Mental effects of physical activity in patients with fibromyalgia: A narrative review

Author: R Talotta1, M Porcello2, R Restuccia3, L Magaudda4
Affiliation:
1 Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. Electronic address: talotta1@virgilio.it.
2 Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina, Messina, Italy. Electronic address: martina.porcello97@gmail.com.
3 Postgraduate School of Sport and Physical Exercise Medicine, BIOMORF Department, University of Messina, Messina, Italy. Electronic address: roberto.restuccia@polime.it.
4 Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina, Messina, Italy; Postgraduate School of Sport and Physical Exercise Medicine, BIOMORF Department, University of Messina, Messina, Italy. Electronic address: lmagaudda@unime.it.
Conference/Journal: J Bodyw Mov Ther
Date published: 2024 Oct 1
Other: Volume ID: 40 , Pages: 2190-2204 , Special Notes: doi: 10.1016/j.jbmt.2024.10.067. , Word Count: 267


Introduction:
Fibromyalgia (FM) is a multifaceted disease that is often associated with neuropsychiatric disorders and is burdened by a high degree of psychological distress. Non-pharmacological interventions, including physical exercise and complementary therapies, have shown satisfactory results for either physical or psychological FM symptoms.

Methods:
In this narrative review, we analyzed scientific evidence of moderate to high quality regarding the psychological and neurocognitive effects of physical therapies for FM. A total of 29 studies were selected after searching the PubMed and Google Scholar databases using the combination of terms « fibromyalgia», «psychological distress», «fibrofog», mental disorder», «aerobic exercise», «strength exercise», «Pilates», «Tai chi» and «Yoga».

Results:
Aerobic exercise can improve depression, anxiety, stress, mental function and mood, thanks to the remodulation of neurotransmitters and hormones. Strength training, on the other hand, has been shown to alleviate mental confusion, anger and depression. Finally, mind-body disciplines appear to be effective for depression, anxiety, catastrophizing, memory and coping strategies. Based on these findings, we devised an ideal exercise program that could relieve the psychological distress of FM patients, thus interrupting the pathogenic neuroendocrine circuits that lead to the exacerbation of pain and other FM-related symptoms.

Conclusions:
Thanks to neuroendocrine remodulation, physical exercise may simultaneously improve the physical and mental health of FM patients. This narrative review collects current evidence on the effects of specific physical interventions on psychological and neurocognitive domains of FM patients and additionally provides an evidence-based training program that could be prescribed to FM patients with high psychological distress or neuropsychiatric symptoms.

Keywords: Aerobic exercise; Fibromyalgia; Mental disorders; Pilates; Psychological distress; Strength exercise; Tai chi; Yoga.

PMID: 39593584 DOI: 10.1016/j.jbmt.2024.10.067

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