ArticleLancet regional health. Americas2026
A randomised, double-blind, sham-controlled, 2×2 factorial trial of aerobic vs. non-aerobic exercise and motor cortex transcranial direct current stimulation in fibromyalgia: effects on clinical outcomes and descending pain modulation.
Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Reassessing combined exercise-tDCS strategies in chronic pain.Lancet regional health. Americas · 2026Article
- Exercise dose, measurement reliability, and mechanistic inference in fibromyalgia trials: a critical appraisal.Lancet regional health. Americas · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Exercise is first-line therapy for fibromyalgia, but the superiority of aerobic vs. non-aerobic modalities is uncertain. Motor-cortex transcranial direct current stimulation (tDCS) may enhance descending pain inhibition. We tested the effects of exercise modality and tDCS on conditioned pain modulation (CPM) and clinical outcomes. Methods: Double-blind, randomised 2 × 2 factorial trial in Boston, USA (2019-2024; allocation 1:1:1:1). Adults with fibromyalgia were assigned to aerobic + active tDCS, aerobic + sham, non-aerobic + active, or non-aerobic + sham. Participants completed 16 in-person sessions over 4 weeks, combining concurrent tDCS and exercise. The non-aerobic condition involved light treadmill walking matched for duration but below aerobic threshold (<40% HRmax). Primary outcomes were changes in CPM and temporal summation of pain (TSP) at week 6; secondary outcomes were pain, fatigue, sleep, quality of life, and depressive symptoms. Findings: Of 116 participants (mean age 47.1 ± 11.9 years), 88.8% were female. Active tDCS improved CPM vs. sham (Cohen's d = 0.66; p = 0.015), independent of exercise modality, and showed a small, nonsignificant improvement in TSP (mean change -0.19 [95% CI -0.90, 0.51]). All groups showed moderate-to-large improvements in pain, fatigue, and quality of life (Cohen's d 0.60-0.92), with no added benefit from tDCS. Non-aerobic and aerobic exercise produced comparable symptom improvements. Greater age and lower body mass index (BMI) were associated with enhanced response. Changes in pain modulation were not mediated by short-term clinical changes. Interpretation: Supervised aerobic and non-aerobic exercise produced meaningful short-term clinical improvements. Motor-cortex tDCS enhanced descending pain inhibition but did not add clinical benefit beyond exercise over 6 weeks. Funding: National Institutes of health (R01 1R01AT009491-01A1).
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.