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This study aimed to develop new equations to estimate cardiorespiratory fitness specifically for older adults and, secondly, to analyze the associations of cardiorespiratory fitness, both objectively measured and estimated using new equations, with cognitive performance. Ninety-two older adults (41 females, 65–75 years) from baseline data of a randomized controlled trial were analyzed (“ClinicalTrials. gov” Identifier: NCT03923712). Participants completed 4 measurement sessions including (i) physiological and health indicators in a laboratory setting, (ii) field-based fitness tests, (iii) sociodemographic and physical activity questionnaires, and (iv) a battery of neuropsychological tests to evaluate cognitive performance. The main findings were as follows: (i) a set of new equations with good predictive value for estimated cardiorespiratory fitness were developed (74– 87%), using different scenarios of complexity and/ or equipment requirements, and (ii) higher estimated cardiorespiratory fitness, even using its simplest equation (eCRF = − 1261.99 + 1.97 × 6 min walking test (m) + 1.12 × bioimpedance basal metabolic rate (kcal/day) + 5.25 × basal heart rate (bpm)), was associated with better cognitive performance evaluated by several neuropsychological tests (i.e., language, cognitive flexibility, fluency, attention, and working memory), similar to using objectively measured cardiorespiratory fitness. In summary, a new set of estimated cardiorespiratory fitness equations have been developed with predictive values ranging from 74 to 87% that could be used based on necessity, availability of equipment, resources, or measurement context. Moreover, similar to objectively measured cardiorespiratory fitness, this measure of estimated cardiorespiratory fitness was positively associated with performance on language, fluency, cognitive flexibility, attention, and working memory, independently of sex, age, and education level., Universidad de Cádiz/CBUA, Spanish Ministry of Science and Innovation - State Research Agency and European Regional Development Fund (FEDER) (grant number: DEP2016-76123-R), FEDER/Junta de Andalucía-Consejeria de Salud y Familias (grant number PI-0002–2017), Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES) and FEDER funds from the European Union (CB16/10/00477), Margarita Salas Postdoctoral Program from European Union Next GenerationEU and University of Cádiz

The revised European consensus defined sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. The aim of this study was to determine the prevalence of sarcopenia and analyse the influence of diet, physical activity (PA) and obesity index as risk factors of each criteria of sarcopenia. A total of 629 European middle-aged and older adults were enrolled in this cross-sectional study. Anthropometrics were assessed. Self-reported PA and adherence to the Mediterranean diet were evaluated with the Global Physical Activity Questionnaire (GPAQ) and Prevention with Mediterranean Diet questionnaire (PREDIMED), respectively. The functional assessment included handgrip strength, lower body muscle strength, gait speed and agility/dynamic balance. Of the participants, 4.84% to 7.33% showed probable sarcopenia. Sarcopenia was confirmed in 1.16% to 2.93% of participants. Severe sarcopenia was shown by 0.86% to 1.49% of participants. Male; age group ≤65 years; lower body mass index (BMI); high levels of vigorous PA; and the consumption of more than one portion per day of red meat, hamburgers, sausages or cold cuts and/or preferential consumption of rabbit, chicken or turkey instead of beef, pork, hamburgers or sausages (OR = 0.126–0.454; all p < 0.013) resulted as protective factors, and more time of sedentary time (OR = 1.608–2.368; p = 0.032–0.041) resulted as a risk factor for some criteria of sarcopenia. In conclusion, age, diet, PA, and obesity can affect the risk of having low muscle strength, low muscle mass or low functional performance, factors connected with sarcopenia.

Positive psychology is the study of positive subjective experience and individual traits. Identifying deficits in positive psychology regarding fibromyalgia may inform targets for management. Therefore, the aim of the present case-control study was to compare the levels of positive affect, negative affect, satisfaction with life, optimism and emotional repair in a large sample of women with fibromyalgia (cases) and age-matched peers without fibromyalgia (controls). This case-control study included 437 women with fibromyalgia (51.6 & PLUSMN; 7.1 years old) and 206 age-matched women without fibromyalgia (50.6 & PLUSMN; 7.2 years old). Participants self-reported their levels of (i) subjective well-being on the Positive and Negative Affect Schedule and the Satisfaction with Life Scale, (ii) dispositional optimism on the Life Orientation Test-Revised and (iii) emotional repair on the Trait Meta-Mood Scale. Women with fibromyalgia showed lower levels of positive affect, satisfaction with life, optimism and emotional repair and higher levels of negative affect. Large effect sizes were found for positive affect, negative affect and satisfaction with life (all, Cohen's d & GE; 0.80) and small-to-moderate for emotional repair and optimism (both, Cohen's d & GE; 0.50). Women with fibromyalgia experience deficits of positive psychology resources. Thus, developing tailored therapies for fibromyalgia focusing on reducing deficits in positive psychology resources may be of clinical interest, though this remains to be corroborated in future research., This work was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639, I+D+I DEP2013-40908); the Spanish Ministry of Education (FPU15/00002), Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). F.E.-L. has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 707404. The funders of this study did not have any role in the study design, data collection and analyses, decision to publish or preparation of the manuscript.

ObjectiveTo analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association.DesignCross-sectional study in 420 women with fibromyalgia.SettingFibromyalgia associations from southern Spain.MethodsPhysical fitness was measured by performance-based tests, and questionnaires were used to measure positive affect, negative affect, and different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). Age, body mass index, and current pain level were included as potential confounders in all analyses.ResultsPhysical fitness was independently associated with general fatigue, physical fatigue, and reduced activity (all P ≤ 0.02). Positive affect was independently associated with all fatigue dimensions (all P ConclusionsIn women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.

