1
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Llorente-Romero S, Herrador-Colmenero M, Acosta-Manzano P, Borges-Cosic M, Gavilán-Carrera B, Latorre Román PÁ, Delgado-Fernández M, Segura-Jiménez V. Association of Moderate-to-Vigorous Physical Activity, Sedentary Time, Fat Percentage, and Physical Fitness with Gait Parameters in Women with Fibromyalgia: The Al-Ándalus Project. Biomedicines 2024; 12:829. [PMID: 38672184 PMCID: PMC11048126 DOI: 10.3390/biomedicines12040829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/23/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024] Open
Abstract
Gait impairments have been found in women with fibromyalgia, reducing the physical activity possibilities in this population and leading to a negative correlation with fibromyalgia impact. The aim of this study was to analyze the individual and independent associations of moderate-to-vigorous physical activity (MVPA), sedentary time, fat percentage, and physical fitness with gait parameters in women with fibromyalgia. A total of 84 women with fibromyalgia were included. MVPA and sedentary time were assessed with accelerometry, fat percentage with bioimpedance analysis, and physical fitness with field-based fitness tests. Gait was assessed during a "6 min walk test" and categorized in velocity, cadence, step length, step cycle duration, unipedal stance phase, and bipedal stance phase. Individual relationships were analyzed by partial correlations and independent relationships by linear regressions, adjusting by age and height. MVPA, sedentary time, fat percentage, and physical fitness were correlated with most gait parameters (rpartial between |0.842| and |0.219|; p ≤ 0.05). Physical fitness was independently associated with all gait parameters (β between |0.346| and |0.761|; p ≤ 0.002). In addition, MVPA was independently associated with velocity and step length (β = 0.241 and 0.292; both p = 0.004), and fat percentage was associated with bipedal stance phase (β = 0.242; p = 0.049). Good levels of MVPA, physical fitness, and adequate weight balance are associated with improved gait parameters in women with fibromyalgia.
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Affiliation(s)
- Sergio Llorente-Romero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain (V.S.-J.)
| | - Manuel Herrador-Colmenero
- La Inmaculada Teacher Training Centre, Sport and Health University Research Institute (iMUDS), University of Granada, 18013 Granada, Spain
| | - Pedro Acosta-Manzano
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
- Sport and Health University Research Institute (IMUDS), University of Granada, 18007 Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain
- Physical Activity for Health Promotion Research Group (PAHELP), 18071 Granada, Spain
| | - Blanca Gavilán-Carrera
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
- Departamento de Didáctica de las Lenguas, las Artes y el Deporte, Facultad de Ciencias de la Educación, Universidad de Málaga, 29010 Málaga, Spain
| | - Pedro Ángel Latorre Román
- Department of Corporal Expression, University of Jaen, Campus Las Lagunillas, s/n, 23071 Jaén, Spain
| | - Manuel Delgado-Fernández
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
| | - Víctor Segura-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain (V.S.-J.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cádiz, Spain
- UGC Medicina Física y Rehabilitación, Hospital Universitario Virgen de las Nieves, 18013 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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2
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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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3
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Bacon AM, White L, Norman A. Coping with fibromyalgia during the COVID-19 pandemic: adjustment and wellbeing. Psychol Health 2023; 38:1345-1360. [PMID: 34903135 DOI: 10.1080/08870446.2021.2013484] [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: 12/29/2020] [Revised: 10/20/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Fibromyalgia syndrome (FMS) is a chronic condition with symptoms known to be exacerbated by stress. Individuals with FMS may be experiencing particular distress under Covid-19 pandemic-related lifestyle restrictions. The present study examined wellbeing, perceived symptom change and coping in individuals with and without FMS during pandemic-related social lockdown in the UK. DESIGN Participants with a diagnosis of FMS (N = 390) and a general public sample with no FMS (N = 151) completed questionnaires at three time points. MAIN OUTCOME MEASURES BBC Wellbeing Scale, Cognitive-Emotional Regulation Questionnaire measure of coping, perception of extent to which symptoms have worsened or improved over time. RESULTS Contrary to expectations, FMS participants reported no worsening of symptoms and an increase in wellbeing over the study period. Non-FMS participants experienced worsening health symptoms and no change in wellbeing. Coping strategies involving positive reappraisal, refocussing and planning were positively associated with wellbeing in the FMS group. CONCLUSION The unpredictable symptom profile in FMS, and the regular readjustment this necessitates, may support a form of resilience which has been adaptive during the pandemic. The results have implications for supporting people with FMS, and potentially other chronic conditions, especially at times of stress.
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Affiliation(s)
- Alison M Bacon
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
| | - Leah White
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
| | - Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
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4
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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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Pinto AM, Luís M, Geenen R, Palavra F, Lumley MA, Ablin JN, Amris K, Branco J, Buskila D, Castelhano J, Castelo-Branco M, Crofford LJ, Fitzcharles MA, Häuser W, Kosek E, López-Solà M, Mease P, Marques TR, Jacobs JWG, Castilho P, da Silva JAP. Neurophysiological and Psychosocial Mechanisms of Fibromyalgia: A Comprehensive Review and Call for An Integrative Model. Neurosci Biobehav Rev 2023:105235. [PMID: 37207842 DOI: 10.1016/j.neubiorev.2023.105235] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/21/2023]
Abstract
Research into the neurobiological and psychosocial mechanisms involved in fibromyalgia has progressed remarkably in recent years. Despite this, current accounts of fibromyalgia fail to capture the complex, dynamic, and mutual crosstalk between neurophysiological and psychosocial domains. We conducted a comprehensive review of the existing literature in order to: a) synthesize current knowledge on fibromyalgia; b) explore and highlight multi-level links and pathways between different systems; and c) build bridges connecting disparate perspectives. An extensive panel of international experts in neurophysiological and psychosocial aspects of fibromyalgia discussed the collected evidence and progressively refined and conceptualized its interpretation. This work constitutes an essential step towards the development of a model capable of integrating the main factors implicated in fibromyalgia into a single, unified construct which appears indispensable to foster the understanding, assessment, and intervention for fibromyalgia.
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Affiliation(s)
- Ana Margarida Pinto
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal; University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; University of Coimbra, Psychological Medicine Institute, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal.
| | - Mariana Luís
- Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal.
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Martinus J. Langeveldgebouw, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands; Altrecht Psychosomatic Medicine Eikenboom, Vrijbaan 2, 3705 WC Zeist, the Netherlands.
| | - Filipe Palavra
- Centre for Child Development, Neuropediatric Unit. Pediatric Hospital, Coimbra Hospital and University Centre, Avenida Afonso Romão, 3000-602 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal.
| | - Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Suite 7908, Detroit, MI 48202, USA.
| | - Jacob N Ablin
- Internal Medicine H, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel.
| | - Kirstine Amris
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Jaime Branco
- Rheumatology Department, Egas Moniz Hospital - Lisboa Ocidental Hospital Centre (CHLO-EPE), R. da Junqueira 126, 1349-019 Lisbon, Portugal; Comprehensive Health Research Center (CHRC), Chronic Diseases Research Centre (CEDOC), NOVA Medical School, NOVA University Lisbon (NMS/UNL), Campo Mártires da Pátria 130, 1169-056 Lisbon, Portugal.
| | - Dan Buskila
- Ben Gurion University of the Negev Beer-Sheba, Israel.
| | - João Castelhano
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
| | - Mary-Ann Fitzcharles
- Division of Rheumatology, Department of Medicine, McGill University, 1650 Cedar Ave, Montreal, Quebec, Canada, H3G 1A4.
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany.
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Marina López-Solà
- Serra Hunter Programme, Department of Medicine and Health Sciences, University of Barcelona.
| | - Philip Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, WA, USA; University of Washington School of Medicine, Seattle, WA, USA.
| | - Tiago Reis Marques
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Hammersmith Hospital, Imperial College London, South Kensington, London SW7 2BU, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Strand, London WC2R 2LS, UK.
| | - Johannes W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal.
| | - José A P da Silva
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal
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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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Pinto AM, Geenen R, Wager TD, Lumley MA, Häuser W, Kosek E, Ablin JN, Amris K, Branco J, Buskila D, Castelhano J, Castelo-Branco M, Crofford LJ, Fitzcharles MA, López-Solà M, Luís M, Marques TR, Mease PJ, Palavra F, Rhudy JL, Uddin LQ, Castilho P, Jacobs JWG, da Silva JAP. Emotion regulation and the salience network: a hypothetical integrative model of fibromyalgia. Nat Rev Rheumatol 2023; 19:44-60. [PMID: 36471023 DOI: 10.1038/s41584-022-00873-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 12/09/2022]
Abstract
Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We present here a model of fibromyalgia that integrates current psychosocial and neurophysiological observations. We propose that an imbalance in emotion regulation, reflected by an overactive 'threat' system and underactive 'soothing' system, might keep the 'salience network' (also known as the midcingulo-insular network) in continuous alert mode, and this hyperactivation, in conjunction with other mechanisms, contributes to fibromyalgia. This proposed integrative model, which we term the Fibromyalgia: Imbalance of Threat and Soothing Systems (FITSS) model, should be viewed as a working hypothesis with limited supporting evidence available. We hope, however, that this model will shed new light on existing psychosocial and biological observations, and inspire future research to address the many gaps in our knowledge about fibromyalgia, ultimately stimulating the development of novel therapeutic interventions.
