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Understanding the Associations across Fibromyalgia-Related Fatigue, Depression, Anxiety, Self-Esteem Satisfaction with Life and Physical Activity in Portuguese and Brazilian Patients: A Structural Equation Modeling Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081097. [PMID: 36013564 PMCID: PMC9414775 DOI: 10.3390/medicina58081097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/27/2022]
Abstract
Background and Objectives: Fibromyalgia are heterogeneous and differ from patient to patient; however, the most reported are general myalgia and at specific points associated with fatigue and certain psychological adversities. Physical activity can mitigate the effects of the symptoms. However, the associations between fibromyalgia-related fatigue, self-esteem, anxiety, depression, satisfaction with life and physical activity are unclear. Therefore, the aim of the present study was to understand the associations between these symptoms and whether there are differences between these associations across two distinct cultures. Materials and Methods: A total of 473 women aged between 28 and 75 years (M = 49.27; SD ± 8.28) completed five questionnaires about fibromyalgia-related fatigue, physical activity, anxiety, depression, self-esteem, and satisfaction with life. Results: Fibromyalgia-related fatigue was positively associated with depression and anxiety, depression and anxiety were negatively associated with self-esteem, self-esteem was positively associated with satisfaction with life, satisfaction with life was positively associated with physical activity and there were no differences in terms of the perceptions and associations of these variables between Portuguese and Brazilian patients. Conclusions: Our results showed the significant role of associations between these variables and a similarity in the perception and relationship of the variables between the two cultures.
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Alvarez MC, Albuquerque MLL, Neiva HP, Cid L, Rodrigues F, Teixeira DS, Matos R, Antunes R, Morales-Sánchez V, Monteiro D. Exploring the Relationship between Fibromyalgia-Related Fatigue, Physical Activity, and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084870. [PMID: 35457737 PMCID: PMC9032824 DOI: 10.3390/ijerph19084870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/28/2022]
Abstract
The symptoms of fibromyalgia are varied, including general muscle pain and pain at specific points (also called tender points), excessive fatigue, anxiety, depression, and some psychological problems that can have a negative impact on quality of life. Physical activity is a widely used option by health professionals to alleviate the effects of this syndrome. However, there is no clear information on the possible mediating role of physical activity in the relationship between fibromyalgia-related fatigue and quality of life. Therefore, this study aims to evaluate the relationship between fibromyalgia-related fatigue and quality of life, and to investigate the mediating role of physical activity in patients with this syndrome. Methods: In a cross-sectional study, 237 Portuguese women aged 28 to 75 years (M = 49.12; SD ± 8.87) and 117 Brazilian women aged 20 to 69 years (M = 46.72; SD ± 8.38) were recruited to participate in this study. These patients completed three valid and reliable questionnaires related to the assessment of fibromyalgia-related fatigue (MDF-Fibro-17), physical activity (IPAQ), and quality of life (SF-36). Results: Both samples had scores above the midpoint for all dimensions of fibromyalgia-related fatigue and scores below the midpoint for quality of life. Physical activity had no mediating effect in either sample, as the total indirect effect was not significant. Conclusions: Physical activity does not mediate the relationship between fatigue and quality of life. However, the results also show that the fatigue dimensions associated with fibromyalgia had a negative and significant association with physical and mental health indicators in both samples. Thus, patients with FM with higher scores on fatigue-related symptoms might suffer more from physical and mental health, both of which are related to quality of life.
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Affiliation(s)
- Marcos C. Alvarez
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
| | - Maria Luiza L. Albuquerque
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (M.C.A.); (M.L.L.A.); (H.P.N.)
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
| | - Luis Cid
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
| | - Filipe Rodrigues
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Diogo S. Teixeira
- Faculty of Physical Education and Sport, Lusófona University (ULHT/FEFD), 1749-024 Lisbon, Portugal;
- Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), 1749-024 Lisbon, Portugal
| | - Rui Matos
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Raúl Antunes
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), 2415-396 Leiria, Portugal
| | - Verónica Morales-Sánchez
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, Faculty of Psychology, Malaga University, 29003 Malaga, Spain;
| | - Diogo Monteiro
- Research Center in Sport, Health and Human Development (CIDESD), Trás os Montes and Alto Douro University, 5000-558 Vila Real, Portugal;
- Life Quality Research Centre (CIEQV), 2400-901 Leiria, Portugal; (F.R.); (R.M.); (R.A.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Correspondence:
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Differences between Portuguese and Brazilian Patients with Fibromyalgia Syndrome: Exploring the Associations across Age, Time of Diagnosis, and Fatigue-Related Symptoms. ACTA ACUST UNITED AC 2021; 57:medicina57040322. [PMID: 33915694 PMCID: PMC8066220 DOI: 10.3390/medicina57040322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The current literature demonstrates that different cultures have different perceptions of the symptoms of Fibromyalgia Syndrome (FM). The aim of the study was to explore the differences between Brazilian and Portuguese patients with FM in their fatigue experience and to measure the differences in the perception of fatigue according to age and duration of diagnosis. Materials and Methods: In total, 209 Portuguese women aged between 21 and 75 years old (M = 47.44; SD = 10.73) and 429 Brazilian women aged between 18 and 77 years old (M = 46.51; SD = 9.24) were recruited to participate in the present study. Participants filled out the items in the Multidimensional Daily Fatigue-Fibromyalgia-17 Diary (MDF-Fibro-17), a specific tool to measure the level of five components of FM-related fatigue. Results: The results showed a greater perception of all of the components of fatigue in the Brazilian sample. No significant differences were found related to the age and duration of FM diagnosis. Conclusions: Overall, there are significant differences in fatigue symptoms between Portuguese and Brazilian women with FM, suggesting that cultural and geographical differences should be considered when describing fatigue-related symptoms in women with FM.
