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Tynan M, Virzi N, Wooldridge JS, Morse JL, Herbert MS. Examining the Association Between Objective Physical Activity and Momentary Pain: A Systematic Review of Studies Using Ambulatory Assessment. THE JOURNAL OF PAIN 2024; 25:862-874. [PMID: 37914094 DOI: 10.1016/j.jpain.2023.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/22/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
Chronic pain (CP) is a debilitating and increasingly common health condition that adversely impacts function, including physical activity (PA). Research using ambulatory assessment (AA) methods (eg, ecological momentary assessment, actigraphy) offers promise for elucidating the relationship between momentary pain and objective PA in CP populations. This study aimed to systematically review articles assessing the association between momentary pain and PA in adults with CP as measured using AA and to make recommendations for the measurement and study of this relationship. Five databases were systematically searched, and 13 unique records (N = 768) met the inclusion criteria. CP conditions included mixed/nonspecific CP (k = 3), low back pain (k = 2), fibromyalgia (k = 1), unspecified arthritis (k = 1), and hip/knee osteoarthritis (k = 6). The average age of participants across studies was 55.29 years, and the majority identified as women (60.68%) and White (83.16%). All studies measured objective PA via actigraphy, and momentary pain with either a diary/log or ratings on an actigraph. Studies varied in the quantification of PA (ie, activity counts, step count, moderate-vigorous PA), statistical method (ie, correlation, regression, multilevel modeling), and inclusion of moderators (eg, pain acceptance). Studies reported mixed results for the pain-PA relationship. This heterogeneity suggests that no summarizing conclusions can be drawn about the pain-PA relationship without further investigation into its complex nuances. More within-person and exploratory examinations that maximize the richness of AA data are needed. A greater understanding of this relationship can inform psychotherapeutic and behavioral recommendations to improve CP outcomes. PERSPECTIVE: This article presents a systematic review of the literature on the association between momentary pain and PA in adults with CP as measured using AA methods. A better understanding of this nuanced relationship could help elucidate areas for timely intervention and may inform clinical recommendations to improve CP outcomes. PROSPERO REGISTRATION NUMBER: CRD42023389913.
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Affiliation(s)
- Mara Tynan
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Nicole Virzi
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California, San Diego, California
| | - Jessica L Morse
- VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California, San Diego, California
| | - Matthew S Herbert
- VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California, San Diego, California; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California
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2
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Rus A, López-Sánchez JA, Martínez-Martos JM, Ramírez-Expósito MJ, Molina F, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Predictive Ability of Serum Amino Acid Levels to Differentiate Fibromyalgia Patients from Healthy Subjects. Mol Diagn Ther 2024; 28:113-128. [PMID: 37843759 DOI: 10.1007/s40291-023-00677-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Fibromyalgia is a complex illness to diagnose and treat. OBJECTIVES To evaluate a broad range of circulating free amino acid (AA) levels in fibromyalgia patients as well as the ability of the AAs to differentiate fibromyalgia patients from healthy subjects. DESIGN We carried out a case-control study to evaluate AA levels in 62 patients with fibromyalgia and 78 healthy subjects. This study adheres to the STROBE guidelines. METHODS AAs content was assayed by HPLC in serum samples. The predictive value of AA levels in fibromyalgia was determined by receiver operating characteristic (ROC) curve and forward binary logistic regression analyses. RESULTS Fibromyalgia patients showed higher serum levels of aspartic acid, glutamic acid, aminoadipic acid, asparagine, histidine, 3-methyl-histidine, 5-methyl-histidine, glycine, threonine, taurine, tyrosine, valine, methionine, isoleucine, phenylalanine, leucine, ornithine, lysine, branched chain AAs (BCAAs), large neutral AAs, essential AAs (EAAs), non-essential AAs (NEAAs), basic AAs, EAAs/NEAAs ratio, phenylalanine/tyrosine ratio, and global arginine bioavailability ratio than the controls. Serum alanine levels were lower in patients than in controls. According to ROC analysis, most of these AAs may be good markers for differentiating individuals with fibromyalgia from healthy subjects. Results of logistic regression showed that the combination of glutamic acid, histidine, and alanine had the greatest predictive ability to diagnose fibromyalgia. CONCLUSIONS Our results show an imbalance in serum levels of most AAs in patients with fibromyalgia, which suggest a metabolic disturbance. The determination of serum levels of these AAs may aid in the diagnosis of fibromyalgia, in combination with clinical data of the patient.
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Affiliation(s)
- Alma Rus
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
| | - José Alberto López-Sánchez
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | | | | | - Francisco Molina
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain.
| | - María Encarnación Aguilar-Ferrándiz
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
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Gavilán-Carrera B, Borges-Cosic M, Álvarez-Gallardo IC, Soriano-Maldonado A, Acosta-Manzano P, Camiletti-Moirón D, Carbonell-Baeza A, Casimiro AJ, Girela-Rejón MJ, Walitt B, Estévez-López F. Effectiveness of Land- and Water-based Exercise on Fatigue and Sleep Quality in Women With Fibromyalgia: The al-Ándalus Quasi-Experimental Study. Arch Phys Med Rehabil 2023; 104:1775-1784. [PMID: 37245691 DOI: 10.1016/j.apmr.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/26/2023] [Accepted: 04/25/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To assess the effectiveness of 24 weeks of land- and water-based exercise on fatigue and sleep quality in women with fibromyalgia, and the persistence of changes 12 weeks after exercise cessation. DESIGN Quasi-experimental study. SETTING University facilities and fibromyalgia associations. PARTICIPANTS Women with fibromyalgia (N=250; 50.8±7.6 years old). INTERVENTIONS Participants were assigned to land-based exercise (n=83), water-based exercise (n=85), or no exercise control (n=82) groups. The intervention groups engaged in a similar multicomponent exercise program for 24 weeks. MAIN OUTCOME MEASURES The Multidimensional Fatigue Inventory and Pittsburgh Sleep Quality Index were used. RESULTS Intention-to-treat analyses revealed that, compared with the control group, at week 24: (i) the land-based exercise group improved physical fatigue (mean difference -0.9 units; 95% confidence interval -1.7 to -0.1; Cohen's d=0.4) and (ii) the water-based exercise group improved general fatigue (-0.8; -1.4 to -0.1, d=0.4), and global sleep quality (-1.6; -2.7 to -0.6, d=0.6). Additionally, compared with the land-based exercise group, the water-based exercise group improved global sleep quality (-1.2; -2.2 to -0.1, d=0.4). Changes were generally not sustained at week 36. CONCLUSION Land-based multicomponent exercise improved physical fatigue, whereas water-based exercise improved general fatigue and sleep quality. The magnitude of the changes was small-to-medium, and no benefits were maintained after exercise cessation.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
| | - Inmaculada C Álvarez-Gallardo
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Pedro Acosta-Manzano
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain; Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Daniel Camiletti-Moirón
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Ana Carbonell-Baeza
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain; MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
| | - Antonio J Casimiro
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - María José Girela-Rejón
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; Department of Didactic of Corporal Expression, Faculty of Education Sciences, University of Granada, Granada, Spain
| | - Brian Walitt
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA.
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Courel-Ibáñez J, Estévez-López F, Hughes C, Adams N, Fullen BM, Davison G, Montgomery A, Cramp F, Maestre C, Martin D, McVeigh JG. Proof of concept of prehabilitation: a combination of education and behavioural change, to promote physical activity in people with fibromyalgia. BMJ Open 2023; 13:e070609. [PMID: 37451740 PMCID: PMC10351288 DOI: 10.1136/bmjopen-2022-070609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES To establish proof of concept of a prehabilitation intervention, a combination of education and behavioural change, preceding a physical activity programme in people with fibromyalgia (FM). SETTINGS Open-label, feasibility clinical trial. PARTICIPANTS Eleven people with FM (10 women). INTERVENTIONS The prehabilitation intervention consisted of 4 weeks, 1 weekly session (~1 to 1.5 hours), aimed to increase self-efficacy and understand why and how to engage in a gentle and self-paced physical activity programme (6 weeks of walking with telephone support). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was the acceptability and credibility of the intervention by means of the Credibility/Expectancy Questionnaire. Secondary outcomes comprised scales to measure FM severity, specific symptoms and sedentary behaviour. An exit interview was conducted to identify the strengths and weaknesses and barriers to the intervention. RESULTS One participant dropped out due to finding the walking programme excessively stressful. Participants expected the intervention would improve their symptoms by 22%-38% but resulted in 5%-26% improvements. Participants would be confident in recommending this intervention to a friend who experiences similar problems. The interviews suggested that the fluctuation of symptoms should be considered as an outcome and that the prehabilitation intervention should accomodate these fluctuation. Additional suggestions were to incorporate initial interviews (patient-centred approach), to tailor the programmes to individuals' priorities and to offer a variety of physical activity programmes to improve motivation. CONCLUSIONS This feasibility study demonstrated that our novel approach is acceptable to people with FM. Future interventions should pay attention to flexibility, symptoms fluctuation and patients support. TRIAL REGISTRATION NUMBER NCT03764397.
