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Sempere-Rubio et al. | Journal of Clinical and Translational Research 2023; 9(6): 369-380 373
Table 1. Characteristics of the reviews included in the umbrella review
Study Studies Meta- Population Intervention Control Outcomes (instruments) Author’s conclusions
k (n) analysis
Types (k)
Antunes 2 RCTs No FMS HEI Comparator - Pain intensity An interdisciplinary health
et al. [19] (65) FMS - TE in FMS (FMS - No intervention (NHP subscale) education program can
(Diagnosis symptoms information - Quality of life (NHP) improve pain and quality of
based on and active coping life in people with FMS
1990/2010ACR strategies)
criteria) (+ Multicomponent
approach in 1/1 RCT)
Elizagaray- 5 RCTs No FMS HEI Comparator - Pain intensity (PPT, HEI, in itself, has not
García (611) (Diagnosis - PNpE - Information about TS, SSP, CPM, FIQ proved to be effective for
et al. [20] based on 1990 - PNE relaxation subscale and number of pain intensity, quality of life
ACR criteria) - TE in FMS - Stretching exercises tender points) or functionality in patients
(FMS symptoms information booklets - Quality of life (SF-36 with FMS. However, HEI
information, SM skills - No intervention and SV-QOLS) in combination with TEx
education or active - Waiting list - Functionality (FIQ showed effectiveness on the
coping strategies) subscale, SF-36 variables analyzing.
(+TEx in 3/5 RCT) subscale and 6MWT)
García-Ríos 12 No FMS HEI Comparator - Pain intensity (VAS, The scientific evidence that
et al. [21] RCTs (Diagnosis - PNpE - Information about PPT, SSP, PCI, MPI-S supports the effectiveness
(1389) based on 1990 - PNE relaxation and PVAQ) of HEI in the reduction of
ACR criteria) - TE in FMS - Relaxation breathing - Quality of life (FIQ, pain intensity, quality of
(FMS symptoms - Stretching exercises IPQ-R, EQ-5D, SF-36, life, functionality, anxiety,
and pain catastrophizing is
information, SM skills information booklets NHP and SV-QOLS) limited.
education or active - FMS information - Functionality (FIQ
coping strategies) booklets subscale, SF-36
(+ Multicomponent - Waiting list subscale, 6MWT and
approach in 6/12 - Usual practice AIMS)
RCT) - TEx - Anxiety (PGWB and
GADS)
- Pain Catastrophizing
(PCS)
Saracoglu 4 RCTs Yes (4) FMS HEI Comparator - Pain intensity Adding PNE to a
et al. [22] (612) (Diagnosis - PNE - Minimal intervention (VAS and NPRS) multimodal treatment
based on 2010 (+ Multicomponent (patient information - Quality of life (FIQ)* including TEx might be
ACR criteria) approach in 2/4 RCTs) about the disease, - Anxiety (HADs) an effective approach
recommendations - Pain Catastrophizing for improving functional
on aerobic exercise, (PCS) status, pain-related
and pharmacological symptoms, anxiety, and
treatment) depression for patients with
FMS.
Suso-Martí 8 RCTs Yes (8) FMS HEI Comparator - Pain intensity In patients with FMS,
et al. [23] (738) (Diagnosis - PNE - Relaxation (VAS, SF-BPI, NPRS) PNE can decrease the
based on (+TEx in 1/8 RCT) - Breathing exercises - Quality of life (FIQ) pain intensity in the post-
1990/2010/2016 - Minimal intervention - Anxiety (PASS-20, intervention period and
ACR criteria) (pharmacological HAQ, and HADS) the quality of life in the
usual care or general - Pain Catastrophizing follow-up period (3 m).
advice) (PCS) However, it
- No intervention appears that PNE showed no
- TEx effect on anxiety and pain
catastrophizing.
Notes. FMS: Fibromyalgia syndrome; ACR: American college of rheumatology; RCT: Randomized controlled trial; PNpE: Pain Neurophysiology Education; SM: Self-management;
PNE: Pain neuroscience education; TE: Therapeutic education; PPT: Pressure pain threshold; TS: Temporal summation; CPM: Conditioned pain modulation (CPM); FIQ: Fibromyalgia
impact questionnaire; SF-36: 36-Item Short Form Health Survey; QOLS: Swedish version quality of life scale; 6MW: 6 minutes walking test; HEI: Health education interventions;
PT: Physical Therapy; m: months; PCS: Pain catastrophizing scale; VAS: Visual analogue scale; SF-BPI: Short form of brief pain inventory; NPRS: Numeric pain rating scale; HAQ: Health
assessment questionnaire; PASS-20: Pain anxiety symptoms scale-20; HADS: Hospital anxiety and depression scale; TEx: Therapeutic exercise; SSP: Spatial summation of pain; PCI: Pain
coping inventory; PVAQ: Pain and awareness surveillance questionnaire; MPI-S: Swedish version of the Multidimensional pain inventory; IPQ-R: Revised illness perception questionnaire;
EQ-5D: EuroQoL-5D questionnaire; AIMS: Arthritis impact measurement scales; NHP: Nottingham health profile. PGWB: Psychological general well-being and GADS: Goldberg scale of
anxiety and depression.
*The quality of life variable was reinterpreted for this study. In the original review, it is found as: severity of FMS

DOI: http://dx.doi.org/10.18053/jctres.09.202306.23-00108