Modulation of Autonomic Function by Physical Exercise in Patients with Fibromyalgia Syndrome: A Systematic Review

Objective To evaluate the effects of physical exercise on autonomic dysfunction in patients with fibromyalgia syndrome (FM). Literature Survey and Methodology A systematic review of experimental studies published until December 2017 that analyzed the effect of physical exercise on autonomic dysfunction in patients with FM was performed using the PubMed, Pedro, Scopus, ScienceDirect, and Web of Science databases. Synthesis A total of 1105 articles were identified, 12 of which were included in the final analysis. The most analyzed exercise modalities were aerobic and resistance exercises. Overall, the studies demonstrated that aerobic exercise performed twice a week with moderate to high intensity was effective in reducing autonomic dysfunction by increasing heart rate variability. Resistance training was associated with reduced symptoms of anxiety and depression as well as increased muscle strength; however, it did not reduce autonomic dysfunction in these patients in the short or long term. Conclusions Preliminary evidence suggests that aerobic exercise reduces autonomic dysfunction in patients with FM, whereas resistance training reduces psychological symptoms such as anxiety and depression. Level of Evidence I