El envejecimiento es un proceso natural asociado a un declive que repercute en un mayor riesgo de padecer discapacidad física y cognitiva, y/o afección emocional y social. En consecuencia, diversos estudios muestran los múltiples beneficios de los programas de entrenamiento multicomponente. Además, las directrices actuales amplían este enfoque hacia los programas multidominio. Por ello, el objetivo de este trabajo es presentar el programa de intervención multidominio Healthy-Age que sigue las recomendaciones de las principales instituciones y literatura científica e incluye los principales dominios (físico, social, cognitivo y motivacional) en las personas mayores. Su finalidad es la de prevenir, mantener o mejorar la salud integral (física, psíquica, emocional y social) y educarles para un envejecimiento saludable. Además de incluir unas recomendaciones generales de actividad física, se muestran recomendaciones para el entrenamiento de la resistencia aeróbica, el equilibrio, la coordinación, la fuerza y resistencia muscular, la flexibilidad y el entrenamiento cognitivo; y se presentan dos modalidades; un plan de 5 días supervisado y un plan de 3 días supervisado más 2 días autónomo. === Ageing is a natural process associated with a decline that results in an increased risk of physical and cognitive disability and/or emotional and sentimental impairment. Consequently, several studies show the multiple benefits of multi-component training programmes. The current guidelines extend this approach to multi-domain programmes. For this reason, the objective of this paper is to present the Healthy-Age multi-domain intervention programme that follows the recommendations of the main institutions and scientific literature and includes the main domains (physical, social, cognitive and motivational) in older people. Its purpose is to prevent, maintain or improve the overall health (physical, psychological, emotional and social level) for a healthy ageing. In addition to including general recommendations of physical activity, recommendations are shown for aerobic resistance, balance, coordination, muscular strength and resistance, flexibility and cognitive training; and two modalities are presented; a 5-day supervised plan and a 3-day supervised plan plus 2 autonomous days.

Aims: The purposes of this research were to study the convergent validity of the Mode and Frequency of Commuting To and From School Questionnaire using objectively assessed steps and time spent in different physical activity intensities and to compare the self-reported versus objective journey time in Spanish youths. Methods: Three hundred and eighty-nine Spanish youth aged 7–19 years were asked to complete the questionnaire and wore an accelerometer for five days. The objective commuting distance and time from home to school were estimated using Google MapsTM. Results: There were significant differences between passive and walking participants on step numbers, sedentary time and physical activity levels (except for vigorous physical activity in children). For children, a mean difference of −4.03 minutes between objective measured and self-reported journey time was found (95% limits of agreement were 13.55 and −21.60 minutes). For adolescents, the mean difference was −1.39 minutes (95% limits of agreement were 15.23 and −18.02 minutes). Conclusions: The findings indicated that the Mode of Commuting To and From School Questionnaire showed a convergent validity to assess this behaviour in Spanish youths. Self-reported journey time for walking is comparable to Google MapsTM in adolescents but not in children.

Aging is associated with a progressive loss of functional capacity that affects the health and quality of life of middle-aged and older people. The purpose of this study was to report functional autonomy evaluation levels in middle-aged and older women in the Spanish context. A total of 709 middle-aged and older women, between 50 and 90 years old, were selected to participate in the study. The sample was divided by age category every five years. The functional autonomy levels were determined by the Latin American Group for Maturity (GDLAM) protocol and we developed a classification pattern for middle-aged and older women living in Spain. The GDLAM Index (GI) was then calculated to assess functional autonomy. The classification of the tests and the GI followed the percentile rank (P) Very Good (p < 0.15), Good (p 0.16–p 0.50), Regular (p 0.51–p 0.85), and Poor (p > 0.85). It was considered that the lower the value found for the percentile, the better the result. The GDLAM protocol showed strong reliability with intraclass correlation coefficient (ICC) values greater than 0.92 in all tests. It is observed that all variables of the GDLAM protocol presented a positive and significant correlation with age (p < 0.001). The Roc Curve showed that GI values higher than 26 (CI95% = 0.97–1.00; p < 0.001) and 32 (CI95% = 0.98–1.00; p < 0.001) for middle-aged and elderly women, respectively, can predict and indicate low functional autonomy. The normative values hereby provided will enable evaluation and adequate interpretation of Spanish middle-aged and older women’s functional autonomy.

Self-rated health (SRH) is an independent determinant for all-cause mortality. We aimed to examine the independent and combined associations of components of physical fitness with SRH at baseline (cross-sectional) and two years later (longitudinal) in children and adolescents. Spanish youth (N = 1378) aged 8 to 17.9 years participated at baseline. The dropout rate at 2-year follow-up was 19.5% (n = 270). Participants were categorized as either children (8 to 11.9 years age) or adolescents (12 to 17.9 years age). The ALPHA health- related fitness test battery for youth was used to assess physical fitness, and SRH was measured by a single-item question. Cumulative link, ANOVA and ANCOVA models were fitted to analyze the data. Cardiorespiratory fitness, relative upper body isometric muscular strength, muscular strength score, and global physical fitness were positively associated with SRH in children (OR, 1.048, 95% CI, 1.020&ndash, 1.076, OR, 18.921, 95% CI, 3.47&ndash, 104.355, OR, 1.213, 95% CI, 1.117&ndash, 1.319, and OR, 1.170, 95% CI, 1.081&ndash, 1.266, respectively, all p &lt, 0.001) and adolescents (OR, 1.057, 95% CI, 1.037&ndash, OR, 5.707, 95% CI, 1.122&ndash, 29.205, OR, 1.169, 95% CI, 1.070&ndash, 1.278, and OR, 1.154 95% CI, 1.100&ndash, 1.210, respectively, 0.001), and motor fitness was positively associated with SRH only in adolescents at baseline (OR, 1.192, 95% CI, 1.066&ndash, 1.309, p &lt, 0.01). Cardiorespiratory fitness and global physical fitness were positively associated with SRH in children two years later (OR, 1.056, 95% CI, 1.023&ndash, 1.091, 0.001, and OR, 1.082, 95% CI, 1.031&ndash, 1.136, 0.01, respectively). Only cardiorespiratory fitness was independently associated with SRH in children and adolescents at baseline (OR, 1.059, 95% CI, 1.029&ndash, 1.090, and OR, 1.073, 95% CI, 1.050&ndash, 1.097, respectively, both p &lt, 0.001) and two years later (OR, 1.075, 95% CI, 1.040&ndash, 1.112, and OR, 1.043, 95% CI, 1.014&ndash, 1.074, 0.01, respectively). A high level of cardiorespiratory fitness at baseline or maintaining high levels of cardiorespiratory fitness from the baseline to 2-year follow-up were associated with a higher level of SRH at 2-year follow-up in children (p &lt, 0.01) and adolescents (p &lt, 0.05). These findings emphasize the importance of cardiorespiratory fitness as strong predictor of present and future SRH in youth. Intervention programs to enhance cardiorespiratory fitness level of the youth population are urgently needed for present and future youth&rsquo, s health.

