Rivas Neira, S, Pasqual Marques, A, Fernández Cervantes, R et al. · Physiotherapy · 2024 · DOI
This study compared two types of exercise therapy for women with fibromyalgia: exercising in a pool (aquatic therapy) versus exercising on land. Both groups did 60-minute exercise sessions three times a week for 12 weeks. Six weeks after the program ended, women who did aquatic therapy reported less pain and better sleep quality than those who exercised on land, suggesting that water-based exercise may be particularly helpful for fibromyalgia.
ME/CFS and fibromyalgia frequently co-occur and share overlapping symptoms including pain and sleep disturbance. This study identifies aquatic therapy as a potentially superior non-pharmacological intervention for pain management in a related chronic condition, providing evidence that may inform exercise recommendations for post-exertional malaise-aware rehabilitation in ME/CFS populations. The sustained benefit at follow-up suggests potential long-term value of aquatic approaches in managing persistent symptoms.
This study does not establish that aquatic therapy is effective for ME/CFS specifically, as it enrolled only fibromyalgia patients; outcomes may differ substantially given ME/CFS's distinctive post-exertional malaise and neurological features. The study does not determine whether benefits persist beyond 18 weeks or explain the biological mechanisms underlying aquatic therapy's advantages. The single-blind design and per-protocol (rather than intention-to-treat) analysis may introduce bias and limit causal inference.
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
Rivas Neira, S, Pasqual Marques, A, Fernández Cervantes, R, Seoane Pillado, M T, & Vivas Costa, J (2024). Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial.. Physiotherapy. https://doi.org/10.1016/j.physio.2024.02.005
BibTeX
@article{mecfsatlas-rivas-neira-2024-efficacy-aquatic,
author = {Rivas Neira, S and Pasqual Marques, A and Fernández Cervantes, R and Seoane Pillado, M T and Vivas Costa, J},
title = {Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial.},
journal = {Physiotherapy},
year = {2024},
doi = {10.1016/j.physio.2024.02.005},
note = {PubMed: 38447497},
url = {https://www.mecfsatlas.com/evidence/rivas-neira-2024-efficacy-aquatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/rivas-neira-2024-efficacy-aquatic
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