Stretching exercises or walking did not produce clinically meaningful improvements in quality of life of patients with fibromyalgia,2026, Pontes-Silva

[Dolphin]

https://www.sciencedirect.com/science/article/abs/pii/S0211563826000015

Fisioterapia​

Available online 2 March 2026
In Press, Corrected ProofWhat’s this?

Original​

A. Pontes-Silva, M.A. Avila

https://doi.org/10.1016/j.ft.2026.01.001Get rights and content

Abstract​

Overview​

Considering that walking is the most studied exercise in fibromyalgia trials, and it has not been tested as a positive-control in previous trials, the question arises: does stretching exercises provide similar clinical benefits to walking as a positive-control in fibromyalgia patients?

Objective​

To test the effects of stretching exercises on quality of life (single primary outcome) against a positive-control group of moderate-intensity walking in fibromyalgia patients.

Methods​

Non-randomized controlled clinical trial. We used the FIQ-R to evaluate the single primary outcome of the study: quality of life. Intervention in positive-control group: 40 min of moderate-intensity walking, 2×/week, 12 weeks duration + 12 weeks follow-up without exercise. Intervention in the stretching group: moderate intensity stretching, 2×/week, 12 weeks duration + 10 weeks follow-up without exercise. We compared the quality of life using mixed linear models, time × group interaction, Bonferroni post hoc, and Cohen's d to test the effect size of significant differences (α = 0.05).

Results​

The total sample consisted of 225 volunteer fibromyalgia patients who were divided into two groups: a walking group (n = 15, age 45 ± 9.93) and a stretching group (n = 210, age 47.81 ± 1.57). Our study found no adverse effects and no adherence to the intervention. Between-group comparisons revealed non-significant differences (p > .05) in quality of life for fibromyalgia patients at all time points: baseline, 6th week, 12th week, and follow-up. In the within-group comparisons, only the walking group showed significant differences (p ≤ .05, d ≥ .5) from baseline at all time points: baseline–6th week (17.44 [95% CI: 4.30, 30.57]), baseline–12th week (17.19 [95% CI: 1.16, 33.21]), and baseline–follow-up (16.84 [95% CI: 1.78, 31.90]). However, these differences did not reach the minimal clinically important difference threshold.

Conclusion​

Stretching exercises or walking did not produce clinically meaningful improvements in the quality of life of patients with fibromyalgia.

Resumen​

Descripción general​

Dado que caminar es el ejercicio más estudiado en ensayos sobre la fibromialgia y no se ha utilizado como control positivo en estudios previos, surge la siguiente pregunta: ¿los ejercicios de estiramiento proporcionan beneficios clínicos similares a los de caminar como control positivo en pacientes con fibromialgia?.

Objetivo​

Probar los efectos de los ejercicios de estiramiento sobre la calidad de vida (resultado primario único) en comparación con un grupo de control positivo de caminata de intensidad moderada en pacientes con fibromialgia.

Métodos​

Ensayo clínico controlado no aleatorizado. Se utilizó el FIQ-R para evaluar el resultado principal del estudio: la calidad de vida. Intervención en el grupo de control positivo: 40 min de caminata de intensidad moderada, 2 veces por semana, durante 12 semanas, más 12 semanas de seguimiento sin ejercicio. Intervención en el grupo de estiramientos: estiramientos de intensidad moderada, 2 veces por semana, durante 12 semanas, más 10 semanas de seguimiento sin ejercicio. Comparamos la calidad de vida utilizando modelos lineales mixtos con interacción tiempo-grupo, pruebas post hoc de Bonferroni y d de Cohen para probar el tamaño del efecto de las diferencias significativas (α = 0,05).

Resultados​

La muestra total constó de 225 pacientes voluntarios con fibromialgia, que se dividieron en dos grupos: un grupo de caminata (n = 15, edad: 45 ± 9,93) y un grupo de estiramiento (n = 210, edad: 47,81 ± 1,57). Nuestro estudio no encontró efectos adversos ni falta de adherencia a la intervención. Las comparaciones entre grupos no revelaron diferencias significativas (p > 0,05) en la calidad de vida de los pacientes con fibromialgia en ningún momento: basal, sexta semana, duodécima semana y seguimiento. En las comparaciones intragrupales, solo el grupo de caminata mostró diferencias significativas (p ≤ 0,05, d ≥ 0,5) con respecto al valor inicial en todos los puntos temporales: valor inicial-6.a semana (17,44 [IC del 95%: 4,30-30,57]), valor inicial-12.a semana (17,19 [IC del 95%: 1,16-33,21]) y valor inicial-seguimiento (16,84 [IC del 95%: 1,78-31,90]). Sin embargo, estas diferencias no alcanzaron el umbral de diferencia mínima clínicamente importante.

Conclusión​

Los ejercicios de estiramiento o caminar no produjeron mejoras clínicamente significativas en la calidad de vida de los pacientes con fibromialgia.

 

[Trish]

Our study found no adverse effects and no adherence to the intervention.

no adherence? I assume they intended to use the double negative: no non-adherence.

Stretching exercises or walking did not produce clinically meaningful improvements in the quality of life of patients with fibromyalgia.

So all those endless variations on exercise interventions for FM are useless. The emperor has no clothes.

 

[Turtle]

Honest at last, but will it be read by rehabs etc. who still "think" the opposit is true?

Clothes everywhere (@Trish) and still the emperors can't find them.
Most of them don't look so good in their birthday suits.

 

[shak8]

My primary care doc showed his deep knowledge of FM when he asked me (when I complained of pain):
"do you stretch?"

With my FM, I'm okay with stretching leg muscles, but this past week I made the mistake (yet again) of stretching my upper body: shoulders/arms/lateral rib muscles.

What ensued 2 days later were multiple areas that felt like I had pulled muscles (pain intensity was 4 out of a possible 5).

 

[rvallee]

walking is the most studied exercise in fibromyalgia trials

these differences did not reach the minimal clinically important difference threshold

walking did not produce clinically meaningful improvements in the quality of life of patients with fibromyalgia

Where even does this idea that there is a magical series of movements that will cause meaningful improvements? And that trying them all is something worth doing? The whole premise makes no sense, it's barely any better than what medieval alchemists did.

There is literally no plausible mechanism here, other than "these people are perfectly fine and healthy and just need either a gentle guiding hand, or perhaps a firmer approach to the same, but just the same it doesn't matter because there is nothing wrong with them anyway", which is the real motivation, but it's misrepresented because it has no validity.

I don't even know how any of this is better than nonsense like "balance bracelets". For sure it's just as plausible, in a 0=0 way. Hell, even the questionnaires they use to drive this ideology aren't any better than mood crystals that change color based on, I guess, body heat.

 

[rvallee]

My primary care doc showed his deep knowledge of FM when he asked me (when I complained of pain):
"do you stretch?"

With my FM, I'm okay with stretching leg muscles, but this past week I made the mistake (yet again) of stretching my upper body: shoulders/arms/lateral rib muscles.

What ensued 2 days later were multiple areas that felt like I had pulled muscles (pain intensity was 4 out of a possible 5).

It's all so ridiculous because there are definitely types of pain that improve with gentle stretching and movement, and those are precisely the kinds of pain that do get reported as having improved, but the underlying chronic pain causing the low activity levels that cause those secondary pains never gets addressed, and the added burden of doing those is never considered because they operate on the belief that there is no such thing anyway.