Perception and lived experience of movement in patients with fibromyalgia: a qualitative systematic review with meta-synthesis and meta-summary.

OBJECTIVE: To systematically synthesize and summarize qualitative findings on how adults with fibromyalgia perceive, negotiate, and sustain exercise and everyday movement. DESIGN: Systematic review of qualitative studies with meta-synthesis and meta-summary. LITERATURE SEARCH: We searched CINAHL, EMBASE, PsycINFO, MEDLINE, Scopus, SPORTDiscus, and Web of Science until October 2025, supplemented by berry-picking techniques and gray literature. STUDY SELECTION CRITERIA: We included qualitative primary studies or mixed-methods studies that clearly reported qualitative data; involved adults (≥ 18 years) with fibromyalgia; and explored experiences of movement, physical activity, or exercise. DATA SYNTHESIS: Sandelowski and Barroso's methodology was used for study classification, meta-synthesis, and meta-summary. Methodological quality was appraised with Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool. The Confidence in the Evidence from Reviews of Qualitative Research approach evaluated certainty. RESULTS: Thirteen studies (N = 213, 204 women; 19-82 years) were included. Four hundred thirty-two statements were extracted, synthesized into 15 categories, and grouped into four themes: (1) past experiences of movement; (2) movement during daily life: strategies, adaptations, and effects; (3) barriers to movement: personal, environmental, and relational; (4) facilitators to movement: peer support, empathic relationships, and f guide. Inter-study frequency effect sizes were highest for "Positive effects" (77%) and "Altered body perception" (69%) and lowest for "Standardized, not personalized plan" (31%). Overall confidence in the findings was moderate. CONCLUSION: For individuals with fibromyalgia, movement is experienced as both beneficial and risky. Patient-centered rehabilitation could validate pacing, formalize existing self-management strategies, and offer tailored, supported pathways to sustainable activity.

Duke Scholars

Author Chad E. Cook Orthopaedic Surgery, Physical Therapy