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

OBJECTIVE: To evaluate the effects of a 6-month supervised multicomponent telerehabilitation programme combining Pilates-based therapeutic exercise and self-myofascial release on fibromyalgia impact, sleep quality, and psychological outcomes. DESIGN: Two-arm, parallel-group randomized controlled trial. SUBJECTS/PATIENTS: 68 adults with fibromyalgia confirmed according to the 2016 ACR criteria. METHODS: Participants were randomized to a 6-month supervised home-based telerehabilitation programme (n = 35) or usual care (n = 33). The intervention comprised 3 live online sessions weekly combining Pilates-based therapeutic exercise, self-myofascial release, core stabilization, low-load resistance exercise, stretching, and relaxation. Outcomes were assessed at baseline, 3 months, and 6 months using validated patient-reported measures. RESULTS: Significant group-by-time interactions were observed for fibromyalgia impact (p < 0.001, partial η2 = 0.132), sleep quality (p < 0.001, partial η2 = 0.129), depressive symptoms (p = 0.002, partial η2 = 0.129), and perceived stress (p = 0.028, partial η2 = 0.065), but not for anxiety (p = 0.701). Mean intervention adherence was 87.5%, with no adverse or serious adverse events reported in either group. CONCLUSION: 6 months of supervised multicomponent telerehabilitation produced favourable longitudinal changes in fibromyalgia impact, sleep quality, depressive symptoms, and perceived stress compared with usual care.