Publications by authors named "Alberto Soriano-Maldonado"

73 Publications

Relative Handgrip Strength as Marker of Cardiometabolic Risk in Women with Systemic Lupus Erythematosus.

Int J Environ Res Public Health 2021 Apr 27;18(9). Epub 2021 Apr 27.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

This study aimed to examine the association of relative handgrip strength (rHGS) with cardiometabolic disease risk factors in women with systemic lupus erythematosus (SLE).

Methods: Seventy-seven women with SLE (mean age 43.2, SD 13.8) and clinical stability during the previous six months were included. Handgrip strength was assessed with a digital dynamometer and rHGS was defined as absolute handgrip strength (aHGS) divided by body mass index (BMI). We measured blood pressure, markers of lipid and glucose metabolism, inflammation (high sensitivity C-reactive protein [hs-CRP]), arterial stiffness (pulse wave velocity [PWV]), and renal function. A clustered cardiometabolic risk index (z-score) was computed.

Results: Pearson's bivariate correlations revealed that higher rHGS was associated with lower systolic blood pressure (SBP), triglycerides, hs-CRP, PWV, and lower clustered cardiometabolic risk (r = from -0.43 to -0.23; all < 0.05). Multivariable linear regression analyses adjusted for age, disease activity (SLEDAI), and accrual damage (SDI) confirmed these results (all < 0.05) except for triglycerides.

Conclusions: The findings suggest that higher rHGS is significantly associated with lower cardiometabolic risk in women with SLE.
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http://dx.doi.org/10.3390/ijerph18094630DOI Listing
April 2021

Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials.

Rev Endocr Metab Disord 2021 Apr 16. Epub 2021 Apr 16.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO or VO, resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO / VO (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO / VO, HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
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http://dx.doi.org/10.1007/s11154-021-09651-3DOI Listing
April 2021

The force-velocity profile as determinant of spike and serve ball speed in top-level male volleyball players.

PLoS One 2021 2;16(4):e0249612. Epub 2021 Apr 2.

Department of Physical Education and Sport, Faculty of Sport Science, University of Granada, Granada, Spain.

Understanding the relationship between mechanical variables derived from actions such as jumping, sprinting, or ballistic bench press throwing and sport-specific performance moves is of scientific and practical interest for strength and conditioning coaches for improving training programs. We examined the association between mechanical variables derived from the force-velocity (FV) profiles of the aforementioned actions and spike and serve ball speeds in elite volleyball players. Twenty-two male elite volleyball players (age: 24.3 ± 4.5 years; height: 1.89 ± 0.06 m; body mass: 86.3 ± 8.6 kg) were tested in two sessions. Squatting, sprinting, and bench press throwing FV profiles were determined in the first session, while spike and serve ball speeds were assessed in the second session. The theoretical maximal force (F0) of vertical jumping, the theoretical maximal velocity of sprinting, and the F0 of bench press throwing in ascending order, were strongly associated (rs range 0.53-0.84; p<0.05) with spike and serve ball speeds. These mechanical variables explained 20%-36% of the variability in spike and serve ball speeds, with a greater influence on the serve speed. These results suggest that assessing jumping, sprinting, and bench press throwing force-velocity profiles might help provide player-specific training programs and optimize performance in these technical-tactical actions in male elite volleyball players.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249612PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018657PMC
April 2021

Is active commuting associated with sedentary behaviour and physical activity in women with fibromyalgia? The al-Ándalus project.

Disabil Rehabil 2021 Feb 28:1-9. Epub 2021 Feb 28.

PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.

Purpose: This study aimed to examine the association between active commuting and sedentary time (ST) and physical activity (PA) in women with fibromyalgia.

Materials And Methods: This cross-sectional study included 420 women with fibromyalgia (aged 30 to 74 years old) from Spain. The participants wore an accelerometer during seven days to record ST and PA. They also self-reported patterns of active commuting. Linear regression analyses were conducted to examine the relationships between commuting and accelerometer outcomes. Age, pressure pain threshold, and accelerometer wear time were used as confounders.

Results: There was a negative association between active commuting and ST whereas active commuting was positively associated with moderate PA, moderate-to-vigorous PA, total PA, and step count (all  ≤ 0.01). No associations were observed in the older group.

Conclusion: Younger women with fibromyalgia who were active commuters spent less ST and were involved in greater PA than passive commuters. This study highlights the importance of promoting active commuting to increase PA among young women with fibromyalgia, while other sources of PA might be recommended for older patients if levels of active commuting are not increased.Implications for rehabilitationActive commuting is a source to increase PA in women with fibromyalgia.Active commuting alone does not seem to be enough to increase PA levels in older women with fibromyalgia and additional PA strategies should be implemented.Promotion of active commuting in young women with fibromyalgia is recommended.
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http://dx.doi.org/10.1080/09638288.2021.1884758DOI Listing
February 2021

Ideal cardiovascular health in women with systemic lupus erythematosus: Association with arterial stiffness, inflammation, and fitness.