This study aims to examine the associations of parental rules with sedentary behavior (SB) in youth. Leisure-time SB was assessed by accelerometry and questionnaire. In boys, parental rules regarding TV were negatively associated with objectively-measured leisure-time SB and time spent in all screen behaviors, but positively associated with educational SB. Among girls, the total number of parental rules was negatively associated with the time spent surfing the Internet, but positively related with educational SB, on weekends. The imposition of rules by parents may be a simple and effective strategy to improve sedentary patterns in youth, especially among boys. Sin financiación 0.947 JCR (2020) Q4, 40/46 Family Studies 0.280 SJR (2020) Q3, 188/291 Clinical Psychology No data IDR 2020 UEM

Background: Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents. Method: Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health-related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule). Results: Higher performance on physical fitness components was associated with positive affect (β = -0.176-0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = -0.100-0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76). Conclusions: Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health. Sin financiación 1.617 JCR (2021) Q4, 104/130 Pediatrics 0.415 SJR (2021) Q2, 148/320 Pediatrics, Perinatology and Child Health No data IDR 2021 UEM

Background Compelling evidence supports the efficacy of physical exercise in the management of fibromyalgia (FM)1. Although exercise interventions have typically focused on either land or water-based programs, research comparing the efficacy of both protocols is limited. Objectives The aim of this study was to compare the effect of two exercise interventions (land-based and water-based training) on quality of life (QOL) of patients with FM. Methods Among the 272 participants initially randomized, a total of 151 (age:50.6±7.6 years, 98%women) completed all the assessments with an attendance ≥70% (land-based n=48, water-based n=42, control n=61). The intervention groups trained 3 non-consecutive days/week (60 minutes per session) during 24 weeks. Each session involved exercises to improve cardiorespiratory fitness, muscular strength, and flexibility. Physical and mental domains of QOL were assessed through the 36-item Short Form Health Survey (SF-36). Participants were evaluated at baseline (pre-test), at the end of the intervention (post-test) and following a detraining period of 12 weeks after the end of the intervention (re-test). Land-based, water-based, and control groups were comparable in sex, sociodemographic characteristics, disease duration, drugs intake, and BMI. Age, tenderness, and baseline outcomes values were used as covariates in the comparisons of the changes from baseline (post-test vs. pre-test and re-test vs. pre-test) between groups Results Post-intervention changes from baseline in QOL dimensions in the land-based exercise group were better for physical role (compared to the control and water-based groups; all, p 0.05). After a detraining period of 12 weeks, changes in QOL from baseline in the land-based exercise group were better for physical role, bodily pain (compared to the control and water-based exercise groups; all, p 0.05). Conclusion A land-based exercise intervention improved FM patients’ QOL, whereas a water-based exercise intervention showed no significant effect. Improvements in the physical role and bodily pain domains of QOL were sustained in a 12-week detraining period. Land-based exercise might be an easily accessible treatment option that improves QOL to a greater extent than water-based exercise for FM patients. Reference [1] Macfarlane GJ, et al. Ann Rheum Dis, 2018; 76(2), 318-328. Acknowledgement Funding: This study was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639; I+D+I DEP2013-40908-R; BES-2014-067612) and the Spanish Ministry of Education (FPU14/02518; FPU 15/00002) Disclosure of Interests None declared

Background Non-pharmacological approaches are the mainstay of treatment in fibromyalgia. The current recommendations of the European League Against Rheumatism (EULAR) for the management of fibromyalgia highlight that exercise is the only therapy with a ‘strong’ evidence [1]. Exercise has been typically implemented on either land- or water-based settings. However, it is unclear whether to perform exercise in different settings has different effects on pain; this knowledge might help to maximise the beneficial effects that exercise has in fibromyalgia [2] Objectives To compare the effects of two exercise interventions (land- and water-based training) on pain in people with fibromyalgia. Methods From 272 initially randomized, a total of 151 participants (50.6±7.6 years old, 98% women) completed all the assessments and attended to at least 70% of the programme; 48, 42 and 61 participants pertained to the land-based exercise, water-based exercise, and usual care (control) groups, respectively. The intervention groups trained 3 non-consecutive days/week (45-60 minutes per session) for 24 weeks. Each session included aerobic exercises, muscular strengthening and stretching for all the major muscle groups. Pain was measured by the 0-100 mm visual analogue scale (VAS) from the Fibromyalgia Impact Questionnaire (FIQ). Catastrophizing and self-efficacy pain-related cognitions were assessed by the Pain Catastrophizing Scale (PCS total score) and pain management subscale (PSE) of the Chronic Pain Self-efficacy Scale (CPSS), respectively. We calculated an algometer score based on the sum of pain thresholds (kg/cm2) of the 18 tender pints according to the 1990 American College of Rheumatology fibromyalgia diagnostic criteria. Participants were evaluated at baseline (pre-test), at the end of the 24-week intervention (post-test) and after a 12-week detraining period (re-test). The groups were comparable in sociodemographic and clinical characteristics; they only differ on age, which was included as a covariate along with baseline levels of pain. Results Adjusting for Bonferroni, most of the between-group comparisons of pain changes over time were not significant. As exceptions, in comparison to the control group, participants in the land-based exercise group lowered catastrophizing and improved algometer score at the post-tests; mean difference (95% interval confidence) [MD(95% CI)] = -4.0 (-7.5 to -0.5) and 6.2 (2.0 to 10.5), respectively. These differences became non-significant at the re-test. Conclusion These preliminary results suggest that a 24-week land-based exercise intervention had beneficial effects by reducing pain catastrophizing and increasing algometer score in people with fibromyalgia. However, these benefits were unsustained after the detraining period. In compassion to the control group, a water-based exercise intervention did not show any effect on pain. Although our finding suggest that a land-based exercise intervention may have short-term beneficial effects on pain, these findings must be considered as preliminary until more robust analyses are performed. References [1] Macfarlane GJ, et al. Ann Rheum Dis2017;76:318–28. Doi:10.1136/annrheumdis-2016-209724 [2] Carbonell-Baeza A, et al. BMC Musculoskelet Disord2012;13:18. Doi:10.1186/1471-2474-13-18 Acknowledgement This study was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639; I+D+I DEP2013-40908-R; BES-2014-067612) and the Spanish Ministry of Education (FPU14/02518; FPU 15/00002) Disclosure of Interests None declared