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Affiliation(s)
- Javier Courel-Ibáñez
- Department of Physical Education and Sports, Faculty of Education and Sport Sciences, University of Granada, Melilla, Spain
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024) and CERNEP Research Center, University of Almería, Almería, Spain
| | - Ciara Hughes
- School of Health Sciences, Ulster University, Belfast, UK
| | - Nicola Adams
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Brona M Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Gareth Davison
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | | | - Fiona Cramp
- College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Cristina Maestre
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Denis Martin
- School of Health and Life Sciences, Teesside University & NIHR Applied Research Collaboration for the North East and North Cumbria, Middlesbrough, UK
| | - Joseph G McVeigh
- Discipline of Physiotherapy, College of Medicine and Health, University College Cork, Cork, Ireland
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5
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Houge IS, Hoff M, Videm V. The association between rheumatoid arthritis and reduced estimated cardiorespiratory fitness is mediated by physical symptoms and negative emotions: a cross-sectional study. Clin Rheumatol 2023:10.1007/s10067-023-06584-x. [PMID: 36964449 PMCID: PMC10038374 DOI: 10.1007/s10067-023-06584-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/23/2023] [Accepted: 03/17/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES Persons with rheumatoid arthritis (RA) have lower cardiorespiratory fitness (CRF) than healthy individuals. We sought to identify variables explaining the association between RA status and reduced CRF. METHODS RA patients recruited from two Norwegian hospitals and blood donors recruited as controls filled in questionnaires about physical activity, physical symptoms, and psychological factors. Estimated CRF (eCRF) was calculated from non-exercise models. The relationship between RA status and reduced eCRF was explored with structural equation modelling. The latent variables physical symptoms (based on morning stiffness, joint pain, and pain in neck, back, or hips) and negative emotions (based on Hospital Anxiety and Depression Scale's Depression score and Cohen's perceived stress scale) were included as possible mediators between RA status and eCRF in separate and combined models adjusted for age and sex. RESULTS Two-hundred-and-twenty-seven RA patients and 300 controls participated. The patients were older and had lower eCRF than controls (age- and sex-adjusted mean difference: 1.7 mL/kg/min, p=0.002). Both latent variables were significant mediators of the association between RA and reduced eCRF when included in separate models. The latent variables mediated 74% of the total effect of RA on eCRF in the combined model. Standardized coefficients: direct effect of RA -0.024 (p=0.46), indirect effect through physical symptoms -0.034 (p=0.051), and indirect effect through negative emotions -0.034 (p=0.039). CONCLUSION Both physical symptoms and negative emotions mediated the association between RA and reduced eCRF with similar effect sizes. To successfully increase CRF in RA patients, both physical and psychological factors should be addressed. Key Points • The RA patients in the present study had 1.7 mL/kg/min lower mean estimated cardiorespiratory fitness (CRF) compared to healthy controls. • Mediation analysis demonstrated that physical symptoms and negative emotions mediated 74% of the total negative effect of RA on estimated CRF in a combined, adjusted model. • This suggests that both physical and psychological factors should be addressed when supporting RA patients in improving their CRF.
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Affiliation(s)
- Ingrid Sæther Houge
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Hoff
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, Trondheim, Norway.
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6
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Gavilán-Carrera B, Delgado-Fernández M, Álvarez-Gallardo IC, Acosta-Manzano P, Borges-Cosic M, Estévez-López F, Soriano-Maldonado A, Carbonell-Baeza A, Aparicio VA, Segura-Jiménez V. Longitudinal association of sedentary time and physical activity with pain and quality of life in fibromyalgia. Scand J Med Sci Sports 2023; 33:292-306. [PMID: 36326665 DOI: 10.1111/sms.14258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To analyze changes over time and the predictive value of baseline and changes of sedentary time (ST) and physical activity (PA) on pain, disease impact, and health-related quality of life (HRQoL) at 2- and 5-year follow-up in women with fibromyalgia. METHODS This is a longitudinal and exploratory study with three time points. A total of 427 women with fibromyalgia (51.4 ± 7.6 years) were followed after 2 (n = 172) and 5 years (n = 185). ST and PA (light and moderate-to-vigorous [MVPA]) were assessed using triaxial accelerometers. Pain, disease impact, and HRQoL were measured using: pressure pain threshold, the pain subscale of the revised fibromyalgia impact questionnaire (FIQR), the bodily pain subscale of the 36-item short-form health survey (SF-36), a visual analog scale (VAS), the FIQR, and the SF-36 physical and mental components. RESULTS Over 5 years, pressure pain threshold, ST, light PA, and MVPA variables were worsened, while FIQR and SF-36 variables were improved (Cohen's d < 0.1-0.3). Baseline ST or light PA were not associated with future outcomes, whereas greater MVPA at baseline was associated with better SF-36 bodily pain at 5-year follow-up (β = 0.13). Reducing ST and increasing light PA were associated with better bodily pain (β = -0.16 and 0.17, respectively) and SF-36 physical component (β = -0.20 and 0.17, respectively) at 5-year follow-up. Increasing MVPA was associated with less pain (pressure pain threshold, VAS, and FIQR-pain) and better SF-36 physical component at 2- and 5-year follow-up (β's from -0.20 to 0.21). CONCLUSIONS Objectively measured variables slightly worsened over years, while for self-reported outcomes there was a trend for improvement. Reductions in ST and increases in light PA and MVPA were associated with better HRQoL at 5-year follow-up, and increases in MVPA were additionally associated with better pain and HRQoL at 2-year follow-up.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain
| | - Manuel Delgado-Fernández
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain
| | - Inmaculada C Álvarez-Gallardo
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Pedro Acosta-Manzano
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain.,Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Milkana Borges-Cosic
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Massachusetts, Boston, USA
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,Sport Research Group (Cts-1024), Cernep Research Center, University of Almería, Almería, Spain
| | - Ana Carbonell-Baeza
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain.,MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain.,Department of Physiology, School of Pharmacy, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain.,UGC Neurotraumatología y Rehabilitación, Hospital Universitario Virgen de las Nieves, Granada, Spain
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7
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Alvarez MC, Albuquerque MLL, Neiva HP, Cid L, Rodrigues F, Teixeira DS, Matos R, Antunes R, Morales-Sánchez V, Monteiro D. Exploring the Relationship between Fibromyalgia-Related Fatigue, Physical Activity, and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084870. [PMID: 35457737 PMCID: PMC9032824 DOI: 10.3390/ijerph19084870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/28/2022]
Abstract
The symptoms of fibromyalgia are varied, including general muscle pain and pain at specific points (also called tender points), excessive fatigue, anxiety, depression, and some psychological problems that can have a negative impact on quality of life. Physical activity is a widely used option by health professionals to alleviate the effects of this syndrome. However, there is no clear information on the possible mediating role of physical activity in the relationship between fibromyalgia-related fatigue and quality of life. Therefore, this study aims to evaluate the relationship between fibromyalgia-related fatigue and quality of life, and to investigate the mediating role of physical activity in patients with this syndrome. Methods: In a cross-sectional study, 237 Portuguese women aged 28 to 75 years (M = 49.12; SD ± 8.87) and 117 Brazilian women aged 20 to 69 years (M = 46.72; SD ± 8.38) were recruited to participate in this study. These patients completed three valid and reliable questionnaires related to the assessment of fibromyalgia-related fatigue (MDF-Fibro-17), physical activity (IPAQ), and quality of life (SF-36). Results: Both samples had scores above the midpoint for all dimensions of fibromyalgia-related fatigue and scores below the midpoint for quality of life. Physical activity had no mediating effect in either sample, as the total indirect effect was not significant. Conclusions: Physical activity does not mediate the relationship between fatigue and quality of life. However, the results also show that the fatigue dimensions associated with fibromyalgia had a negative and significant association with physical and mental health indicators in both samples. Thus, patients with FM with higher scores on fatigue-related symptoms might suffer more from physical and mental health, both of which are related to quality of life.
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Affiliation(s)
- Marcos C. Alvarez
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
| | - Maria Luiza L. Albuquerque
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
| | - Luis Cid
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
| | - Filipe Rodrigues
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Diogo S. Teixeira
- Faculty of Physical Education and Sport, Lusófona University (ULHT/FEFD), 1749-024 Lisbon, Portugal;
- Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), 1749-024 Lisbon, Portugal
| | - Rui Matos
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Raúl Antunes
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), 2415-396 Leiria, Portugal
| | - Verónica Morales-Sánchez
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, Faculty of Psychology, Malaga University, 29003 Malaga, Spain;
| | - Diogo Monteiro
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Correspondence:
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8
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Elkfury JL, Antunes LC, Dal Moro Angoleri L, Sipmann RB, de Souza A, da Silva Torres IL, Caumo W. Dysfunctional eating behavior in fibromyalgia and its association with serum biomarkers of brain plasticity (BDNF and S100B): an exploratory study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:713-722. [PMID: 34591410 PMCID: PMC10065384 DOI: 10.20945/2359-3997000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess disordered eating, hunger and satiety perceptions in women with fibromyalgia (FM) compared to healthy controls (HC) and their association with biomarkers of brain plasticity (brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100B)). METHODS Cross-sectional exploratory study. The sample included FM (n = 20) and HC (n = 19), matched to age and waist perimeter. Dysfunctional eating was assessed through the Three Factor Eating Questionnaire and Eating Disorders Examination with a questionnaire. Hunger and satiety levels were rated by a Numerical Scale. Serum leptin, S100B and BDNF were analyzed. RESULTS The MANCOVA analysis showed that the mean of Emotional Eating rates was 30.65% higher in FM compared to HC (p = 0.015). Eating, shape and weight concerns were 77.77%, 57.14% and 52.22% higher in FM (p = <0.001) compared to HC, respectively. Moreover, the FM group reported higher scores for feeling of hunger "[5.2 (±2.9) vs. 4.8 (±2.0); p = 0.042] and lower scores for satiety [7.0 (±1.7) vs. 8.3 (±1.0); p = 0.038]. In the FM group, serum BDNF was negatively associated with hunger (r = - 0.52; p = 0.02), while S100B was positively associated with hunger scores (r = 0.463; p = 0.004). CONCLUSION The present findings support the hypothesis that the association between FM and obesity can be mediated by a hedonistic pathway. Further research is needed.
