Skip to main content

Table 4 Non-pharmacological strategies

From: Beyond pain in fibromyalgia: insights into the symptom of fatigue

Intervention Design and sample Scales used Effect on fatigue
Conventional therapies    
Cognitive behavioral therapy One RCT comparing multidisciplinary treatment to treatment augmented with CBT (n = 83) of women with FM [71] FIQ fatigue Cannot draw conclusion
Exercise - aerobic exercise 1 single-arm study of women with FM, CFS, and CFIDS (n = 7) [72] VAS fatigue Cannot draw conclusion in single arm study, 2 meta-analyses found improvement, MCID cannot be determined
2 meta-analyses of 28 RCTs (n = 2,494) [73] and 34 RCTs (n = 2,276) [74]
Exercise - strength training 1 RCT (n = 26) of postmenopausal women with FM [75] VAS fatigue Clinically meaningful improvement in 2 RCTs, cannot draw conclusion in 1 RCT
1 double-arm study of aerobic versus strength training (n = 30) of women with FM [76]
1 RCT (n = 21) of premenopausal women with FM [77]
Multicomponent/multidisciplinary treatmenta 2 single-arm studies (n = 305) of patients with FM [78, 79], 4 RCTs (n = 513) of patients with FM [8083], 1 RCT (n = 855) in patients with FM, OA, and RA [84] FIQ fatigue Clinically meaningful improvement in 4 RCTs, no clinically meaningful improvement in 3 RCTs
1 meta-analysis of 9 RCTs (n = 1119) [85] VAS fatigue Meta-analysis found no evidence for efficacy in long-term follow-up
Complementary and alternative medicine    
Acupuncture 1 meta-analysis of 7 RCTs (median treatment time 9 sessions, n = 385) [86]   No improvement
Meditative movement therapies 1 meta-analysis of 7 RCTs (n = 362) [87]   Improvement overall, in subgroup analysis, only yoga improved fatigue
  1. aMultidisciplinary treatments varied between studies but typically included education, exercise, psychotherapy (that is, cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and so on), and occupational and physical therapies. CF, chronic fatigue; CFIDS, chronic fatigue and immune dysfunction syndrome; FIQ, Fibromyalgia Impact Questionnaire; FM, fibromyalgia; MCID, minimal clinically important difference; OA, osteoarthritis; RA, rheumatoid arthritis; RCT, randomized controlled trial; VAS, Visual Analogue Scale.