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Affiliation(s)
- Ana Margarida Pinto
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Coimbra, Portugal
- University of Coimbra, Psychological Medicine Institute, Faculty of Medicine, Coimbra, Portugal
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
- Altrecht Psychosomatic Medicine Eikenboom, Zeist, The Netherlands
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Jacob N Ablin
- Internal Medicine H, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Kirstine Amris
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Jaime Branco
- Rheumatology Department, Egas Moniz Hospital - Lisboa Ocidental Hospital Centre (CHLO-EPE), Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Chronic Diseases Research Centre (CEDOC), NOVA Medical School, NOVA University Lisbon (NMS/UNL), Lisbon, Portugal
| | - Dan Buskila
- Ben Gurion University of the Negev Beer-Sheba, Beersheba, Israel
| | - João Castelhano
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Coimbra, Portugal
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Coimbra, Portugal
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary-Ann Fitzcharles
- Division of Rheumatology, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Marina López-Solà
- Serra Hunter Programme, Department of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mariana Luís
- Rheumatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Tiago Reis Marques
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Hammersmith Hospital, Imperial College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Filipe Palavra
- Centre for Child Development, Neuropediatric Unit, Paediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, Coimbra, Portugal
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Johannes W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - José A P da Silva
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Coimbra, Portugal.
- Rheumatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, Coimbra, Portugal.
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Test-Retest Reliability and Concurrent Validity of the 3 m Backward Walk Test under Single and Dual-Task Conditions in Women with Fibromyalgia. J Clin Med 2022; 12:jcm12010212. [PMID: 36615014 PMCID: PMC9821607 DOI: 10.3390/jcm12010212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Previous studies have reported good test-retest reliability for the 3 m backward test (3MBWT) in different populations. However, reliability of the 3MBWT has not been studied in fibromyalgia (FM) under single and dual-task conditions; Methods: A total of 21 women with FM participated in this study. Participants completed the Revised Fibromyalgia Impact Questionnaire and two physical fitness tests: the 3MBWT and the Timed Up and Go (TUG). The dual-task condition consisted of subtracting two by two while performing the test, starting from a random number less than 100; Results: Values showed that the 3MBWT can be considered reliable under single and dual-task conditions when measured with both a manual stopwatch and a Chronopic automatic stopwatch. A strong concurrent validity was shown of 3MBWT and TUG results in the test and retest and the different devices. The relationship between the performance of the 3MBWT in test and retest conditions under single and dual-task conditions measured with different devices and the impact of the disease were high; Conclusions: The 3MBWT is a reliable tool under the single and dual-task conditions in women with FM. It shows higher reliability values when time is taken using a Chronopic. This test also shows high concurrent validity with the TUG test. Its performance is related to the impact of the disease.
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9
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Gavilán-Carrera B, Geenen R, Hughes C, Barbosa L, Visser M, McVeigh J, Ferreira RJO, Boschloo L, Estévez-López F. NET-RMDs study: networks of fatigue and pain in rheumatic and musculoskeletal diseases - protocol for an international cross-sectional study. BMJ Open 2022; 12:e061099. [PMID: 36379658 PMCID: PMC9668028 DOI: 10.1136/bmjopen-2022-061099] [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] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Fatigue and pain are the main symptoms of rheumatic and musculoskeletal diseases (RMDs). Healthcare professionals have a primary role in helping patients to manage both these symptoms, which are part of a complex network of co-occurring factors including sleep problems, psychological distress, social support, body weight, diet, inactive lifestyle and disease activity. The patterns of relationships (networks) between these factors and these symptoms, fatigue and pain, are largely unknown. The current proposal aims to reveal them using network estimation techniques. We will also consider differences in networks for subgroups of people with (1) different RMDs and (2) different clusters (profiles) of biopsychosocial factors. METHODS AND ANALYSIS Adults with at least one RMD will be recruited to this online cross-sectional observational project. To provide a complete overview, a large sample size from different countries will be included. A brief online survey, using 0-10 numeric rating scales will measure, for the past month, levels of fatigue and pain as well as scores on seven biopsychosocial factors. These factors were derived from literature and identified by interviews with patients, health professionals and rheumatologists. Using this input, the steering committee of the project decided the factors to be measured giving priority to those that can be modified in self-management support in community health centres worldwide. Network estimation techniques are used to detect the complex patterns of relationships between these biopsychosocial factors, fatigue and pain; and how these differ for subgroups of people with different RMDs and profiles. ETHICS AND DISSEMINATION Ethical approval of national Institutional Review Boards was obtained. The online survey includes an information letter and informed consent form. The findings will be disseminated via conferences and publications in peer-reviewed scientific journals, while public media channels will be used to inform people with RMDs and other interested parties.
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Affiliation(s)
- Blanca Gavilán-Carrera
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Andalucía, Spain
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Ciara Hughes
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, UK
| | - Lourdes Barbosa
- Department of Rheumatology, Hospital Garcia de Orta EPE, Almada, Setúbal, Portugal
| | - Marianne Visser
- EULAR PARE Patient Research Partners, Amsterdam, The Netherlands
| | | | - Ricardo J O Ferreira
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Higher School of Nursing of Lisbon, Lisbon, Portugal
| | - Lynn Boschloo
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Fernando Estévez-López
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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10
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Coping and Beliefs as Predictors of Functioning and Psychological Adjustment in Fibromyalgia Subgroups. Pain Res Manag 2022; 2022:1066192. [PMID: 35463626 PMCID: PMC9023200 DOI: 10.1155/2022/1066192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/04/2022] [Accepted: 03/18/2022] [Indexed: 11/19/2022]
Abstract
Objectives Research has pointed to two profiles of persons with fibromyalgia according to differences in functionality, thus distinguishing between functional and dysfunctional patients. The role of psychological factors underlying such clusters is unclear. This study aims to explore the contribution of pain beliefs and coping on fibromyalgia clustering. Methods A cluster analysis was performed to classify 238 women with fibromyalgia using the Fibromyalgia Impact Questionnaire and the Beck Depression Inventory as clustering variables. Cluster differences in physical functioning, depression, pain beliefs, coping, and age were then calculated (Student's t-test). Finally, a binary logistic regression was conducted to study the unique contribution of age, beliefs, and coping on cluster classification. Results Two clusters were revealed. Cluster 1 had a poor adaptation to fibromyalgia regarding physical functioning and depression. They generally embraced less adaptive beliefs (i.e., disability, harm, emotion, and requests) and coping strategies (i.e., guarding, resting, and asking for assistance). Cluster 2 showed a better adaptation to fibromyalgia and adopted more favorable beliefs (i.e., control) and coping strategies (i.e., exercise and task persistence). Cluster differences in age were significant but small. The backward binary logistic regression suggested a final model with six predictors (guarding, task persistence, harm, emotion, solicitude, and age) that explained 31% of the variance of group membership. Discussion. These results suggest that only a subset of psychological variables uniquely and independently contribute to functional/dysfunctional group membership. The results support the need to address psychological components in the management of fibromyalgia and point to a subset of preferred target beliefs and coping strategies.
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11
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Sanromán L, Catalá P, Écija C, Suso-Ribera C, San Román J, Peñacoba C. The Role of Walking in the Relationship between Catastrophizing and Fatigue in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4198. [PMID: 35409880 PMCID: PMC8998906 DOI: 10.3390/ijerph19074198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/11/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022]
Abstract
Walking is one of the most beneficial treatments for fibromyalgia patients. However, adherence to walking behavior is low due to the initially associated symptoms (including pain and fatigue). Although the association of catastrophism with greater symptoms is known, the results regarding fatigue have not always been consistent. Nevertheless, it is unknown whether the association between catastrophism and fatigue could, in turn, be conditioned by whether the patients walk or not. Therefore, our goal was to explore the moderating effect of walking on the association between catastrophizing and fatigue in patients with fibromyalgia. A cross-sectional study was carried out with 203 women with fibromyalgia. We used the Multidimensional Fatigue Inventory to assess fatigue and the Pain Catastrophizing Scale to assess pain catastrophizing (differentiating between its three dimensions). An ad hoc item was used to evaluate walking (moderator). Lower scores for fatigue and pain catastrophizing were found among patients who walked versus those who did not. Walking moderated the relationship between rumination and fatigue (Beta = 0.16, t = 1.96, p = 0.049) and between magnification and fatigue (Beta = 0.22, t = 21.83, p = 0.047). Helplessness showed no direct or interaction effect for fatigue. Nevertheless, higher rumination and magnification were associated with higher fatigue only in patients who walked. Therefore, to promote adherence to walking and reduce the effects of catastrophizing on fatigue, it seems necessary to manage rumination and magnification among patients who walk.
