Physical activity is related to function and fatigue but not pain in women with fibromyalgia: baseline analyses from the Fibromyalgia Activity Study with TENS (FAST)

Ericka N Merriwether, Laura A Frey-Law, Barbara A Rakel, Miriam B Zimmerman, Dana L Dailey, Carol G T Vance, Meenakshi Golchha, Katherine M Geasland, Ruth Chimenti, Leslie J Crofford, Kathleen A Sluka, Ericka N Merriwether, Laura A Frey-Law, Barbara A Rakel, Miriam B Zimmerman, Dana L Dailey, Carol G T Vance, Meenakshi Golchha, Katherine M Geasland, Ruth Chimenti, Leslie J Crofford, Kathleen A Sluka

Abstract

Background: Although exercise is an effective treatment for fibromyalgia, the relationships between lifestyle physical activity and multiple symptomology domains of fibromyalgia are not clear. Thus, the purpose of this study was to comprehensively examine the relationships between lifestyle physical activity with multiple outcome domains in women with fibromyalgia, including pain, fatigue, function, pain-related psychological constructs, and quality of life.

Methods: Women (N = 171), aged 20 to 70 years, diagnosed with fibromyalgia, recruited from an ongoing two-site clinical trial were included in this prespecified subgroup analysis of baseline data. Physical activity was assessed using self-report and accelerometry. Symptomology was assessed using questionnaires of perceived physical function, quality of life, fatigue, pain intensity and interference, disease impact, pain catastrophizing, and fear of movement. In addition, quantitative sensory testing of pain sensitivity and performance-based physical function were assessed. Correlation coefficients, regression analyses and between-group differences in symptomology by activity level were assessed, controlling for age and body mass index (BMI).

Results: Lifestyle physical activity was most closely associated with select measures of physical function and fatigue, regardless of age and BMI. Those who performed the lowest levels of lifestyle physical activity had poorer functional outcomes and greater fatigue than those with higher physical activity participation. No relationships between lifestyle physical activity and pain, pain sensitivity, or pain-related psychological constructs were observed.

Conclusions: Lifestyle physical activity is not equally related to all aspects of fibromyalgia symptomology. Lifestyle physical activity levels have the strongest correlations with function, physical quality of life, and movement fatigue in women with fibromyalgia. No relationships between lifestyle physical activity and pain, pain sensitivity, or psychological constructs were observed. These data suggest that physical activity levels are more likely to affect function and fatigue, but have negligible relationships with pain and pain-related psychological constructs, in women with fibromyalgia.

Trial registration: ClinicalTrials.gov, NCT01888640 . Registered on 28 June 2013.

Keywords: Accelerometry; ActiGraph; Fatigue; Fibromyalgia; Function; IPAQ; PROMIS; Pain.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the institutional review board at the University of Iowa and Vanderbilt University. All subjects provided informed written consent.

Consent for publication

Not applicable.

Competing interests

KAS serves as a consultant for Novartis Consumer Healthcare/GSK Consumer Healthcare, has an active research grant from the American Pain Society/Pfizer, and receives royalties from IASP Press. The remaining authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Mean (SEM) fibromyalgia symptomology by accelerometry activity classification (min/d of moderate to vigorous activity). Select function, fatigue, quality of life, and pain measures are shown. Those with the lowest levels of objectively measured physical activity had the lowest function, highest fatigue with walking, and lowest physical quality of life, but no differences in pain, pain sensitivity or disease impact were noted. * p < 0.01. 5TSTS Five Times Sit to Stand Test, 6MWT 6-minute walk test, FIQR Revised Fibromyalgia Impact Questionnaire, MAF Multidimensional Assessment of Fatigue, PCS Physical Component Summary, PF Physical function, PROMIS Patient-Reported Outcomes Measurement Information System, SF-36 36-item Medical Outcomes Study Short Form Health Survey
Fig. 2
Fig. 2
Mean (SEM) fibromyalgia symptomology by self-reported International Physical Activity Questionnaire short form activity classification. Select function, fatigue, quality of life, and pain measures are shown. Those with the lowest levels of self-reported physical activity had the lowest function and greater fatigue. * p < 0.01. 5TSTS Five Times Sit to Stand Test, 6MWT 6-minute walk test, FIQR Revised Fibromyalgia Impact Questionnaire, MAF Multidimensional Assessment of Fatigue, PCS Physical Component Summary, PF Physical function, PROMIS Patient-Reported Outcomes Measurement Information System, SF-36 36-item Medical Outcomes Study Short Form Health Survey

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