Effect of Pilates on Pain and Health-Related Quality of Life in Fibromyalgia Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Pilates is one of the non-pharmacological interventions for fibromyalgia (FM). However, its impacts on pain and health-related quality of life (HRQOL) in fibromyalgia patients (FMPs) are inconclusive. This study aimed to assess the effects of Pilates on pain and HRQOL among FMPs. Methods: A systematic review and meta-analysis were conducted. Four databases—PubMed, ScienceDirect, Scopus, and Cochrane CENTRAL—along with one grey literature source, Google Scholar, were searched for randomized controlled trials comparing Pilates with other exercises or usual care in FMPs. The outcomes were pain and HRQOL. A meta-analysis was performed using a random-effects model. Results: Six studies were included (n = 265). We found that the effects of Pilates from each individual study on pain were inconsistent. Our pooled analysis of visual analog scale (VAS) scores demonstrated significant pain reduction (mean difference (MD), −0.71, 95%CI, −1.33 to −0.10, p = 0.023; (I2 = 29.3%, p = 0.226)). However, neither the algometric score (AS) nor tender point count (TPC) showed an insignificant difference (AS: MD, −0.43, 95%CI, −2.60 to 1.74, p = 0.700; (I2 = 0.0%, p = 0.654); TPC: MD, −0.16, 95%CI, −2.22 to 1.89, p = 0.520; (I2 = 0.0%, p = 0.515)). Regarding HRQOL, Pilates showed statistically significant improvements on the Fibromyalgia Impact Questionnaire (FIQ) (MD, −7.28, 95%CI, (−12.06 to −2.49), p = 0.003; (I2 = 95.7%, p < 0.001)). A sensitivity analysis of three RCTs (n = 176) based on the ACR 2010 supported this finding (MD, −7.68, 95% CI, −8.60 to −6.76, p < 0.001; (I2 = 0.0%, p = 0.832)) with non-important heterogeneity. Conclusions: Pilates may benefit FMPs. It could reduce pain and improve HRQOL. Given the small number of studies and the presence of data heterogeneity, future high-quality RCTs would provide a clearer conclusion.