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Affiliation(s)
- Jéssica Lorenzzi Elkfury
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Luciana C Antunes
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Centro de Ciências da Saúde, Divisão de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Letícia Dal Moro Angoleri
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Raquel Busanello Sipmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andressa de Souza
- Programa de Pós-graduação em Saúde e Desenvolvimento Humano, LaSalle, Canoas, RS, Brasil
- Programa de Pós-graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Iraci Lucena da Silva Torres
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Wolnei Caumo
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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9
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Sola-Rodríguez S, Vargas-Hitos JA, Gavilán-Carrera B, Rosales-Castillo A, Ríos-Fernández R, Sabio JM, Soriano-Maldonado A. Physical Fitness Attenuates the Impact of Higher Body Mass and Adiposity on Inflammation in Women With Systemic Lupus Erythematosus. Front Immunol 2021; 12:729672. [PMID: 34721392 PMCID: PMC8552526 DOI: 10.3389/fimmu.2021.729672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Aims Higher body mass and adiposity represent independent contributors to the systemic low-grade inflammatory state often observed in patients with systemic lupus erythematosus (SLE). This study assessed the role of physical fitness in the association of body mass and adiposity with inflammation in women with SLE. Methods A total of 77 women with SLE were included in this cross-sectional study. We obtained body mass index, waist-to-height ratio, and body fat percentage as indicators of body mass and adiposity. Inflammation was assessed through Serum levels of C-reactive protein, interleukin 6, and leptin. Cardiorespiratory fitness was assessed with the 6-minute walk test, range of motion with the back-scratch test, and muscular strength with handgrip dynamometry. Results Cardiorespiratory fitness attenuated the association of both body mass index and body fat percentage with interleukin 6 (all, P<0.05). Range of motion attenuated the association of body mass index with interleukin 6 (P<0.05) and the association of body fat percentage with C-reactive protein (P<0.05). These interactions indicated that higher fitness was associated with a lower increase in inflammation per unit increase of body mass or adiposity. Muscular strength showed a non-significant trend to attenuate the association of body fat percentage with interleukin 6 (P=0.057) but potentiated the association of body fat percentage with leptin (P<0.05). Conclusion These findings suggest that higher levels of cardiorespiratory fitness and range of motion might attenuate the impact of higher body mass and adiposity on inflammation in women with SLE. The role of muscular strength requires further investigation.
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Affiliation(s)
- Sergio Sola-Rodríguez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - José Antonio Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Antonio Rosales-Castillo
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Raquel Ríos-Fernández
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "San Cecilio" University Hospital, Granada, Spain
| | - José Mario Sabio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
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10
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Abstract
Fibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmacologic interventions, with the understanding that medications provide only modest benefit for most patients, and with particular concern about adverse effects in older patients. If FM is not recognized, treatments may be misdirected to the other medical condition, with failure to address FM symptoms, leading to overall poor outcome. In contrast, new complaints in older patients should not immediately be attributed to FM, and physicians should be vigilant to ensure that onset of a new illness is not ignored. As FM is most often a lifelong condition, patients should be encouraged to identify their own personal strategies that can attenuate symptoms, especially when symptoms flare. Continued life participation should be the outcome goal.
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Affiliation(s)
- Amir Minerbi
- Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel.,Ruth and Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mary-Ann Fitzcharles
- Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. .,Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada.
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11
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Women with Fibromyalgia Prefer Resistance Exercise with Heavy Loads-A Randomized Crossover Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126276. [PMID: 34200618 PMCID: PMC8296097 DOI: 10.3390/ijerph18126276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
Fibromyalgia (FM) is a chronic pain condition associated with impaired muscle strength and exercise-induced pain. Physical exercise has been highlighted, by international clinical guidelines and stakeholders, as an essential component of rehabilitation in FM. Exposure to pain during exercise is generally correlated with elevated lactate levels and, additionally, is one known reason for persons with FM to avoid physical exercise and activity. A crossover design was used to test and evaluate an approach consisting of resistance exercise with heavy loads and a low number of repetitions among ten women with FM. The participants were consecutively recruited to test and perform exercise with two different resistance levels (A = light/moderate load, and B = heavy load) in a randomized crossover trial using an AB/BA setting. Results showed that the heavy load exercise session was experienced as more positive than the light/moderate load exercise session and that lower lactate levels followed exercise with heavier weight loads. This is promising and indicates that the approach of heavy weight loads and accustomed repetitions is accepted in FM and has the potential to attenuate hesitation to exercise due to exercise-induced pain. However, these effects need to be further investigated in more extensive studies.
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12
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Does the Addition of Pain Neurophysiology Education to a Therapeutic Exercise Program Improve Physical Function in Women with Fibromyalgia Syndrome? Secondary Analysis of a Randomized Controlled Trial. J Clin Med 2021; 10:jcm10112518. [PMID: 34200137 PMCID: PMC8201111 DOI: 10.3390/jcm10112518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022] Open
Abstract
Therapeutic exercise (TE) is one of the most investigated approaches for the management of FMS. Pain neurophysiology education (PNE) helps toward understanding the pain condition, leading to maladaptive pain cognitions and coping strategies in patients with chronic pain. Our study aimed to assess the effects of therapeutic exercise and pain neurophysiology education versus TE in isolation on fatigue, sleep disturbances, and physical function in the short term and at three months of follow-up in women with fibromyalgia syndrome (FMS). A single-blind randomized controlled trial was carried out. A total of 32 women with FMS referred from medical doctors and fibromyalgia association were randomized in 2 groups: PNE + TE group or TE group. Fatigue and sleep disturbances (Visual Analog Score) and physical function (Senior Fitness Test) were assessed before, after intervention, and at three months of follow-up. Significant improvements were achieved in the Timed Up and Go test (p = 0.042) and Arm Curl test (p = 0.043) after intervention and on handgrip in the non-dominant side at three months of follow-up (p = 0.036) on the PNE + TE group. No between-groups differences were found for fatigue, sleep disturbances, and the rest of test included in the Senior Fitness Test. In conclusion, these results suggest that PNE + TE appears to be more effective than TE in isolation for the improvement of physical function (Timed Up and Go test and Arm Curl test) in women with FMS in the short term.
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13
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Estévez-López F, Rodriguez-Ayllon M, Soriano-Maldonado A, Acosta-Manzano P, Segura-Jiménez V, Álvarez-Gallardo IC, Pulido-Martos M, Herrador-Colmenero M, Geenen R, Carbonell-Baeza A, Delgado-Fernández M. Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Ándalus Project. PAIN MEDICINE 2020; 20:2506-2515. [PMID: 30698774 DOI: 10.1093/pm/pny304] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association. DESIGN Cross-sectional study in 420 women with fibromyalgia. SETTING Fibromyalgia associations from southern Spain. METHODS Physical fitness was measured by performance-based tests, and questionnaires were used to measure positive affect, negative affect, and different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). Age, body mass index, and current pain level were included as potential confounders in all analyses. RESULTS Physical fitness was independently associated with general fatigue, physical fatigue, and reduced activity (all P ≤ 0.02). Positive affect was independently associated with all fatigue dimensions (all P < 0.001). Negative affect was independently associated with general fatigue, physical fatigue, reduced motivation, and mental fatigue (all P ≤ 0.04). The interaction of overall physical fitness and positive affect was related to general fatigue and physical fatigue (all P ≤ 0.02). Women with fibromyalgia with higher levels of overall physical fitness and positive affect showed the lowest general fatigue and physical fatigue. CONCLUSIONS In women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.
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Affiliation(s)
- Fernando Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Northern Ireland, UK.,Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - María Rodriguez-Ayllon
- PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | | | - Manuel Pulido-Martos
- Department of Psychology, Faculty of Humanities and Sciences of Education, University of Jaén, Jaén, Spain
| | - Manuel Herrador-Colmenero
- PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ana Carbonell-Baeza
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
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14
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Mülkoğlu C, Taşkın S, Vural S, Mansız Kaplan B, Selvi AB, Genç H. Isokinetic evaluation of the trunk muscle strength in housewives with fibromyalgia: a cross-sectional study. Adv Rheumatol 2020; 60:40. [PMID: 32799927 DOI: 10.1186/s42358-020-00142-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is known that physical activity and muscular performance are reduced in fibromyalgia (FM) syndrome. This study aims to compare the performance of trunk muscles in women with FM and healthy controls and evaluate the correlation between trunk muscle strength and FM severity. METHODS Forty-six patients with FM and 42 age- and body mass index-matched healthy housewives without FM were included in the FM and control groups, respectively. The Fibromyalgia Impact Questionnaire (FIQ) was used for the assessment of FM severity. The pain intensity was evaluated using the visual analogical scale (VAS). An isokinetic dynamometer was used to measure the isokinetic trunk muscle strength. The peak torque (PT) values were recorded. The psychological status of the patients was evaluated using the Beck Depression Inventory. RESULTS There was no statistically significant difference in terms of age, BMI, and BDI scores in two groups (p > 0.05, for all). The isokinetic trunk extensor PT values were significantly lower in the FM group (p = 0.002 for 60°/s, and p < 0.001 for 90°/s and 120°/s) than control group. There was a statistically significant negative correlation between FIQ score and isokinetic extensor muscle parameters. CONCLUSION The results indicate that trunk extensor muscles were significantly weaker in FM patients. Trunk extensor muscle strength decreased as FM severity increased in FM patients.
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Affiliation(s)
- Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey.
| | - Sühan Taşkın
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Seçil Vural
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Başak Mansız Kaplan
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Ahmet Buğra Selvi
- Department of Physiotherapy and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Hakan Genç
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, 06230, Ankara, Turkey
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15
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Álvarez-Salvago F, Lara-Ramos A, Cantarero-Villanueva I, Mazheika M, Mundo-López A, Galiano-Castillo N, Fernández-Lao C, Arroyo-Morales M, Ocón-Hernández O, Artacho-Cordón F. Chronic Fatigue, Physical Impairments and Quality of Life in Women with Endometriosis: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3610. [PMID: 32455618 PMCID: PMC7277433 DOI: 10.3390/ijerph17103610] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/29/2020] [Accepted: 05/13/2020] [Indexed: 12/22/2022]
Abstract
AIM To explore endometriosis-related fatigue (ERF), health-related fitness, sleep quality, and health-related quality of life (HRQoL) in women with endometriosis in comparison with matched controls. METHODS Twenty-five affected women and twenty-five age and height-matched women without endometriosis were included. ERF was assessed through the Piper Fatigue Scale; health-related fitness was assessed through the Schöber, flamingo, and 6-min walking tests and dynamometry; and body composition was assessed through impedanciometry. Self-perceived physical fitness, sleep quality, and HRQoL were assessed through the International Fitness Scale, the Pittsburgh Sleep Quality Index, and the 12-item Short Form Health Survey, respectively. RESULTS Affected women exhibited higher levels of ERF than controls, increased fat mass, and physical deconditioning (reduced back strength, lumbar flexibility, body balance, and functional capacity, p-values < 0.050). Moreover, cases also had poorer perceived physical fitness, sleep quality, and HRQoL (p-value < 0.050). Finally, we observed deteriorated health-related fitness, sleep quality, and HRQoL in those women with endometriosis with higher levels of ERF. CONCLUSIONS This study constitutes the first evidence that women with endometriosis describe a generalized physical deconditioning, even more pronounced in affected women with higher levels of ERF. Further studies assessing the efficacy of rehabilitation interventions to face these physical impairments in women with endometriosis are warranted.
