Land- and water-based supervised exercise intervention for women with fibromyalgia: a CERT-based protocol from the al-Ándalus randomized controlled trial

Background: Exercise is a core non-pharmacological treatment for fibromyalgia and is consistently recommended in clinical guidelines. However, exercise interventions are often inadequately reported, limiting reproducibility, implementation in clinical practice, and comparison across studies. Aim: This article aims to provide a comprehensive description of the rationale, design, and delivery of the land- and water-based exercise interventions implemented in the al-Ándalus Randomized Controlled Trial (RCT), following the Consensus on Exercise Reporting Template (CERT). Methods: Women aged 35–65 years diagnosed with fibromyalgia (n = 180) were recruited in Southern Spain (Andalusia) and allocated to one of three groups: usual care (control), land-based supervised exercise, or water-based supervised exercise (n = 60 per group). Participants in the intervention groups completed a 24-week supervised multicomponent exercise program comprising aerobic, strength, and flexibility training delivered three times per week on non-consecutive days (45–60 min/session). The intervention rationale, progression criteria, supervision procedures, adherence strategies, and exercise components are reported according to the 16-item CERT checklist. Discussion: This report provides a detailed and standardised description of a supervised multicomponent exercise intervention for women with fibromyalgia delivered in both land- and water-based settings. By facilitating transparency, reproducibility, and implementation, the protocol may serve as a practical resource for clinicians and exercise professionals and as a methodological reference for researchers seeking to improve the reporting quality of exercise interventions in fibromyalgia and other chronic musculoskeletal conditions.Trial registration: ClinicalTrials.gov ID: NCT01490281.