Int J Cardiol 2021 May 20;330:207-213. Epub 2021 Feb 20.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.

Background: Systemic Lupus Erythematosus (SLE) is closely related to cardiovascular morbidity and mortality. We aimed to examine the association of ideal cardiovascular health (ICH) with arterial stiffness, inflammation, and physical fitness in women with SLE.

Methods: This cross-sectional study included 76 women with SLE (age 43.4±13.8 years old). Ideal levels of 7 health metrics (smoking, body mass index, physical activity, healthy diet, blood pressure, cholesterol, and glucose) were used to define the ICH score (ranging from 0 to 7 ideal metrics) and the ICH status ( defined as presenting ≥4 ideal metrics). Arterial stiffness was measured through pulse wave velocity (PWV) and inflammation through serum high sensitivity C-reactive protein (hs-CRP). Cardiorespiratory fitness (CRF) was measured by 6-min walk test (6MWT), and Siconolfi step test and muscular strength by handgrip strength and 30-s chair stand, and range of motion (ROM) by the back-scratch test.

Results: Higher ICH score was associated with lower PWV (β = -0.122, p = 0.002), lower hs-CRP (β = -0.234, p = 0.056), higher CRF [6MWT (β = 0.263, p = 0.041); Siconolfi step test (β = 0.330, p < 0.001)], higher ROM (β = 0.278, p = 0.013) and higher relative handgrip strength (β = 0.248, p = 0.024). Women with ICH status presented lower PWV (mean difference 0.40 m/s, 95% CI 0.17 to 0.63, p = 0.001), and higher CRF [assessed by 6MWT (mean difference 43.9 m, 95% CI 5.0 to 82.7, p = 0.028)], than women with non-ICH status. Sensitivity analyses using ICH score ranging 0-14 and considering ICH status with ≥5 metrics revealed consistent results.

Conclusion: ICH is associated with lower arterial stiffness, lower inflammation, and higher fitness in women with SLE. Although these results extend current knowledge about the potential role of ICH for primordial prevention of CVD in SLE, they are yet to be confirmed in future prospective research .
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http://dx.doi.org/10.1016/j.ijcard.2021.02.040DOI Listing
May 2021

Gender-Specific Association of the Sprint Mechanical Properties With Change of Direction Performance in Basketball.

J Strength Cond Res 2021 Feb 4. Epub 2021 Feb 4.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain; Center for Sport Studies, Rey Juan Carlos University, Madrid, Spain; and National Basketball Team, Spanish Basketball Federation and Basketball Club Unicaja, Málaga, Spain.

Abstract: Baena-Raya, A, Jiménez-Reyes, P, Romea, ES, Soriano-Maldonado, A, and Rodríguez-Pérez, MA. Gender-specific association of the sprint mechanical properties with change of direction performance in basketball. J Strength Cond Res XX(X): 000-000, 2020-We evaluated the gender-specific associations between the mechanical variables derived from the horizontal force-velocity (FV) profile (i.e., theoretical maximal force [F0], velocity [V0], maximal power output [Pmax], peak ratio of the effective horizontal component [RFpeak], and the force application technique index [DRF]) and the change of direction (COD) performance for basketball players. Seventy-one players (23 women and 48 men) were assessed for the horizontal FV profile and COD using the modified 505 and V-cut tests. The FV profile parameters were significantly higher for the men than those for the women. The F0, RFpeak, and Pmax were strongly associated with performance in the 505 test (women rrange = -0.72 to -0.82; men: rrange = -0.67 to -0.75; p < 0.001) and the V-cut test (women rrange = -0.68 to -0.76; men rrange = -0.45 to -0.50; p < 0.001), as well as with a lower COD deficit (women rrange = 0.58 to 0.75 (p < 0.01); men rrange = 0.49 to 0.54; all p < 0.001). For the women, a 1 N·kg-1 increase of the F0 was associated with -0.20 seconds and -0.56 seconds in the 505 and V-cut tests, respectively, and 0.16 seconds for the COD deficit. In the men, it was associated with -0.13 seconds and -0.37 seconds in the 505 and V-cut tests, respectively, and 0.10 seconds for the COD deficit. F0, RFpeak, and Pmax are the most determinant sprint mechanical properties to successfully COD and reduce the COD deficit. The horizontal FV profile assessment is recommended for diagnosing and prescribing a training program for basketball players.
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http://dx.doi.org/10.1519/JSC.0000000000003974DOI Listing
February 2021

Heart Rate Variability in Women with Systemic Lupus Erythematosus: Association with Health-Related Parameters and Effects of Aerobic Exercise.