Background People with fibromyalgia identify fatigue as one of the main symptoms of the disease [1]. It is hypothesised that the pathogenesis of fibromyalgia involves a genetic susceptibility that is modulated by environmental factors [2] Objectives To examine the possible role of genetic susceptibility for fatigue in southern Spanish women with fibromyalgia, by looking at the possible associations of fatigue and single nucleotide polymorphisms in 34 fibromyalgia candidate-genes, at the interactions between genes, and at the associations between gene-physical activity. Methods In this cross-sectional study participated 276 women with fibromyalgia. We extracted DNA from saliva in order to analyse gene-polymorphisms related to fibromyalgia susceptibility, symptoms, or potential mechanisms. Accelerometers registered the participants’ physical activity and sedentary time. Five dimensions of fatigue were assessed with the Multidimensional Fatigue Inventory. Age, body fat (%), and analgesics and antidepressants consumption were considered as confounders in all analyses. Based on the Bonferroni’s and False Discovery Rate (FDR) values, the statistical significance was interpreted. Results AT carriers of the rs4453709 polymorphism (sodium channel protein type 9 subunit alpha, SCN9A, gene) showed the highest scores on fatigue. Carriers of the heterozygous genotype of the rs1801133 (methylene tetrahydrofolate reductase, MTHFR, gene) or rs4597545 (SCN9A gene) polymorphisms who were physically active reported lower fatigue compared to their inactive counterparts. Highly sedentary carriers of the homozygous genotype of the rs7607967 polymorphism (AA/GG genotype; SCN9A gene) presented higher fatigue than those with lower levels of sedentary time. Conclusion Physical (in)activity behaviours and the SCN9A and MTHFR genes were jointly related to fatigue. Thereby, the potential benefits of following an active lifestyle might be observed more clearly in women with fibromyalgia genetically predispose to higher levels of fatigue. References [1] Bennett RM, et al. BMC Musculoskelet Disord 2010;11:134. doi:10.1186/1471-2474-11-134 [2] McBeth J, Mulvey MR. Nat Rev Rheumatol 2012;8:108–16. doi:10.1038/nrrheum.2011.216 Acknowledgement This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+i DEP2010-15639, I+D+i DEP2013-40908-R to M.D.-F.; BES-2014-067612 to F.E.-L.]; the Spanish Ministry of Education [FPU13/03410 to D.S.-T.; FPU 15/00002 to B.G.C]; the Consejeria de Turismo, Comercio y Deporte, Junta de Andalucia [CTCD-201000019242-TRA to MD-F]; and the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). Disclosure of Interests None declared

Background: Physical fitness (PF) represents a marker of health and is associated with health-related quality of life (HRQoL). Different components of PF have shown to be consistently associated with lower symptomatology in people with fibromyalgia1,2. Identifying which PF components are associated with HRQoL in people with fibromyalgia may contribute to the development of more specific therapeutic strategies. Objectives: The aim was to examine the associations of different PF components with HRQoL in women with fibromyalgia. Methods: This population-based cross-sectional study included 466 women with fibromyalgia. The Senior Fitness Tests battery plus handgrip test were used to assess PF 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 and used as confounders. Firstly, multivariate linear regression assessed the individual relationship of each PF test with the eight dimensions of the SF-36. Secondly, a standardized composite score was computed for each component of PF (aerobic fitness, muscular strength, flexibility and motor agility). Forward stepwise regression was performed to analyse which components of PF were independently associated with the SF-36 physical and mental component scales. Results: Overall, higher performance on PF tests was associated with higher levels of HRQoL in all SF-36 dimensions and subscales (all p Conclusion: High PF is consistently associated with better HRQoL in women with fibromyalgia. Muscular strength, flexibility and cardiorespiratory fitness are independent indicators of HRQoL in this population. These results might have implications for future intervention studies because it could facilitate the selection of the most suitable exercise interventions according to the clinical profile of each patient. References [1] Soriano-Maldonado A, Ruiz JR, Aparicio VA, Estevez-Lopez F, Segura-Jimenez V, Alvarez-Gallardo IC, et al. Association of physical fitness with pain in women with fibromyalgia: The al-Andalus project. Arthritis Care Res 2015;67. [2] Estevez-Lopez F, Gray CM, Segura-Jimenez V, Soriano-Maldonado A, Alvarez-Gallardo IC, Arrayas-Grajera MJ, et al. Independent and combined association of overall physical fitness and subjective well-being with fibromyalgia severity: the al-Andalus project. Qual Life Res 2015;24. Acknowledgement: This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+i DEP2010-15639, I+D+i DEP2013-40908-R to M.D.-F.; BES-2014-067612 to F.E.-L.]; the Spanish Ministry of Education [FPU2014/02518 to MB-C; FPU 15/00002 to B.G.C]; the Consejeria de Turismo, Comercio y Deporte, Junta de Andalucia [CTCD-201000019242-TRA to MD-F]. Disclosure of Interests: None declared

BACKGROUND This study aimed to evaluate the therapeutic validity of exercise interventions included in a previous umbrella systematic review of high-quality randomized controlled trials (RCTs) in the management of fibromyalgia and to explore whether exercise interventions with high therapeutic validity and that meet the 2013 American College of Sports Medicine (ACSM) guidelines are positively associated with greater pain relief. METHODS Therapeutic validity was evaluated based on the CONsensus on Therapeutic Exercise and Training (CONTENT) Scale, in high methodological quality RCTs found in the nine systematic reviews of a previous umbrella review on exercise interventions in the management of fibromyalgia. Additionally, adherence to the 2013 ACSM exercise recommendations for fibromyalgia was analyzed. The effect size for pain relief after the exercise programs was also considered. RESULTS The CONTENT mean total score was 4.42 out of 9, demonstrating generally low therapeutic validity of the 28 included RCTs. There was poor concordance between therapeutic validity and pain relief (Kappa values ranging between -0.6 to 0.57). Kappa statistic results showed poor concordance (k=0.01) between statistically significant (P

Background 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. Objective 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. Design A cross-sectional design was used. Methods 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. Results 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. Limitations 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. Conclusions 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.

