Effectiveness of multicomponent treatment compared with other therapeutic interventions in patients with fibromyalgia: A systematic review with meta-analysis.

Felipe Andres Araya-Quintanilla, Iván Cuyul-Vásquez, Jorge Fuentes, Mayte Serrat, Héctor Gutiérrez-Espinoza
Purpose:

To determine the effectiveness of multicomponent treatment compared with other therapeutics interventions in patients with fibromyalgia.

Methods:

An electronic search was performed using the MEDLINE, CENTRAL, EMBASE, Web of Science, PEDro, CINAHL, SPORTDiscus, Scopus and LILACS databases. The eligibility criteria included RCTs investigating the effects of multicomponent treatment compared to other therapeutic interventions in patients with FM. Two authors independently performed the search, study selection, data extraction, and risk of bias assessment. For the analysis of we performed the Hartung–Knapp–Sidik–Jonkman random effect method or the Mantel–Haenszel fixed effect method in the case of low inconsistency.


Results:

Twenty-five RCTs met the eligibility criteria with 3476 patients were included. At 10 to 16 weeks, for multicomponent treatment versus all other interventions, the standardized mean difference for pain intensity was -0.51 (95% CI: -0.92 to -0.10, P= 0.021). For functional status, quality of life, depression and anxiety shows statistically significant differences in favor of multicomponent treatment (all p-values 0.05). Additionally, there were no differences in the effects between multicomponent treatment versus passive interventions for all clinical outcomes. 

Conclusion(s):

In the medium-term, the multicomponent treatment in comparison with all other interventions (active and passive) showed statistically significant differences in pain intensity in patients with FM. The quality of evidence is low to high according to GRADE approach. Additionally, there were no differences in the comparison of multicomponent treatment versus passive interventions in patients with FM. 

Implications:

Regarding the clinical implications of our study, the great synthesis of evidence about multicomponent treatment in patients with FM is noteworthy. Although we were unable to establish a dose-response protocol, our findings suggest that the use of multicomponent treatment (physical exercise strategies and mind-body exercises, cognitive-behavioral therapy and/or education) may be beneficial for clinical and psychological outcomes in patients with FM. Our findings emphasize the need to address some clinical considerations in future studies, such as the specific dose of exercises and the most effective combined therapeutic interventions combined to achieve more promising results in these patients

Funding acknowledgements:
The authors did not receive any financial support for the investigation, authorship, and/or publication of this article.
Keywords:
Fibromyalgia
Multicomponent therapy
Pain
Primary topic:
Musculoskeletal
Second topic:
Pain and pain management
Third topic:
Disability and rehabilitation
Did this work require ethics approval?:
No
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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