OBJECTIVE: The aim of this study was to summarize evidence on the effectiveness of therapeutic exercise in Fibromyalgia Syndrome. DESIGN: Studies retrieved from the Cochrane Plus, PEDro, and PubMed databases were systematically reviewed. Randomized controlled trials and meta-analyses involving adults with fibromyalgia were included. The primary outcomes considered in this systematic review were pain, global well-being, symptoms of depression, and health-related quality of life. RESULTS: Effects were summarized using standardized mean differences with 95% confidence intervals using a random effects model. This study provides strong evidence that physical exercise reduces pain (-1.11 (95% CI) -1.52 to -0.71; overall effect p < 0.001), global well-being (-0.67 (95% CI) -0.89 to -0.45; p < 0.001), and symptoms of depression (-0.40 (95% CI) -0.55 to -0.24; p < 0.001) and that it improves both components of health-related quality of life (physical 0.77 (95% CI) 0.47 to 1.08; p < 0.001; mental 0.49 (95% CI) 0.27 to 0.71; p < 0.001). CONCLUSIONS: This study concludes that aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global well-being in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life. In addition, combined exercise produces the biggest beneficial effect on symptoms of depression.

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