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Affiliation(s)
- Lucía Sanromán
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Spain; (L.S.); (P.C.); (C.É.)
| | - Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Spain; (L.S.); (P.C.); (C.É.)
| | - Carmen Écija
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Spain; (L.S.); (P.C.); (C.É.)
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, 12006 Castellón de la Plana, Spain;
| | - Jesús San Román
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Spain; (L.S.); (P.C.); (C.É.)
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12
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Luque-Reca O, Soriano-Maldonado A, Gavilán-Carrera B, Acosta-Manzano P, Ariza-Vega P, Del Paso GAR, Álvarez-Gallardo IC, Estévez-López F. Longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction in adult women with fibromyalgia. Qual Life Res 2022; 31:2047-2058. [PMID: 35098387 DOI: 10.1007/s11136-021-03058-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE This study analysed the longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction at 2- and 5-year follow-up. METHODS In 312 adult women with fibromyalgia, physical fitness was measured by performance-based tests and affect, depression, anxiety and life satisfaction were self-reported using the Positive and Negative Affect Schedule (PANAS), Beck Depression Inventory-second edition (BDI-II), State Trait Anxiety Inventory-I (STAI) and Satisfaction with Life Scale (SWLS), respectively. We conducted sequential linear regression analyses adjusted for baseline levels of depression, anxiety, life satisfaction, age, body fat percentage and education. RESULTS At the 2-year follow-up, all the associations under study were significant. At the 5-year follow-up, a number of associations remained significant. First, lowering negative affect was independently associated with lower depression, anxiety and higher life satisfaction (β's from 0.14 to 0.31). Second, favourable changes in positive affect were independently associated with lower anxiety (β = 0.21) and higher life satisfaction (β = 0.28). Third, enhancing physical fitness was related to higher life satisfaction (β = 0.16). CONCLUSION Reductions in negative affect were associated with more favourable depression, anxiety and life satisfaction at the 2- and 5-year follow-up. Improvements in positive affect were associated with more favourable anxiety and life satisfaction and enhancements in physical fitness were associated with higher life satisfaction. If corroborated in clinical-experimental research, these findings may guide the development of interventions that are tailored to the levels of physical fitness, affect and the outcome of interest (i.e. depression, anxiety or life satisfaction) in women with fibromyalgia.
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Affiliation(s)
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.
| | - Blanca Gavilán-Carrera
- Physical Activity for Health Promotion Research Group (PA-HELP), Department of Physical Education and Sport, Faculty of Sport Sciences and Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physical Education, Faculty of Education Sciences and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
| | - Pedro Acosta-Manzano
- Physical Activity for Health Promotion Research Group (PA-HELP), Department of Physical Education and Sport, Faculty of Sport Sciences and Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Patrocinio Ariza-Vega
- Occupational Therapy Division, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Inmaculada C Álvarez-Gallardo
- Department of Physical Education, Faculty of Education Sciences and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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13
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Pain-Related Worrying and Goal Preferences Determine Walking Persistence in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031513. [PMID: 35162534 PMCID: PMC8835050 DOI: 10.3390/ijerph19031513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
Physical activity and exercise are relevant behaviors for fibromyalgia health outcomes; however, patients have difficulties undertaking and maintaining an active lifestyle. With a cross-sectional design, this study explored the role of pain-related worrying and goal preferences in the walking persistence of women with fibromyalgia. The sample included 111 women who attended a tertiary health setting. We adapted the Six-Minute Walk Test where participants decided either to stop or continue walking in five voluntary 6 min bouts. Women who were categorized higher in pain-related worrying reported higher preference for pain avoidance goals (t = -2.44, p = 0.02) and performed worse in the walking task (LongRank = 4.21; p = 0.04). Pain avoidance goal preference increased the likelihood of stopping after the first (OR = 1.443), second (OR = 1.493), and third (OR = 1.540) 6 min walking bout, and the risk of ending the walking activity during the 30 min task (HR = 1.02, [1.0-1.03]). Influence of pain-related worrying on total walking distance was mediated by goal preferences (ab = -3.25). In interventions targeting adherence in physical activity and exercise, special attention is needed for women who are particularly worried about pain to help decrease their preference for short-term pain avoidance goals relative to long-term goals such as being active through walking.
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14
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Estévez-López F, Guerrero-González JM, Salazar-Tortosa D, Camiletti-Moirón D, Gavilán-Carrera B, Aparicio VA, Acosta-Manzano P, Álvarez-Gallardo IC, Segura-Jiménez V, Soriano-Maldonado A, Geenen R, Delgado-Fernández M, Martínez-González LJ, Ruiz JR, Álvarez-Cubero MJ. Interplay between genetics and lifestyle on pain susceptibility in women with fibromyalgia: The al-Ándalus project. Rheumatology (Oxford) 2021; 61:3180-3191. [PMID: 34875034 PMCID: PMC9348776 DOI: 10.1093/rheumatology/keab911] [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: 08/04/2021] [Revised: 11/29/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives It is widely acknowledged that the experience of pain is promoted by both genetic susceptibility and environmental factors such as engaging in physical activity (PA), and that pain-related cognitions are also important. Thus, the purpose of the present study was to test the association of 64 polymorphisms (34 candidate genes) and the gene–gene, gene–PA and gene–sedentary behaviour interactions with pain and pain-related cognitions in women with FM. Methods Saliva samples from 274 women with FM [mean (s.d.) age 51.7 (7.7) years] were collected for extracting DNA. We measured PA and sedentary behaviour by accelerometers for a week, pain with algometry and questionnaires, and pain-related cognitions with questionnaires. To assess the robustness of the results, a meta-analysis was also performed. Results The rs6311 and rs6313 polymorphisms (5-hydroxytryptamine receptor 2A, HTR2A) were individually related to algometer scores. The interaction of rs4818 (catechol-O-methyltransferase, COMT) and rs1799971 (opioid receptor μ gene, OPRM1) was related to pain catastrophizing. Five gene–behaviour interactions were significant: the interactions of sedentary behaviour with rs1383914 (adrenoceptor alpha 1A, ADRA1A), rs6860 (charged multivesicular body protein 1A, CHMP1A), rs4680 (COMT), rs165599 (COMT) and rs12994338 (SCN9A) on bodily pain subscale of the Short Form 36. Furthermore, the meta-analysis showed an association between rs4680 (COMT) and severity of FM symptoms (codominant model, P-value 0.032). Conclusion The HTR2A gene (individually), COMT and OPRM1 gene–gene interaction, and the interactions of sedentary behaviour with ADRA1A, CHMP1A, COMT and SCN9A genes were associated with pain-related outcomes. Collectively, findings from the present study indicate a modest contribution of genetics and gene–sedentary behaviour interaction to pain and pain catastrophizing in women with FM. Future research should examine whether reducing sedentary behaviour is particularly beneficial for reducing pain in women with genetic susceptibility to pain.
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Affiliation(s)
- Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, The Netherlands, 3015 GD Rotterdam
| | - Juan M Guerrero-González
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - Diego Salazar-Tortosa
- Department of Ecology and Evolutionary Biology, University of Arizona, USA, Tucson, AZ 85719
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain, 18010 Granada
| | | | - Víctor Segura-Jiménez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Spain, Granada.,Hospital Universitario Virgen de las Nieves of Granada, Spain, Granada.,GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain, Cádiz
| | | | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands, 3508 TC Utrecht
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain, 18010 Granada
| | - Luis J Martínez-González
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - Jonatan 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, Spain, 18071 Granada
| | - María J Álvarez-Cubero
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain.,University of Granada, Department of Biochemistry and Molecular Biology III, Faculty of Medicine, Spain, PTS, Granada
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15
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Fibromyalgia: Evidence for Deficits in Positive Psychology Resources. A Case-Control Study from the Al-Ándalus Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212021. [PMID: 34831775 PMCID: PMC8618469 DOI: 10.3390/ijerph182212021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/10/2021] [Indexed: 01/07/2023]
Abstract
Positive psychology is the study of positive subjective experience and individual traits. Identifying deficits in positive psychology regarding fibromyalgia may inform targets for management. Therefore, the aim of the present case–control study was to compare the levels of positive affect, negative affect, satisfaction with life, optimism and emotional repair in a large sample of women with fibromyalgia (cases) and age-matched peers without fibromyalgia (controls). This case–control study included 437 women with fibromyalgia (51.6 ± 7.1 years old) and 206 age-matched women without fibromyalgia (50.6 ± 7.2 years old). Participants self-reported their levels of (i) subjective well-being on the Positive and Negative Affect Schedule and the Satisfaction with Life Scale, (ii) dispositional optimism on the Life Orientation Test-Revised and (iii) emotional repair on the Trait Meta-Mood Scale. Women with fibromyalgia showed lower levels of positive affect, satisfaction with life, optimism and emotional repair and higher levels of negative affect. Large effect sizes were found for positive affect, negative affect and satisfaction with life (all, Cohen’s d ≥ 0.80) and small-to-moderate for emotional repair and optimism (both, Cohen’s d ≥ 0.50). Women with fibromyalgia experience deficits of positive psychology resources. Thus, developing tailored therapies for fibromyalgia focusing on reducing deficits in positive psychology resources may be of clinical interest, though this remains to be corroborated in future research.
