Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Clinical Determinants of Physical Activity in Fibromyalgia Patients.

Ang¹, Dennis, Kaleth³, Anthony, Bigatti², Silvia, Mazzuca², Steven, Saha², Chandan, Bandy², Robert

Indiana University, Indianapolis, IN
Indiana University
Indiana University-Purdue University Indianapolis

Background:

The standard of care for fibromyalgia (FM) includes recommendations for increased physical activity (PA) and exercise. Unfortunately, while most FM patients have no medical contraindications to begin a physically active lifestyle, many remain sedentary. In this report, we sought to determine modifiable clinical correlates of physical activity (PA).

Methods:

This was an analysis of cross-sectional data from a randomized clinical trial of motivational interviewing (MI) to improve exercise adherence for patients with FM. Subjects (n=216) completed web-based assessments and wore an ActiGraph monitor around the waist for >=10 waking hours/day for 4–7 days. Logistic regression was used to identify clinical factors associated with exhibiting median or greater PA in two respects: >=3,722 steps/day and >=77 minutes/week in moderately intense PA.

Results:

Most of the FM patients were female (95.8%), white (88.4%), married (61.1%) and employed (53.7%). Baseline means for demographic and clinical variables and bivariate associations with PA indicators (P<= 0.15) are tabled below.

Dependent Variable	Predictor	Mean ± SD	Odds Ratio*	95% CI
>=3,722 steps/day	Employed vs. unemployed		2.28	1.29–4.02
	# of co-morbidities	1.0 ± 1.0	0.62	0.45–0.84
	BMI, kg/m²	31.4 ± 7.2	0.63	0.47–0.85
	Total FIQ	67.0 ± 12.7	0.65	0.47–0.89
	PHQ-8 depression severity	12.5 ± 4.9	0.71	0.54–0.94
	Age, years	45.8 ± 11.3	0.71	0.54–0.94
	FM duration, years	9.0 ± 7.0	0.74	0.56–0.98
	# of medications	3.0 ± 1.6	0.78	0.59–1.03
BPI pain intensity		6.0 ± 1.3	0.80	0.61–1.06
Moderate PA >=77 minutes/week
	BMI, kg/m²	31.4 ± 7.2	0.63	0.47–0.85
	PHQ-8 depression severity	12.5 ± 4.9	0.64	0.48–0.85
	# of co-morbidities	1.0 ± 1.0	0.76	0.57–1.02
	Total FIQ	67.0 ± 12.7	0.76	0.56–1.03
	# of medications	3.0 ± 1.6	0.80	0.61–1.05
*Change in odds of being above median, relative to below, associated with a 1-SD increment in the predictor variable except for total FIQ where a 14% change is considered clinically meaningful.

In the multivariate analysis, being relatively active (>=3,722 steps/day) was associated with lower BMI (OR: 0.62, 0.45–0.86), fewer co-morbidities (OR: 0.71, 0.51–0.99), shorter disease duration (OR: 0.72, 0.52–1.0) and lower Total FIQ (OR: 0.61, 0.43–0.88). Alternatively, time spend in PA of moderate or greater intensity (>=77 min/wk) was limited by greater BMI (OR: 0.64, 0.48–0.86) and increased depressive symptomatology (OR: 0.74, 0.56–0.99).

Conclusions/Implications:

Active lifestyles were rare in this sample of FM patients. Employed patients were more active than unemployed ones. While several associations with clinical variables may be bidirectional, sedentary patients tended to be more obese and have greater duration and severity of FM and more numerous co-morbidities. Clinicians may take these associations as evidence supporting the encouragement of PA early in the disease process. However, attainment of appreciable levels of moderate intensity of PA may be difficult without attention to weight loss and mood, when indicated.

To cite this abstract, please use the following information:
Ang, Dennis, Kaleth, Anthony, Bigatti, Silvia, Mazzuca, Steven, Saha, Chandan, Bandy, Robert; Clinical Determinants of Physical Activity in Fibromyalgia Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :93
DOI: 10.1002/art.27862

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