of psychosocial well-being.
• Pain and fatigue are primary barriers that reduce motivation and adherence to physical activity.
• Facilitators include professional guidance, particularly physiotherapist support, graded pacing, and group activities that provide social interaction and encouragement.
• Walking elicits mixed responses, experienced both as discomfort and as an opportunity for progress and social engagement.
• Personal beliefs and previous experiences significantly shape engagement with exercise and movement strategies.
• Tailored, gradual progression of exercise intensity aligned with individual preferences and comorbidities enhances adherence.

Clinical Implications

Clinicians should adopt patient-centered rehabilitation plans that acknowledge the complex and varied perceptions of movement in FM patients. Emphasizing professional support, graded activity pacing, and social facilitation can help overcome barriers such as pain and fatigue. Individualizing exercise programs to patient preferences and fitness levels is essential to improve adherence and outcomes.

Conclusion

This qualitative synthesis highlights the nuanced experiences of movement in adults with fibromyalgia, underscoring the importance of personalized, supportive approaches to physical activity. Integrating patient-reported barriers and facilitators into rehabilitation can optimize engagement and quality of life.

References

1. Fibromyalgia Clinical Context and Management Guidelines
2. Sandelowski and Barroso 2007 -- Meta-Synthesis Methodology
3. Open Science Framework Registries 2025 -- Review Registration