Mannerkorpi 2010.
| Methods | 2 groups: Nordic walking (AE); low intensive walking (AE) Length: 15 weeks; follow‐up: 26 weeks Study design: randomized clinical trial with parallel group |
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| Participants | Female:Male: 67:0 Age (years (SD)): 48.0 (7.8); 50.0 (7.6) Inclusion: diagnosis of fibromyalgia (ACR 1990), ability to manage a bicycle test at 50 watts or more, interest in exercising outdoors Exclusion: did not speak or read Swedish, presence of other severe somatic or psychiatric disease, ongoing planned physical therapy ‐ including exercise, inability to accept times for planned exercise sessions Duration of illness (years (SD)): 11 (5.4); 12 (5.3) |
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| Interventions |
Nordic walking (n = 34): supervised moderate‐ to high‐intensity aerobic exercise. Frequency: 2/wk; Duration: 20'; Intensity: 10' light (RPE 9‐11), 2' interval moderate to vigorous (RPE 13‐15) alternated with 2' light (RPE 10 to 11); Mode: walking in parks and forests with flat areas and small hills Low intensive walking (n = 33): supervised low‐intensity aerobic exercise. Frequency: 1/wk; Duration: 20'; Intensity: light (RPE 9 to 11); Mode: walking in parks and forests with flat areas and small hills |
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| Outcomes | Health‐related quality of life (FIQ Total), pain (FIQ), fatigue (FIQ), physical function (FIQ), CR submax (6‐minute walk test, ergometer test) Others: fatigue (multidimensional fatigue inventory) Measurements taken at 0, 15, and 26 weeks |
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| Adherence to exercise protocols | Monitoring methods: participant monitored; adherence criteria: not specified; adherence: median attendance was 62% and 50%, respectively, in a and b | |
| Congruence with ACSM guidelines for aerobic training | No, based on frequency and duration (only twice or once a week with 20' session duration) | |
| Notes | Country: Sweden Language: English Study author contacted: yes, study author provided information on post‐test data Funding source/declaration of interest: Work was supported by Swedish Research Council, the Health and Medical Care Executive Board of Västra Götaland Region, the Swedish Rheumatism Association, the Rheumatic Pain Society in Göteborg/RiG, and the LUA/ALF at Sahlgrenska University Hospital |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomization was prepared by a statistician using a random number generator |
| Allocation concealment (selection bias) | Low risk | "Randomization was conducted by using concealed envelopes prepared by a statistician" (page 2) |
| Blinding of self reported outcome assessment (detection bias) All outcomes | Low risk | Self‐report instruments: health‐related quality of life (FIQ Total), pain intensity (FIQ), fatigue (FIQ), physical function (FIQ). Active comparison group of similar conditions |
| Blinding of objective outcome assessment (detection bias) All outcomes | Low risk | CR submax (6‐minute walk test, ergometer test). Communication from study authors indicates that all assessors were blinded for all post test measures."..where single‐blinded examiners did not know the group to which patient would be randomized" (page 2‐10) |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Insufficient information on blinding of participants and personnel to permit judgment of risk |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Missing outcome data were balanced in numbers across intervention groups with similar reasons for missing data across groups |
| Selective reporting (reporting bias) | Low risk | Study protocol is available (ClinicalTrials.gov ID NCT00498264) and all of the study's prespecified outcomes of interest in the review have been reported in the prespecified way |
| Other bias | Low risk | Study appears to be free of other sources of bias |