UP&DOWN Study Group additional members: Coordinator: Ascension Marcos; Principal Investigators: Ascension Marcos, Jose Castro-Piñero, Oscar L. Veiga, and Fernando Bandres; Scientific Coordinators: David Martinez-Gomez (chair), Jonatan R. Ruiz (co-chair), Ana Carbonell-Baeza, Sonia Gomez-Martinez, and Catalina Santiago; Spanish National Research Council: Ascension Marcos, Sonia Gomez-Martinez, Esther Nova, Ligia-Esperanza Diaz, Belen Zapatera, Ana M. Veses, Aurora Hernandez, and Alina Gheorghe; University of Cadiz: José Castro-Piñero, Jesus Mora-Vicente, Jose L. Gonzalez-Montesinos, Julio Conde-Caveda, Jonatan R. Ruiz (University of Granada [UGR]), Francisco B. Ortega (UGR), Carmen Padilla Moledo, Ana Carbonell Baeza, Palma Chillon (UGR), Jorge del Rosario Fernandez, Ana Gonzalez Galo, Gonzalo Bellvis Guerra, Alvaro Delgado Alfonso, Fernando Parrilla, Roque Gomez, and Juan Gavala; Autonomous University of Madrid: Oscar L. Veiga, H. Ariel Villagra, Juan del-Campo, Carlos Cordente (UPM), Mario Diaz, Carlos M. Tejero, Aitor Acha, Jose M. Moya, Alberto Sanz, David Martinez-Gomez, Veronica Cabanas-Sanchez, Gabriel RodriguezRomo (UPM), Rocio Izquierdo, Laura Garcia-Cervantes, and Irene Esteban-Cornejo; Complutense University of Madrid: Fernando Bandres, Alejandro Lucia (European University of Madrid [UEM]), Catalina Santiago (UEM), and Felix Gomez-Gallego (UEM)., [Objectives]: To study the cross-sectional and longitudinal (2-year follow-up) association between muscle fitness and cardiovascular disease (CVD) risk factors in youth; whether there are muscle fitness cut points associated with CVD risk (cross-sectional); and whether the health-related muscle fitness cut points identified at baseline are associated with CVD risk 2 years later. [Study design]: In total, 237 children (110 girls) aged 6-10 years and 274 adolescents (131 girls) aged 12-16 years with complete data were included in the study (10.3% drop out). The handgrip strength and the standing long jump tests were used to assess muscle fitness. CVD risk score was computed with sum of 2 skinfolds, systolic blood pressure, insulin, glucose, triglycerides, and total cholesterol/high density lipoprotein cholesterol. [Results]: Muscle fitness at baseline was associated inversely with single CVD risk factors and CVD risk score at baseline and 2-year follow-up (all P, Supported by the DEP 2010-21662-C04-00 (DEP 2010-21662-C04-01: DEP 2010-21662-C04-02: DEP 2010-21662-C04-03: DEP 2010-21662-C04-04) grant from the National Plan for Research, Development and Innovation (R + D + i) MICINN, by the FPU15/05337 grant from the Spanish Ministry of Education, and by Plan Propio de Investigación 2016 of the University of Granada (Spain), Excellence actions: Units of Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES).

Background: In fibromyalgia there is a discordance between performance-based (i.e., objective) and patient-reported (i.e., subjective) physical functioning (1,2). However, it is unknown whether the association of physical functioning with health outcomes is different between objective and subjective measures. Objectives: To analyse the associations of the objective and subjective dimensions of physical activity, sedentary behaviour, and physical fitness with subjective well-being in women with fibromyalgia. Methods: This population-based cross-sectional study included 375 women with fibromyalgia from southern Spain. Physical activity, sedentary behaviour, and physical fitness were measured by questionnaires, accelerometers, and performance testing. Participants self-reported their levels of positive affect, negative affect, and satisfaction with life. Conservative multivariate analyses were used to analyse the association between these physical functioning measures and the assessment of affect and life satisfaction. Results: We found independent associations of the objective measures but not the subjective assessments of physical activity with positive affect and satisfaction with life (both, p 0.06) and of sedentary time with positive affect (p 0.03). Moreover, we observed consistent and independent associations of both the objective and subjective dimensions of physical fitness with all the components of subjective well-being (all, p

Objectives To identify lifestyle clusters in children and adolescents, to analyze associations between lifestyle clusters and body fat percentage (BFP) at baseline and 2 years later, and to examine if BFP at baseline is associated with BFP 2 years later. Study design This longitudinal study involved 1634 Spanish youth (804 girls) aged 8-18 years (mean, 12.45 ± 2.51 years). Cluster analysis was performed by including objectively measured sedentary time and physical activity and self-reported screen time and diet. The associations between cluster membership and BFP was analyzed through general linear models. All the analyses were separated by 3 age groups: older children, younger adolescents, and older adolescents. Results Four clusters were identified in the 3 age groups: (1) healthy lifestyle cluster (high moderate-to-vigorous physical activity, low screen and total sedentary time), (2) predominantly sedentary cluster, (3) mainly screen time consumers cluster, and (4) nonhealthy lifestyle cluster (predominantly low moderate-to-vigorous physical activity and unhealthy diet). Participants belonging to the healthy lifestyle cluster showed significantly lower BFP at baseline and 2 years later compared with the other profiles. These differences remained significant when adjusted by BFP at baseline within the younger adolescents. Moreover, BFP at baseline positively predicted BFP 2 years later in all groups. Conclusions These findings identify distinct lifestyle patterns. These clusters could be useful to develop interventions to reduce overweight and obesity in children and adolescents.

Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods: This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. Results: In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions: Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.

OBJECTIVE: To characterize the levels of objectively measured time spent in sedentary activities (sedentary time) and physical activities in female patients with fibromyalgia and compare them with the levels in age-matched healthy control women. METHODS: The study comprised 413 female patients with fibromyalgia (mean ± SD age 51.9 ± 7.4 years) and 188 female control subjects (age 50.9 ± 7.5 years). Sedentary time, the amount of time spent engaged in physical activity, and step counts were measured using triaxial accelerometry. The amounts of time (minutes/day) during which the participants were engaged in sedentary behaviors as well as in physical activity of different intensities (light, moderate, and moderate-to-vigorous) and the step counts were calculated. RESULTS: The amount of time spent in sedentary behavior was longer in patients with fibromyalgia compared with controls (estimated mean ± SEM difference 39 ± 8 minutes/day; P < 0.001). The patients with fibromyalgia spent less time than controls engaged in light physical activity (mean ± SEM difference -21 ± 7 minutes/day; P = 0.005), moderate physical activity (mean ± SEM difference -17 ± 3 minutes/day; P

OBJECTIVE: This population-based cross-sectional study aimed to characterize the association of different components of physical fitness with pain levels, pain-related catastrophizing, and chronic pain self-efficacy in women with fibromyalgia (FM). METHODS: A total of 468 women with FM participated. The experience of pain was assessed with different tools (algometry, a numeric rating scale [revised FM impact questionnaire], a visual analog scale, and the bodily pain subscale on the Short Form 36 health survey). We also assessed pain-related catastrophizing and chronic pain self-efficacy. Physical fitness was assessed with performance-based tests (Senior Fitness Test battery and handgrip dynamometry). A standardized composite score was computed for each component of physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility), and their average comprised a clustered global fitness profile. RESULTS: Overall, higher physical fitness was consistently associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy (regardless of the pain assessment method and the fitness test evaluated). Muscle strength and flexibility were independently associated with pain (P < 0.005 for both), and participants with high muscle strength plus high flexibility (combined effect) had the lowest levels of pain in this population. Aerobic fitness and flexibility were independently associated with pain-related catastrophizing (P < 0.001 for both) and chronic pain self-efficacy (P < 0.001 for both), and participants with high flexibility plus high aerobic fitness (combined effect) had the best catastrophizing and self-efficacy profiles. CONCLUSION: Our results suggest that higher physical fitness is associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy in women with FM. These results might have implications for future intervention studies in this population.

To assess the association between physical fitness and fibromyalgia (FM) severity in women with FM as well as to assess whether different fitness components present an independent relation with FM severity.Population-based cross-sectional study.University facilities and FM associations.Women with FM (N=444).Not applicable.FM severity was assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Aerobic fitness (6-min walk test), muscle strength (handgrip, chair stand, and arm curl tests), flexibility (chair sit and reach and back scratch tests), and motor agility (8 foot Up and Go test) were measured with the Senior Fitness Test battery and digital dynamometry. A standardized composite score (hereafter "global fitness profile") was calculated and divided into quintiles.Overall, physical fitness was significantly associated with the FIQR total and subscale scores, regardless of the fitness test used (all P.05). The 6-minute walk and back-scratch tests were independently associated with the FIQR total score (R(2)=.88; both P.005). The group with the highest global fitness profile had 16% lower FM severity than did the group with the lowest global fitness profile (P.001).Our results suggest that higher physical fitness is consistently associated with lower FM severity in women with FM. Aerobic fitness and flexibility present independent associations with FM severity. However, the FIQR variability explained by these fitness tests was rather low (10%), and further research on the potential disagreement between performance-based physical fitness and different self-reported outcomes in women with FM is warranted.

The purpose of this study was to examine the differences in illness perception and overall impact on fibromyalgia females from Spain and the Netherlands. A total of 325 fibromyalgia females from Spain (54.3 ± 7.1 years) and the Netherlands (51.8 ± 7.2 years) participated in the study. Illness perception and impact of fibromyalgia were assessed by the Revised Illness Perception Questionnaire and the Fibromyalgia Impact Questionnaire, respectively. Spanish fibromyalgia females perceived more symptoms related to their fibromyalgia (identity) such as nausea, breathlessness, wheezing or fatigue (P < 0.001) and had greater emotional representation (P < 0.01). Dutch fibromyalgia females experienced less timeline (acute/chronic) and consequences (all, P < 0.05), had a better cyclical timeline, personal control, treatment control and illness coherence (all, P < 0.001). Spanish fibromyalgia females reported higher impact of fibromyalgia than Dutch females (61.2 + 14.8 vs. 54.9 + 16.4, respectively; P < 0.001), but the effect size was small (Cohen's d = 0.41) . Impact of fibromyalgia and negative views of fibromyalgia were higher in Spanish fibromyalgia females, whereas Dutch fibromyalgia females presented higher score of positive beliefs about the controllability of the illness. Psychological interventions which help patients to cope with their illness perception might lead to an improvement of the impact of the disease on fibromyalgia females.

This study aimed to determine the ability of a set of physical fitness tests to discriminate presence or absence of fibromyalgia in women.The sample comprised 487 women with fibromyalgia (52.1 ± 8 yr) and 250 control women (49.3 ± 9 yr). We assessed physical fitness using the arm curl, 30-s chair stand, handgrip strength, 8-ft up and go, 6-min walk, chair sit and reach, and the back scratch tests. The revised fibromyalgia impact questionnaire was used to assess fibromyalgia severity and symptomatology.Patients with fibromyalgia performed worse than control women in all the fitness tests studied (all, P0.001). The receiver operating characteristic analysis showed that all the fitness tests were able to discriminate between presence and absence of fibromyalgia (all, P0.001). The area under the curve ranged from 0.708 to 0.910 (all, P0.001). Among the fitness tests studied, the arm curl test, followed by the 30-s chair-stand and handgrip strength tests, showed the highest capacity discriminating between the presence and absence of fibromyalgia. An arm curl test score of20 repetitions was associated with increased odds of having fibromyalgia (odds ratio (OR), 35.6; 95% confidence interval, 12.6-101) in women age 35-44 yr. An arm curl test score of16 repetitions was associated with increased odds of having fibromyalgia (OR, 23.7; 95% confidence interval, 10.3-54.0) in women age 35-44 yr. In the group of women age 55-65 yr, the highest OR was observed for the handgrip strength test and the odds of having fibromyalgia was 17 times greater than that in patients who performed less than 19 kg.The arm curl, 30-s chair stand, and handgrip strength tests powerfully discriminated women with fibromyalgia from healthy women. Identification of women who fail to meet the suggested standards can help to easily, quickly, and cheaply rule out the presence of the disease, especially in primary care settings.

