Department of Community Medicine, West Virginia University, Morgantown, West Virginia, USA.
BMC Public Health. 2010 Apr 20;10:198. doi: 10.1186/1471-2458-10-198.
Exercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.
Studies were derived from six electronic sources, cross-referencing from retrieved studies and expert review. Dual selection of randomized controlled exercise training studies published between January 1, 1980 and January 1, 2008 and in which global well-being was assessed using the Fibromyalgia Impact Questionnaire (FIQ) were included. Dual abstraction of data for study, subject and exercise program characteristics as well as assessment of changes in global well-being using the total score from the FIQ was conducted. Risk of bias was assessed using the Cochrane bias assessment tool. Random-effects models and Hedge's standardized effect size (g) were used to pool results according to per-protocol and intention-to-treat analyses.
Of 1,025 studies screened, 7 representing 5 per-protocol and 5 intention-to-treat outcomes in 473 (280 exercise, 193 control) primarily female (99%) participants 18-73 years of age were included. Small, statistically significant improvements in global well-being were observed for per-protocol (g and 95% confidence interval, -0.39, -0.69 to -0.08) and intention-to-treat (-0.34, -0.53 to -0.14) analyses. No statistically significant within-group heterogeneity was found (per-protocol, Qw = 6.04, p = 0.20, I2 = 33.8%; intention-to-treat, Qw = 3.19, p = 0.53, I2 = 0%) and no between-group differences for per-protocol and intention-to-treat outcomes were observed (Qb = 0.07, p = 0.80). Changes were equivalent to improvements of 8.2% for per-protocol analyses and 7.3% for intention-to-treat analyses.
The results of this study suggest that exercise improves global well-being in community-dwelling women with fibromyalgia. However, additional research on this topic is needed, including research in men as well as optimal exercise programs for improving global well-being in adults.
运动已被推荐用于改善纤维肌痛成人的整体健康状况。然而，尚无荟萃分析使用单一工具并根据意向治疗和方案分析分别进行分析来确定运动对整体健康的影响。本研究旨在填补这一空白。
研究来源于六个电子来源，通过检索研究和专家评审进行交叉引用。纳入了发表于 1980 年 1 月 1 日至 2008 年 1 月 1 日之间的使用纤维肌痛影响问卷（FIQ）评估整体健康状况的随机对照运动训练研究的双选择。对研究、受试者和运动方案特征的数据进行双提取，并使用 FIQ 的总分评估整体健康状况的变化。使用 Cochrane 偏倚评估工具评估偏倚风险。根据方案分析和意向治疗分析，使用随机效应模型和 Hedge 的标准化效应大小（g）对结果进行合并。
在筛选出的 1025 项研究中，纳入了 7 项研究，涉及 5 项方案分析和 5 项意向治疗结果，涉及 473 名（280 名运动组，193 名对照组）主要为女性（99%）年龄在 18-73 岁的参与者。对方案分析（g 和 95%置信区间，-0.39，-0.69 至 -0.08）和意向治疗分析（-0.34，-0.53 至 -0.14）均观察到全球健康状况的小而有统计学意义的改善。方案分析（Qw = 6.04，p = 0.20，I2 = 33.8%）和意向治疗分析（Qw = 3.19，p = 0.53，I2 = 0%）内组间无统计学显著异质性，并且方案分析和意向治疗分析的组间无差异（Qb = 0.07，p = 0.80）。变化相当于方案分析中 8.2%的改善和意向治疗分析中 7.3%的改善。
本研究结果表明，运动可改善社区居住的纤维肌痛女性的整体健康状况。然而，需要对这一主题进行更多研究，包括男性研究以及改善成年人整体健康状况的最佳运动方案。
