Abstract

Background:Optimizing the highly deteriorated quality of life (QoL) of patients with fibromyalgia is one of the main goals in the management of the disease1. Physical fitness has been identified as a powerful marker of health that is positively related to QoL in this population2, although previous evidence is mainly based on cross-sectional data.Objectives:This study aimed to examine the longitudinal associations (2- and 5-year follow-up) between physical fitness and QoL in women with fibromyalgia.Methods:In this prospective cohort study, women diagnosed with fibromyalgia (age: 51.3±7.6 years) with completed data were included at baseline (n=441), at 2-year follow-up (n=220) and at 5-year follow-up (n=227). The Senior Fitness Tests battery was used to assess physical fitness components and a standardized global fitness index was calculated. The eight dimensions plus the two physical and mental component summaries of the Short-Form health survey-36 questionnaire were used to assess QoL. To examine whether changes in fitness predicted QoL at follow-up, multiple linear regression models were built. The bidirectionallity of the associations (whether changes in QoL predicted fitness at follow-up) was also tested. Outcome values at baseline and age, fat percentage, analgesic consumption, educational level, and occupational status at follow-up were entered as potential confounders in all analyses.Results:Changes in fitness were associated with physical function (β=0.160), physical role (β=0.275), bodily pain (β=0.271), general health (β=0.144), and physical component summary (β=0.276) at 2-year follow-up (all,P<0.05) and with changes in physical role (β=0.215) and physical component summary (β=0.135) at 5-year follow-up (all,P<0.05). Changes in physical function (β=0.165), physical role (β=0.230), bodily pain (β=0.230), general health (β=0.130) and physical summary component (β=0.251) were associated with fitness at 2-year follow-up (all,P<0.05). Changes in all dimensions of QoL (β rating from 0.113 to 0.198), as well as the physical (β=0.174) and mental (β=0.164) summary components were associated with fitness at 5-year follow-up (all,P<0.05).Conclusion:Increasing levels of physical fitness over time predicts future QoL in women with fibromyalgia, especially for physical domains at 2-year follow-up. In addition, increasing QoL across all domains over time predicts future global fitness at 2- and, specially, 5-year follow-up. Future research is warranted to determine the clinical relevance of the bidirectional association between physical fitness and QoL in fibromyalgia.

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