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Álvarez MC, Albuquerque MLL, Neiva HP, Cid L, Rodrigues F, Teixeira DS, Monteiro D. The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 Items (MDF-Fibro-17): Evidence from Validity, Reliability and Transcultural Invariance between Portugal and Brazil. J Clin Med 2020; 9:jcm9082330. [PMID: 32707855 PMCID: PMC7463927 DOI: 10.3390/jcm9082330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 11/16/2022] Open
Abstract
The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 (MDF-fibro-17) is an instrument that measures the different components of fibromyalgia-related fatigue symptoms. The current study aims to examine the factor structure of the MDF-fibro-17 in a sample of Portuguese and Brazilian patients diagnosed with fibromyalgia. Additionally, a cross-cultural analysis was carried out on these samples to understand the multidimensional complexity of examining the different dimensions of fatigue in patients with different cultural backgrounds and how fibromyalgia impacts patients with this syndrome. A confirmatory factor analysis was performed to examine the psychometric properties of the measure. Additionally, a multigroup analysis was carried out on the samples of these two cultures to examine measurement invariance. In total, 209 Portuguese women aged between 21 and 75 years (M = 47.44; SD = 10.73) and 429 Brazilians women aged between 16 and 77 years (M = 46.51; SD = 9.24) participated in this study. The results revealed that the measurement model provided an acceptable fit to the data in both the Portuguese and Brazilian samples, also displaying acceptable convergent and discriminant validity. In addition, the model showed acceptable internal consistency and was invariant between cultures. In sum, the MDF-fibro-17 is a valid measure that offers a unique assessment of fatigue symptoms in Portuguese and Brazilian women with fibromyalgia.
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Affiliation(s)
- Marcos C. Álvarez
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
| | - Maria Luiza L. Albuquerque
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
| | - Luís Cid
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
| | - Filipe Rodrigues
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Rio Maior, Portugal
| | - Diogo S. Teixeira
- Faculty of Physical Education and Sport (ULHT/FEFD), University of Lusófona, 1749-024 Lisbon, Portugal;
- Center for the Study of Human Performance (CIPER), 1495-751 Lisbon, Portugal
| | - Diogo Monteiro
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Correspondence:
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Silva HJDA, Lins CADA, Nobre TTX, de Sousa VPS, Caldas RTJ, de Souza MC. Mat Pilates and aquatic aerobic exercises for women with fibromyalgia: a protocol for a randomised controlled blind study. BMJ Open 2019; 9:e022306. [PMID: 30782866 PMCID: PMC6377548 DOI: 10.1136/bmjopen-2018-022306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Physical exercises have been recommended to improve the overall well-being of patients with fibromyalgia, with the main objective of repairing the effects of lack of physical conditioning and of improving the symptoms, especially pain and fatigue. Although widely recommended and widely known, few studies support the use of Pilates as an effective method in improving the symptoms of the disease, comparing it with other well-founded exercise modalities. This protocol was developed to describe the design of a randomised controlled study with a blind evaluator that evaluates the effectiveness of mat Pilates, comparing it with aquatic aerobic exercises, in improving pain in women with fibromyalgia. METHODS Sixty women aged 18-60 years with a diagnosis of fibromyalgia, with a score of between 3 and 8 points on the Visual Analogue Scale for pain, and who sign the clear and informed consent form will be recruited according to the inclusion criteria. They will be randomised into one of the two intervention groups: (1) Pilates, to perform an exercise programme based on mat Pilates; and (2) aquatic exercise, to participate in a programme of aerobic exercises in the swimming pool. The protocol will correspond to 12 weeks of treatment, with both groups performing the exercises with supervision twice a week. The primary outcome will be pain (Visual Analogue Scale for pain). The secondary outcomes are to include impact related to the disease, functional capacity, sleep quality and overall quality of life. The evaluations will be performed at three points: at baseline and after 6 weeks and 12 weeks of treatment. ETHICS AND DISSEMINATION This protocol has been approved by the Ethics Committee of FACISA/UFRN (number: 2.116.314). Data collection will begin after approval by the ethics committee. There will be prior contact with the women, at which time all the information about the study and the objectives will be presented, as well as resolution no 466/2012 of the National Health Council of Brazil for the year 2012, which provides guidelines and regulatory standards for research involving human beings. Participants must sign the informed consent form before the study begins. TRIAL REGISTRATION NUMBER NCT03149198.