The aim of the present study was to determine the reliability and feasibility of physical fitness tests in female fibromyalgia patients. 100 female fibromyalgia patients (aged 50.6±8.6 years) performed the following tests twice (7 days interval test–retest): chair sit and reach, back scratch, handgrip strength, arm curl, chair stand, 8 feet up and go, and 6-min walk. Significant differences between test and retest were found in the arm curl (mean difference: 1.25±2.16 repetitions, Cohen d =0.251), chair stand (0.99±1.7 repetitions, Cohen d =0.254) and 8 feet up and go (−0.38±1.09 s, Cohen d =0.111) tests. Intraclass correlation coefficients (ICC) range from 0.92 in the arm curl test to 0.96 in the back scratch test. The feasibility of the tests (patients able to complete the test) ranged from 89% in the arm curl test to 100% in the handgrip strength test. Therefore, the reliability and feasibility of the physical fitness tests examined is acceptable for female fibromyalgia patients.

Psychological positive health and health complaints have long been ignored scientifically. Sleep plays a critical role in children and adolescents development. We aimed at studying the association of sleep duration and quality with psychological positive health and health complaints in children and adolescents from southern Spain. A randomly selected two-phase sample of 380 healthy Caucasian children (6–11.9 years) and 304 adolescents (12–17.9 years) participated in the study. Sleep duration (total sleep time), perceived sleep quality (morning tiredness and sleep latency), psychological positive health and health complaints were assessed using the Health Behaviour in School-aged Children questionnaire. The mean (standard deviation [SD]) reported sleep time for children and adolescents was 9.6 (0.6) and 8.8 (0.6) h/day, respectively. Sleep time ≥10 h was significantly associated with an increased likelihood of reporting no health complaints (OR 2.3; P = 0.005) in children, whereas sleep time ≥9 h was significantly associated with an increased likelihood of overall psychological positive health and no health complaints indicators (OR ~ 2; all P

Objective. The aim of this study was to validate the modified 2010 ACR preliminary criteria for FM in a Spanish population. Methods. Five hundred and seventy-nine (550 women) FM and 294 (240 women) control participants were enrolled in the study. FM patients were previously diagnosed by a rheumatologist. All participants underwent both the 1990 ACR criteria (1990c) and the modified 2010 ACR criteria (m-2010c). Results. The tender points count showed correlations of 0.69, 0.65 and 0.71 with the widespread pain index (WPI), symptoms severity (SS) and polysymptomatic distress (PSD) scales, respectively (all P < 0.001). The WPI, SS and PSD showed greater correlations with impact of FM health-related quality of life, general fatigue and depression than the tender points count. The 1990c showed sensitivity and specificity values of 84.1 and 97.6, respectively, whereas the m-2010c showed values of 88.3 and 91.8, respectively. Both criteria showed the same overall accuracy, with a value of 0.89. When the 1990c and m-2010c were combined and patients had to satisfy one of two criteria to be diagnosed with FM, the sensitivity, specificity and accuracy of questionnaires were 96.7, 89.8 and 0.94, respectively. The original cut-off points (WPI5 7, SS5 5 and PSD5 12) showed the best test characteristics in the present study. Conclusion. The m-2010c, with the same cut-off points as the original version, are a valid tool for the diagnosis of FM in our population. Whenever possible, the combination of the 1990c and m-2010c is recommended (patients have to meet one of the two criteria to be diagnosed), since this approach showed the best diagnostic characteristics.

OBJECTIVES: The aim of this study was to identify subgroups in terms of adaptation to FM and to test differences in FM severity between these subgroups. METHODS: The al-Ándalus project made it possible to perform a comprehensive population-based cross-sectional study in 486 FM patients including multiple assessments of modifiable (could be targeted in therapy) resilience and vulnerability factors, measured by objective and subjective assessments, related to psychological and physical function. FM severity was assessed by means of FM impact (total score of the Revised Fibromyalgia Impact Questionnaire) and distress (Polysymptomatic Distress Scale of the modified 2011 preliminary criteria for FM). Exploratory factor analysis, cluster analysis and analysis of variance were conducted. RESULTS: Factor analysis yielded eight factors: three included objective measures (declarative memory, active lifestyle and objective physical fitness) and five included subjective measures (fatigue, psychological distress, catastrophizing, resilience and subjective physical fitness). Cluster analysis based on these eight factors identified five profiles: Adapted (16%), Fit (18%), Poor performer (20%), Positive (20%) and Maladapted (26%). Most profile comparisons revealed different levels of FM severity varying from Adapted (the most favourable profile) to Maladapted (the most unfavourable profile) with Fit, Poor performer and Positive obtaining intermediate positions. CONCLUSIONS: Heterogeneity of FM was shown by five clinically meaningful profiles of modifiable factors that were associated with FM severity. It is of clinical interest to examine whether these profiles are associated with FM prognosis and the effectiveness of interventions, which would enhance the development of customized interventions based on adaptation profiles in FM. KEYWORDS: accelerometry; chronic pain; cognitive performance; coping; epidemiology; functional capacity; patient subgroups; quality of life; resilience (psychological); vulnerability (psychological)

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls (P

Fibromyalgia is characterized by chronic and extended musculoskeletal pain. The combination of exercise therapy with the warm water may be an appropriate treatment. However, studies focusing on the analysis of immediate pain during and after an exercise session are rare. This study aimed to determine the immediate changes of a warm water pool-based exercise program (12 weeks) on pain (before vs. after session) in female fibromyalgia patients. 33 Spanish women with fibromyalgia were selected to participate in a 12 weeks (2 sessions/week) low-moderate intensity warm water pool-based program. We assessed pain by means of a Visual Analogue Scale before and after each single session (i. e., 24 sessions). We observed immediate benefits on pain with a mean decrease ~15% in all sessions, except in the fourth one. There was an association of pain difference (pre-post) session with pain pre session (p=0.005; β=0.097±0.034) and with age (p0.001; β=0.032±0.008). There were no significant accumulative differences on pain, pre session, post session, and pre-post changes (all p0.05). Therefore this study showed that a warm water pool-based exercise program for 12 weeks (2 times/week) led to a positive immediate decrease in level of pain in female patients with fibromyalgia. Improvements were higher in older women and in those with more intense pain.

