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Benefits of Exergame Training for Female Patients With Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Published:January 13, 2022DOI:https://doi.org/10.1016/j.apmr.2021.10.022

      Abstract

      Objective

      The objective of this systematic review and meta-analysis was to evaluate the effects of exergame training on female patients with fibromyalgia syndrome (FMS). Outcome measurements mainly include overall functioning, pain perception, quality of life, exercise capacity, health perception, kinesiophobia, and fatigue severity.

      Data Sources

      Five electronic databases (PubMed, Web of Science, PsycInfo, Scopus, and Cochrane Library) were searched from inception until June 24, 2021. In addition to searches, review the reference lists of relevant papers by hand was also conducted. Cochrane Collaboration's tool for assessing risk of bias was used to evaluate the risk of bias in the included studies.

      Study Selection

      Articles were collected with the following study inclusion criteria: (1) randomized controlled trial (RCT) design; (2) participants were female patients with FMS aged older than 18 years; (3) participants in experimental groups received exergame training using any modality; and (4) outcome measures included overall functioning, quality of life, exercise capacity, health perception, kinesiophobia, and fatigue severity.

      Data Extraction

      The data were independently extracted by 2 researchers. The extracted data related to the document characteristics (first author, publication year, and country) participant characteristics (number and age of participants in the experimental and control groups), and interventions (intervention content, frequency, and duration, and measurement tools).

      Data Synthesis

      Nine RCTs including 466 female patients with FMS were included in the analysis. Exergame training had significant positive effects on overall functioning (standardized mean difference [SMD], −0.52; 95% confidence interval [CI], −0.77 to 0.27; P<.0001), pain perception (SMD, −0.49; 95% CI, −0.97 to −0.02; P=.04), quality of life (SMD, 0.77; 95% CI, 0.44-1.10; P<.00001), exercise capacity (SMD, 0.58; 95% CI, 0.32-0.84; P<.0001), health perception (SMD, 0.69; 95% CI, 0.38-1.01; P<.0001), and fatigue severity (SMD, −0.97; 95% CI, −1.55 to −0.38; P=.001). However, exergame training did not have significant effects on kinesiophobia (SMD, −1.13; 95% CI, −2.88 to 0.62; P=.21).

      Conclusions

      Exergame training has beneficial effects on the overall functioning, pain perception, quality of life, exercise capacity, health perception and fatigue severity of female patients with FMS. Exergame training is a potential non-drug therapy for the treatment of patients with FMS.

      Keywords

      List of abbreviations:

      6MWT (6-minute walking test), BPI (Brief Pain Inventory), CI (confidence interval), EQ-5D (European Quality of Life-5 Dimensions), FIQ (Fibromyalgia Impact Questionnaire), FMS (fibromyalgia syndrome), FSS (Fatigue Severity Scale), GRADE (Grading of Recommendations, Assessment, Development, and Evaluation), SMD (standardized mean difference), TSK (Tampa Scale of Kinesiophobia), VAS (visual analog scale)
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      References