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16
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Dépelteau A, Lagueux É, Pagé R, Hudon C. Occupational Adaptation of People Living With Fibromyalgia: A Systematic Review and Thematic Synthesis. Am J Occup Ther 2021; 75:12530. [PMID: 34780617 DOI: 10.5014/ajot.2021.047134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Fibromyalgia (FM) is a chronic pain disorder that interferes with daily activities. Because occupational adaptation varies among people, there is a need to determine which factors can influence adaptation to FM in order to better intervene with them. OBJECTIVE To understand the occupational adaptation process of people living with FM. DATA SOURCES A systematic review of the literature was conducted in the AMED, CINAHL, MEDLINE, OTseeker, OTDBASE, and PsycINFO databases. Articles dated before September 2020 were searched using a strategy with the keywords fibromyalgia and occupation. Study Selection and Data Collection: This article follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Qualitative articles were included if they documented occupational aspects of participants with FM. Two independent reviewers screened the articles and performed the quality assessment using the Critical Appraisal Skills Program checklist. A thematic synthesis was conducted. FINDINGS Of the 560 articles identified, 347 remained after duplicates were removed. After screening titles and abstracts, 303 articles were rejected, and 44 articles were read in their entirety. Twelve qualitative articles were included in the review. The synthesis highlights that support from relatives is a key to successfully adapting to FM. Identity is crucial to a fulfilled life, and occupational competence is greatly affected by the experience of FM. Occupational adaptation is an issue for some people, but maintaining routines and integrating management strategies would help them to achieve it. CONCLUSIONS AND RELEVANCE This review highlights the importance of considering the components of occupational adaptation while caring for people with FM. What This Article Adds: This systematic review identifies the factors influencing the occupational adaptation of people living with FM and emphasizes the importance of addressing those factors.
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Affiliation(s)
- Andréa Dépelteau
- Andréa Dépelteau, OT, MSc, is Occupational Therapist and PhD Student, École de réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada;
| | - Émilie Lagueux
- Émilie Lagueux, OT, PhD, is Occupational Therapist and Professor, École de réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada, and Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Raphaël Pagé
- Raphaël Pagé, MOT, is Occupational Therapist, École de réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Hudon
- Catherine Hudon, MD, PhD, CCFP, is Doctor and Professor, Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada, and Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Fibromyalgia as a Heterogeneous Condition: Subgroups of Patients Based on Physical Symptoms and Cognitive-Affective Variables Related to Pain. SPANISH JOURNAL OF PSYCHOLOGY 2021; 24:e33. [PMID: 34002687 DOI: 10.1017/sjp.2021.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fibromyalgia (FM) is a chronic syndrome characterized by heterogeneous clinical manifestations, and knowing this variability can help to develop tailored treatments. To understand better the heterogeneity of FM the present cross-sectional study analyzed the role of several physical symptoms (pain, fatigue and poor sleep quality) and cognitive-affective variables related to pain (pain catastrophizing, pain vigilance, self-efficacy in pain management, and pain acceptance) in the configuration of clinical profiles. A sample of 161 women with FM fulfilled an interview and several self-report measures to explore physical symptoms, cognitive-affective variables, disability and psychopathology. To establish FM groups a hierarchical cluster analysis was performed. The findings revealed three clusters that differed in the grouping variables, Wilks' λ = .17, F(14, 304) = 31.50, p < .001, ηp2 = .59. Group 1 (n = 72) was characterized by high physical and psychological affectation, Group 2 (n = 19) by low physical affectation and high pain self-efficacy, and Group 3 (n = 70) by moderate physical affectation and low pain catastrophizing. The external validation of the clusters was confirmed, Wilks' λ = .72, F(4, 314) = 14.09, p < .001, ηp2 = .15, showing Group 1 the highest levels of FM impact and psychopathological distress. Considering the distinctive clinical characteristics of each subgroup therapeutic strategies addressed to the specific needs of each group were suggested. Assessing FM profiles may be key for a better understanding and approach of this syndrome.
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Estévez-López F, Salazar-Tortosa DF, Camiletti-Moirón D, Gavilán-Carrera B, Aparicio VA, Acosta-Manzano P, Segura-Jiménez V, Álvarez-Gallardo IC, Carbonell-Baeza A, Munguía-Izquierdo D, Geenen R, Lacerda E, Delgado-Fernández M, Martínez-González LJ, Ruiz JR, Álvarez-Cubero MJ. Fatigue in Women with Fibromyalgia: A Gene-Physical Activity Interaction Study. J Clin Med 2021; 10:jcm10091902. [PMID: 33924903 PMCID: PMC8125111 DOI: 10.3390/jcm10091902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Fatigue is a cardinal symptom in fibromyalgia. Fatigue is assumed to be the result of genetic susceptibility and environmental factors. We aimed at examining the role of genetic susceptibility for fatigue in southern Spanish women with fibromyalgia, by looking at single nucleotide polymorphisms in 34 fibromyalgia candidate-genes, at the interactions between genes, and at the gene-physical activity interactions. We extracted DNA from saliva of 276 fibromyalgia women to analyze gene-polymorphisms. Accelerometers registered physical activity and sedentary behavior. Fatigue was assessed with the Multidimensional Fatigue Inventory. Based on the Bonferroni’s and False Discovery Rate values, we found that the genotype of the rs4453709 polymorphism (sodium channel protein type 9 subunit alpha, SCN9A, gene) was related to reduced motivation (AT carriers showed the highest reduced motivation) and reduced activity (AA carriers showed the lowest reduced activity). Carriers of the heterozygous genotype of the rs1801133 (methylene tetrahydrofolate reductase, MTHFR, gene) or rs4597545 (SCN9A gene) polymorphisms who were physically active reported lower scores on fatigue compared to their inactive counterparts. Highly sedentary carriers of the homozygous genotype of the rs7607967 polymorphism (AA/GG genotype; SCN9A gene) presented more reduced activity (a dimension of fatigue) than those with lower levels of sedentary behavior. Collectively, findings from the present study suggest that the contribution of genetics and gene-physical activity interaction to fatigue in fibromyalgia is modest.
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Affiliation(s)
- Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands;
| | - Diego F. Salazar-Tortosa
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ 85719, USA
- Correspondence:
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (D.C.-M.); (B.G.-C.); (V.S.-J.); (I.C.Á.-G.); (A.C.-B.)
| | - Blanca Gavilán-Carrera
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (D.C.-M.); (B.G.-C.); (V.S.-J.); (I.C.Á.-G.); (A.C.-B.)
| | - Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain;
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18010 Granada, Spain; (P.A.-M.); (M.D.-F.)
