Clinical Scorecard: Understanding Movement Perception and Experiences in Fibromyalgia Patients: A Qualitative Systematic Review with Meta-Synthesis and Summary

At a Glance

Key Highlights

• Exercise is a key non-pharmacological treatment involving aerobic, resistance, flexibility, and mind–body components tailored to individual preferences and fitness levels.
• Patients report heterogeneous and ambivalent perceptions of movement, with pain and fatigue as barriers and professional guidance and group activities as facilitators.
• Qualitative evidence synthesis identifies patient-reported barriers and facilitators to exercise adherence, informing patient-centered rehabilitation strategies.

Guideline-Based Recommendations

Diagnosis

• Diagnosis based on clinical presentation of chronic widespread pain with associated symptoms including fatigue, sleep disturbance, mood, and cognitive issues.

Management

• Adopt a personalized, multimodal approach combining education, cognitive-behavioral therapy, exercise, and pharmacotherapy as needed.
• Implement individualized, gradually progressed exercise programs integrating aerobic, resistance, flexibility, and mind–body elements.
• Address patient beliefs and fears about movement to improve adherence.

Monitoring & Follow-up

• Regularly assess patient-reported barriers and facilitators to exercise participation.
• Monitor symptom fluctuations and adjust exercise intensity accordingly.

Risks

• Risk of symptom flares and overwhelming fatigue may undermine exercise adherence.
• Comorbid anxiety and depression can exacerbate pain perception and cognitive impairment.

Patient & Prescribing Data

Adults with fibromyalgia experiencing chronic pain, fatigue, and psychosocial comorbidities.

Support from physiotherapists and graded pacing strategies enhance exercise adherence; group activities and professional guidance facilitate participation despite pain and fatigue.

Clinical Best Practices

• Use a patient-centered approach to understand individual perceptions and experiences of movement.
• Incorporate graded, multicomponent exercise tailored to patient preferences, comorbidities, and fitness levels.
• Provide professional support and education to address fears and misconceptions about movement.
• Encourage group-based activities when appropriate to enhance motivation and social support.
• Continuously evaluate and adapt rehabilitation plans based on patient feedback and symptom variability.

References

• Open Science Framework Registries