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Affiliation(s)
- Francisco Álvarez-Salvago
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain
| | - Ana Lara-Ramos
- Gynaecology and Obstetrics Unit, “Virgen de las Nieves” University Hospital, E-18014 Granada, Spain;
| | - Irene Cantarero-Villanueva
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
| | - Maryna Mazheika
- Department of Obstetrics and Gynaecology, University of Granada, E-18016 Granada, Spain;
| | | | - Noelia Galiano-Castillo
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
| | - Carolina Fernández-Lao
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
| | - Manuel Arroyo-Morales
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
- Gynaecology and Obstetrics Unit, “San Cecilio” University Hospital, E-18016 Granada, Spain
| | - Francisco Artacho-Cordón
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), University of Granada, E-18016 Granada, Spain; (F.A.-S.); (I.C.-V.); (N.G.-C.); (C.F.-L.); (M.A.-M.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18016 Granada, Spain;
- Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28015 Madrid, Spain
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16
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Comparable conditioned pain modulation and augmented blood pressure responses to cold pressor test among resistance exercisers compared to healthy controls. Biol Psychol 2020; 153:107889. [DOI: 10.1016/j.biopsycho.2020.107889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 11/19/2022]
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17
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Gavilán-Carrera B, Segura-Jiménez V, Acosta-Manzano P, Borges-Cosic M, Álvarez-Gallardo IC, Delgado-Fernández M. Patterns of Sedentary Time and Quality of Life in Women With Fibromyalgia: Cross-Sectional Study From the al-Ándalus Project. JMIR Mhealth Uhealth 2020; 8:e14538. [PMID: 32191211 PMCID: PMC7118547 DOI: 10.2196/14538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/01/2019] [Accepted: 09/24/2019] [Indexed: 12/22/2022] Open
Abstract
Background Sedentary time (ST) has been associated with detrimental health outcomes in fibromyalgia. Previous evidence in the general population has shown that not only is the total amount of ST harmful but the pattern of accumulation of sedentary behaviors is also relevant to health, with prolonged unbroken periods (ie, bouts) being particularly harmful. Objective To examine the association of the patterns of ST with health-related quality of life (HRQoL) in women with fibromyalgia and to test whether these associations are independent of moderate-to-vigorous physical activity (MVPA). Methods A total of 407 women (mean 51.4 years of age [SD 7.6]) with fibromyalgia participated. ST and MVPA were measured with triaxial accelerometry. The percentage of ST accumulated in bouts and the frequency of sedentary bouts of different lengths (≥10 min, ≥20 min, ≥30 min, and ≥60 min) were obtained. Four groups combining total ST and sedentary bout duration (≥30 min) were created. We assessed HRQoL using the 36-item Short-Form Health Survey (SF-36). Results A greater percentage of ST spent in all bout lengths was associated with worsened physical function, bodily pain, vitality, social function, and physical component summary (PCS) (all P<.05). In addition, a higher percentage of ST in bouts of 60 minutes or more was related to worsened physical role (P=.04). A higher frequency of bouts was negatively associated with physical function, social function, the PCS (≥30 min and ≥60 min), physical role (≥60 min), bodily pain (≥60 min), and vitality (≥20 min, ≥30 min, and ≥60 min) (all P<.05). Overall, for different domains of HRQoL, these associations were independent of MVPA for higher bout lengths. Patients with high total ST and high sedentary bout duration had significantly worsened physical function (mean difference 8.73 units, 95% CI 2.31-15.15; independent of MVPA), social function (mean difference 10.51 units, 95% CI 2.59-18.44; not independent of MVPA), and PCS (mean difference 2.71 units, 95% CI 0.36-5.06; not independent of MVPA) than those with low ST and low sedentary bout duration. Conclusions Greater ST in prolonged periods of any length and a higher frequency of ST bouts, especially in longer bout durations, are associated with worsened HRQoL in women with fibromyalgia. These associations were generally independent of MVPA.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,Physical Activity for Health Promotion Research Group (PA-HELP), Granada, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,Physical Activity for Health Promotion Research Group (PA-HELP), Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,Physical Activity for Health Promotion Research Group (PA-HELP), Granada, Spain
| | - Inmaculada C Álvarez-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Physical Activity for Health Promotion Research Group (PA-HELP), Granada, Spain.,Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,Physical Activity for Health Promotion Research Group (PA-HELP), Granada, Spain
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18
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Lazaridou A, Martel MO, Cornelius M, Franceschelli O, Campbell C, Smith M, Haythornthwaite JA, Wright JR, Edwards RR. The Association Between Daily Physical Activity and Pain Among Patients with Knee Osteoarthritis: The Moderating Role of Pain Catastrophizing. PAIN MEDICINE 2020; 20:916-924. [PMID: 30016486 DOI: 10.1093/pm/pny129] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The primary objective of this study was to examine the day-to-day association between physical activity and pain intensity among a sample of patients with knee osteoarthritis (KOA) and the potential moderation of this association by negative cognitive processes. METHODS In this micro-longitudinal daily diary study, KOA patients (N = 121) completed questionnaires assessing pain (Brief Pain Inventory) and psychosocial functioning (pain catrophizing scale, WOMAC McMaster Universities Osteoarthritis Index function, Patient-Reported Outcomes Measurement Information System [PROMIS; anxiety and depression], the Godin-Shephard Leisure-Time Physical Activity questionnaire, the six-minute walking test) and were then asked to report their levels of physical activity and pain intensity once per day for a period of seven days using an electronic diary. RESULTS Multilevel modeling analyses indicated that day-to-day increases in physical activity were associated with heightened levels of pain intensity (B = 0.13 SE = 0.03, P < 0.001). In addition, it was revealed that the association between physical activity and pain intensity was moderated by catastrophizing (B = -0.01 SE = 0.002, P < 0.05), with patients scoring higher in catastrophizing showing a relatively stronger link between day-to-day physical activity and increased knee pain. This effect was specific to catastrophizing, as depression and anxiety did not moderate the activity-pain relationship (P > 0.05). CONCLUSIONS Our findings suggest that increases in daily physical activity are associated with concurrent increases in KOA patients' levels of knee pain, particularly among patients reporting higher levels of pain catastrophizing. These results may have clinical implications for the design and testing of interventions targeted at reducing catastrophizing and increasing physical activity among patients with chronic osteoarthritis pain.
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Affiliation(s)
- Asimina Lazaridou
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Marc O Martel
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Marise Cornelius
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Olivia Franceschelli
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
| | - Claudia Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John R Wright
- Department of Orthopedic Surgery, Harvard Medical School, Brigham & Women's Hospital, Chestnut Hill, Massachusetts, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, USA
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19
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Salaffi F, Farah S, Di Carlo M. Force-time curve features of handgrip strength in fibromyalgia syndrome. Sci Rep 2020; 10:3372. [PMID: 32099072 PMCID: PMC7042213 DOI: 10.1038/s41598-020-60227-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/31/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to compare the handgrip strength (HGs), assessed with a cylindrical-shape grip device, of fibromyalgia syndrome (FM) patients with healthy subjects and to demonstrate the relationship between HGs characteristics and disease severity. Consecutive female patients with FM were enrolled and compared to a group of healthy women. The correlations between HGs curve characteristics and disease severity indices were studied through the Spearman’s rho correlation coefficients (rho). The HGs threshold distinguishing the FM presence was determined using the receiver operating characteristic (ROC) curves analysis. Multivariate regression analysis was used in order to assess the contribution of covariates on the HGs. 110 patients (mean age 53.8 ± 12.4 years) and 111 healthy controls have been enrolled. Altogether all parameters related to the analysis of HGs were worse in patients with FM. The HGs cut-off distinguishing the presence of a FM was 14.2 Kg. A negative correlation was found between disease severity indices and peak force (p < 0.001). Factors significantly associated with HGs area under the curve (AUC) in multivariate analysis were the Widespread Pain Index (WPI) (p = 0.003) and the revised Fibromyalgia Impact Questionnaire (FIQR) (p = 0.016). HGs is reduced in female FM patients and is inversely related to disease severity. The force-time curves analysis may be used as a complementary tool in the FM assessment and monitoring.
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Affiliation(s)
- Fausto Salaffi
- Rheumatological Clinic, Ospedale "Carlo Urbani", Università Politecnica delle Marche, Jesi (Ancona), Italy
| | - Sonia Farah
- Rheumatological Clinic, Ospedale "Carlo Urbani", Università Politecnica delle Marche, Jesi (Ancona), Italy
| | - Marco Di Carlo
- Rheumatological Clinic, Ospedale "Carlo Urbani", Università Politecnica delle Marche, Jesi (Ancona), Italy.
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20
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Tavares LF, Germano Maciel D, Pereira Barros da Silva TY, Brito Vieira WHD. Comparison of functional and isokinetic performance between healthy women and women with fibromyalgia. J Bodyw Mov Ther 2020; 24:248-252. [PMID: 31987552 DOI: 10.1016/j.jbmt.2019.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fibromyalgia is a condition that predominantly affects women and is characterized by chronic pain. As a consequence, it has been suggested that there is a decrease in muscle strength, a prime component of physical fitness, and thus a reduction in functional performance. Therefore, it is necessary to perform a complete and reliable physical evaluation of functional performance. The aim of this study was to compare the functional and isokinetic performance between women with fibromyalgia and healthy women. METHODS This is a cross-sectional study that evaluated 40 women divided into 2 groups: Healthy Group (HG) (n = 20); Fibromyalgia Group (FG) (n = 20), aged between 30 and 50 years. The individuals were submitted to an evaluation of functional performance through the following tests: Timed Up and Go (TUGT), Chair Stand Test, 6-Minute Walk test (6MWT), Sit and Reach Test, and Isokinetic performance of the knee extensor and flexor groups. Statistical analysis was performed by the statistical SPSS 22.0 software for Windows. RESULTS A lower index was observed in the 6-min Walk Test (p < 0.001), Chair Stand Test (p < 0.001), and VO2 Peak (p < 0.001) for FG. There were no significant differences in isokinetic performance (p > 0.05). CONCLUSIONS The results point to lower functional performance in individuals with fibromyalgia when compared to healthy individuals of the same age and physical activity level. Therefore, it is evident that performing therapeutic exercises of different modalities to improve the functional performance of patients with FM is important.