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (D.C.-M.); (B.G.-C.); (V.S.-J.); (I.C.Á.-G.); (A.C.-B.)
| | - Inmaculada C. Álvarez-Gallardo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (D.C.-M.); (B.G.-C.); (V.S.-J.); (I.C.Á.-G.); (A.C.-B.)
| | - Ana Carbonell-Baeza
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (D.C.-M.); (B.G.-C.); (V.S.-J.); (I.C.Á.-G.); (A.C.-B.)
| | - Diego Munguía-Izquierdo
- Physical Performance and Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sport Sciences, Universidad Pablo de Olavide, 41013 Seville, Spain;
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, 3508 TC Utrecht, The Netherlands;
| | - Eliana Lacerda
- Department of Clinical Research, Faculty of Infectious & Tropical Disease, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18010 Granada, Spain; (P.A.-M.); (M.D.-F.)
| | - Luis J. Martínez-González
- GENYO, Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, PTS Granada, Av. Ilustracion, 114, 18016 Granada, Spain;
| | - Jonatan 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, 18071 Granada, Spain;
| | - María J. Álvarez-Cubero
- Department of Biochemistry and Molecular Biology III, Faculty of Medicine, University of Granada, 18010 Granada, Spain;
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Braun A, Evdokimov D, Frank J, Pauli P, Üçeyler N, Sommer C. Clustering fibromyalgia patients: A combination of psychosocial and somatic factors leads to resilient coping in a subgroup of fibromyalgia patients. PLoS One 2020; 15:e0243806. [PMID: 33370324 PMCID: PMC7769259 DOI: 10.1371/journal.pone.0243806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/26/2020] [Indexed: 11/19/2022] Open
Abstract
Background Coping strategies and their efficacy vary greatly in patients suffering from fibromyalgia syndrome (FMS). Objective We aimed to identify somatic and psychosocial factors that might contribute to different coping strategies and resilience levels in FMS. Subjects and methods Standardized questionnaires were used to assess coping, pain, and psychological variables in a cohort of 156 FMS patients. Quantitative real-time polymerase chain reaction (qRT-PCR) determined gene expression of selected cytokines in white blood cells of 136 FMS patients and 25 healthy controls. Data of skin innervation, functional and structural sensory profiles of peripheral nociceptive nerve fibers of a previous study were included into the statistics. An exploratory factor analysis was used to define variance explaining factors, which were then included into cluster analysis. Results 54.9% of the variance was explained by four factors which we termed (1) affective load, (2) coping, (3) pain, and (4) pro-inflammatory cytokines (p < 0.05). Considering differences in the emerged factors, coping strategies, cytokine profiles, and disability levels, 118 FMS patients could be categorized into four clusters which we named “maladaptive”, “adaptive”, “vulnerable”, and “resilient” (p < 0.05). The adaptive cluster had low scores in disability and in all symptom categories in contrast to the vulnerable cluster, which was characterized by high scores in catastrophizing and disability (p < 0.05). The resilient vs. the maladaptive cluster was characterized by better coping and a less pro-inflammatory cytokine pattern (p < 0.05). Conclusion Our data suggest that problem- and emotion-focused coping strategies and an anti-inflammatory cytokine pattern are associated with reduced disability and might promote resilience. Additional personal factors such as low anxiety scores, ability of acceptance, and persistence further favor a resilient phenotype. Individualized therapy should take these factors into account.
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Affiliation(s)
- Alexandra Braun
- Department of Neurology, University of Würzburg, Würzburg, Germany
- * E-mail:
| | | | - Johanna Frank
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), and Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Nurcan Üçeyler
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
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Sheila B, Octavio LR, Patricia C, Dolores B, Lilian V, Cecilia P. Perfectionism and Pain Intensity in Women with Fibromyalgia: Its Influence on Activity Avoidance from The Contextual Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228442. [PMID: 33202698 PMCID: PMC7698249 DOI: 10.3390/ijerph17228442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/25/2022]
Abstract
Given the scarcity of studies regarding perfectionism from a contextual perspective, this study aims to analyze its role in the relationship between pain and activity avoidance and its differential effect among patients with different fibromyalgia severity. A cross-sectional study with 228 women with fibromyalgia classified into two disease severity groups (low/moderate vs. high) was carried out. Moderation analyses were conducted; perfectionism was used as moderator, pain (in high and low pain situations) as independent variable, and activity avoidance as the outcome. Among the high disease severity group, analyses showed direct contributions of perfectionism (p < 0.001) but not of pain (p > 0.05); moderation effects were found in high pain situations (p = 0.002) (for low levels of perfectionism, a positive association was found between pain intensity and avoidance). Among the low severity group, direct effects of perfectionism (p < 0.05) and pain intensity (p = 0.04) were found (although the latter only for high pain situations); moderation effects were found in high pain situations (p = 0.018) (for high levels of perfectionism a positive and significant association was found between pain intensity and avoidance). Perfectionism has been found to be a key variable in the differential relationship between pain intensity (in high pain situations) and activity avoidance in groups with high and low disease severity.
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Affiliation(s)
- Blanco Sheila
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Luque-Reca Octavio
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Catala Patricia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Bedmar Dolores
- Pain Unit, Hospital Universitario de Fuenlabrada, 28944 Fuenlabrada, Madrid, Spain;
| | - Velasco Lilian
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Peñacoba Cecilia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
- Correspondence: ; Tel.: +34-91-488-88-64
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21
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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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22
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Słomko J, Estévez-López F, Kujawski S, Zawadka-Kunikowska M, Tafil-Klawe M, Klawe JJ, Morten KJ, Szrajda J, Murovska M, Newton JL, Zalewski P. Autonomic Phenotypes in Chronic Fatigue Syndrome (CFS) Are Associated with Illness Severity: A Cluster Analysis. J Clin Med 2020; 9:jcm9082531. [PMID: 32764516 PMCID: PMC7464864 DOI: 10.3390/jcm9082531] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/11/2022] Open
Abstract
In this study we set out to define the characteristics of autonomic subgroups of patients with Chronic Fatigue Syndrome (CFS). The study included 131 patients with CFS (Fukuda criteria). Participants completed the following screening symptom assessment tools: Chalder Fatigue Scale, Fatigue Impact Scale, Fatigue Severity Scale, Epworth Sleepiness Scales, the self-reported Composite Autonomic Symptom Scale. Autonomic parameters were measured at rest with a Task Force Monitor (CNS Systems) and arterial stiffness using an Arteriograph (TensioMed Kft.). Principal axis factor analysis yielded four factors: fatigue, subjective and objective autonomic dysfunction and arterial stiffness. Using cluster analyses, these factors were grouped in four autonomic profiles: 34% of patients had sympathetic symptoms with dysautonomia, 5% sympathetic alone, 21% parasympathetic and 40% had issues with sympathovagal balance. Those with a sympathetic-dysautonomia phenotype were associated with more severe disease, reported greater subjective autonomic symptoms with sympathetic over-modulation and had the lowest quality of life. The highest quality of life was observed in the balance subtype where subjects were the youngest, had lower levels of fatigue and the lowest values for arterial stiffness. Future studies will aim to design autonomic profile-specific treatment interventions to determine links between autonomic phenotypes CFS and a specific treatment.
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Affiliation(s)
- Joanna Słomko
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
- Correspondence: ; Tel.: +48-52-585-36-16
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, PO Box 2040 Rotterdam, The Netherlands;
| | - Sławomir Kujawski
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
| | - Monika Zawadka-Kunikowska
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Karłowicza 24, 85-092 Bydgoszcz, Poland;
| | - Jacek J. Klawe
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
| | - Karl J. Morten
- Nuffield Department of Women’s & Reproductive Health, The Women Centre, University of Oxford, Oxford OX3 9DU, UK;
| | - Justyna Szrajda
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
| | - Modra Murovska
- Institute of Microbiology and Virology, Riga Stradiņš University, LV-1067 Riga, Latvia;
| | - Julia L. Newton
- Population Health Science Institute, The Medical School, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4HH, UK;
| | - Paweł Zalewski
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (S.K.); (M.Z.-K.); (J.J.K.); (J.S.); (P.Z.)
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Effectiveness of Exercise on Fatigue and Sleep Quality in Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Trials. Arch Phys Med Rehabil 2020; 102:752-761. [PMID: 32721388 DOI: 10.1016/j.apmr.2020.06.019] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine the effects of exercise on fatigue and sleep quality in fibromyalgia (primary aim) and to identify which type of exercise is the most effective in achieving these outcomes (secondary aim). DATA SOURCES PubMed and Web of Science were searched from inception until October 18, 2018. STUDY SELECTION Eligible studies contained information on population (fibromyalgia), intervention (exercise), and outcomes (fatigue or sleep). Randomized controlled trials (RCT) testing the effectiveness of exercise compared with usual care and randomized trials (RT) comparing the effectiveness of 2 different exercise interventions were included for the primary and secondary aims of the present review, respectively. Two independent researchers performed the search, screening, and final eligibility of the articles. Of 696 studies identified, 17 RCTs (n=1003) were included for fatigue and 12 RCTs (n=731) for sleep. Furthermore, 21 RTs compared the effectiveness of different exercise interventions (n=1254). DATA EXTRACTION Two independent researchers extracted the key information from each eligible study. DATA SYNTHESIS Separate random-effect meta-analyses were performed to examine the effects from RCTs and from RTs (primary and secondary aims). Standardized mean differences (SMD) effect sizes were calculated using Hedges' adjusted g. Effect sizes of 0.2, 0.4, and 0.8 were considered small, moderate, and large. Compared with usual care, exercise had moderate effects on fatigue and a small effect on sleep quality (SMD, -0.47; 95% confidence interval [CI], -0.67 to -0.27; P<.001 and SMD, -0.17; 95% CI, -0.32 to -0.01; P=.04). RTs in which fatigue was the primary outcome were the most beneficial for lowering fatigue. Additionally, meditative exercise programs were the most effective for improving sleep quality. CONCLUSIONS Exercise is moderately effective for lowering fatigue and has small effects on enhancing sleep quality in fibromyalgia. Meditative exercise programs may be considered for improving sleep quality in fibromyalgia.
