Reduced Physical Activity Levels Observed in Patients With Fibromyalgia

Patients with fibromyalgia were shown to be less physically active when compared with healthy individuals, according to a study published in The Journal of the Turkish Society and Algology.¹ A link between reduced activity levels and pain was observed, but not for the impact of the disease. Investigators noted considering the association between the patient’s physical activity behaviors that are negatively affected by pain may help to provide a more holistic approach to this patient population during disease management.

Muhammed Recai Akdoğan, MD

Credit: HIS Medical Travel

While exercise has been deemed beneficial in the management of fibromyalgia, the symptoms of the condition can create barriers that discourage exercise, including the belief that exercise may intensify symptoms. Further, anecdotal data showed that most patients with fibromyalgia lead a sedentary lifestyle.²

“Fibromyalgia-related pain and fatigue may lead to inactivity, which in turn causes muscle deconditioning that may be resulted with an increase in pain and fatigue, “ wrote Muhammed Recai Akdoğan, MD, Division of Rheumatology, Department of Internal Medicine, Atatürk University Faculty Medicine, Turkey, and a group of Turkish investigators. “It has been shown that exercise, by breaking this vicious cycle, causes improvement of fibromyalgia-associated symptoms and psychological problems. In view of its proven positive effect on fibromyalgia, exercise was recommended with Ia level of evidence in the current European Alliance of Associations for Rheumatology (EULAR) revised recommendations for the management of fibromyalgia.”

A total of 70 adult patients with fibromyalgia (60 females and 10 males) and 50 age- and gender-matched controls (43 females and 7 males) were included in the case-control study designed to analyze the physical activity levels of patients with fibromyalgia to determine the relationship between fibromyalgia characteristics and physical activity.

Demographics and the duration of symptoms of participants were recorded. The impact of fibromyalgia was determined using the Fibromyalgia Impact Questionnaire (FIQ) and physical activity was assessed via the International Physical Activity Questionnaire (IPAQ). The IPAQ was developed for adult patients and allows for subscales for work-related aspects, transportation, recreational physical activity, and housework to be computed. Pain was determined using the visual analog scale (VAS).

The mean age of the fibromyalgia cohort was 41.90 years, and the symptom duration was 61.0 months.

Patients with fibromyalgia reported significantly less recreational, transportation-related, and total physical activity levels when compared with controls. Further, they also reported significantly less time spent walking and in vigorous activities when compared with healthy individuals (P <.05).

A negative correlation between pain and scores of self-reported moderate or vigorous physical activity was reported in the fibromyalgia cohort (r= -.41, P <.01). However, no association between FIQ and IPAQ scores was observed.

Investigators noted that one of the important questions that arose during the study was whether a reduction of physical activity in patients with fibromyalgia was the cause or the result of their condition. They explained that pain and other related symptoms may limit physical activity in this patient population; however, a vicious cycle of fibromyalgia-related symptoms may develop in patients with already reduced physical activity, thus affecting the clinical course of the disease.

“In our study, we determined no association between the impact of fibromyalgia and physical activity,” investigators concluded. “Previous studies have also determined no association between impact of fibromyalgia and reduced physical activity. It may be concluded that independent from the impact of the disease, fibromyalgia itself may be associated with reduced physical activity.”

References

1. ^{Akdoğan MR, Doğancı EB, Tüzün Z, Arslan S, Alkan Melikoğlu M. Does fibromyalgia affect physical activity due to pain?. Fibromiyalji ağrı nedeniyle fiziksel aktiviteyi etkiliyor mu?. Agri. 2023;35(2):63-67. doi:10.14744/agri.2022.54533}
2. ^{Oliver K, Cronan T. Predictors of exercise behaviors among fibromyalgia patients. Prev Med 2002;35:383–9}