Int J Environ Res Public Health 2020 12 18;17(24). Epub 2020 Dec 18.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

Abnormal heart rate variability (HRV) has been observed in patients with systemic lupus erythematosus (SLE). In a combined cross-sectional and interventional study approach, we investigated the association of HRV with inflammation and oxidative stress markers, patient-reported outcomes, and the effect of 12 weeks of aerobic exercise in HRV. Fifty-five women with SLE (mean age 43.5 ± 14.0 years) were assigned to either aerobic exercise ( = 26) or usual care ( = 29) in a non-randomized trial. HRV was assessed using a heart rate monitor during 10 min, inflammatory and oxidative stress markers were obtained, psychological stress (Perceived Stress Scale), sleep quality (Pittsburg Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), depressive symptoms (Beck Depression Inventory), and quality of life (36-item Short-Form Health Survey) were also assessed. Low frequency to high frequency power (LFHF) ratio was associated with physical fatigue ( = 0.019). Sample entropy was inversely associated with high-sensitivity C-reactive protein ( = 0.014) and myeloperoxidase ( = 0.007). There were no significant between-group differences in the changes in HRV derived parameters after the exercise intervention. High-sensitivity C-reactive protein and myeloperoxidase were negatively related to sample entropy and physical fatigue was positively related to LFHF ratio. However, an exercise intervention of 12 weeks of aerobic training did not produce any changes in HRV derived parameters in women with SLE in comparison to a control group.
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http://dx.doi.org/10.3390/ijerph17249501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766283PMC
December 2020

Association of the vertical and horizontal force-velocity profile and acceleration with change of direction ability in various sports.

Eur J Sport Sci 2021 Jan 11:1-9. Epub 2021 Jan 11.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

This study aimed to assess the association of the mechanical variables derived from the force-velocity (FV) profile (i.e. theoretical maximal force [], velocity [] and maximal power output []) with change of direction (COD) performance in soccer, basketball and tennis players. Fifty-four male athletes (soccer  = 23; tennis  = 16; basketball  = 15) were assessed for the vertical (Vrt) and horizontal (Hzt) FV profiles, COD with the dominant (D) and nondominant (ND) legs, using the modified 505 test, and sprint. Hzt FV profile parameters showed stronger associations with performance than Vrt FV profile in the three sports. Specifically, the Hzt parameter most strongly associated with COD performance was in tennis ( = -0.83; <0.001) and in soccer and basketball ( = -0.79; <0.001). Associations between sprint times and COD test ranged from ( = 0.73-0.82) in soccer players, ( = 0.74-0.87) in tennis players and ( = 0.62-0.85) in basketball players, respectively (<0.05). Considering the whole sample and the random effect of the type of sports, an improvement in sprint acceleration (i.e. one N/kg increase in and one W/kg in ) was associated with -0.15 s and -0.04 s to complete the 505 test, respectively. In conclusion, our results suggest the potential usefulness of assessing the Hzt FV profile to maximize acceleration capabilities through training interventions which, in turn, may translate into improved COD performance. However, further longitudinal and experimental research is needed to confirm this hypothesis.
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http://dx.doi.org/10.1080/17461391.2020.1856934DOI Listing
January 2021

Effects of 12-week aerobic exercise on patient-reported outcomes in women with systemic lupus erythematosus.

Disabil Rehabil 2020 Sep 2:1-9. Epub 2020 Sep 2.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

Purpose: To evaluate the effects of aerobic exercise on patient-reported outcomes (PROs) in women with systemic lupus erythematosus (SLE), and whether changes in cardiorespiratory fitness (CRF) mediate the changes in PROs.

Methods: A total of 58 women with SLE were assigned to either an exercise group (EG;  = 26) or a control group (CG;  = 32) in this non-randomized clinical trial. The EG comprised 12 weeks of aerobic exercise (2 sessions/week) between 40%-75% of the individual's heart rate reserve. At baseline, and at week 12, CRF (Bruce test) and PROs were assessed including psychological stress (Perceived Stress Scale), sleep quality (Pittsburg Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), depressive symptoms (Beck Depression Inventory), and quality of life (36-item Short-Form Health Survey).

Results: In comparison to the CG, the EG showed a significant reduction in general fatigue (mean difference (MD) -2.86 units; 95%CI -5.70 to -0.01;  = 0.049), physical fatigue (MD -4.33 units; 95%CI -7.02 to -1.65;  = 0.002) and a non-significant reduction of reduced motivation (MD - 1.29 units; 95%CI -2.60 to 0.03;  = 0.055). There were no significant between-group differences in the changes in psychological stress, sleep quality, depressive symptoms, quality of life, or other fatigue dimensions (all  > 0.05). Changes in CRF mediated the effects of the exercise intervention on general fatigue by 53.8%.