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Girela-Rejón MJ, Gavilán-Carrera B, Aparicio-Ortega E, Borges-Cosic M, García-Rodríguez IC, Delgado-Fernández M, Estévez-López F. Is type of work associated with physical activity and sedentary behaviour in women with fibromyalgia? A cross-sectional study from the al-Ándalus project. BMJ Open 2020; 10:e034697. [PMID: 32350014 PMCID: PMC7213859 DOI: 10.1136/bmjopen-2019-034697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To analyse the association between the type of work (productive vs reproductive work) and the levels of physical activity and sedentary behaviour in women with fibromyalgia. METHOD This cross-sectional study involved 258 women with fibromyalgia from southern Spain. Of them, 55% performed reproductive work (unpaid, associated with caregiving and domestic roles) exclusively, while 45% had productive job (remunerated, that results in goods or services). Physical activity of light, moderate and vigorous intensity in the leisure time, at home, at work, and totally were measured through the leisure time physical activity instrument and with the physical activity at home and work instrument, respectively. Sedentary behaviour was measured by the Sedentary Behaviour Questionnaire. RESULTS After adjusting for age, fat percentage, education level and marital status, the multivariate analysis of covariance model informed the existence of significant differences between type of work groups (p<0.001). Women with productive work engaged in more light physical activity at work (mean difference =448.52 min; 95 % CI 179.66 to 717.38; p=0.001), and total physical activity of light (809.72 min; 535.91 to 1085.53; p<0.001) and moderate (299.78 min; 97.31 to 502.25; p=0.004) intensity. Women with reproductive work engaged in more light physical activity at home (379.14; 175.64 to 582.64; p<0.001). Leisure time physical activity and sedentary behaviour were similar in both groups (p>0.05 for all comparisons). CONCLUSIONS Women with productive work had greater levels of physical activity compared with those who only did reproductive work, except for physical activity at home. Having productive work might facilitate movement of women with fibromyalgia towards a more active lifestyle.
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Affiliation(s)
- Maria José Girela-Rejón
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Didactic of Corporal Expression, Faculty of Education Sciences, University of Granada, Granada, Spain
| | - Blanca Gavilán-Carrera
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Esther Aparicio-Ortega
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Inmaculada C García-Rodríguez
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Manuel Delgado-Fernández
- Physical Activity for HEaLth Promotion research group (PA-HELP), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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25
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Galvez-Sánchez CM, Reyes del Paso GA. Diagnostic Criteria for Fibromyalgia: Critical Review and Future Perspectives. J Clin Med 2020; 9:E1219. [PMID: 32340369 PMCID: PMC7230253 DOI: 10.3390/jcm9041219] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/21/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic illness characterized by widespread pain and other clinical and emotional symptoms. The lack of objective markers of the illness has been a persistent problem in FMS research, clinical management, and social recognition of the disease. A critical historical revision of diagnostic criteria for FMS, especially those formulated by the American College of Rheumatology (ACR), was performed. This narrative review has been structured as follows: Introduction; historical background of FMS, including studies proposing and revising the diagnostic criteria; the process of development of the ACR FMS diagnostic criteria (1990 and 2010 versions); revisions of the 2010 ACR FMS diagnostic criteria; the development of scales based on the 2010 and 2011 criteria, which could help with diagnosis and evaluation of the clinical severity of the disease, such as the Polysymptomatic Distress Scale and the FMS Survey Questionnaire; relationships of prevalence and sex ratio with the different diagnostic criteria; validity and diagnostic accuracy of the ACR FMS criteria; the issues of differential diagnosis and comorbidity; the strength and main limitations of the ACR FMS criteria; new perspectives regarding FMS diagnosis; and the impact of the novel findings in the diagnosis of FMS. It is concluded that despite the official 2010 FMS diagnostic criteria and the diagnostic proposal of 2011 and 2016, complaints from health professionals and patients continue.
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Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-Ándalus Project. J Clin Med 2020; 9:jcm9030733. [PMID: 32182753 PMCID: PMC7141225 DOI: 10.3390/jcm9030733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/21/2020] [Accepted: 03/04/2020] [Indexed: 01/10/2023] Open
Abstract
To examine the associations of prolonged sedentary time (ST) with disease severity in women with fibromyalgia, and to analyse the combined association of total ST and prolonged ST with the disease severity in this population. Women (n = 451; 51.3 ± 7.6 years old) with fibromyalgia participated. Sedentary time and moderate-to-vigorous physical activity (MVPA) were measured using triaxial accelerometry and ST was processed into 30- and 60-min bouts. Dimensions of fibromyalgia (function, overall, symptoms) and the overall disease impact were assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Body fat percentage was assessed using a bio-impedance analyser, and physical fitness was assessed with the Senior Fitness Tests Battery. Greater percentage of ST in 30-min bouts and 60-min bouts were associated with worse function, overall, symptoms and the overall impact of the disease (all, P < 0.05). Overall, these associations were statistically significant when additionally controlling for MVPA and overall physical fitness. Participants with low levels of total ST and prolonged ST (>60-min bouts) presented lower overall impact compared to participants with high levels of total ST and prolonged ST (mean difference = 6.56; 95% confidence interval (CI) = 1.83 to 11.29, P = 0.002). Greater percentage of ST accumulated in 30- and 60-min bouts and a combination of high levels of total and prolonged ST are related to worse disease severity. Although unable to conclude on causality, results suggest it might be advisable to motivate women with fibromyalgia to break prolonged ST and reduce their total daily ST.
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Luque-Reca O, Pulido-Martos M, Gavilán-Carrera B, García-Rodríguez IC, McVeigh JG, Aparicio VA, Estévez-López F. Emotional intelligence impairments in women with fibromyalgia: Associations with widespread pain. J Health Psychol 2019; 26:1901-1912. [PMID: 31814453 DOI: 10.1177/1359105319890916] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study aimed at testing the differences in emotional intelligence ability between women with fibromyalgia (cases) and their age-matched counterparts not with fibromyalgia from the general population (controls) and analysing the association between emotional intelligence ability and widespread pain in women with fibromyalgia. A total of 133 cases and 77 controls participated in this cross-sectional study. Controls performed better than cases on emotion understanding. Higher emotion perception and management were significantly associated with lower widespread pain. Therefore, women with fibromyalgia may experience difficulties in understanding emotional information. In fibromyalgia, higher emotion perception and management abilities are independently related to lower widespread pain.
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Álvarez-Gallardo IC, Estévez-López F, Torres-Aguilar XC, Segura-Jiménez V, Borges-Cosic M, Soriano-Maldonado A, Camiletti-Moirón D, García-Rodríguez IC, Munguía-Izquierdo D, Sierras-Robles Á, Delgado-Fernández M, Girela-Rejón MJ. Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project. Clin Rheumatol 2019; 38:3585-3593. [PMID: 31468225 DOI: 10.1007/s10067-019-04750-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/06/2019] [Accepted: 08/12/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION/OBJECTIVES Reproductive labour refers to activities and tasks directed at caregiving and domestic roles, such as cleaning, cooking, and childcare. Productive labour refers to activities that involve economic remuneration. The aim of the present study was to analyse physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engaged, or did not engage, in productive work. METHOD This cross-sectional study comprised 276 women with fibromyalgia from Andalusia (southern of Spain). Levels of physical activity (light, moderate, and vigorous) and sedentary behaviour were measured by an accelerometer. Physical fitness and cognitive performance were measured with a battery of performance-based tests. RESULTS More hours/week of homemaker-related tasks were associated with higher time spend in light physical activity and lower sedentary behaviour (P < 0.001 and P < 0.05, respectively). Furthermore, in comparison with those who only engaged in reproductive labour, women with fibromyalgia who engaged in productive work showed lower levels of sedentary behaviour and higher levels of light and moderate physical activity, physical fitness (except muscular strength), and cognitive performance (all, P < 0.05). CONCLUSIONS Altogether, our findings suggest that productive work is consistently related to better physical and cognitive functioning in women with fibromyalgia. If future research corroborates causality of our findings, then, to maintain women with fibromyalgia engaging in productive work may be strived for not only because of societal or economic reasons but also for better health. However, we should keep in mind that people with fibromyalgia have a chronic condition, and therefore, adaptations at the workplace are imperative.Key Points• Women with fibromyalgia, who spend more time in reproductive labour, have higher levels of light physical activity and lower sedentary behaviour; however, it is associated with poorer general health (as lower physical fitness or cognitive performance).• Household tasks are often seen as a responsibility associated with the gender roles that women with fibromyalgia perform, despite the feelings of incapacity they cause. Policies focused on reducing reproductive labour demands for fibromyalgia patients (i.e. social help on housework or childcare) might facilitate the inclusion of daily active behaviours.• People with fibromyalgia who engage in productive work seem to have better health outcomes than those who have not; however, we cannot forget that adaptations and flexibility at the workplace are imperative.
