Overview of findings from included studies
| Study | Sample | MR procedure | MR findings | Clinical measures | Physical exercise intervention |
| Ellingson et al43 | Chronic fibromyalgia, n=11 (11 female) | fMRI | Exercise-induced increased activity in the left dorsolateral PFC. | MPQ significantly decreased postexercise (Cohen’s d=0.39). | One session of aerobic exercise. One session of 25 min moderate intensity. |
| Flodin et al44 | Chronic fibromyalgia, n=14 (14 female) | Resting state fMRI | Out of six connectivity pairs, four significantly changed (normalised) after the exercise intervention: (1) Insula - S1/M1 (p=0.0017), (2) Supr. Gyr. - S1/M1 (p=0.0081), (3) Supr. Gyr. - inferior PFC (p=0.0053), (4) Supr. Gyr. - cerebellum (p=0.0033) | FIQ: sign improvement (p=0.04, effect size=0.53 (medium)). SF-36 BP: no change (p=0.98). Changes in functional connectivity due to physical exercise were not correlated with FIQ and SF-36 BP scores (all r<0.5). | 15-week exercise programme including aerobic, isometric, concentric, non-concentric and stretching exercises. Two sessions a week of 60 min each. |
| Martinsen et al45 | Chronic fibromyalgia, n=19 (19 female) | fMRI with Stroop Colour Word Test | Postexercise, a significant change in activation of the bilateral amygdala (p<0.001) was found. | FIQ: significant decreased (p=0.048) SF-36-PCS: Intervention effect (p=0.048) | 15-week exercise programme including resistance exercises. Two sessions a week of 60 min each. |
| Micalos et al46 | Chronic pain, including fibromyalgia (n=8), low back pain (n=2), complex regional pain syndrome (n=1), n=11 (9 female) | fMRI | Exercise-induced significant change in activation of the thalamus (p=0.04). | MPQ only measured at baseline, no change score available. | 12-week exercise programme including aerobic exercises. Two sessions a week of 20 min each. |
BP, bodily pain; FIQ, Fibromyalgia Impact Questionnaire; fMRI, functional MRI; M1, primary motor cortex; MPQ, McGill Pain Questionnaire; PCS, Physical Component Score; PFC, prefrontal cortex; S1, primary somatosensory cortex; SF-36, Short Form-36; Supr. Gyr., supramarginal gyrus.