What is known about fitness, physical activity, health-related quality of life and muscle-strengthening activities in adults with fibromyalgia? A scoping review

Objective

To map the current evidence on components of fitness, physical activity and health-related quality of life, in addition to common fitness and health-related quality of life outcomes and assessment tools, explore existing evidence on the design and effects of muscle-strengthening activities on health-related quality of life, and map the research on the barriers and facilitators to engagement in physical activities, specifically muscle-strengthening activities, in adults living with fibromyalgia.

Design

Scoping review of published articles.

Data sources

Electronic databases (PubMed, SPORTDiscus, SCOPUS, CINAHL, Cochrane Library, MedLine and Google Scholar) and reference searching were included from the earliest date to March 2025.

Eligibility criteria

Studies were included if they assessed components of fitness, physical activity, health-related quality of life and/or muscle-strengthening activities in relation to fibromyalgia and were published in English. Articles containing reviews, case reports, protocols, editorials or opinion pieces were excluded.

Results

79 articles were included in the scoping review. Compared with healthy controls, individuals with fibromyalgia have decreased muscle strength, cardiovascular fitness, agility, balance and flexibility levels of physical activity and health-related quality of life. The fibromyalgia impact questionnaire, 36-item short-form health survey and visual analogue scale were predominant tools used to assess health-related quality of life, though methods varied considerably across studies. Muscle-strengthening activity intervention study designs were heterogeneous, although progressions during resistance-based strength exercise emerged as a promising modality to improve health-related quality of life. Currently, the barriers to and facilitators of muscle-strengthening activities are underexplored.

Conclusion

This scoping review highlights substantial heterogeneity in health-related quality of life assessment tools and muscle-strengthening activity intervention design in adults with fibromyalgia. While muscle-strengthening activities appear beneficial, the absence of standardised protocols limits the comparability of studies. Moreover, further work is needed within qualitative research to understand the barriers to engagement in muscle-strengthening activities to further inform the development of tailored, patient-centred muscle-strengthening programmes.

OSF Registration

10.17605/OSF.IO/DJWBQ .