Physical activity in the treatment of fibromyalgia, 2021, Masquelier and D'haeyere

Abstract
International treatment recommendations for fibromyalgia (FM) highlight the importance of adapted physical activity (APA) combined with patient education. Cognitive and behavioral therapies as well as an interdisciplinary approach can be proposed for more complex or severe clinical situations, with a biopsychosocial vision of rehabilitation.

To personalize the rehabilitation’s therapeutic approach, a clinician can use simple and validated instruments for measuring physical performance that will highlight levels of physical conditioning, which range from low to very low in FM patients.

Several systematic reviews and meta-analyses have found strong evidence that supervised aerobic and resistance training programs reduce the pain intensity and significantly improve the quality of life and the physical and psychological functioning of female FM subjects. These therapeutic approaches appear safe and promising in terms of cost-effectiveness and should be the subject of more randomized controlled trials among male FM subjects and adolescents.

Paywall, https://www.sciencedirect.com/science/article/pii/S1297319X21000749

 

I've never found that exercise reduced my fibro pain. Improves mood at times, if outdoors, but it leads to activation of the pain generating muscle tissues.

The dose of exercise has to be so carefully monitored for that reason and it varies, and it is hard to ascertain if you're doing yourself in by doing the same amount you did the day before or can get away with it, or that it will be cumulative in producing a pain state (resembling or is PEM).

Also, muscle resistance training in especially the upper body, is something that ALWAYS leads to intense and longer lasting pain and I've never been able to sustain it. One or two tiny reps is all I can get away with.

All upper body activities of daily living are pain instigators.

 

Decades of using this in practice. And still the actual evidence is no better than "can be proposed" or "has been suggested" or variations of the same "some people are saying", which actually stands for "many people want to be true".

This has already been used in widespread practice for decades. And all the research still has to be done because the research that's already been done, which is used to support its decades in practice, can only be summed up with the cheapest euphemisms for "it doesn't work but we'll continue trying anyway because we believe in this". It even says they should be part of studies, which have been ongoing for decades already, hence why there are systematic reviews of this stuff. And this here, a review article on the body of evidence they make up, suggests they should be performed, what, again? It says the existing evidence is strong, so why would it have to be done again? The hundreds of prior studies are copy-paste versions of the same, as would any future ones.

Of course none of the "evidence" is strong, let alone evidence. As is evident by the fact that the very best that can be said is that they can "be proposed". At best it's speculation that some day it will be understood but the one thing that is sure is that this thing is true, a true teleological model. All the steps in-between the beginning and the end are formalities, the end is guaranteed to happen one way and only one way: it "works".

Seriously this is amazing. The article portrays both versions of reality in the abstract with zero self-awareness, pointing at a "strong" evidence base large enough for systematic reviews but admitting that at the very best it has "been proposed", some people are saying. Amazing. The process is completely broken, that this article passed peer review is like the end-stage of a terminal pathology.

This reminds me of background actors in cheap TV shows, whose role is overlooked so they do something that looks silly if you pay attention but nobody does because it happens with a lot of foreground action. This is who these people are, this is what they are doing, the guy in the background "turning" some wheel on the wall:

Spoiler: Just turning that wall wheel because it needs turning