        • Wolfe F
        • Smythe HA
        • Yunus MB
        • et al.
        The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee.
        Arthritis Rheum. 1990; 33: 160-172
        • Wolfe F
        • Ross K
        • Anderson J
        • Russell IJ
        • Hebert L.
        The prevalence and characteristics of fibromyalgia in the general population.
        Arthritis Rheum. 1995; 38: 19-28
        • Rao UR.
        Soft tissue rheumatism.
        J Indian Med Assoc. 2003; 101: 528-530
        • Maquet D
        • Croisier JL
        • Crielaard JM.
        [Fibromyalgia in the year 2000].
        Rev Med Liege. 2000; 55 ([French]): 991-997
        • Berger A
        • Dukes E
        • Martin S
        • Edelsberg J
        • Oster G.
        Characteristics and healthcare costs of patients with fibromyalgia syndrome.
        Int J Clin Pract. 2007; 61: 1498-1508
        • Walker J.
        Fibromyalgia: clinical features, diagnosis and management.
        Nurs Stand. 2016; 31: 51-63
        • McLoughlin MJ
        • Colbert LH
        • Stegner AJ
        • Cook DB.
        Are women with fibromyalgia less physically active than healthy women?.
        Med Sci Sports Exerc. 2011; 43: 905-912
        • Bidonde J
        • Busch AJ
        • Schachter CL
        • et al.
        Aerobic exercise training for adults with fibromyalgia.
        Cochrane Database Syst Rev. 2017; 6CD012700
        • Galvez-Sánchez CM
        • Reyes Del Paso GA
        Diagnostic criteria for fibromyalgia: critical review and future perspectives.
        J Clin Med. 2020; 9: 1219
        • Carville SF
        • Arendt-Nielsen S
        • Bliddal H
        • et al.
        EULAR evidence-based recommendations for the management of fibromyalgia syndrome.
        Ann Rheum Dis. 2008; 67 (:563-41)
        • Häuser W
        • Klose P
        • Langhorst J
        • et al.
        Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials.
        Arthritis Res Ther. 2010; 12: R79
        • Andrade A
        • Dominski FH
        • Sieczkowska SM.
        What we already know about the effects of exercise in patients with fibromyalgia: an umbrella review.
        Semin Arthritis Rheum. 2020; 50: 1465-1480
        • Bidonde J
        • Busch AJ
        • Bath B
        • Milosavljevic S.
        Exercise for adults with fibromyalgia: an umbrella systematic review with synthesis of best evidence.
        Curr Rheumatol Rev. 2014; 10: 45-79
        • Busch AJ
        • Schachter CL
        • Overend TJ
        • Peloso PM
        • Barber KA.
        Exercise for fibromyalgia: a systematic review.
        J Rheumatol. 2008; 35: 1130-1144
        • van Diest M
        • Stegenga J
        • Wörtche HJ
        • Verkerke GJ
        • Postema K
        • Lamoth CJ.
        Exergames for unsupervised balance training at home: a pilot study in healthy older adults.
        Gait Posture. 2016; 44: 161-167
        • Song H
        • Peng W
        • Lee KM.
        Promoting exercise self-efficacy with an exergame.
        J Health Commun. 2011; 16: 148-162
        • Arane K
        • Behboudi A
        • Goldman RD.
        Virtual reality for pain and anxiety management in children.
        Can Fam Physician. 2017; 63: 932-934
        • Moher D
        • Liberati A
        • Tetzlaff J
        • Altman DG
        • Group PRISMA
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6e1000097
        • Lewis GN
        • Rosie JA.
        Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs and expectations of the users?.
        Disabil Rehabil. 2012; 34: 1880-1886
        • Villafaina S
        • Borrega-Mouquinho Y
        • Fuentes-García JP
        • Collado-Mateo D
        • Gusi N.
        Effect of exergame training and detraining on lower-body strength, agility, and cardiorespiratory fitness in women with fibromyalgia: Single-blinded randomized controlled trial.
        Int J Env Res Pu He. 2020; 17: 161
        • Martín-Martínez JP
        • Villafaina S
        • Collado-Mateo D
        • Pérez-Gómez J
        • Gusi N.
        Effects of 24-week exergame intervention on physical function under single-and dual-task conditions in fibromyalgia: a randomized controlled trial.
        Scand J Med Sci Sports. 2019; 29: 1610-1617
        • Villafaina S
        • Collado-Mateo D
        • Domínguez-Muñoz FJ
        • Fuentes-García JP
        • Gusi N.
        Benefits of 24-week exergame intervention on health-related quality of life and pain in women with fibromyalgia: a single-blind, randomized controlled trial. Games for.
        Health J. 2019; 8: 380-386
        • Collado-Mateo D
        • Dominguez-Muñoz FJ
        • Adsuar JC
        • Merellano-Navarro E
        • Gusi N.
        Exergames for women with fibromyalgia: a randomised controlled trial to evaluate the effects on mobility skills, balance and fear of falling.
        PeerJ. 2017; 5: e3211
        • Garcia-Palacios A
        • Herrero R
        • Vizcaíno Y
        • et al.
        Integrating virtual reality with activity management for the treatment of fibromyalgia.
        Clin J Pain. 2015; 31: 564-572
        • Gulsen C
        • Soke F
        • Eldemir K
        • et al.
        Effect of fully immersive virtual reality treatment combined with exercise in fibromyalgia patients: a randomized controlled trial.
        Assist Technol. 2020; (Jul 9. [Epub ahead of print])
        • Polat M
        • Kahveci A
        • Muci B
        • Günendi Z
        • Kaymak Karataş G
        The Effect of virtual reality exercises on pain, functionality, cardiopulmonary capacity, and quality of life in fibromyalgia syndrome: a randomized controlled study.
        Games Health J. 2021; 10: 165-173
        • Carvalho MS
        • Carvalho LC
        • Menezes FDS
        • Frazin A
        • Gomes EDC
        • Iunes DH.
        Effects of exergames in women with fibromyalgia: a randomized controlled study.
        Games Health J. 2020; 9: 358-367
        • Collado-Mateo D
        • Dominguez-Muñoz FJ
        • Adsuar JC
        • Garcia-Gordillo MA
        • Gusi N.
        Effects of exergames on quality of life, pain, and disease effect in women with fibromyalgia: a randomized controlled trial.
        Arch Phys Med Rehabil. 2017; 98: 1725-1731
        • Ferro Moura Franco K
        • Lenoir D
        • Dos Santos Franco YR
        • Jandre Reis FJ
        • Nunes Cabral CM
        • Meeus M
        Prescription of exercises for the treatment of chronic pain along the continuum of nociplastic pain: a systematic review with meta-analysis.
        Eur J Pain. 2021; 25: 51-70
        • Sosa-Reina MD
        • Nunez-Nagy S
        • Gallego-Izquierdo T
        • et al.
        Effectiveness of therapeutic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomized clinical trials.
        BioMed Res Int. 2017; 20172356346
        • Franco K
        • Lenoir D
        • Franco Y
        • Reis F
        • Cabral C
        • Meeus M.
        Prescription of exercises for the treatment of chronic pain along the continuum of nociplastic pain: a systematic review with meta-analysis.
        Eur J Pain. 2021; 25: 51-70
        • Higgins J P
        • Green S.
        Cochrane handbook for systematic reviews of interventions: assessing risk of bias in included studies.
        Cochrane Collaboration. 2008; : 187-241
        • Balshem H
        • Helfand M
        • Schünemann HJ
        • et al.
        GRADE guidelines: 3. Rating the quality of evidence.
        J Clin Epidemiol. 2011; 64: 401-406
        • Higgins J.
        Cochrane handbook for systematic reviews of interventions, version 5.0.1. The Cochrane Collaboration.
        Naunyn Schmiedebergs Arch Pharmacol. 2008; 5: S38
        • de Carvalho MS
        • Carvalho LC
        • Alves RDS
        • et al.
        Analysis of the muscular activity, peak torque in the lower limbs, and static balance after virtual rehabilitation in women with fibromyalgia: a randomized controlled study.
        Games Health J. 2021; 10: 190-197
        • Leon-Llamas JL
        • Villafaina S
        • Murillo-Garcia A
        • Dominguez-Munoz FJ
        • Gusi N.
        Effects of 24-week exergame intervention on the gray matter volume of different brain structures in women with fibromyalgia: a single-blind, randomized controlled trial.
        J Clin Med. 2020; 9: 2436
        • Botella C
        • Garcia-Palacios A
        • Vizcaino Y
        • et al.
        Virtual reality in the treatment of fibromyalgia: a pilot study.
        Cyberpsychol Behav Soc Netw. 2013; 16: 215-223
        • Morris LD
        • Louw QA
        • Grimmer KA
        • Meintjes E.
        Targeting pain catastrophization in patients with fibromyalgia using virtual reality exposure therapy: a proof-of-concept study.
        J Phys Ther Sci. 2015; 27: 3461-3467
        • Herrero R
        • García-Palacios A
        • Castilla D
        • Molinari G
        • Botella C.
        Virtual reality for the induction of positive emotions in the treatment of fibromyalgia: a pilot study over acceptability, satisfaction, and the effect of virtual reality on mood.
        Cyberpsychol Behav Soc Netw. 2014; 17: 379-384
      1. Villafaina S, Collado-Mateo D, Domínguez-Muñoz FJ, Gusi N, Fuentes-Garcia JP. Effects of exergames on heart rate variability of women with fibromyalgia: a randomized controlled trial. Sci Rep 2020;10:5168.