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Affiliation(s)
- Inmaculada C Álvarez-Gallardo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui, s/n, 11519, Cádiz, Spain. .,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cadiz, Spain.
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Xitlali C Torres-Aguilar
- 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, Avenida República Saharaui, s/n, 11519, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cadiz, Spain
| | - Milkana Borges-Cosic
- 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
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui, s/n, 11519, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cadiz, Spain
| | | | - Diego Munguía-Izquierdo
- Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, University Pablo de Olavide, Seville, Spain.,Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
| | - Ángela Sierras-Robles
- Department of Physical Education, Music, and Fine Arts, University of Huelva, Huelva, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - María J Girela-Rejón
- Department of Didactic of Corporal Expression, Faculty of Education Sciences, University of Granada, Granada, Spain
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Pastor-Mira MA, López-Roig S, Martínez-Zaragoza F, León E, Abad E, Lledó A, Peñacoba C. Goal Preferences, Affect, Activity Patterns and Health Outcomes in Women With Fibromyalgia. Front Psychol 2019; 10:1912. [PMID: 31496975 PMCID: PMC6712496 DOI: 10.3389/fpsyg.2019.01912] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/05/2019] [Indexed: 02/05/2023] Open
Abstract
Some motivational models understand health behavior as a result of the interaction between goal preferences and mood. However, this perspective has not been explored in fibromyalgia. Furthermore, in chronic pain, it has only been explored with regard to negative affect. Thus, our aims were: (1) to develop a Spanish version of the Goal Pursuit Questionnaire (GPQ); (2) to explore the relationships between goal preferences and health outcomes, testing the moderator role of affect and the mediating role of chronic pain activity patterns. We conducted two cross-sectional studies. In Study 1, after a double translation/back-translation process, we interviewed 94 women attending the Fibromyalgia Unit of the Community of Valencia in order to identify the cultural feasibility and the content validity of the GPQ. Study 2 comprised 260 women. We explored the GPQ structure and performed path analyses to test conditional mediation relationships. Eight activities from the original GPQ were changed while maintaining the conceptual equivalence. Exploratory factor analysis showed two factors: 'Pain-avoidance goal' and 'Mood-management goal' (37 and 13% of explained variance, respectively). These factors refer to patients' preference for hedonic goals (pain avoidance or mood-management) over achievement goals. Robust RMSEA fit index of the final models ranged from 0.039 for pain to 0.000 for disability and fibromyalgia impact. Pain avoidance goals and negative affect influenced pain mediated by task-contingent persistence. They also affected disability mediated by task and excessive persistence. Pain avoidance goals and positive affect influenced fibromyalgia impact mediated by activity avoidance. We also found a direct effect of negative and positive affect on health outcomes. Preference for pain avoidance goals was always related to pain, disability and fibromyalgia impact through activity patterns. Affect did not moderate these relationships and showed direct and indirect paths on health outcomes, mainly by increasing persistence and showing positive affect as an asset and not a risk factor. Intervention targets should include flexible reinforcement of achievement goals relative to pain avoidance goals and positive affect in order to promote task-persistence adaptive activity patterns and decreased activity avoidance.
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Affiliation(s)
| | - Sofía López-Roig
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | | | - Eva León
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | - Ester Abad
- Fibromyalgia Unit, San Vicente del Raspeig Hospital, San Vicente del Raspeig, Spain
| | - Ana Lledó
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | - Cecilia Peñacoba
- Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
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30
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Pulido-Martos M, Luque-Reca O, Segura-Jiménez V, Álvarez-Gallardo IC, Soriano-Maldonado A, Acosta-Manzano P, Gavilán-Carrera B, McVeigh JG, Geenen R, Delgado-Fernández M, Estévez-López F. Physical and psychological paths toward less severe fibromyalgia: A structural equation model. Ann Phys Rehabil Med 2019; 63:46-52. [PMID: 31386910 DOI: 10.1016/j.rehab.2019.06.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Previous research suggested isolated associations of physical and psychological factors with fibromyalgia severity. Integration of physical and psychological, experienced and observed, modifiable factors associated with fibromyalgia severity in a single model will reveal therapeutic paths toward less severity of disease. We aimed to examine an encompassing model of determinants of fibromyalgia severity. METHODS This observational, population-based cross-sectional study included 569 people with fibromyalgia. An integrative model of fibromyalgia severity was tested by using structural equation modelling. This model included 8 factors: resilience, catastrophizing, active lifestyle, declarative memory, subjective fitness, objective fitness, psychological distress, and physical fatigue. RESULTS Two core paths were associated with reduced fibromyalgia severity: 1) a psychological path connecting high resilience and low catastrophizing with low distress and 2) a physical path, connecting a more active lifestyle (directly and via high objective and subjective physical fitness) with low fatigue. Additional interconnecting paths especially suggested a connection from the psychological to physical path. Our model explained 83% of the fibromyalgia severity. CONCLUSIONS The present model integrated the complexity of mutually influencing factors of fibromyalgia severity, which may help to better understand the disease. It emphasised the importance of: 1) physical factors and psychological factors and their interconnections, 2) patients' experiences and clinical measurements, and 3) positive and negative signs such as physical fitness and distress. Future longitudinal and experimental research should aim at testing the causal direction of the associations in the model as well as the clinical implications suggested by the model. For instance, to reduce fatigue, exercise should enhance not only objective fitness but also fitness-related perceptions. Reducing distress and fatigue seems crucial for lowering fibromyalgia severity.
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Affiliation(s)
- Manuel Pulido-Martos
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaén, Jaén, Spain
| | - Octavio Luque-Reca
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, 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
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Joseph G McVeigh
- Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Rinie Geenen
- Department of Psychology, Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Psychology, Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Effects of Exergames on Brain Dynamics in Women with Fibromyalgia: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8071015. [PMID: 31336706 PMCID: PMC6679308 DOI: 10.3390/jcm8071015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/04/2019] [Accepted: 07/09/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Exergames are non-immersive versions of virtual reality that involve physical exercise and have shown several benefits on physical fitness and quality of life in women with fibromyalgia. However, the effects on brain dynamics are still unknown. Aim: the aim was to evaluate the effects of a 24-week exergame intervention on resting brain dynamics in women with fibromyalgia in a single-blinded, randomized controlled trial. Methods: Fifty-six women with fibromyalgia were assessed for eligibility; 55 fulfilled the inclusion criteria. The exercise group completed a 24-week exergame-based intervention that focused on mobility, postural control, upper and lower limb coordination, aerobic fitness, and strength. This group received two 60-min sessions per week. We measured electroencephalographic (EEG) signals from 19 channels. Participants were also divided into two subgroups according to the duration of their symptoms. The intervention was more effective in the group with a shorter duration of symptoms, showing between-group differences in F8, T5 and T4. Conclusion: Exergames may lead to changes in brain dynamics that could be related to increased cerebral blood flow.
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32
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Villafaina S, Collado-Mateo D, Domínguez-Muñoz FJ, Fuentes-García JP, Gusi N. Benefits of 24-Week Exergame Intervention on Health-Related Quality of Life and Pain in Women with Fibromyalgia: A Single-Blind, Randomized Controlled Trial. Games Health J 2019; 8:380-386. [PMID: 31259617 DOI: 10.1089/g4h.2019.0023] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective: To evaluate the effects of 24-week exergame-based intervention on health-related quality of life (HRQoL) and pain in patients with fibromyalgia as well as to analyze the effectiveness of the intervention in subgroups of patients with different pain intensity levels. Design: Single-blinded, randomized controlled trial. Setting: University facilities Participants: Fifty-five women with fibromyalgia participated in the study. Intervention: The exercise group (EG) completed 24 weeks of exergames focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. A total of 120 minutes per week, divided into two sessions of 60 minutes, was completed. Main outcome measures: The Euroqol-5 Dimensions-5 Levels (EQ-5D-5L) was used to assess the HRQoL. In addition, pain intensity was measured using a visual analog scale (VAS). Results: Twenty-five out of 28 women allocated to the EG completed the intervention, which means an 89.29% of adherence. They were randomly divided into an exercise (age = 54.04 [8.45]) and a control group (52.72 [9.98]). Significant effects on the perceived health status and pain intensity (P < 0.05) were found. K-means clustering procedure revealed two groups with different response to the intervention. The respond group obtained significant effects of the exergame intervention in EQ-5D-5L, pain VAS, and VAS-EQ, compared with those who did not respond. Conclusions: Exergames could be a useful tool to improve perceived health status and pain intensity level in women with fibromyalgia with a reduced health-related quality of life.