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Affiliation(s)
- Luiz Felipe Tavares
- Universidade Federal do Rio Grande do Norte (UFRN) - Physical Therapy Department, Brazil.
| | - Daniel Germano Maciel
- Universidade Federal do Rio Grande do Norte (UFRN) - Physical Therapy Department, Brazil.
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21
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Álvarez-Gallardo IC, Soriano-Maldonado A, Segura-Jiménez V, Estévez-López F, Camiletti-Moirón D, Aparicio VA, Herrador-Colmenero M, Castro-Piñero J, Ortega FB, Delgado-Fernández M, Carbonell-Baeza A. High Levels of Physical Fitness Are Associated With Better Health-Related Quality of Life in Women With Fibromyalgia: The al-Ándalus Project. Phys Ther 2019; 99:1481-1494. [PMID: 31392995 DOI: 10.1093/ptj/pzz113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/18/2018] [Accepted: 03/19/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Physical fitness is a marker of health and is associated with health-related quality of life (HRQoL). Identifying which components of physical fitness are associated with HRQoL in people with fibromyalgia may contribute to the development of more specific therapeutic strategies. OBJECTIVE The 2 aims of this study were to examine the association of different components of physical fitness (ie, flexibility, muscle strength, speed and agility, and cardiorespiratory fitness) with HRQoL and to determine the extent to which any association between the components of physical fitness and HRQoL were of clinical relevance to women with fibromyalgia. DESIGN A cross-sectional design was used. METHODS This study included 466 women with fibromyalgia from southern Spain (Andalusia). The Senior Fitness Test battery and the handgrip test were used to assess physical fitness, and the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL. Tender points, cognitive impairment, anthropometric measurements, and medication usage were also measured. First, multivariate linear regression was used to assess the individual relationship of each physical fitness test with the 8 dimensions of the SF-36. Second, a standardized composite score was computed for each component of physical fitness (flexibility, muscle strength, speed and agility, and cardiorespiratory fitness). A 1-way analysis of covariance to assess the differences in each of the 8 dimensions of the SF-36 across each physical fitness composite score was conducted. Forward stepwise regression was performed to analyze which components of physical fitness were independently associated with the SF-36 physical and mental component scales. RESULTS Overall, higher levels of physical fitness were associated with higher levels of HRQoL (regardless of the SF-36 subscale evaluated). The effect sizes for HRQoL between participants with the lowest and the highest physical fitness levels ranged from moderate to large (Cohen d = 0.53-0.90). The muscle strength composite score was independently associated with the SF-36 physical component scale, whereas the flexibility composite score and cardiorespiratory fitness were independently associated with the SF-36 mental component scale. LIMITATIONS A limitation was that the cross-sectional design precluded the establishment of causality. Additionally, only women were included in the study, because fibromyalgia predominantly affects women. CONCLUSIONS High levels of physical fitness were consistently associated with better HRQoL in women with fibromyalgia; clinically relevant differences were demonstrated between those at extreme physical fitness levels. Muscle strength, flexibility, and cardiorespiratory fitness were independent indicators of HRQoL. These results warrant further prospective research on the potential of fitness to predict HRQoL in this population.
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Affiliation(s)
- Inmaculada C Álvarez-Gallardo
- Department of Physical Education, Faculty of Education Science, University of Cadiz, Calle República Saharaui, s/n, 11519 Puerto Real, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Víctor Segura-Jiménez
- GALENO Research Group and Department of Physical Education, Faculty of Education Science, University of Cadiz; and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Daniel Camiletti-Moirón
- GALENO Research Group and Department of Physical Education, Faculty of Education Science, University of Cadiz; and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz
| | - Virginia A Aparicio
- Department of Physiology and Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Spain; and Sport and Health Research Centre, University of Granada
| | - Manuel Herrador-Colmenero
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health through physical activity" Research Group, University of Granada
| | - Jose Castro-Piñero
- GALENO Research Group and Department of Physical Education, Faculty of Education Science, University of Cadiz; and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health through physical activity" Research Group, University of Granada.,La Inmaculada Teacher Training Centre, University of Granada
| | | | - Ana Carbonell-Baeza
- MOVE-IT Research group and Department of Physical Education, Faculty of Education Sciences University of Cádiz; and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz
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22
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Munguía-Izquierdo D, Pulido-Martos M, Acosta FM, Acosta-Manzano P, Gavilán-Carrera B, Rodriguez-Ayllon M, Geenen R, Delgado-Fernández M, Álvarez-Gallardo IC, Segura-Jiménez V, Walitt B, Estévez-López F. Objective and subjective measures of physical functioning in women with fibromyalgia: what type of measure is associated most clearly with subjective well-being? Disabil Rehabil 2019; 43:1649-1656. [PMID: 31638450 DOI: 10.1080/09638288.2019.1671503] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To find modifiable factors that are related to subjective well-being would be valuable for improving interventions in fibromyalgia. Physical activity, sedentary behaviour, and physical fitness may represent potential areas to optimize treatment regimens. In fibromyalgia, there is a discordance between clinical observations and patient-reported outcomes (objective and subjective assessments). Therefore, the present study aims at analyzing the associations of objective and subjective evaluations of physical activity, sedentary behaviour, and physical fitness with subjective well-being and determine if and how objective and subjective associations differ. METHODS In this population-based cross-sectional study participated 375 women with fibromyalgia from the al-Ándalus project (Spain). Physical activity, sedentary behaviour, and physical fitness were objectively (accelerometers and performance testing) and subjectively (questionnaires) measured. Participants self-reported their levels of positive affect, negative affect, and life satisfaction. RESULTS In the most conservative multivariate analysis, we found independent associations of the objective measures of physical activity with positive affect and life satisfaction and sedentary behaviour with positive affect. No such relationship was seen with subjective measures of the same behaviours. Moreover, we observed that objective and subjective physical fitness evaluations were independent of each other related to subjective well-being. CONCLUSIONS Independent associations of the objective measures (but not the subjective assessments) of physical activity with positive affect and life satisfaction, and of sedentary behaviour with positive affect were observed. However, objective measures and subjective appraisals of physical fitness appear to be independently related to well-being, which should be considered when developing physical exercise interventions for fibromyalgia.Implications for rehabilitationThe analysis of concurrent associations of objective and subjective evaluations of physical functioning with subjective well-being offers indications for modifiable targets in rehabilitation that can improve well-being in fibromyalgia.Exercise-based rehabilitation may help women with fibromyalgia to improve subjective well-being, particularly positive affect.Rehabilitation should focus on both the objective physical performance of women with fibromyalgia and on their perceptions of what they can do physically.When rehabilitation aims at enhancing positive affect or life satisfaction by changing the lifestyle of women with fibromyalgia, physical activity and sedentary behaviour should be objectively monitored.
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Affiliation(s)
- Diego Munguía-Izquierdo
- Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain
| | - Manuel Pulido-Martos
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaén, Jaén, Spain
| | - Francisco M Acosta
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences University of Granada, Granada, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences University of Granada, Granada, Spain
| | - María Rodriguez-Ayllon
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences University of Granada, Granada, Spain
| | | | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Brian Walitt
- National Institute of Nursing Research (NINR), Bethesda, MD, USA
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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23
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Sempere-Rubio N, Aguilar-Rodríguez M, Inglés M, Izquierdo-Alventosa R, Serra-Añó P. Physical Condition Factors that Predict a Better Quality of Life in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173173. [PMID: 31480366 PMCID: PMC6747062 DOI: 10.3390/ijerph16173173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022]
Abstract
What physical qualities can predict the quality of life (QoL) in women with fibromyalgia (FM)? QoL is a very complex outcome affected by multiple comorbidities in people with fibromyalgia. This study aims to determine which physical qualities can predict the quality of life in women with FM. Also, a comparison between the physical qualities of women with FM and healthy counterparts was conducted. In total, 223 women participated in this cross-sectional study, 123 with FM, with ages ranging between 45 and 70 years. The study was conducted at several fibromyalgia associations and specialized medical units. QoL was measured as the main outcome. In addition, functional capacity, muscular strength, maintenance of thoracic posture, postural control, flexibility, pain threshold, and anxiety were measured. Prediction of the QoL was conducted with multiple linear regression analysis and comparison between groups, using the Mann–Whitney U test. There were significant differences between groups in all the variables measured (p < 0.01). The multiple linear regression model showed that factors influencing QoL in women with FM for all the variables measured were functional capacity, handgrip strength and bicep strength, maintenance of thoracic posture, pain threshold, and anxiety (R2 = 0.53, p < 0.05). To conclude, women with FM show a significantly lower QoL than their healthy counterparts, and the factors that predict their perceived QoL are functional capacity, muscular strength, postural maintenance, pain threshold, and anxiety.
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Affiliation(s)
- Núria Sempere-Rubio
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Marta Aguilar-Rodríguez
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES-ISCIII), Fundación Investigación del Hospital Clínico Universitario de Valencia (INCLIVA), València 46010, Spain
| | - Ruth Izquierdo-Alventosa
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain
| | - Pilar Serra-Añó
- Unidad de Biomecánica Clínica (UBIC Research Group), Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València 46010, Spain.
