Mind-body therapies for the treatment of fibromyalgia. A systematic review

Objective. To assess the effectiveness of mind-body therapy (MBT) for fibro myalgia syndrome (FM) by systematically reviewing randomized/quasirandomize d controlled trials using methods recommended by the Cochrane Collaboration . Methods. Nine electronic databases, 69 conference proceedings, and several citation lists were searched for relevant trials in any language. Eligible trials were scored for methodological quality using a validated instrument. Information on major outcomes was extracted. Insufficient data reporting p revented statistical pooling, therefore a best-evidence synthesis was perfo rmed. Results. Thirteen trials involving 802 subjects were included. Seven trials received a high methodological score. Compared to waiting list/treatment a s usual, there is strong evidence that MBT is more effective fur self-effic acy, limited evidence fur quality of life, inconclusive evidence for all ot her outcomes. There is limited evidence that MBT is more effective than pla cebo (for pain and global improvement); inconclusive evidence that MBT is m ore effective than physiotherapy, psychotherapy, or education/attention con trol for all outcomes; strong evidence that moderate/high intensity exercis e is more effective than MBT (for pain and function). There is moderate evi dence that MBT plus exercise (MBT+E) is more effective than waiting list/tr eatment as usual (for self-efficacy and quality of life); limited evidence that MBT+E is more effective than education/attention control; inconclusive for other outcomes. There is inconclusive evidence for MBT+E vs other acti ve treatments for all outcomes. Longterm within-groups results show greates t benefit fur MBT+E. Conclusion. MBT is more Effective for some clinical outcomes compared to wa iting list/treatment as usual or placebo. Compared to active treatments, re sults are largely inconclusive, except for moderate/high intensity exercise , where results favor the latter. Further research needs to focus on the sy nergistic effects of MBT plus exercise and/or plus antidepressants.