        • Mortensen J
        • Kristensen LQ
        • Brooks EP
        • Brooks AL.
        Women with fibromyalgia's experience with three motion-controlled video game consoles and indicators of symptom severity and performance of activities of daily living.
        J Disabil Rehabil Assist Technol. 2015; 10: 61-66
        • Brosseau L
        • Wells GA
        • Tugwell P
        • et al.
        Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: part 1.
        Phys Ther. 2008; 88: 857-871
        • Busch AJ
        • Barber KA
        • Overend TJ
        • Peloso PM
        • Schachter CL.
        Exercise for treating fibromyalgia syndrome.
        Cochrane Database Syst Rev. 2007; 2007: D3786
        • Burckhardt CS
        • Goldenberg D
        • Crofford L
        • et al.
        Guideline for the management of fibromyalgia syndrome pain in adults and children.
        American Pain Society, 2005
        • Rutledge DN
        • Martinez A
        • Traska TK
        • Rose DJ.
        Fall experiences of persons with fibromyalgia over 6 months.
        J Adv Nurs. 2013; 69: 435-448
        • Subramanian S
        • Dahl Y
        • Skjæret Maroni N
        • Vereijken B
        • Svanæs D
        Assessing motivational differences between young and older adults when playing an exergame.
        Games Health J. 2020; 9: 24-30
        • Staiano AE
        • Abraham AA
        • Calvert SL.
        Motivating effects of cooperative exergame play for overweight and obese adolescents.
        J Diabetes Sci Technol. 2012; 6: 812-819
        • Wickens JR
        • Reynolds JN
        • Hyland BI.
        Neural mechanisms of reward-related motor learning.
        Curr Opin Neurobiol. 2003; 13: 685-690
        • Wiederhold BK
        • Gao K
        • Sulea C
        • Wiederhold MD.
        Virtual reality as a distraction technique in chronic pain patients.
        Cyberpsychol Behav Soc Netw. 2014; 17: 346-352