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24
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Association of Patterns of Moderate-to-Vigorous Physical Activity Bouts With Pain, Physical Fatigue, and Disease Severity in Women With Fibromyalgia: the al-Ándalus Project. Arch Phys Med Rehabil 2019; 100:1234-1242.e1. [DOI: 10.1016/j.apmr.2018.12.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/04/2018] [Indexed: 11/20/2022]
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25
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Pujol J, Ramos-López D, Blanco-Hinojo L, Pujol G, Ortiz H, Martínez-Vilavella G, Blanch J, Monfort J, Deus J. Testing the effects of gentle vibrotactile stimulation on symptom relief in fibromyalgia. Arthritis Res Ther 2019; 21:148. [PMID: 31200775 PMCID: PMC6570892 DOI: 10.1186/s13075-019-1932-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/06/2019] [Indexed: 01/01/2023] Open
Abstract
Background Sensory disturbances in fibromyalgia extend beyond nociception. It has been proposed that imbalance in the mutual competition between painful input and non-painful sensory activity may, to a significant extent, account for the augmented subjective perception of pain. In this context, non-nociceptive somatosensory stimulation could arguably attenuate fibromyalgia symptoms by restoring the sensory balance. We specifically tested the effect of vibrotactile stimulation on symptom relief in fibromyalgia patients with a randomized, double-blind, sham-controlled, crossover clinical trial. Methods Seventy-seven female patients were randomized and data from 63 valid cases were analyzed. Active intervention involved extensive body stimulation with gentle mechanical vibrations administered during 3 h at night for 3 weeks, and the placebo effect was controlled using identical instruments to simulate an alternative treatment option. The primary outcome measure combined pain, fatigue, and complaints of poor cognition. Results Vibrotactile stimulation was significantly superior to sham in alleviating fibromyalgia symptoms globally. However, univariate analyses showed that the effect was not universal. Benefits were perceived on unpleasant somatic sensations such as generalized pain and fatigue, but not on poor cognition, anxiety, and depression. Vibrotactile stimulation was notably well tolerated and sleep quality significantly improved despite the fact that vibrations were administered at night. Conclusions Results thus provide new evidence that non-nociceptive somatosensory stimulation may favorably act upon altered somatosensory balance in fibromyalgia. From a clinical perspective, both the degree of improvement and the easy application of our proposal would seem to support a potential role for vibrotactile stimulation in the symptomatic treatment of fibromyalgia. Trial registration ClinicalTrials.gov registration number NCT03227952. Registered 24 July, 2017.
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Affiliation(s)
- Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain. .,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain.
| | - Daniel Ramos-López
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Guillem Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Héctor Ortiz
- Department of Project and Construction Engineering, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Gerard Martínez-Vilavella
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Josep Blanch
- Rheumatology Department, Hospital del Mar, Barcelona, Spain
| | - Jordi Monfort
- Rheumatology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.,Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain
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26
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Marín-Jiménez N, Acosta-Manzano P, Borges-Cosic M, Baena-García L, Coll-Risco I, Romero-Gallardo L, Aparicio VA. Association of self-reported physical fitness with pain during pregnancy: The GESTAFIT Project. Scand J Med Sci Sports 2019; 29:1022-1030. [PMID: 30933387 DOI: 10.1111/sms.13426] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 01/22/2023]
Abstract
AIMS To explore the association of self-reported physical fitness with bodily, lumbar and sciatic pain, and pain disability during pregnancy. METHODS The present study sample comprised 159 pregnant women (32.9 ± 4.7 years old). Self-reported physical fitness was assessed with the International Fitness Scale (IFIS), where higher scores indicate greater physical fitness. Bodily pain was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores indicate lower pain. Lumbar and sciatic pain were measured with a visual analogue scale (VAS). The Oswestry Disability Index (ODI) questionnaire was employed to assess the disability resulting from pain. Measures were assessed at 16th and 34th gestational weeks (g. w.). RESULTS Pregnant women showed low-moderate pain during pregnancy course. Most of them showed medium self-reported overall physical fitness. At 16th g. w., greater self-reported overall physical fitness and cardiorespiratory fitness were associated with less bodily and lumbar pain, and pain disability (all, P < 0.05). Greater muscular strength was associated with less bodily pain and pain disability (both, P < 0.05). Greater speed-agility was associated with less bodily pain (P < 0.01) and less pain disability (P < 0.05). Self-reported flexibility was not associated with any outcome (P > 0.05). At 34th g. w., greater overall physical fitness and its components were associated with less bodily and sciatic pain (all, P < 0.05). CONCLUSION Greater self-reported overall physical fitness and its components are associated with less bodily, lumbar and sciatic pain, and reduced pain disability during pregnancy. Future studies are needed to explore whether increasing physical fitness before and during pregnancy could decrease pain in this relevant stage.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Sport and Health Research Centre, University of Granada, Granada, Spain.,Department of Physiology, Biomedical Research Centre and Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Sport and Health Research Centre, University of Granada, Granada, Spain.,Department of Physiology, Biomedical Research Centre and Sport and Health Research Centre, University of Granada, Granada, Spain
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Gavilán-Carrera B, Garcia da Silva J, Vargas-Hitos JA, Sabio JM, Morillas-de-Laguno P, Rios-Fernández R, Delgado-Fernández M, Soriano-Maldonado A. Association of physical fitness components and health-related quality of life in women with systemic lupus erythematosus with mild disease activity. PLoS One 2019; 14:e0212436. [PMID: 30785923 PMCID: PMC6382148 DOI: 10.1371/journal.pone.0212436] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/01/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To study the association of different components of physical fitness [flexibility, muscle strength and cardiorespiratory fitness (CRF)] and a clustered fitness score with health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and to analyze whether participants with high fitness level have better HRQoL. METHODS This cross-sectional study included 70 women with SLE (aged 42.5; SD 13.9 years). The back-scratch test assessed flexibility, the 30-sec chair stand and handgrip strength tests assessed muscle strength, and the 6-min walk test (n = 49) assessed CRF. HRQoL was assessed through the 36-item Short-Form Health Survey (SF-36). RESULTS Flexibility was positively associated with the physical function dimension and the physical component summary (PCS) (rpartial between 0.26 and 0.31; p<0.05), and negatively related with social functioning dimension (rpartial = -0.26; p<0.05). Muscle strength was positively associated with the physical function, physical role, bodily pain dimensions and the PCS (rpartial between 0.27 and 0.49; all p<0.05). CRF was positively associated with the physical function and bodily pain dimensions, and PCS (rpartial between 0.39 and 0.65; all p<0.05). The clustered fitness score was associated with the physical function (B = 17.16) and bodily pain (B = 14.35) dimensions, and the PCS (B = 6.02), all p<0.005. Patients with high fitness level had greater scores in the physical function, physical role, and bodily pain dimensions and the PCS, all p≤0.05. CONCLUSIONS Our study suggests that muscle strength and CRF are positively associated with HRQoL, while flexibility showed contradictory results. These findings highlight the importance of maintaining adequate fitness levels in women with SLE.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jaqueline Garcia da Silva
- Department of Personality, Assessment, and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | - José A. Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, “Virgen de las Nieves” University Hospital, Granada, Spain
| | - José M. Sabio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, “Virgen de las Nieves” University Hospital, Granada, Spain
| | - Pablo Morillas-de-Laguno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Raquel Rios-Fernández
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, “San Cecilio” University Hospital, Granada, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
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Germano Maciel D, Trajano da Silva M, Rodrigues JA, Viana Neto JB, de França IM, Melo ABM, Barros da Silva TYP, de Brito Vieira WH. Low-level laser therapy combined to functional exercise on treatment of fibromyalgia: a double-blind randomized clinical trial. Lasers Med Sci 2018; 33:1949-1959. [DOI: 10.1007/s10103-018-2561-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
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Larsson A, Palstam A, Bjersing J, Löfgren M, Ernberg M, Kosek E, Gerdle B, Mannerkorpi K. Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia. BMC Musculoskelet Disord 2018; 19:121. [PMID: 29673356 PMCID: PMC5907704 DOI: 10.1186/s12891-018-2047-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/12/2018] [Indexed: 01/27/2023] Open
Abstract
Background Health and physical capacity are commonly associated with disease, age, and socioeconomic factors. The primary objective of this study was to investigate the degree to which physical capacity, defined as muscle strength and walking ability, is decreased in women with fibromyalgia (FM), as compared to healthy women, who are matched for age and level of education. The secondary aim was to investigate whether muscle strength and walking ability are associated with age, symptom duration, activity limitations and, Body Mass Index (BMI) in women with FM and control subjects. Methods This controlled, cross-sectional, multi-center study comprised 118 women with FM and 93 age- and education-level-matched healthy women. The outcome measures were isometric knee-extension force, isometric elbow-flexion force, isometric hand-grip force, and walking ability. Differences between the groups were calculated, and for the women with FM analyses of correlations between the measures of physical capacity and variables were performed. Results The women with FM showed 20% (p < 0.001) lower isometric knee-extension force, 36% (p < 0.001) lower isometric elbow-flexion force, 34% (p < 0.001) lower isometric hand-grip force, and 16% lower walking ability (p < 0.001), as compared to the healthy controls. All measures of muscle strength in women with FM showed significant weak to moderate relationship to symptom duration (rs = − 0.23–0.32) and walking ability (rs = 0.25–0.36). Isometric knee-extension force correlated with activity limitations, as measured using the SF-36 Physical function subscale (rs=0.23, p = 0.011). Conclusions Physical capacity was considerably decreased in the women with FM, as compared to the age- and education-level-matched control group. All measures of physical capacity showed a significant association with symptom duration. Knee-extension force and walking ability were significantly associated with activity limitations, age, and BMI. It seems important to address this problem and to target interventions to prevent decline in muscle strength. Assessments of muscle strength and walking ability are easy to administer and should be routinely carried out in the clinical setting for women with FM. Trial registration ClinicalTrials.gov identification number: NCT01226784, Oct 21, 2010.
