Abstract
This study was aimed to investigate the effects of an exercise trial on self-esteem, self-concept and quality of life in patients with fibromyalgia and to evaluate whether improvements in psychological distress were related to changes in physical functioning. Twenty-eight women with a primary diagnosis of fibromyalgia were randomized to a usual care control group or to a 12-week supervised training programme consisting of 3 weekly sessions of aerobic, strengthening and flexibility exercises. Outcomes were physical functioning (Fibromyalgia Impact Questionnaire (FIQ), lower-body strength and flexibility) and psychological functioning (SF-36, Rosenberg self-esteem scale and Erdmann self-concept scale). Outcomes were measured at study entry and at the end of the intervention. Compared to the control group, statistically significant improvements in self-esteem, self-concept, FIQ, physical functioning, role physical, bodily pain, vitality, role emotional, social functioning, mental health, isometric strength, muscular endurance and flexibility were evident in the exercise group at the end of treatment. Self-esteem and self-concept scores were correlated positively with role emotional, mental health and the mental component summary of SF-36 and were negatively correlated to FIQ scores. No significant correlation existed between self-esteem or self-concept and isometric strength, muscular endurance or flexibility. Our results highlight the need for a broader array of physical and mental outcomes and the importance of examining patient’s perceptions in future research therapies.
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References
Mengshoel AM, Haugen M (2001) Health status in fibromyalgia—a followup study. J Rheumatol 28:2085–2089
Staud R (2004) Fibromylgia pain: do we know the source? Curr Opin Rheumatol 16:157–163
Hauser W, Klose P, Langhorst J, Moradi B, Schiltenwolf M, Busch A (2010) Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther 12:R79
Thomas EN, Blotman F (2010) Aerobic exercise in fibromyalgia: a practical review. Rheumatol Int 30:1143–1150
Dupree K, Adams D, Winters-Stone K, Burckhardt KS (2006) A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988–2005). Halth Qual Life Outcomes 4:67
Jones KD, Lipton G (2009) Exercise interventions in fibromyalgia: clinical applications from the evidence. Rheum Dis Clin North Am 35:373–3791
Bircan C, Karasel SA, Akgun B, El O, Alper S (2008) Effects of muscle strengthening versus aerobic exercise program in fibromyalgia. Rheumatol Int 28:527–532
Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, Da Silva JA, Danneskiold-Samsøe B, Dincer F, Henriksson C, Henriksson KG, Kosek E, Longley K, McCarthy GM, Perrot S, Puszczewicz M, Sarzi-Puttini P, Silman A, Späth M, Choy EH (2008) Eular evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67:536–541
Valencia M, Alonso B, Alvarez MJ, Barrientos MJ, Ayan C, Martin V (2009) Effects of 2 physiotherapy programs on pain perception, muscular flexibility, and illness impact in women with fibromyalgia: a pilot study. J Manipul Physiol Ther 32:84–92
Meyer BB, Lemley KJ (2000) Utilizing exercise to affect the symptomology of fibromyalgia. Med Sci Sports Exerc 32:1691–1697
Rivera J, Moratalla C, Valdepeñas F, García Y, Osés JJ, Ruiz J, González T, Carmona L, Vallejo MA (2004) Long-term efficacy of therapy in patients with fibromyalgia: a physical exercise-based program and a cognitive-behavioral approach. Artritis Rheumat 51:184–192
Morea JM, Firend R, Bennett RM (2008) Conceptualizing and measuring illness self-concept: a comparison with self-esteem and optimism in predicting fibromyalgia adjustment. Res Nurs Health 31:563–575
Chang CL, Chiu CM, Hung SY, Lee SH, Lee CS, Hunag CM, Chou CL (2009) The relationship between quality of life and aerobic fitness in patients with rheumatoid arthritis. Clin Rheumatol 28:685–691
Johnson M, Paananen ML, Rahinantti P, Hannonen P (1997) Depressed fibromyalgia patients are equipped with an emphatic competence dependent-self-esteem. Clin Rheumatol 16:578–584
Michielsen HJ, Van Houdenhove B, Leirs I, Vandenbroeck A, Onghena P (2006) Depression, attribution style and self-esteem in chronic fatigue syndrome and fibromyalgia patients: is there a link? Clin Rheumatol 25:183–188
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62:600–610