Conclusion: The results suggest that 12 weeks of progressive aerobic exercise might improve relevant dimensions of fatigue in women with SLE, despite the absence of effects on other PROs. Improvements in CRF seem to mediate the effect of exercise on general fatigue. Implications for rehabilitation Aerobic exercise could be safely introduced in rehabilitation programs for inactive patients with SLE with mild disease activity. Including physical activity recommendations as part of rehabilitation could improve relevant aspects of fatigue in women with SLE. When rehabilitation aims at reducing fatigue, cardiorespiratory fitness improvements derived from physical activity might enhance benefits.
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http://dx.doi.org/10.1080/09638288.2020.1808904DOI Listing
September 2020

Physical Exercise following bariatric surgery in women with Morbid obesity: Study protocol clinical trial (SPIRIT compliant).

Medicine (Baltimore) 2020 Mar;99(12):e19427

Obstetrics and Gynecology Unit, Torrecárdenas University Hospital, Almería.

Background: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life.

Methods: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured.

Discussion: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery.

Trial Registration Number: ISRCTN registry (ISRCTN27697878).
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http://dx.doi.org/10.1097/MD.0000000000019427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220774PMC
March 2020

Effects of a 12-week resistance and aerobic exercise program on muscular strength and quality of life in breast cancer survivors: Study protocol for the EFICAN randomized controlled trial.

Medicine (Baltimore) 2019 Nov;98(44):e17625

Department of Education, Faculty of Education Sciences.

Background: The number of people living with the side effects of breast cancer treatment (eg, loss of muscular mass and muscular strength, upper-limb mobility and disability, lymphedema, cardiac toxicity, and reduced quality of life) is increasing yearly. These consequences can be improved through exercise, specially combining resistance and aerobic training. Previous exercise trials have not been consistent in applying training principles and standardized reporting, and this partly explains the variability in obtained results. The aim of this study is to assess the effect of a 12-week supervised resistance exercise program combined with home-based aerobic exercise, compared with home-based aerobic exercise only, on muscular strength and several aspects of health-related quality of life in breast cancer survivors. To maximize transparency, replicability, and clinical applicability, the intervention is described following the consensus on exercise reporting template.

Methods: This study is a parallel-group randomized controlled trial in which 60 female breast cancer survivors, who have completed central treatments of the disease in the last 5 years, will be randomly assigned to either an experimental group that will perform a total of 24 progressive resistance training sessions for 12 weeks (ie, 2 weeks of individual training and 10 weeks of micro-group training) and will be requested to undertake 10,000 steps/d, or a control group that will be requested to undertake 10,000 steps/d, only. Outcomes will be evaluated at baseline and at week 12. Primary outcome measure is peak isometric muscular strength of the lower- and upper-body, assessed with several exercises through an electromechanical dynamometer. Secondary outcomes include cardiorespiratory fitness, upper-joint mobility and disability, health-related quality of life, cancer-related fatigue, depression, life satisfaction, and presence of lymphedema.

Discussion: This study aims to investigate the extent to which a 12-week supervised and progressive resistance exercise program, in addition to home-based aerobic physical activity, might improve muscular strength and health-related quality of life in breast cancer survivors. The comprehensive description of the intervention will likely contribute to enhancing exercise prescription in this population.

Trial Registration Number: ISRCTN14601208.
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http://dx.doi.org/10.1097/MD.0000000000017625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946307PMC
November 2019

International Fitness Scale-IFIS: Validity and association with health-related quality of life in pregnant women.

Scand J Med Sci Sports 2020 Mar 15;30(3):505-514. Epub 2019 Nov 15.

Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.

This study aimed (a) to examine the construct validity of the International Fitness Scale (IFIS) to discriminate between different objectively measured physical fitness levels in pregnant women and (b) to assess the extent to which IFIS is able to discriminate between pregnant women with different levels of health-related quality of life (HRQoL). A total of 159 pregnant women were involved in the GESTAtion and FITness project: 106 pregnant women (mean age 32.7, SD 4.4 years) were included. Self-reported physical fitness-that is, cardiorespiratory fitness, muscular strength, flexibility, and overall fitness-was assessed with the IFIS. Physical fitness was objectively measured using the Bruce test, the handgrip strength test and the back-scratch test. The HRQoL was assessed with the 36-item Short Form Health Survey (SF-36). Higher self-reported physical fitness measured with IFIS was associated with higher objectively measured physical fitness (P < .05). There was a linear association so that higher self-reported physical fitness (ie, IFIS; regardless of the fitness component) was related to greater General Health dimension scores (P < .05). Moreover, higher self-reported physical fitness (all components except muscular strength) was associated with better Physical Functioning, lower Bodily Pain and higher Vitality scores (ie, SF-36 components). This linear trend was not seen for objectively measured physical fitness. The results of this study suggest that IFIS might be a useful tool for identifying pregnant women with low or very low physical fitness and with low quality of life health-related. Further research should elucidate whether IFIS can identify women with pregnancy complications before it can be implemented in clinical practice.
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http://dx.doi.org/10.1111/sms.13584DOI Listing
March 2020

Body Composition Changes Following a Concurrent Exercise Intervention in Perimenopausal Women: The FLAMENCO Project Randomized Controlled Trial.

