Department of Physical Education, Faculty of Education Science, University of Cadiz, Calle República Saharaui, s/n, 11519 Puerto Real, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz.
Department of Education, Faculty of Education Sciences, SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.
Phys Ther. 2019 Nov 25;99(11):1481-1494. doi: 10.1093/ptj/pzz113.
Physical fitness is a marker of health and is associated with health-related quality of life (HRQoL). Identifying which components of physical fitness are associated with HRQoL in people with fibromyalgia may contribute to the development of more specific therapeutic strategies.
The 2 aims of this study were to examine the association of different components of physical fitness (ie, flexibility, muscle strength, speed and agility, and cardiorespiratory fitness) with HRQoL and to determine the extent to which any association between the components of physical fitness and HRQoL were of clinical relevance to women with fibromyalgia.
A cross-sectional design was used.
This study included 466 women with fibromyalgia from southern Spain (Andalusia). The Senior Fitness Test battery and the handgrip test were used to assess physical fitness, and the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL. Tender points, cognitive impairment, anthropometric measurements, and medication usage were also measured. First, multivariate linear regression was used to assess the individual relationship of each physical fitness test with the 8 dimensions of the SF-36. Second, a standardized composite score was computed for each component of physical fitness (flexibility, muscle strength, speed and agility, and cardiorespiratory fitness). A 1-way analysis of covariance to assess the differences in each of the 8 dimensions of the SF-36 across each physical fitness composite score was conducted. Forward stepwise regression was performed to analyze which components of physical fitness were independently associated with the SF-36 physical and mental component scales.
Overall, higher levels of physical fitness were associated with higher levels of HRQoL (regardless of the SF-36 subscale evaluated). The effect sizes for HRQoL between participants with the lowest and the highest physical fitness levels ranged from moderate to large (Cohen d = 0.53-0.90). The muscle strength composite score was independently associated with the SF-36 physical component scale, whereas the flexibility composite score and cardiorespiratory fitness were independently associated with the SF-36 mental component scale.
A limitation was that the cross-sectional design precluded the establishment of causality. Additionally, only women were included in the study, because fibromyalgia predominantly affects women.
High levels of physical fitness were consistently associated with better HRQoL in women with fibromyalgia; clinically relevant differences were demonstrated between those at extreme physical fitness levels. Muscle strength, flexibility, and cardiorespiratory fitness were independent indicators of HRQoL. These results warrant further prospective research on the potential of fitness to predict HRQoL in this population.
身体机能是健康的标志，与健康相关的生活质量（HRQoL）有关。确定身体机能的哪些组成部分与纤维肌痛患者的 HRQoL 相关，可能有助于制定更具体的治疗策略。
本研究的 2 个目的是检查身体机能的不同组成部分（即柔韧性、肌肉力量、速度和敏捷性以及心肺适应性）与 HRQoL 的关系，并确定身体机能的组成部分与 HRQoL 之间的任何关联在多大程度上与纤维肌痛女性具有临床相关性。
采用横断面设计。
本研究纳入了来自西班牙南部（安达卢西亚）的 466 名纤维肌痛女性。使用 Senior Fitness Test 电池和握力测试来评估身体机能，使用 36-Item Short-Form Health Survey（SF-36）来评估 HRQoL。还测量了压痛点、认知障碍、人体测量学测量值和药物使用情况。首先，使用多元线性回归评估每个身体机能测试与 SF-36 的 8 个维度之间的个体关系。其次，为每个身体机能组成部分（柔韧性、肌肉力量、速度和敏捷性以及心肺适应性）计算标准化综合评分。使用单向方差分析比较每个身体机能综合评分在 SF-36 的 8 个维度上的差异。进行逐步向前回归分析，以分析哪些身体机能组成部分与 SF-36 的身体和心理成分量表独立相关。
总体而言，身体机能水平较高与 HRQoL 水平较高相关（无论评估的 SF-36 亚量表如何）。参与者中身体机能水平最低和最高之间的 HRQoL 差异的效应大小从中等到大（Cohen d = 0.53-0.90）。肌肉力量综合评分与 SF-36 身体成分量表独立相关，而柔韧性综合评分和心肺适应性与 SF-36 心理成分量表独立相关。
局限性在于横断面设计排除了因果关系的确立。此外，由于纤维肌痛主要影响女性，因此仅纳入女性。
高水平的身体机能与纤维肌痛女性的 HRQoL 始终相关；在处于极端身体机能水平的个体之间表现出具有临床意义的差异。肌肉力量、柔韧性和心肺适应性是 HRQoL 的独立指标。这些结果证明了在该人群中，身体适应性预测 HRQoL 的潜力值得进一步进行前瞻性研究。