Wolfe F, Smyhte HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172
Monterde S, Salvat I, Montull S, Fernandez-Ballart J (2004) Validación de la version española del Fibromyalgia Impact Questionnaire. Rev Esp Reumatol 31:507–513
Rivera J, Gonzalez T (2004) The Fibromyalgia Impact Questionnaire: a validated Spanish version to assess the health status in women with fibromyalgia. Clin Exp Rheumatol 22:5554–5560
Burckhardt CS, Clark SR, Bennett RM (1991) The Fibromyalgia impact questionnaire: development and validation. J Rheumatol 18:728–733
Dunkl PR, Taylor AG, McConnell GG, Alfano AP, Conaway MR (2000) Responsiveness of fibromyalgia clinical trial outcome measures. J Rheumatol 27:2683–2691
De Souza-Teixeira F, Costilla S, Ayán C, García-Lopez D, González-Gallego J, De Paz JA (2009) Effects of resistance training in multiple sclerosis. In J Sports Med 30:245–250
Mannerkorpi K, Burckhardt C, Bjelle A (1994) Physical performance characteristics of women with fibromyalgia. Arthritis Care Res 7:123–129
Ware JE, Sherbourne CD (1992) The MOS-36 item short form health survey (SF-36). Med Care 30:473–483
Alonso J, Prieto L, Antón JM (1995) La versión española del SF-36 Health Survey (Cuestionario de salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin Barc 105:771–776
Rosenberg M (1965) Society and the adolescent self-image. Princenton University Press, Princenton
Vazquez AJ, Jimenez R, Vazquez R (2004) Escala de autoestima de Rosenberg: fiabilidad y validez en poblacion clinica española. Apunt Psicol 22:247–255
Erdmann R (1987) Relativierte Macht. Hans Richardz, Sankt Augustin
Rodriguez Barquero V, Araya G (2009) Efecto de ocho clases de expresión corporal en el estado de ánimo y autoconcepto general de jóvenes universitarios. Rev Educ 33:139–152
Bennett RM (2005) The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 39:154–156
Gowans SE, deHueck A, Voss S, Silaj A, Abbey SE, Reynolds WJ (2001) Effect of a randomized, controlled trial of exercise on mood and physical function in individuals with fibromyalgia. Arthritis Rheum 45:519–529
Tomas-Carus P, Hakkinen A, Gusi N, Leal A, Hakkinen K, Ortega-Alonso A (2007) Aquatic training and detraining on fitness and quality of life in fibromyalgia. Med Sci Sports Exerc 39:1044–1050
Assis MR, Silva LE, Alves AM, Pessanha AP, Valim V, Feldman D, Neto TL, Natour J (2006) A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum 55:57–65
Mannerkorpi K, Nyberg B, Ahlmen M, Ekdahl C (2000) Pool exercise combined with an education program for patients with fibromyalgia syndrome: a prospective, randomized study. J Rheumatol 27:2473–2481
Da Costa D, Abrahamowicz M, Lowensteyn I, Bernatsky S, Dritsa M, Fitzcharles MA, Dobkin PL (2005) A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia. Rheumatology 44:1422–1427
Schachter CL, Busch AJ, Peloso PM, Sheppard MS (2003) Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther 83:340–358
Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C (1999) Tests of functional limitations in fibromyalgia syndrome: a reliability study. Arthritis Care Res 12:193–199
Gusi N, Tomas-Carus P, Hakkinen A, Hakkinen K, Ortega-Alonso A (2006) Exercise in waist-high warm decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum 55:66–73
Tomas-Carus P, Gusi N, Hakkinen A, Hakkinen K, Raimundo A, Ortega-Alonso A (2009) Improvements of muscle strength predicted benefits in HRQQL and postural balance in women with fibromyalgia: an 8 month randomized controlled trial. Rheumatology 48:117–151
Hoffman DL, Dukes EM (2008) The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. Clin Pract 62:115–126
Yoshikawa GT, Heymann RE, Helfenstein M, Feldman D (2010) A comparison of quality of life, demographic and clinical characteristics of Brazilian men with fibromyalgia syndrome with male patients with depression. Rheumatol Int 30:473–478
Valim V, Oliveira L, Suda A, Silva L, de Assis M, Neto TB, Feldman D, Natour J (2003) Aerobic fitness effects in fibromyalgia. J Rheumatol 30:1060–1069
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García-Martínez, A.M., De Paz, J.A. & Márquez, S. Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: a randomized controlled trial. Rheumatol Int 32, 1869–1876 (2012). https://doi.org/10.1007/s00296-011-1892-0
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DOI: https://doi.org/10.1007/s00296-011-1892-0