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Affiliation(s)
| | - Daniel Collado-Mateo
- Faculty of Sport Science, University of Cáceres, Cáceres, Spain.,Facultad de Educación, Universidad Autónoma de Chile, Talca, Chile
| | | | | | - Narcis Gusi
- Faculty of Sport Science, University of Cáceres, Cáceres, Spain
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Borges-Cosic M, Aparicio VA, Estévez-López F, Soriano-Maldonado A, Acosta-Manzano P, Gavilán-Carrera B, Delgado-Fernández M, Geenen R, Segura-Jiménez V. Sedentary time, physical activity, and sleep quality in fibromyalgia: The al-Ándalus project. Scand J Med Sci Sports 2018; 29:266-274. [DOI: 10.1111/sms.13318] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/25/2018] [Accepted: 10/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology, Biomedical Research Center, Sport and Health Research Centre; University of Granada; Granada Spain
| | - 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 Behavioral Sciences; Utrecht University; Utrecht The Netherlands
| | - 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
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioral Sciences; Utrecht University; Utrecht The Netherlands
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences; University of Cádiz; Cádiz Spain
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Koçyiğit BF, Okyay RA. The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia. PeerJ 2018; 6:e4917. [PMID: 29868295 PMCID: PMC5978395 DOI: 10.7717/peerj.4917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/16/2018] [Indexed: 12/16/2022] Open
Abstract
Background Obesity is a possible factor which affects severity of symptoms and disease activity in fibromyalgia syndrome (FMS). The aim of our study was to determine the association between body mass index (BMI) and pain, tender point count (TPC), disease activity, anxiety and depression in patients with FMS. Methods This was a descriptive study. A total of 124 female FMS patients between 18 and 55 years of age were enrolled. FMS patients were evaluated with visual analog scale (VAS), fibromyalgia impact questionnaire (FIQ), Hamilton anxiety scale (HAM-A) and Hamilton depression scale (HAM-D). Patients were divided into three groups according to BMI levels: normal weight, overweight and obese. Normal weight was defined as BMI 18.5-24.9, overweight as BMI 25.0-29.9 and obesity as BMI ≥ 30. We assessed the BMI status and its association with symptom severity in patients with FMS. Results Significant differences were detected in VAS, TPC, FIQ and HAM-D among the groups (p < 0.05). There were no significant differences between the groups in HAM-A (p = 0.328). The highest scores were found in the obese group. Significant positive correlations were determined between BMI levels and VAS, TPC, FIQ and HAM-D (r = 0.277, p = 0.002; r = 0.384, p < 0.001; r = 0.292, p = 0.001; r = 0.357, p < 0.001). Discussion Obese female FMS patients had higher levels of pain, TPC, disease activity and depression. BMI was significantly and positively correlated with clinical manifestations of FMS. Therefore, FMS treatment programs should include weight loss strategies.
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Affiliation(s)
- Burhan Fatih Koçyiğit
- Department of Physical Medicine and Rehabilitation, Kahramanmaras Sütcü Imam University, Kahramanmaras, Turkey
| | - Ramazan Azim Okyay
- Department of Public Health, Kahramanmaras Sütcü Imam University, Kahramanmaras, Turkey
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35
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Estévez-López F, Camiletti-Moirón D, Aparicio VA, Segura-Jiménez V, Álvarez-Gallardo IC, Soriano-Maldonado A, Borges-Cosic M, Acosta-Manzano P, Geenen R, Delgado-Fernández M, Martínez-González LJ, Ruiz JR, Álvarez-Cubero MJ. Identification of candidate genes associated with fibromyalgia susceptibility in southern Spanish women: the al-Ándalus project. J Transl Med 2018; 16:43. [PMID: 29486785 PMCID: PMC5828244 DOI: 10.1186/s12967-018-1416-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/16/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Candidate-gene studies on fibromyalgia susceptibility often include a small number of single nucleotide polymorphisms (SNPs), which is a limitation. Moreover, there is a paucity of evidence in Europe. Therefore, we compared genotype frequencies of candidate SNPs in a well-characterised sample of Spanish women with fibromyalgia and healthy non-fibromyalgia women. METHODS A total of 314 women with a diagnosis of fibromyalgia (cases) and 112 non-fibromyalgia healthy (controls) women participated in this candidate-gene study. Buccal swabs were collected for DNA extraction. Using TaqMan™ OpenArray™, we analysed 61 SNPs of 33 genes related to fibromyalgia susceptibility, symptoms, or potential mechanisms. RESULTS We observed that the rs841 and rs1799971 GG genotype was more frequently observed in fibromyalgia than in controls (p = 0.04 and p = 0.02, respectively). The rs2097903 AT/TT genotypes were also more often present in the fibromyalgia participants than in their control peers (p = 0.04). There were no differences for the remaining SNPs. CONCLUSIONS We identified, for the first time, associations of the rs841 (guanosine triphosphate cyclohydrolase 1 gene) and rs2097903 (catechol-O-methyltransferase gene) SNPs with higher risk of fibromyalgia susceptibility. We also confirmed that the rs1799971 SNP (opioid receptor μ1 gene) might confer genetic risk of fibromyalgia. We did not adjust for multiple comparisons, which would be too stringent and yield to non-significant differences in the genotype frequencies between cases and controls. Our findings may be biologically meaningful and informative, and should be further investigated in other populations. Of particular interest is to replicate the present study in a larger independent sample to confirm or refute our findings. On the other hand, by including 61 SNPs of 33 candidate-genes with a strong rationale (they were previously investigated in relation to fibromyalgia susceptibility, symptoms or potential mechanisms), the present research is the most comprehensive candidate-gene study on fibromyalgia susceptibility to date.
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Affiliation(s)
- Fernando Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, 18011 Granada, Spain
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, 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
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, 18011 Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, 18011 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 Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, 18011 Granada, Spain
| | - Luis J. Martínez-González
- Liquid Biopsy and Metastasis Research Group and Genomic Unit, GENyO (Pfizer-University of Granada, Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - Jonatan 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
| | - María J. Álvarez-Cubero
- Liquid Biopsy and Metastasis Research Group and Genomic Unit, GENyO (Pfizer-University of Granada, Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
- Department of Biochemistry and Molecular Biology III, Faculty of Medicine, University of Granada, Granada, Spain
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Estévez-López F, Aparicio VA, Ruiz JR, Martínez-González LJ, Delgado-Fernández M, Álvarez-Cubero MJ. The TT genotype of the rs6860 polymorphism of the charged multivesicular body protein 1A gene is associated with susceptibility to fibromyalgia in southern Spanish women. Rheumatol Int 2017; 38:531-533. [PMID: 29247346 DOI: 10.1007/s00296-017-3896-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/26/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Fernando 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.
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Jonatan 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
| | - Luis J Martínez-González
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Av. Ilustracion, 114-PTS, 18016, Granada, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - María J Álvarez-Cubero
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Av. Ilustracion, 114-PTS, 18016, Granada, Spain.,Department of Biochemistry & Molecular Biology III, Faculty of Medicine, University of Granada, Granada, Spain
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Clinical, psychological features and quality of life of fibromyalgia patients: a cross-sectional study of Chinese sample. Clin Rheumatol 2017; 37:527-537. [PMID: 29027043 DOI: 10.1007/s10067-017-3872-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/26/2017] [Accepted: 10/05/2017] [Indexed: 01/09/2023]
Abstract
This study aimed to determine the clinical, psychological features, and quality of life in Chinese fibromyalgia (FM) patients who fulfilled the American College of Rheumatology (ACR) 2010 FM classification criteria at initial diagnosis. A cross-sectional study was carried out in the Chinese People's Liberation Army (PLA) General Hospital. A hundred and seven Chinese FM patients (86 females, 21 males) were included. Eighty-six patients completed the questionnaires. Descriptive, differences, and correlation analyses were performed. The results showed that Chinese FM patients started their diseases at a median age of 37 years, with a male-to-female ratio of 1:4.1. Most patients were diagnosed about 2 years after symptoms onset. Nearly 60 % (59.81%) patients had less than college education, 58.88% did not have a full-time job, and 41.12% had low-back pain. Out of 86 patients, 58 (67.4%) had anxiety and 75 (87.2%) had depression. FM patients had poor quality of life in each aspect and deficient social support. The level of pain for the past 7 days was strongly correlated with patient global impression of severity (PGI-S; r = 0.651, p < 0.001) and patient global impression of bother (PGI-B; r = 0.628, p < 0.001). PGI-B was correlated with seven subscales of short-form health survey (SF-36). The study demonstrated the clinical, psychological features of Chinese patients. The diagnosis was delayed for about 2 years. Most of the patients had anxiety and depression, had poor quality of life, and lacked proper social support. PGI-B might be a simple measurement to evaluate patients' quality of life.
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