Del-Moral-García, María, Obrero-Gaitán, Esteban, Rodríguez-Almagro, Daniel et al. · Journal of clinical medicine · 2020 · DOI
People with fibromyalgia often have trouble with balance, which increases their risk of falling and affects their ability to do daily activities. This review looked at 10 studies testing whether active exercise-based training programs could help improve balance in fibromyalgia patients. The results showed that these training programs did help people improve their balance and stability compared to other treatments or no treatment.
Balance impairment is a common but understudied symptom in ME/CFS, similar to fibromyalgia. Understanding which physical interventions effectively improve balance without triggering post-exertional malaise is critical for developing safe rehabilitation protocols. This evidence synthesis provides a foundation for considering whether similar exercise-based approaches might benefit ME/CFS patients with balance dysfunction.
This study does not establish that ATBT is safe or effective for ME/CFS patients specifically, as fibromyalgia and ME/CFS have distinct pathophysiology and post-exertional responses. The review does not address whether improvements persist long-term or whether benefits extend to reducing fall-related injuries in real-world settings. Additionally, the study cannot determine optimal exercise intensity or duration, as this variation existed across the included trials.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Del-Moral-García, María, Obrero-Gaitán, Esteban, Rodríguez-Almagro, Daniel, Rodríguez-Huguet, Manuel, Osuna-Pérez, María Catalina, & Lomas-Vega, Rafael (2020). Effectiveness of Active Therapy-Based Training to Improve the Balance in Patients with Fibromyalgia: A Systematic Review with Meta-Analysis.. Journal of clinical medicine. https://doi.org/10.3390/jcm9113771
BibTeX
@article{mecfsatlas-del-moral-garca-2020-effectiveness-active,
author = {Del-Moral-García, María and Obrero-Gaitán, Esteban and Rodríguez-Almagro, Daniel and Rodríguez-Huguet, Manuel and Osuna-Pérez, María Catalina and Lomas-Vega, Rafael},
title = {Effectiveness of Active Therapy-Based Training to Improve the Balance in Patients with Fibromyalgia: A Systematic Review with Meta-Analysis.},
journal = {Journal of clinical medicine},
year = {2020},
doi = {10.3390/jcm9113771},
note = {PubMed: 33266511},
url = {https://www.mecfsatlas.com/evidence/del-moral-garca-2020-effectiveness-active},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/del-moral-garca-2020-effectiveness-active
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