J Clin Med 2019 Oct 14;8(10). Epub 2019 Oct 14.

Department of Physiology, Faculty of Pharmacy, and Institute of Nutrition and Food Technology(INYTA), Biomedical Research Centre (CIBM), University of Granada, 18071 Granada, Spain.

We assessed the effects of a 16-week primary-care-based exercise program on body composition in perimenopausal women. The women ( = 150) were randomized into control ( = 75) or exercise ( = 75) groups. Exercise was provided in a 16-week (60 min/session, 3 days/week) concurrent program. Body composition was measured using dual-energy X-ray absorptiometry. These are secondary analyses of the FLAMENCO Project (Clinical Trials Reference NCT02358109). In the intention-to-treat analyses, the control group showed no changes in body mass index (BMI) between post- and pre-test, whereas the exercise group showed a 0.75 kg/m decrease in BMI (95% CI: -1.29 to -0.22; = 0.006). Gynoid and android fat mass in control group decreased by 98.3 g and 46.1 g after the 16 weeks, whereas they decreased by 213 g and 139 g in the exercise group, respectively (95% CI: -209 to -3.86; = 0.042 and 95% CI: -164 to -26.9; = 0.007, respectively). The control group decreased their pelvis bone mineral content by 2.85 g in the post-test compared with the pre-test, whereas the exercise group increased it by 1.13 g (95% CI: 0.93 to 7.81; = 0.013). Per-protocol analyses showed similar results. These analyses suggest that the exercise intervention decreased fat depositions and BMI. Exercise might improve bone mineral content in specific areas such as the pelvis.
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http://dx.doi.org/10.3390/jcm8101678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832269PMC
October 2019

Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial.

BMC Surg 2019 Sep 5;19(1):127. Epub 2019 Sep 5.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

Background: There is increasing evidence of weight regain in patients after bariatric surgery (BS), generally occurring from 12 to 24 months postoperatively. Postoperative exercise has been suggested to ad long-term weight maintenance and to improve physical function in BS patients. However, there are a limited number of intervention studies investigating the possible benefits of exercise in this population. The aim of the current report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the exercise programme implemented in the EFIBAR Study (Ejercicio FÍsico tras cirugía BARiátrica), a randomised controlled trial investigating the effects of a 16-week supervised concurrent (aerobic and strength) exercise intervention program on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, physical activity and quality of life (secondary outcomes) in patients with severe/morbid obesity following bariatric surgery.

Methods: A total of 80 BS patients [60-80% expected women, aged 18 to 60 years, body mass index (BMI) ≥ 40 kg/m or ≥ 35 kg/m with comorbid conditions)] will be enrolled in the EFIBAR Randomized Control Trial (RCT). Participants allocated in the exercise group (n = 40) will undertake a 16-week supervised concurrent (strength and aerobic) exercise programme (three sessions/week, 60 min/session), starting 7 to 14 days after surgery. The rationale of the exercise programme will be described following the CERT criteria detailing the 16 key items. The study has been reviewed and approved by the Ethics Committee of the Torrecárdenas University Hospital (Almería, Spain) (ref. N° 76/2016).

Discussion: The present study details the exercise programme of the EFIBAR RCT, which may serve: 1) exercise professionals who would like to implement an evidence-based exercise programme for BS patients, and 2) as an example of the application of the CERT criteria.

Trial Registration: The trial was prospectively registered at Clinicaltrials.gov NCT03497546 on April 13, 2018.
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http://dx.doi.org/10.1186/s12893-019-0566-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729089PMC
September 2019

Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project.

Clin Rheumatol 2019 Dec 29;38(12):3585-3593. Epub 2019 Aug 29.

Department of Didactic of Corporal Expression, Faculty of Education Sciences, University of Granada, Granada, Spain.

Introduction/objectives: Reproductive labour refers to activities and tasks directed at caregiving and domestic roles, such as cleaning, cooking, and childcare. Productive labour refers to activities that involve economic remuneration. The aim of the present study was to analyse physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engaged, or did not engage, in productive work.

Method: This cross-sectional study comprised 276 women with fibromyalgia from Andalusia (southern of Spain). Levels of physical activity (light, moderate, and vigorous) and sedentary behaviour were measured by an accelerometer. Physical fitness and cognitive performance were measured with a battery of performance-based tests.

Results: More hours/week of homemaker-related tasks were associated with higher time spend in light physical activity and lower sedentary behaviour (P < 0.001 and P < 0.05, respectively). Furthermore, in comparison with those who only engaged in reproductive labour, women with fibromyalgia who engaged in productive work showed lower levels of sedentary behaviour and higher levels of light and moderate physical activity, physical fitness (except muscular strength), and cognitive performance (all, P < 0.05).

