BACKGROUND: There is very limited knowledge about the effects of exercise on men with Chronic Widespread Pain (CWP), especially regarding fatigue. We wanted to investigate the effects of resistance exercise compared with pool exercise on multidimensional fatigue, psychological distress and physical capacity in men with CWP. METHODS: Thirty-four men with CWP, with a mean age of 49 (SD 8, range 26 to 59) years, were randomised to 12 weeks of standardised pool exercise (PE) or resistance exercise (RE). The primary outcome was the Multidimensional Fatigue Inventory (MFI-20). Depression, anxiety, isometric force, pain and health-related quality of life were also assessed. RESULTS: No significant differences were found for changes in MFI-20 between the exercise groups. The RE group improved the isometric forces of right shoulder abduction (RE 2.2 SD 1.5 N, PE 0.6 SD 1.2 N, p = 0.009), right knee flexion (RE 50, SD 50 N, PE -17, SD 71 N, p = 0.003) and left knee flexion (RE 33 SD 39, PE -9 SD 52 N, p = 0.017) compared with the PE group. The drop-out rate was 29% in the RE group and 18% in the PE group. CONCLUSIONS: Both a resistance exercise programme and a pool exercise programme improved different dimensions of fatigue in men with CWP. There were no differences in the change in fatigue over time between the exercise groups. Resistance exercise improved isometric strength compared with pool exercise. Because different types of exercise appear to improve different aspects of health, the goals could guide the choice of treatment. Further exercise studies with larger groups are needed to gain more knowledge about the effect of exercise on fatigue in men with CWP. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT01278641. Registration date April 2008.

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