Daily Symptom Fluctuations and Functional Impact in Fibromyalgia

September 12, 2026 updated by: Hatice Gözde Sümer, Mardin Artuklu University

Relationship Between Daily Symptom Fluctuations and Functional Impact in Fibromyalgia

Fibromyalgia is a chronic condition that commonly causes widespread pain, fatigue, and difficulty in daily activities. These symptoms may change from day to day, even when their average severity is similar.

This study aims to examine whether daily changes in pain and fatigue are related to functional impact in adults with fibromyalgia. Participants will complete clinical questionnaires at the first visit and record their pain and fatigue levels for seven days. Sleep quality and perceived control over symptoms will also be recorded. No treatment or additional medical procedure will be given as part of the study.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Fibromyalgia symptoms do not always remain at the same level. Pain and fatigue may increase or decrease between days and may also change between morning and evening. Clinical assessments usually focus on the average severity of these symptoms. However, patients with similar average pain or fatigue levels may have different levels of difficulty in daily life. This study will therefore examine whether symptom fluctuation provides additional information about functional impact beyond average symptom severity.

Adults diagnosed with fibromyalgia according to the 2016 American College of Rheumatology criteria will be included. At the initial visit, demographic and clinical information will be recorded. Functional impact will be assessed using the Fibromyalgia Impact Questionnaire. Anxiety and depression symptoms will be assessed using the Hospital Anxiety and Depression Scale, and symptoms related to central sensitization will be assessed using the Central Sensitization Inventory.

After the initial visit, participants will record pain and fatigue levels every morning and evening for seven days using 0-10 numerical rating scales. They will also record their sleep quality each morning and their perceived control over symptoms once daily. These records will be used to calculate average pain and fatigue levels, daily fluctuations in these symptoms, maximum symptom levels, and the degree to which pain and fatigue change together within each participant.

The main analysis will examine the relationship between pain and fatigue fluctuations and functional impact. It will also evaluate whether symptom fluctuation is related to functional impact after considering average pain and fatigue levels, age, sex, and disease duration. Additional analyses will examine the relationships of pain-fatigue synchrony, sleep quality, maximum symptom levels, and perceived symptom control with functional impact. The study is observational and is not designed to determine cause-and-effect relationships.

Study Type

Observational

Enrollment (Estimated)

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Hatice Gözde Sümer, M.D.
  • Phone Number: +90 532 157 72 99
  • Email: gzdsmr@outlook.com

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population will consist of adults aged 18-65 years who attend the Physical Medicine and Rehabilitation outpatient clinic of Mardin Training and Research Hospital and meet the 2016 American College of Rheumatology criteria for fibromyalgia. Both female and male participants will be included. All participants must be able to complete the seven-day symptom records and provide written informed consent. No healthy control group will be included.

Description

Inclusion Criteria:

  • Diagnosis of fibromyalgia according to the 2016 American College of Rheumatology criteria
  • Age between 18 and 65 years
  • Ability to understand and complete the daily symptom records
  • Ability and willingness to provide written informed consent

Exclusion Criteria:

  • Active inflammatory rheumatic disease
  • Major neurological disease
  • Major change in fibromyalgia treatment within the previous three months
  • Pregnancy, postpartum period, or breastfeeding
  • Cognitive impairment or inability to provide informed consent
  • Completion of less than 70% of the required daily symptom records
  • Major change in fibromyalgia treatment during the seven-day monitoring period

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Adults With Fibromyalgia
Adults aged 18-65 years who meet the 2016 American College of Rheumatology criteria for fibromyalgia will be included. Participants will complete clinical questionnaires at the initial visit and record pain and fatigue levels for seven days. Sleep quality and perceived symptom control will also be recorded. No treatment or experimental intervention will be administered as part of the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional Impact Assessed by the Fibromyalgia Impact Questionnaire
Time Frame: At the initial visit
Functional impact will be assessed using the Fibromyalgia Impact Questionnaire (FIQ). The total score ranges from 0 to 100, with higher scores indicating greater impact of fibromyalgia. The main analysis will examine whether within-person variability in pain and fatigue over seven days is associated with the FIQ score independently of average pain and fatigue levels.
At the initial visit

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Within-Person Association Between Pain and Fatigue
Time Frame: During the 7-day monitoring period
Participants will rate pain and fatigue every morning and evening for seven days using 0-10 numerical rating scales. The within-person correlation between paired pain and fatigue ratings will be calculated for each participant. The relationship between this correlation and the FIQ total score will be examined.
During the 7-day monitoring period
Maximum Pain and Fatigue Levels
Time Frame: During the 7-day monitoring period
The highest pain rating and the highest fatigue rating reported by each participant during the seven-day monitoring period will be identified separately. Both are measured on scales from 0 to 10, with higher scores indicating greater symptom severity. Their relationships with the FIQ total score will be examined.
During the 7-day monitoring period
Perceived Symptom Control
Time Frame: During the 7-day monitoring period
Participants will rate their perceived control over their symptoms once daily for seven days using a scale from 0 to 10. The relationship between perceived symptom control and the FIQ total score will be examined.
During the 7-day monitoring period
Sleep Quality
Time Frame: During the 7-day monitoring period
Participants will rate the quality of the previous night's sleep each morning for seven days using a scale from 0 to 10. The relationships of sleep quality with pain, fatigue, and the FIQ total score will be examined.
During the 7-day monitoring period

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2026

Primary Completion (Estimated)

February 15, 2027

Study Completion (Estimated)

February 15, 2027

Study Registration Dates

First Submitted

September 12, 2026

First Submitted That Met QC Criteria

September 12, 2026

First Posted (Actual)

September 17, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 12, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • MTRH-PMR-TYY3

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.