Conclusions: Altogether, our findings suggest that productive work is consistently related to better physical and cognitive functioning in women with fibromyalgia. If future research corroborates causality of our findings, then, to maintain women with fibromyalgia engaging in productive work may be strived for not only because of societal or economic reasons but also for better health. However, we should keep in mind that people with fibromyalgia have a chronic condition, and therefore, adaptations at the workplace are imperative.Key Points• Women with fibromyalgia, who spend more time in reproductive labour, have higher levels of light physical activity and lower sedentary behaviour; however, it is associated with poorer general health (as lower physical fitness or cognitive performance).• Household tasks are often seen as a responsibility associated with the gender roles that women with fibromyalgia perform, despite the feelings of incapacity they cause. Policies focused on reducing reproductive labour demands for fibromyalgia patients (i.e. social help on housework or childcare) might facilitate the inclusion of daily active behaviours.• People with fibromyalgia who engage in productive work seem to have better health outcomes than those who have not; however, we cannot forget that adaptations and flexibility at the workplace are imperative.
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http://dx.doi.org/10.1007/s10067-019-04750-8DOI Listing
December 2019

Sedentary Time, Physical Activity, and Sleep Duration: Associations with Body Composition in Fibromyalgia. The Al-Andalus Project.

J Clin Med 2019 Aug 20;8(8). Epub 2019 Aug 20.

Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain.

To explore the individual-independent relationships of sedentary time (ST) and physical activity (PA) (light and moderate-to-vigorous intensity (MVPA)), with sleep duration and body composition (waist circumference, body mass index (BMI), body fat percentage, and muscle mass index) in women with fibromyalgia, and to determine whether these associations are independent of physical fitness. This cross-sectional study involved 385 women with fibromyalgia. ST and PA were assessed by triaxial accelerometry, sleep duration was self-reported. Waist circumference was measured using an anthropometric tape, and body weight, body fat percentage, and muscle mass were estimated using a bio-impedance analyzer. In individual regression models, ST and sleep were directly associated with waist circumference, BMI, and body fat percentage ( between 0.10 and 0.25; all < 0.05). Light PA and MVPA were inversely associated with waist circumference, BMI, and body fat percentage ( between -0.23 and -0.12; all < 0.05). In multiple linear regression models, ST ( between 0.17 and 0.23), light PA ( between -0.16 and -0.21), and sleep duration ( between 0.11 and 0.14) were independently associated with waist circumference, BMI, and body fat percentage (all < 0.05). MVPA was associated with waist circumference independent of light physical activity (LPA) and sleep duration ( = -0.11; < 0.05). Except for MVPA, these associations were independent of physical fitness. These results suggest that longer ST and sleep duration, and lower PA levels (especially light intensity PA), are independently associated with greater adiposity, but not muscle mass, in women with fibromyalgia. These associations are, overall, independent of physical fitness.
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http://dx.doi.org/10.3390/jcm8081260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722714PMC
August 2019

Correction to: Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials.

Obes Surg 2019 Nov;29(11):3778

Department of Education, Faculty of Education Sciences, University of Almería, Ctra. Sacramento s/n, La Cañada de San Urbano, 04120, Almería, Spain.

In the original article the name of author Enrique G. Artero was misspelled.
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http://dx.doi.org/10.1007/s11695-019-04130-wDOI Listing
November 2019

High Levels of Physical Fitness Are Associated With Better Health-Related Quality of Life in Women With Fibromyalgia: The al-Ándalus Project.

Phys Ther 2019 11;99(11):1481-1494

MOVE-IT Research group and Department of Physical Education, Faculty of Education Sciences University of Cádiz; and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz.

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.
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http://dx.doi.org/10.1093/ptj/pzz113DOI Listing
November 2019

Physical and psychological paths toward less severe fibromyalgia: A structural equation model.

Ann Phys Rehabil Med 2020 Jan 3;63(1):46-52. Epub 2019 Aug 3.

Department of Psychology, Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Objectives: Previous research suggested isolated associations of physical and psychological factors with fibromyalgia severity. Integration of physical and psychological, experienced and observed, modifiable factors associated with fibromyalgia severity in a single model will reveal therapeutic paths toward less severity of disease. We aimed to examine an encompassing model of determinants of fibromyalgia severity.

Methods: This observational, population-based cross-sectional study included 569 people with fibromyalgia. An integrative model of fibromyalgia severity was tested by using structural equation modelling. This model included 8 factors: resilience, catastrophizing, active lifestyle, declarative memory, subjective fitness, objective fitness, psychological distress, and physical fatigue.

Results: Two core paths were associated with reduced fibromyalgia severity: 1) a psychological path connecting high resilience and low catastrophizing with low distress and 2) a physical path, connecting a more active lifestyle (directly and via high objective and subjective physical fitness) with low fatigue. Additional interconnecting paths especially suggested a connection from the psychological to physical path. Our model explained 83% of the fibromyalgia severity.