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Affiliation(s)
- Anette Larsson
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Box 430, 40530, Gothenburg, Sweden. .,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
| | - Annie Palstam
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Bjersing
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute and Stockholm Spine Center, Stockholm, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Box 430, 40530, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.,Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Effectiveness of Tai Chi on Cardiac Autonomic Function and Symptomatology in Women With Fibromyalgia: A Randomized Controlled Trial. J Aging Phys Act 2018; 26:214-221. [PMID: 28657825 DOI: 10.1123/japa.2017-0038] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The present study examined the effects of a 12-week Tai Chi (TC) training regimen on heart rate variability (HRV), symptomatology, muscle fitness and body composition in women with fibromyalgia. Participants were randomly assigned to either a TC training group (n = 18) or a control group (n = 19). HRV, symptomatology, muscle fitness and body composition were measured before and after 12 weeks. There were significant decreases (p < 0.05) in sympathovagal balance (LnLF/LnHF), sympathetic tone (LnLF, nLF), pain, and fatigue, and significant increases (p < 0.05) in parasympathetic tone (LnHF, nHF), strength and flexibility following TC compared with no changes after control. The changes in LnLF and LnLF/LnHF were correlated with changes in pain. There were no significant changes in HR, sleep quality and body composition after TC or control. TC may be an effective therapeutic intervention for improving sympathovagal balance, pain, fatigue, strength and flexibility in women with fibromyalgia.
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Steiner JL, Bigatti SM, Slaven JE, Ang DC. The Complex Relationship between Pain Intensity and Physical Functioning in Fibromyalgia: The Mediating Role of Depression. JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH 2017; 22:e12079. [PMID: 29527113 PMCID: PMC5839337 DOI: 10.1111/jabr.12079] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Fibromyalgia (FM) is typically associated with the experience of diffuse pain and physical impairment. Depression also commonly co-exists in patients with FM, and has been correlated with pain intensity and physical functioning. Previous research suggests an association between pain intensity and physical functioning; however, the direct causal relationship between improvements in pain intensity and in functioning is not observed in many FM patients. This may suggest that another factor such as depression is mediating this relationship. The present work examined mediating role of depression. METHODS 216 patients with FM completed measures of pain intensity, depression, and physical function as part of a larger longitudinal study. Assessments were completed at baseline, 12, 24, and 36 weeks. RESULTS Longitudinal mediational analyses indicated that depression is a partial mediator of the relationship between pain intensity and physical functioning at all four assessment points. Beta coefficients for the path from pain to physical functioning ranged from 0.18 - 0.36, with attenuated path coefficients ranging from 0.03 - 0.08, still showing significant but decreased associations when depression was added as a mediator. CONCLUSIONS Clinical implication includes the importance of treating co-morbid depression in patients with fibromyalgia early in the course of treatment to prevent engagement in the cycle of disability.
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Affiliation(s)
| | - Silvia M Bigatti
- Indiana University, Richard M. Fairbanks School of Public Health, Indianapolis
| | - James E Slaven
- Indiana University School of Medicine, Department of Biostatistics, Indianapolis
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Aparicio VA, Borges-Cosic M, Ruiz-Cabello P, Coll-Risco I, Acosta-Manzano P, Špacírová Z, Soriano-Maldonado A. Association of objectively measured physical activity and physical fitness with menopause symptoms. The Flamenco Project. Climacteric 2017; 20:456-461. [DOI: 10.1080/13697137.2017.1329289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- V. A. Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Department of Public and Occupational Health., VU University and EMGO + Institute for Health and Care Research., Amsterdam, The Netherlands
| | - M. Borges-Cosic
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - P. Ruiz-Cabello
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - I. Coll-Risco
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - P. Acosta-Manzano
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Z. Špacírová
- Department of Applied Economics, Faculty of Economics, University of Granada, Granada, Spain
| | - A. Soriano-Maldonado
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- SPORT Research Group (CTS-1024), Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
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Relationships among Disability, Quality of Life, and Physical Fitness in Lumbar Spinal Stenosis: An Investigation of Elderly Korean Women. Asian Spine J 2017; 11:256-263. [PMID: 28443170 PMCID: PMC5401840 DOI: 10.4184/asj.2017.11.2.256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/29/2016] [Accepted: 08/05/2016] [Indexed: 01/03/2023] Open
Abstract
STUDY DESIGN A cross-sectional, case-control study. PURPOSE To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women. OVERVIEW OF LITERATURE LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS. METHODS Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL. RESULTS The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores. CONCLUSIONS In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.
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Estévez-López F, Álvarez-Gallardo IC, Segura-Jiménez V, Soriano-Maldonado A, Borges-Cosic M, Pulido-Martos M, Aparicio VA, Carbonell-Baeza A, Delgado-Fernández M, Geenen R. The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions. The al-Ándalus project. Disabil Rehabil 2016; 40:329-337. [PMID: 27973914 DOI: 10.1080/09638288.2016.1258737] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. METHODS This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. RESULTS In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. CONCLUSIONS Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia. Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.
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Affiliation(s)
- Fernando Estévez-López
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,b Department of Psychology, Faculty of Social and Behavioural Sciences , Utrecht University , Utrecht , The Netherlands
| | - Inmaculada C Álvarez-Gallardo
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,c Department of Physical Education, Faculty of Education Sciences , University of Cádiz , Cádiz , Spain
| | - Víctor Segura-Jiménez
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,c Department of Physical Education, Faculty of Education Sciences , University of Cádiz , Cádiz , Spain
| | - Alberto Soriano-Maldonado
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,d Department of Education, Faculty of Education Sciences , University of Almería , Almería , Spain
| | - Milkana Borges-Cosic
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Manuel Pulido-Martos
- e Department of Psychology, Faculty of Humanities and Sciences of Education , University of Jaén , Jaén , Spain
| | - Virginia A Aparicio
- f Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology , University of Granada , Granada , Spain.,g Department of Public and Occupational Health , EMGO + Institute for Health and Care Research, VU University Medical Centre , Amsterdam , The Netherlands
| | - Ana Carbonell-Baeza
- c Department of Physical Education, Faculty of Education Sciences , University of Cádiz , Cádiz , Spain
| | - Manuel Delgado-Fernández
- a Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Rinie Geenen
- b Department of Psychology, Faculty of Social and Behavioural Sciences , Utrecht University , Utrecht , The Netherlands
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Álvarez-Gallardo IC, Carbonell-Baeza A, Segura-Jiménez V, Soriano-Maldonado A, Intemann T, Aparicio VA, Estévez-López F, Camiletti-Moirón D, Herrador-Colmenero M, Ruiz JR, Delgado-Fernández M, Ortega FB. Physical fitness reference standards in fibromyalgia: The al-Ándalus project. Scand J Med Sci Sports 2016; 27:1477-1488. [PMID: 27747931 DOI: 10.1111/sms.12741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 11/30/2022]
Abstract
We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls (P < 0.001) in all age ranges (P < 0.001). This study provides a comprehensive description of age-specific physical fitness levels among patients with fibromyalgia and controls in a large sample of patients with fibromyalgia from southern of Spain. Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls. This information could be useful to correctly interpret physical fitness assessments and helping health care providers to identify individuals at risk for losing physical independence.
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Affiliation(s)
- I C Álvarez-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - A Carbonell-Baeza
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Physical Education, Faculty of Education Science, University of Cadiz, Puerto Real, Spain
| | - V Segura-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Physical Education, Faculty of Education Science, University of Cadiz, Puerto Real, Spain
| | - A Soriano-Maldonado
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - T Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - V A Aparicio
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy, University of Granada, Granada, Spain.,Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - D Camiletti-Moirón
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - M Herrador-Colmenero
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - J R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - M Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - F B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Segura-Jiménez V, Soriano-Maldonado A, Estévez-López F, Álvarez-Gallardo IC, Delgado-Fernández M, Ruiz JR, Aparicio VA. Independent and joint associations of physical activity and fitness with fibromyalgia symptoms and severity: The al-Ándalus project. J Sports Sci 2016; 35:1565-1574. [PMID: 27618648 DOI: 10.1080/02640414.2016.1225971] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We examined independent and joint associations of objectively measured physical activity (PA) and physical fitness (PF) with pain, fatigue and the overall impact of fibromyalgia in 386 fibromyalgia women aged 51.2 ± 7.6 years. Levels of PA (light, moderate and vigorous) and PF were measured with triaxial accelerometry and the Senior Fitness Test, respectively. We used the Short-Form health survey-36 pain sub-scale and the Multidimensional Fatigue Inventory to assess pain and multiple dimensions of fatigue, respectively. The impact of fibromyalgia was studied with the Revised Fibromyalgia Impact Questionnaire (FIQR). Both, total PA and global PF were independently associated with pain pressure threshold, SF-36 pain, reduced activity, reduced motivation and FIQR total score (all, P ≤ 0.027). The associations between total PA and symptoms were weaker than those observed between global PF and symptoms. Overall, unfit patients with low PA showed a worse profile that fit patients with high PA (all, P ≤ 0.001). In summary, PA and PF are independently associated with pain, fatigue and the overall impact of fibromyalgia in women. Although PF presented greater associations with symptoms, the results suggest that both being physically active and keep adequate fitness levels might be convenient for fibromyalgia women.
