Abstract

Objective: The purpose of this study was to examine the dose-response relationship between aerobic exercise programs and changes in pain intensity and health status in patients with fibromyalgia. Data Sources: Data sources for this study were PubMed, PEDro, Google Scholar, and EBSCO from inception until February 9, 2024. Study Selection: Randomized controlled trials (RCTs) of aerobic exercise in patients with a clinical diagnosis of fibromyalgia were included. Data Extraction: Outcome measures were pain intensity (Visual Analog Scale) and health status (Fibromyalgia Impact Questionnaire (FIQ)). The dose-response relationship was evaluated using a restricted cubic spline model. Data Synthesis: Twenty-three RCTs were included. The meta-analysis showed a significant improvement in pain intensity and functional status. A minimum dose of 50 min per week standardized mean difference (SMD = −0.67; 95% CI = −0.70 to −0.65) and a total duration of 600 min (SMD = −0.65; 95% CI = −0.69 to −0.62) were estimated to effectively reduce pain intensity. The maximum effect was achieved with 90 min per week (SMD = −1.14; 95% CI = −1.19 to −1.09) and 1200 min total duration (SMD = −1.08; 95%CI = −1.13 to −1.02). Additionally, a minimum dose of 65 min per week (SMD = −0.62; 95% CI = −0.6 to −0.69) and a total duration of 950 min (SMD = −0.61; 95% CI = −0.60 to −0.67) were estimated to effectively reduce the FIQ score. While the maximum effect was obtained with 150 min per week (SMD = −1.77; 95% CI = −1.89 to −1.65) and 3000 min of total duration (SMD = −1.43; 95% CI = −1.54 to −1.31). Conclusion: These findings may be useful in optimizing the minimal dose of aerobic exercise to achieve health improvements in people with fibromyalgia. © The Author(s) 2025.