Conclusions: The present model integrated the complexity of mutually influencing factors of fibromyalgia severity, which may help to better understand the disease. It emphasised the importance of: 1) physical factors and psychological factors and their interconnections, 2) patients' experiences and clinical measurements, and 3) positive and negative signs such as physical fitness and distress. Future longitudinal and experimental research should aim at testing the causal direction of the associations in the model as well as the clinical implications suggested by the model. For instance, to reduce fatigue, exercise should enhance not only objective fitness but also fitness-related perceptions. Reducing distress and fatigue seems crucial for lowering fibromyalgia severity.
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http://dx.doi.org/10.1016/j.rehab.2019.06.017DOI Listing
January 2020

Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials.

Obes Surg 2019 10;29(10):3371-3384

Department of Education, Faculty of Education Sciences, University of Almería, Ctra. Sacramento s/n, La Cañada de San Urbano, 04120, Almería, Spain.

The combination of bariatric surgery and physical exercise has been suggested as a promising strategy to positively influence obesity, not only body weight but also all associated comorbidities. An electronic search of intervention studies was carried out in which an exercise training program was implemented after bariatric surgery. The quality of each study was assessed and the data were meta-analyzed using a random effect model. Twenty-six articles were included in the systematic review and 16 in the meta-analysis. As the main conclusion, exercise in patients who have undergone bariatric surgery does not seem to be effective in enhancing weight loss (SMD = 0.15; 95% CI = - 0.02, 0.32; p = 0.094). However, the variability in the protocols used makes it too early to reach a definite conclusion.
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http://dx.doi.org/10.1007/s11695-019-04096-9DOI Listing
October 2019

Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study.

Medicina (Kaunas) 2019 Jul 3;55(7). Epub 2019 Jul 3.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Neck circumference (in the anthropometric model; : 0.889; : age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; : 0.891; : age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (: 0.894; : age = 0.882, FFMI = 0.126, neck = 0.093). It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
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http://dx.doi.org/10.3390/medicina55070334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681323PMC
July 2019

Association of objectively measured physical activity and sedentary time with health-related quality of life in women with fibromyalgia: The al-Ándalus project.

J Sport Health Sci 2019 May 27;8(3):258-266. Epub 2018 Jul 27.

Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.

Purpose: To examine the association of physical activity (PA) intensity levels and sedentary time with health-related quality of life (HRQoL) in women with fibromyalgia and whether patients meeting the current PA guidelines present better HRQoL.

Methods: This cross-sectional study included 407 women with fibromyalgia aged 51.4 ± 7.6 years. The time spent (min/day) in different PA intensity levels (light, moderate, and moderate-to-vigorous physical activity (MVPA) and sedentary time were measured with triaxial accelerometry. The proportion of women meeting the American PA recommendations (≥150 min/week of MVPA in bouts ≥10 min) was also calculated. HRQoL domains (physical function, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health), as well as physical and mental components, were assessed using the 36-item Short-Form Health Survey.

Results: All PA intensity levels were positively correlated with different HRQoL dimensions ( between 0.10 and 0.23, all < 0.05). MVPA was independently associated with social functioning ( < 0.05). Sedentary time was independently associated with physical function, physical role, bodily pain, vitality, social functioning, and both the physical and mental component summary score (all < 0.05). Patients meeting the PA recommendations presented better scores for bodily pain (mean = 24.2 (95%CI: 21.3-27.2) mean = 20.4 (95%CI: 18.9-21.9),  = 0.023) and better scores for social functioning (mean = 48.7 (95%CI: 43.9-44.8) mean = 42.3 (95%CI: 39.8-44.8),  = 0.024).

Conclusion: MVPA (positively) and sedentary time (negatively) are independently associated with HRQoL in women with fibromyalgia. Meeting the current PA recommendations is significantly associated with better scores for bodily pain and social functioning. These results highlight the importance of being physically active and avoiding sedentary behaviors in this population.
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http://dx.doi.org/10.1016/j.jshs.2018.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523872PMC
May 2019

Physical Fitness and Body Composition in Women with Systemic Lupus Erythematosus.

Medicina (Kaunas) 2019 Feb 21;55(2). Epub 2019 Feb 21.

Department of Education, Faculty of Education Sciences, University of Almería, Almería 04120, Spain.