The purpose of this study is to examine gender differences in quality of life (QoL) and symptomatology in fibromyalgia (FM) patients. A total of 20 men (48.0 ± 8.0 years) and 78 women (49.8 ± 7.2 years) with FM participated in the study (age range 31-63 years). Health-related QoL and FM impact were assessed by means of the Spanish versions of the Short-Form-36 Health Survey (SF36) and the Fibromyalgia Impact Questionnaire (FIQ), respectively. Comparisons in QoL were performed using one-way analysis of covariance adjusted by age and body mass index (BMI), and comparisons in FIQ dimensions were performed using Mann-Whitney test. Overall FM impact, as measured by FIQ-total score ( p = .01) and FIQ-physical impairment ( p = .02) was higher in men, whereas women presented higher values of FIQ-fatigue and FIQ-morning tiredness ( p = .04) and less SF36-vitality ( p = .02). Therefore, women appear to feel more fatigue, whereas men present higher FM overall impact. Due to the small number of men included in this study and the consequent small statistical power, these results should be taken as preliminary. Higher powered studies are warranted to further address gender differences in FM in order to design more successful treatments.

Objectives To describe the anthropometric profile and body composition of women from Southern Spain diagnosed with fibromyalgia (FM) and to compare the observed values with values from other studies conducted on FM patients and with national reference values. Materials and methods The body composition of 104 women diagnosed with FM was assessed using an eight-electrode impedance meter. The reliability of the body composition measurement was tested in a randomly selected sub-sample (n = 28). The reliability study showed a test-retest systematic error close to zero in most of the parameters studied. Results The women with FM who were studied had a mean weight of 71.3 ± 13.4 kg, height of 158 ± 6 cm, body mass index of 28.6 ± 5.1 kg/m2, body fat mass of 38.6 ± 7.6%, total body water of 31.6 ± 3.8 L and muscle mass of 23.4 ± 3.0 kg. In general, there were no substantial differences in weight and body mass index between women with FM and those analyzed in other Spanish and European studies involving FM patients, nor when they were compared with regional or national reference values. However, the prevalence of obesity in the women with FM under study was 33.7%, a higher figure than that from the national reference data for obesity in similarly aged women (i.e. 26.4%). Conclusions The results suggest that obesity is a common condition in women diagnosed with FM, its prevalence in this population being higher than the national reference values. This study provides detailed information about the body composition characteristics of women with FM.

Objetivos Caracterizar el perfil antropometrico y de composicion corporal de mujeres con fibromialgia (FM) del sur de Espana y compararlo con otros estudios nacionales e internacionales de similares caracteristicas, asi como con valores normativos de mujeres espanolas. Materiales y metodos Se ha analizado la composicion corporal de 104 mujeres diagnosticadas de FM mediante un bioimpedianciometro de 8 electrodos. La fiabilidad de la medida fue estudiada en una submuestra seleccionada aleatoriamente (n=28). El estudio de fiabilidad mostro un error sistematico test vs re-test cercano a cero en la mayoria de los parametros estudiados. Resultados Las mujeres con FM estudiadas tuvieron un peso promedio de 71,3±13,4kg, 158,1±6cm de altura, 28,6±5,1kg/m2 de indice de masa corporal, 38,6±7,6% de porcentaje graso, 31,6±3,8l de agua corporal total y 23,4±3,0kg de masa muscular. En general, no se observan diferencias importantes en peso e indice de masa corporal, tanto entre las mujeres con FM estudiadas y enfermas procedentes de otros estudios nacionales o europeos, como en comparacion con los valores de referencia andaluces o nacionales. Sin embargo, la prevalencia de obesidad en el grupo de mujeres con FM fue del 33,7%, un valor superior a la prevalencia de obesidad nacional en mujeres de igual rango de edad (i.e. 26,4%). Conclusiones Los resultados sugieren que la obesidad es una condicion frecuente entre mujeres con FM, siendo su prevalencia sustancialmente superior a los valores normativos nacionales. Este estudio presenta informacion detallada sobre la composicion corporal de mujeres con FM

Although flexibility field tests are commonly used in research, sport, and school settings, there is no conclusive evidence about what they actually assess. The first aim of this study was to assess the contributions of the main joints involved in the back-saver sit-and-reach test using angular kinematic analysis. The second aim was to measure the inter-method agreement between the back-saver sit-and-reach test and the sit-and-reach test. A total of 138 adolescents (57 females, 81 males) aged 14.5 +/- 1.7 years performed the back-saver sit-and-reach test and the sit-and-reach test. Hip, lumbar, and thoracic angles were assessed by angular kinematic analysis while the participants were performing the back-saver sit-and-reach test. Stepwise linear regression models and the Bland-Altman method were used. The hip angle independently explained 42% (P < 0.001) of the variance in the back-saver sit-and-reach test, the lumbar angle explained an additional 30% (P < 0.001) of the variance, and the thoracic angle an additional 4% (P < 0.001). The inter-method mean difference between back-saver sit-and-reach (BSSR) and sit-and-reach (SR) measures (BSSR - SR) was 0.41 cm (P = 0.21). The results suggest that hip flexibility is the main determinant of the back-saver sit-and-reach test score in adolescents, followed by lumbar flexibility. The back-saver sit-and-reach test can therefore be considered an appropriate and valid test for assessing hip and low-back flexibility in this age group. The back-saver sit-and-reach and sit-and-reach tests provide comparable values.