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29-08-2018 | Fibromyalgia | Article

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)

Journal: Arthritis Research & Therapy

Authors: 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

Publisher: BioMed Central

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.

Centers for Disease Control and Prevention (CDC). How much physical activity do adults need? Atlanta, GA: CDC; 2016.

Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.CrossRefPubMed

Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L. Physical activity and low back pain: a systematic review of recent literature. Eur Spine J. 2011;20(6):826–45.CrossRefPubMedPubMedCentral

Segura-Jimenez V, Alvarez-Gallardo IC, Estevez-Lopez F, Soriano-Maldonado A, Delgado-Fernandez M, Ortega FB, Aparicio VA, Carbonell-Baeza A, Mota J, Silva P, et al. Differences in sedentary time and physical activity between female patients with fibromyalgia and healthy controls: the al-Andalus project. Arthritis Rheumatol. 2015;67(11):3047–57.CrossRefPubMed

McLoughlin MJ, Colbert LH, Stegner AJ, Cook DB. Are women with fibromyalgia less physically active than healthy women? Med Sci Sports Exerc. 2011;43(5):905–12.CrossRefPubMedPubMedCentral

Kop WJ, Lyden A, Berlin AA, Ambrose K, Olsen C, Gracely RH, Williams DA, Clauw DJ. Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome. Arthritis Rheum. 2005;52(1):296–303.CrossRefPubMed

Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2017;1:CD011279.PubMed

Dailey DL, Rakel BA, Vance CG, Liebano RE, Amrit AS, Bush HM, Lee KS, Lee JE, Sluka KA. Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain. 2013;154(11):2554–62.CrossRefPubMedPubMedCentral

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum. 1990;33(2):160–72.CrossRefPubMed

10.

Clauw DJ. Fibromyalgia: an overview. Am J Med. 2009;122(12 Suppl):S3–13.CrossRefPubMed

11.

Arnold LM, Crofford LJ, Mease PJ, Burgess SM, Palmer SC, Abetz L, Martin SA. Patient perspectives on the impact of fibromyalgia. Patient Educ Couns. 2008;73(1):114–20.CrossRefPubMedPubMedCentral

12.

Staud R. Treatment of fibromyalgia and its symptoms. Expert Opin Pharmacother. 2007;8(11):1629–42.CrossRefPubMed

13.

Staud R, Cannon RC, Mauderli AP, Robinson ME, Price DD, Vierck CJ Jr. Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain. 2003;102(1–2):87–95.CrossRefPubMed

14.

Staud R, Robinson ME, Vierck CJ Jr, Price DD. Diffuse noxious inhibitory controls (DNIC) attenuate temporal summation of second pain in normal males but not in normal females or fibromyalgia patients. Pain. 2003;101(1–2):167–74.CrossRefPubMed

15.

Bauman AE. Updating the evidence that physical activity is good for health: an epidemiological review 2000-2003. J Sci Med Sport. 2004;7(1 Suppl):6–19.CrossRefPubMed

16.

Geva N, Defrin R. Enhanced pain modulation among triathletes: a possible explanation for their exceptional capabilities. Pain. 2013;154(11):2317–23.CrossRefPubMed

17.

Naugle KM, Riley JL 3rd. Self-reported physical activity predicts pain inhibitory and facilitatory function. Med Sci Sports Exerc. 2014;46(3):622–9.CrossRefPubMedPubMedCentral

18.

Tesarz J, Schuster AK, Hartmann M, Gerhardt A, Eich W. Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis. Pain. 2012;153(6):1253–62.CrossRefPubMed

19.

Landmark T, Romundstad P, Borchgrevink PC, Kaasa S, Dale O. Associations between recreational exercise and chronic pain in the general population: evidence from the HUNT 3 study. Pain. 2011;152(10):2241–7.CrossRefPubMed

20.

Landmark T, Romundstad PR, Borchgrevink PC, Kaasa S, Dale O. Longitudinal associations between exercise and pain in the general population - the HUNT pain study. PLoS One. 2013;8(6):e65279.CrossRefPubMedPubMedCentral

21.

Zhang R, Chomistek AK, Dimitrakoff JD, Giovannucci EL, Willett WC, Rosner BA, Wu K. Physical activity and chronic prostatitis/chronic pelvic pain syndrome. Med Sci Sports Exerc. 2015;47(4):757–64.CrossRefPubMedPubMedCentral

22.