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Affiliation(s)
- Víctor Segura-Jiménez
- a Department of Physical Education, Faculty of Education Sciences , University of Cádiz , Cádiz , Spain.,b Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Alberto Soriano-Maldonado
- b Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,c Department of Education, Faculty of Education Science , University of Almería , Almería , Spain
| | - Fernando Estévez-López
- b Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain.,d Department of Psychology, Faculty of Social and Behavioural Sciences , Utrecht University , Utrecht , The Netherlands
| | | | - Manuel Delgado-Fernández
- b Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Jonatan R Ruiz
- e PROFITH "PROmoting FITness and Health through physical activity" Research Group, Faculty of Sport Sciences, Department of Physical Education and Sport , University of Granada , Granada , Spain
| | - Virginia A Aparicio
- f Department of Physiology, Faculty of Pharmacy , University of Granada , Granada , Spain
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Caumo W, Deitos A, Carvalho S, Leite J, Carvalho F, Dussán-Sarria JA, Lopes Tarragó MDG, Souza A, Torres ILDS, Fregni F. Motor Cortex Excitability and BDNF Levels in Chronic Musculoskeletal Pain According to Structural Pathology. Front Hum Neurosci 2016; 10:357. [PMID: 27471458 PMCID: PMC4946131 DOI: 10.3389/fnhum.2016.00357] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/30/2016] [Indexed: 12/26/2022] Open
Abstract
The central sensitization syndrome (CSS) encompasses disorders with overlapping symptoms in a structural pathology spectrum ranging from persistent nociception [e.g., osteoarthritis (OA)] to an absence of tissue injuries such as the one presented in fibromyalgia (FM) and myofascial pain syndrome (MPS). First, we hypothesized that these syndromes present differences in their cortical excitability parameters assessed by transcranial magnetic stimulation (TMS), namely motor evoked potential (MEP), cortical silent period (CSP), short intracortical inhibition (SICI) and short intracortical facilitation (SICF). Second, considering that the presence of tissue injury could be detected by serum neurotrophins, we hypothesized that the spectrum of structural pathology (i.e., from persistent nociception like in OA, to the absence of tissue injury like in FM and MPS), could be detected by differential efficiency of their descending pain inhibitory system, as assessed by the conditioned pain modulation (CPM) paradigm. Third, we explored whether brain-derived neurotrophic factor (BDNF) had an influence on the relationship between motor cortex excitability and structural pathology. This cross-sectional study pooled baseline data from three randomized clinical trials. We included females (n = 114), aged 19-65 years old with disability by chronic pain syndromes (CPS): FM (n = 19), MPS (n = 54), OA (n = 27) and healthy subjects (n = 14). We assessed the serum BDNF, the motor cortex excitability by parameters the TMS measures and the change on numerical pain scale [NPS (0-10)] during CPM-task. The adjusted mean (SD) on the SICI observed in the absence of tissue injury was 56.36% lower than with persistent nociceptive input [0.31(0.18) vs. 0.55 (0.32)], respectively. The BDNF was inversely correlated with the SICI and with the change on NPS (0-10)during CPM-task. These findings suggest greater disinhibition in the motor cortex and the descending pain inhibitory system in FM and MPS than in OA and healthy subjects. Likewise, the inter-hemispheric disinhibition as well as the dysfunction in the descending pain modulatory system is higher in chronic pain without tissue injury compared to a structural lesion. In addition, they suggest that a greater level of serum BDNF may be involved in the processes that mediate the disinhibition of motor cortex excitability, as well as the function of descending inhibitory pain modulation system, independently of the physiopathology mechanism of musculoskeletal pain syndromes.
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Affiliation(s)
- Wolnei Caumo
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation at UFRGSPorto Alegre, Brazil; Anesthesiologist, Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA)Porto Alegre, Brazil; Pain and Anesthesia in Surgery Department, School of Medicine, UFRGSPorto Alegre, Brazil
| | - Alícia Deitos
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation at UFRGSPorto Alegre, Brazil
| | - Sandra Carvalho
- Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar Braga, Portugal
| | - Jorge Leite
- Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar Braga, Portugal
| | - Fabiana Carvalho
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation at UFRGSPorto Alegre, Brazil
| | - Jairo Alberto Dussán-Sarria
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation at UFRGSPorto Alegre, Brazil
| | - Maria da Graça Lopes Tarragó
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation at UFRGSPorto Alegre, Brazil
| | - Andressa Souza
- Post-graduate Program in Health and Human Development, La Salle University Center Canoas, Brazil
| | - Iraci Lucena da Silva Torres
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)Porto Alegre, Brazil; Department of Pharmacology, Instituto de Ciências Básicas da Saúde, UFRGSPorto Alegre, Brazil
| | - Felipe Fregni
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
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Turk DC, Adams LM. Using a biopsychosocial perspective in the treatment of fibromyalgia patients. Pain Manag 2016; 6:357-69. [PMID: 27301637 DOI: 10.2217/pmt-2016-0003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Fibromyalgia (FM) is a complex illness that manifests in different ways across individuals. Given that there are currently no known cures for FM, like treatment for other chronic diseases, interventions focus on learning strategies to alleviate symptom severity, to cope with and manage residual symptoms of the illness and to maximize health-related quality of life despite symptoms. In this article, we highlight the need for providers to adopt a biopsychosocial perspective for understanding and addressing patients with FM, noting that biological, psychosocial and behavioral factors function interdependently to affect a person's experience and adaptation. A cognitive-behavioral approach, which incorporates a biopsychosocial perspective, is detailed, along with specific treatment considerations for helping patients with FM manage their symptoms.
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Affiliation(s)
- Dennis C Turk
- Department of Anesthesiology & Pain Medicine, Box 356540, University of Washington, Seattle, WA 98195, USA
| | - Leah M Adams
- Department of Anesthesiology & Pain Medicine, Box 356540, University of Washington, Seattle, WA 98195, USA.,Women's Health & Aging, Group Health Research Institute, Seattle, WA 98195, USA
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Álvarez-Gallardo IC, Soriano-Maldonado A, Segura-Jiménez V, Carbonell-Baeza A, Estévez-López F, McVeigh JG, Delgado-Fernández M, Ortega FB. International FItness Scale (IFIS): Construct Validity and Reliability in Women With Fibromyalgia: The al-Ándalus Project. Arch Phys Med Rehabil 2016; 97:395-404. [DOI: 10.1016/j.apmr.2015.08.416] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/03/2015] [Accepted: 08/06/2015] [Indexed: 11/29/2022]
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Soriano-Maldonado A, Artero EG, Segura-Jiménez V, Aparicio VA, Estévez-López F, Álvarez-Gallardo IC, Munguía-Izquierdo D, Casimiro-Andújar AJ, Delgado-Fernández M, Ortega FB. Association of physical fitness and fatness with cognitive function in women with fibromyalgia. J Sports Sci 2016; 34:1731-9. [DOI: 10.1080/02640414.2015.1136069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jones MD, Booth J, Taylor JL, Barry BK. Limited Association Between Aerobic Fitness and Pain in Healthy Individuals: A Cross-Sectional Study. PAIN MEDICINE 2016; 17:1799-1808. [DOI: 10.1093/pm/pnv084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/01/2015] [Accepted: 11/08/2015] [Indexed: 11/13/2022]
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Association of Physical Fitness with Depression in Women with Fibromyalgia. PAIN MEDICINE 2015; 17:1542-52. [DOI: 10.1093/pm/pnv036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/19/2015] [Indexed: 11/12/2022]
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Segura-Jiménez V, Borges-Cosic M, Soriano-Maldonado A, Estévez-López F, Álvarez-Gallardo IC, Herrador-Colmenero M, Delgado-Fernández M, Ruiz JR. Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: the al-Ándalus study. Scand J Med Sci Sports 2015; 27:83-92. [DOI: 10.1111/sms.12630] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 01/04/2023]
Affiliation(s)
- V. Segura-Jiménez
- Department of Physical Education; Faculty of Education Sciences; University of Cádiz; Cádiz Spain
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - M. Borges-Cosic
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - A. Soriano-Maldonado
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - F. Estévez-López
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
- Department of Clinical and Health Psychology; Faculty of Social and Behavioural Sciences; Utrecht University; Utrecht The Netherlands
| | - I. C. Álvarez-Gallardo
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - M. Herrador-Colmenero
- PROFITH “PROmoting FITness and Health through physical activity” Research Group; Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - M. Delgado-Fernández
- Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
| | - J. R. Ruiz
- PROFITH “PROmoting FITness and Health through physical activity” Research Group; Department of Physical Education and Sport; Faculty of Sport Sciences; University of Granada; Granada Spain
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Segura-Jiménez V, Castro-Piñero J, Soriano-Maldonado A, Álvarez-Gallardo IC, Estévez-López F, Delgado-Fernández M, Carbonell-Baeza A. The association of total and central body fat with pain, fatigue and the impact of fibromyalgia in women; role of physical fitness. Eur J Pain 2015; 20:811-21. [PMID: 26492384 DOI: 10.1002/ejp.807] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND The relationship between estimates of total and central body fat with fibromyalgia pain, fatigue and overall impact has not been fully described. We aimed to assess the individual and combined association of body fat (total and central) with pain, fatigue and the overall impact in fibromyalgia women; and to study the possible mediation role of physical fitness in these associations. METHODS A total of 486 fibromyalgia women with a mean (standard deviation) age of 52.2 (8.0) years participated. Pain was measured with self-reported measures and algometry, whereas fatigue with the Multidimensional Fatigue Inventory. The impact of fibromyalgia was measured with the Revised Fibromyalgia Impact Questionnaire (FIQR) total score. Total and central body fat were assessed by means of bioelectrical impedance and waist circumference, respectively. The Functional Senior Fitness Test battery and the handgrip strength test were used to assess physical fitness. RESULTS Total and central body fat were positively associated with pain- and fatigue-related measures and the FIQR total score (β from 0.10 to 0.25; all, p < 0.05). A combined effect of total and central body fat was observed on pain (FIQR and 36-item Short-Form Health Survey), general and physical-related fatigue and FIQR total score (all, overall p < 0.05), so that the group with no total and central obesity had more favourable results than those with total and central obesity. Cardiorespiratory fitness partially mediated (between 22-40% of the total effect) the associations between total and central body fat with pain, general fatigue, physical fatigue and reduced activity, and largely mediated (80%) the association of central body fat with the FIQR total score. CONCLUSIONS Physical fitness might potentially explain the association between obesity and fibromyalgia symptoms.
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Affiliation(s)
- V Segura-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - J Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
| | - A Soriano-Maldonado
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - I C Álvarez-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - F Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain.,Department of Clinical and Health Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands
| | - M Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - A Carbonell-Baeza
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
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Córdoba-Torrecilla S, Aparicio VA, Soriano-Maldonado A, Estévez-López F, Segura-Jiménez V, Álvarez-Gallardo I, Femia P, Delgado-Fernández M. Physical fitness is associated with anxiety levels in women with fibromyalgia: the al-Ándalus project. Qual Life Res 2015; 25:1053-8. [DOI: 10.1007/s11136-015-1128-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 11/24/2022]
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