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Six-month supervised telerehabilitation combining pilates-based therapeutic exercise and self-myofascial release in adults with fibromyalgia: a randomized controlled trial.

Marantidou T, Germanou E, et al. • Journal of rehabilitation medicine • 2026

RCT PubMed 42867081 DOI 10.2340/jrm.v58.46786

TL;DR

6 months of supervised multicomponent telerehabilitation produced favourable longitudinal changes in fibromyalgia impact, sleep quality, depressive symptoms, and perceived stress compared with usual care.

Key Findings

Results

Significant group-by-time interaction was observed for fibromyalgia impact favoring the telerehabilitation group over usual care.

Group-by-time interaction for fibromyalgia impact: p < 0.001, partial η² = 0.132
Outcomes were assessed at baseline, 3 months, and 6 months using validated patient-reported measures
The intervention group comprised n = 35 participants; usual care group comprised n = 33 participants
Fibromyalgia was confirmed according to the 2016 ACR criteria

Results

Significant group-by-time interaction was observed for sleep quality favoring the telerehabilitation group.

Group-by-time interaction for sleep quality: p < 0.001, partial η² = 0.129
Sleep quality was measured using a validated patient-reported measure at baseline, 3 months, and 6 months
Effect size (partial η² = 0.129) was similar in magnitude to that observed for fibromyalgia impact

Results

Significant group-by-time interaction was observed for depressive symptoms favoring the telerehabilitation group.

Group-by-time interaction for depressive symptoms: p = 0.002, partial η² = 0.129
Outcomes assessed at baseline, 3 months, and 6 months using validated patient-reported measures
Effect size for depressive symptoms (partial η² = 0.129) was comparable to that for sleep quality and fibromyalgia impact

Results

Significant group-by-time interaction was observed for perceived stress favoring the telerehabilitation group, though with a smaller effect size.

Group-by-time interaction for perceived stress: p = 0.028, partial η² = 0.065
The effect size for perceived stress (partial η² = 0.065) was notably smaller than those observed for fibromyalgia impact, sleep quality, and depressive symptoms
Outcomes assessed at baseline, 3 months, and 6 months

Results

No significant group-by-time interaction was observed for anxiety.

Group-by-time interaction for anxiety: p = 0.701
Anxiety was assessed using a validated patient-reported measure at baseline, 3 months, and 6 months
Anxiety was the only psychological outcome that did not show a significant interaction effect

Results

Mean intervention adherence was high at 87.5%, with no adverse or serious adverse events reported in either group.

Mean adherence to the telerehabilitation programme was 87.5%
No adverse or serious adverse events were reported in either the intervention or usual care group
The programme consisted of 3 live online sessions weekly over 6 months
The intervention combined Pilates-based therapeutic exercise, self-myofascial release, core stabilization, low-load resistance exercise, stretching, and relaxation

Methods

The study was a two-arm, parallel-group randomized controlled trial enrolling 68 adults with fibromyalgia.

68 adults with fibromyalgia confirmed according to the 2016 ACR criteria were enrolled
Participants were randomized to telerehabilitation (n = 35) or usual care (n = 33)
The trial was a 6-month supervised home-based telerehabilitation programme
Outcomes were assessed at three time points: baseline, 3 months, and 6 months

What This Means

This research suggests that a 6-month online exercise programme can meaningfully improve the lives of adults with fibromyalgia, a chronic pain condition that affects daily functioning, sleep, and mental health. The programme involved three live, supervised video sessions per week that combined several components: Pilates-based exercises, self-myofascial release (a technique using gentle pressure to relieve muscle tightness), core strengthening, light resistance training, stretching, and relaxation. Compared to people who received only their usual medical care, those who completed the telerehabilitation programme showed significant improvements in overall fibromyalgia impact, sleep quality, depressive symptoms, and perceived stress over the 6-month period. Notably, anxiety levels did not improve significantly with the programme. A particularly encouraging finding was the high adherence rate of 87.5%, meaning participants attended most of their scheduled sessions, and no injuries or serious adverse events occurred in either group. This suggests the programme is both safe and practical for people to follow from home without needing to travel to a clinic. The use of a telehealth (online) format is especially relevant for fibromyalgia patients, who often face barriers to in-person care due to pain, fatigue, or limited mobility. This research suggests that combining multiple exercise and body-care techniques delivered remotely via video can be an effective and accessible option for managing fibromyalgia symptoms beyond just pain, addressing the broader impacts on sleep and emotional wellbeing. Future research may explore why anxiety specifically did not respond to the intervention and whether longer programmes or different formats could produce even greater benefits.

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Citation

Marantidou T, Germanou E, Manou V, Koutlianos N, Sykaras E, Terzidis I. (2026). Six-month supervised telerehabilitation combining pilates-based therapeutic exercise and self-myofascial release in adults with fibromyalgia: a randomized controlled trial.. Journal of rehabilitation medicine. https://doi.org/10.2340/jrm.v58.46786

Key Findings

What This Means

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