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Affiliation(s)
- Hugo Jario de Almeida Silva
- Faculty of Health Sciences of Trairi - UFRN/FACISA, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Caio Alano de Almeida Lins
- Faculty of Health Sciences of Trairi - UFRN/FACISA, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Thaiza Teixeira Xavier Nobre
- Faculty of Health Sciences of Trairi - UFRN/FACISA, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | | | | | - Marcelo Cardoso de Souza
- Faculty of Health Sciences of Trairi - UFRN/FACISA, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
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Li Y, Morris S, Cole J, Dube' S, Smith JAM, Burbridge C, Symonds T, Hudgens S, Wang W. Multidimensional daily diary of fatigue-fibromyalgia-17 items (MDF-fibro-17): part 2 psychometric evaluation in fibromyalgia patients. BMC Musculoskelet Disord 2017; 18:198. [PMID: 28521738 PMCID: PMC5437630 DOI: 10.1186/s12891-017-1545-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 04/30/2017] [Indexed: 11/16/2022] Open
Abstract
Background The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 instrument (MDF-Fibro-17) has been developed for use in fibromyalgia (FM) clinical studies and includes 5 domains: Global Fatigue Experience, Cognitive Fatigue, Physical Fatigue, Motivation, and Impact on Function. Psychometric properties of the MDF-Fibro-17 needed to demonstrate the appropriateness of using this instrument in clinical studies are presented. Methods Psychometric analyses were conducted to evaluate the factor structure, reliability, validity, and responsiveness of the MDF-Fibro-17 using data from a Phase 2 clinical study of FM patients (N = 381). Confirmatory factor analyses (CFA) were performed to ensure understanding of the multidimensional domain structure, and a secondary factor analysis of the domains examined the appropriateness of calculating a total score in addition to domain scores. Longitudinal psychometric analyses (test-retest reliability and responder analysis) were also conducted on the data from Baseline to Week 6. Results The CFA supported the 17-item, 5 domain structure of this instrument as the best fit of the data: comparative fit index (CFI) and non-normed fit index (NNFI) were 0.997 and 0.992 respectively, standardized root mean square residual (SRMR) was 0.010 and the root mean square error of approximation (RMSEA) was 0.06. In addition, total score (CFI and NNFI both 0.95) met required standards. For the total and 5 domain scores, reliability and validity data were acceptable: test-retest and internal consistency were above 0.9; correlations were as expected with the Global Fatigue Index (GFI) (0.62-0.75), Fibromyalgia Impact Questionnaire (FIQ) Total (0.59–0.71), and 36-Item Short Form Health Survey (SF-36) vitality (VT) (0.43–0.53); and discrimination was shown using quintile scores for the GFI, FIQ Total, and Pain Numeric Rating Scale (NRS) quartiles. In addition, sensitivity to change was demonstrated with an overall mean responder score of -2.59 using anchor-based methods. Conclusion The MDF-Fibro-17 reliably measures 5 domains of FM-related fatigue and psychometric evaluation confirms that this measure meets or exceeds each of the predefined acceptable thresholds for evidence of reliability, validity, and responsiveness to changes in clinical status. This suggests that the MDF-Fibro-17 is an appropriate and responsive measure of FM-related fatigue in clinical studies.
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Affiliation(s)
- Y Li
- Former employees, current consultants of Theravance Biopharma US, Inc, 901 Gateway Boulevard, South San Francisco, CA, 94080, USA.
| | - S Morris
- Former employees, current consultants of Theravance Biopharma US, Inc, 901 Gateway Boulevard, South San Francisco, CA, 94080, USA
| | - J Cole
- Former employees of Covance Market Access, San Diego, CA, USA
| | - S Dube'
- Consulting Associate Professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, 94305, CA, USA.,Adjunct Professor, University of Pittsburgh Schools of Medicine, Pittsburg, 15260, PA, USA
| | - J A M Smith
- Former employees, current consultants of Theravance Biopharma US, Inc, 901 Gateway Boulevard, South San Francisco, CA, 94080, USA
| | - C Burbridge
- Clinical Outcomes Solutions, Unit 68 Basepoint, Shearway Business Park, Shearway Road, Folkestone, Kent, UK
| | - T Symonds
- Clinical Outcomes Solutions, Unit 68 Basepoint, Shearway Business Park, Shearway Road, Folkestone, Kent, UK
| | - S Hudgens
- Clinical Outcomes Solutions, 1790 E. River Rd., Suite 205, Tucson, AZ, 85718, USA
| | - W Wang
- Theravance Biopharma US, Inc., San Francisco, CA, USA
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