Bidonde J, Busch AJ, Bath B, Milosavljevic S. Exercise for adults with fibromyalgia: an umbrella systematic review with synthesis of best evidence. Curr Rheumatol Rev. 2014;10(1):45–79.CrossRefPubMed

23.

Bidonde J, Busch AJ, Schachter CL, Overend TJ, Kim SY, Goes SM, Boden C, Foulds HJ. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017;6:CD012700.PubMed

24.

Segura-Jiménez V, Borges-Cosic M, Soriano-Maldonado A, Estévez-López F, Álvarez-Gallardo IC, Herrador-Colmenero M, Delgado-Fernández M, Ruiz JR. Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: the al-Ándalus study. Scand J Med Sci Sports. 2017;27(1):83–92.CrossRefPubMed

25.

Noehren B, Dailey DL, Rakel BA, Vance CG, Zimmerman MB, Crofford LJ, Sluka KA. Effect of transcutaneous electrical nerve stimulation on pain, function, and quality of life in fibromyalgia: a double-blind randomized clinical trial. Phys Ther. 2015;95(1):129–40.CrossRefPubMed

26.

Merriwether EN, Rakel BA, Zimmerman MB, Dailey DL, Vance CGT, Darghosian L, Golchha M, Geasland KM, Chimenti R, Crofford LJ, et al. Reliability and construct validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) instruments in women with fibromyalgia. Pain Med. 2017;18(8):1485–95.PubMed

27.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed

28.

Kaleth AS, Ang DC, Chakr R, Tong Y. Validity and reliability of community health activities model program for seniors and short-form International Physical Activity Questionnaire as physical activity assessment tools in patients with fibromyalgia. Disabil Rehabil. 2010;32(5):353–9.CrossRefPubMed

29.

Mannerkorpi K. Exercise in fibromyalgia. Curr Opin Rheumatol. 2005;17(2):190–4.CrossRefPubMed

30.

Hildebrand M, Van Hees VT, Hansen BH, Ekelund U. Age group comparability of raw accelerometer output from wrist- and hip-worn monitors. Med Sci Sports Exerc. 2014;46(9):1816–24.CrossRefPubMed

31.

Ellingson LD, Hibbing PR, Kim Y, Frey-Law LA, Saint-Maurice PF, Welk GJ. Lab-based validation of different data processing methods for wrist-worn ActiGraph accelerometers in young adults. Physiol Meas. 2017;38(6):1045–60.CrossRefPubMed

32.

Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23(2):129–38.PubMed

33.

Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the Brief Pain Inventory for chronic nonmalignant pain. J Pain. 2004;5(2):133–7.CrossRefPubMed

34.

Liebano RE, Rakel B, Vance CG, Walsh DM, Sluka KA. An investigation of the development of analgesic tolerance to TENS in humans. Pain. 2011;152(2):335–42.CrossRefPubMed

35.

Knudsen L, Drummond PD. Cold-induced limb pain decreases sensitivity to pressure-pain sensations in the ipsilateral forehead. Eur J Pain. 2009;13(10):1023–9.CrossRefPubMed

36.

Tousignant-Laflamme Y, Page S, Goffaux P, Marchand S. An experimental model to measure excitatory and inhibitory pain mechanisms in humans. Brain Res. 2008;1230:73–9.CrossRefPubMed

37.

Dailey DL, Keffala VJ, Sluka KA. Cognitive and physical fatigue tasks enhance pain, cognitive fatigue and physical fatigue in people with fibromyalgia. Arthritis Care Res (Hoboken). 2015;67:288–96.CrossRef

38.

Mease PJ, Clauw DJ, Arnold LM, Goldenberg DL, Witter J, Williams DA, Simon LS, Strand CV, Bramson C, Martin S, et al. Fibromyalgia syndrome. J Rheumatol. 2005;32(11):2270–7.PubMed

39.

Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL. Correlates of fatigue in older adults with rheumatoid arthritis. Nurs Res. 1993;42(2):93–9.CrossRefPubMed

40.

Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160–4.CrossRefPubMedPubMedCentral

41.

Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: six-minute walk test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82(2):128–37.CrossRefPubMed

42.

Bohannon RW, Bubela DJ, Magasi SR, Wang YC, Gershon RC. Sit-to-Stand Test: performance and determinants across the age-span. Isokinet Exerc Sci. 2010;18(4):235–40.PubMedPubMedCentral

43.

Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: development and validation. Psychol Assess. 1995;7:524–32.CrossRef

44.

Roelofs J, Goubert L, Peters ML, Vlaeyen JW, Crombez G. The Tampa Scale for Kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia. Eur J Pain. 2004;8(5):495–502.CrossRefPubMed

45.

Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther. 2009;11(4):R120.CrossRefPubMedPubMedCentral

46.

Cooper AR, Page A, Fox KR, Misson J. Physical activity patterns in normal, overweight and obese individuals using minute-by-minute accelerometry. Eur J Clin Nutr. 2000;54(12):887–94.CrossRefPubMed

47.

Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.CrossRefPubMed

48.

Segura-Jimenez V, Soriano-Maldonado A, Estevez-Lopez F, Alvarez-Gallardo IC, Delgado-Fernandez M, Ruiz JR, Aparicio VA. Independent and joint associations of physical activity and fitness with fibromyalgia symptoms and severity: the al-Andalus project. J Sports Sci. 2017;35(15):1565–74.CrossRefPubMed

49.

Gregory NS, Gibson-Corley K, Frey-Law L, Sluka KA. Fatigue-enhanced hyperalgesia in response to muscle insult: induction and development occur in a sex-dependent manner. Pain. 2013;154(12):2668–76.CrossRefPubMedPubMedCentral

50.

Naugle KM, Ohlman T, Naugle KE, Riley ZA, Keith NR. Physical activity behavior predicts endogenous pain modulation in older adults. Pain. 2017;158(3):383–90.CrossRefPubMed

51.

Fontaine KR, Conn L, Clauw DJ. Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial. Arthritis Res Ther. 2010;12(2):R55.CrossRefPubMedPubMedCentral

52.

Leung A, Gregory NS, Allen LA, Sluka KA. Regular physical activity prevents chronic pain by altering resident muscle macrophage phenotype and increasing interleukin-10 in mice. Pain. 2016;157(1):70–9.CrossRefPubMedPubMedCentral

53.

Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol. 2017;595(13):4141–50.CrossRefPubMedPubMedCentral

54.

Sluka KA, O’Donnell JM, Danielson J, Rasmussen LA. Regular physical activity prevents development of chronic pain and activation of central neurons. J Appl Physiol (1985). 2013;114(6):725–33.CrossRef

55.

Sluka KA, Rasmussen LA. Fatiguing exercise enhances hyperalgesia to muscle inflammation. Pain. 2010;148(2):188–97.CrossRefPubMed

56.

Booth J, Moseley GL, Schiltenwolf M, Cashin A, Davies M, Hubscher M. Exercise for chronic musculoskeletal pain: a biopsychosocial approach. Musculoskeletal Care. 2017;15(4):413–21.CrossRefPubMed

57.

Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402–7.CrossRefPubMed

58.

Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081–93.CrossRefPubMed

59.

Fontaine KR, Conn L, Clauw DJ. Effects of lifestyle physical activity in adults with fibromyalgia: results at follow-up. J Clin Rheumatol. 2011;17(2):64–8.CrossRefPubMedPubMedCentral

60.

Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2017;4:CD003200.PubMed

61.

Kessels E, Husson O, van der Feltz-Cornelis CM. The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Neuropsychiatr Dis Treat. 2018;14:479–94.CrossRefPubMedPubMedCentral

62.

Busch AJ, Webber SC, Brachaniec M, Bidonde J, Bello-Haas VD, Danyliw AD, Overend TJ, Richards RS, Sawant A, Schachter CL. Exercise therapy for fibromyalgia. Curr Pain Headache Rep. 2011;15(5):358–67.CrossRefPubMedPubMedCentral

63.

Hauser W, Klose P, Langhorst J, Moradi B, Steinbach M, Schiltenwolf M, Busch A. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2010;12(3):R79.CrossRefPubMedPubMedCentral

64.

Busch AJ, Webber SC, Richards RS, Bidonde J, Schachter CL, Schafer LA, Danyliw A, Sawant A, Dal Bello-Haas V, Rader T, et al. Resistance exercise training for fibromyalgia. Cochrane Database Syst Rev. 2013;12:CD010884.

65.

Skender S, Ose J, Chang-Claude J, Paskow M, Bruhmann B, Siegel EM, Steindorf K, Ulrich CM. Accelerometry and physical activity questionnaires - a systematic review. BMC Public Health. 2016;16:515.CrossRefPubMedPubMedCentral