Higher physical fitness is associated with a more favorable weight and body composition in the general population, although this association has not been studied in patients with systemic lupus erythematosus (SLE). The aim of the present study was to examine the association of different components of physical fitness with body composition in women with SLE with mild disease activity. This cross-sectional study included 77 women with SLE (43.2 ± 13.8 years old) and clinical stability during the previous 6 months. Body composition (including body mass index (BMI), fat mass index (FMI), waist circumference, waist-to-height ratio and waist-to-hip ratio) was assessed using a stadiometer, an anthropometric tape, and a bioimpedance device. Physical fitness included cardiorespiratory fitness (Siconolfi step test and 6 min walk test), muscular strength (handgrip strength test as upper body measure and 30 s chair stand as lower body measure), and flexibility (back-scratch test). Participants with a fitness level equal or above the median of the study sample were categorized as "fit" and those below the median were categorized as "unfit". Linear regression assessed the association of physical fitness with body composition parameters. Cardiorespiratory fitness and upper body muscular strength were negatively associated with BMI, FMI, waist circumference, and waist-to-height ratio (all, < 0.05). Lower body muscular strength and flexibility were negatively related to FMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio (all, < 0.05). These relationships were still significant after controlling for age, disease duration, accrual damage, and SLE activity. Overall, fit patients presented significantly lower values in all body composition parameters compared to unfit patients (all, < 0.05). The main findings of the present study suggest that physical fitness is inversely associated with body composition in women with SLE. Given the cross-sectional nature of this study, future clinical trials should study the causal pathways underlying these relationships.
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http://dx.doi.org/10.3390/medicina55020057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410128PMC
February 2019

Association of physical fitness components and health-related quality of life in women with systemic lupus erythematosus with mild disease activity.

PLoS One 2019 20;14(2):e0212436. Epub 2019 Feb 20.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

Objectives: To study the association of different components of physical fitness [flexibility, muscle strength and cardiorespiratory fitness (CRF)] and a clustered fitness score with health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and to analyze whether participants with high fitness level have better HRQoL.

Methods: This cross-sectional study included 70 women with SLE (aged 42.5; SD 13.9 years). The back-scratch test assessed flexibility, the 30-sec chair stand and handgrip strength tests assessed muscle strength, and the 6-min walk test (n = 49) assessed CRF. HRQoL was assessed through the 36-item Short-Form Health Survey (SF-36).

Results: Flexibility was positively associated with the physical function dimension and the physical component summary (PCS) (rpartial between 0.26 and 0.31; p<0.05), and negatively related with social functioning dimension (rpartial = -0.26; p<0.05). Muscle strength was positively associated with the physical function, physical role, bodily pain dimensions and the PCS (rpartial between 0.27 and 0.49; all p<0.05). CRF was positively associated with the physical function and bodily pain dimensions, and PCS (rpartial between 0.39 and 0.65; all p<0.05). The clustered fitness score was associated with the physical function (B = 17.16) and bodily pain (B = 14.35) dimensions, and the PCS (B = 6.02), all p<0.005. Patients with high fitness level had greater scores in the physical function, physical role, and bodily pain dimensions and the PCS, all p≤0.05.

Conclusions: Our study suggests that muscle strength and CRF are positively associated with HRQoL, while flexibility showed contradictory results. These findings highlight the importance of maintaining adequate fitness levels in women with SLE.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212436PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382148PMC
December 2019

Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Ándalus Project.

Pain Med 2019 12;20(12):2506-2515

Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.

Objective: To 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.

Design: Cross-sectional study in 420 women with fibromyalgia.

Setting: Fibromyalgia associations from southern Spain.

Methods: Physical 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.

Results: Physical 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 < 0.001). Negative affect was independently associated with general fatigue, physical fatigue, reduced motivation, and mental fatigue (all P ≤ 0.04). The interaction of overall physical fitness and positive affect was related to general fatigue and physical fatigue (all P ≤ 0.02). Women with fibromyalgia with higher levels of overall physical fitness and positive affect showed the lowest general fatigue and physical fatigue.

Conclusions: In 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.
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http://dx.doi.org/10.1093/pm/pny304DOI Listing
December 2019

Association of Patterns of Moderate-to-Vigorous Physical Activity Bouts With Pain, Physical Fatigue, and Disease Severity in Women With Fibromyalgia: the al-Ándalus Project.

Arch Phys Med Rehabil 2019 07 5;100(7):1234-1242.e1. Epub 2019 Jan 5.

Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.

Objectives: To examine the associations of non-bouted moderate-to-vigorous physical activity (MVPA) and patterns of MVPA in bouts ≥10 minutes with pain, physical fatigue, and disease severity in women with fibromyalgia, and test whether these associations are independent of sedentary time (ST) and physical fitness (PF).

Design: Cross-sectional study carried out from November 2011 to January 2013.

Setting: University facilities and fibromyalgia associations.

Participants: Women with fibromyalgia (N=439; 51.3±7.6y).

Interventions: Not applicable.

Main Outcome Measures: ST and MVPA were measured with triaxial accelerometry, and PF with the Senior Fitness test battery. We assessed pain, physical fatigue and disease severity with diverse questionnaires.

Results: Total time in non-bouted MVPA only was independently associated with lower physical fatigue (B=-0.012; P=.010) and disease severity (B=-0.068; P=.007) in women with fibromyalgia, regardless of PF but not of ST. Patterns of bouted MVPA were overall associated with symptoms independently of ST or PF. The strongest regressor was the maximum time in MVPA bout (min/bout), which was consistently and independently associated with pain, physical fatigue and disease severity after controlling for ST or PF (all, P≤.002). Patients meeting bouted physical activity guidelines displayed lower disease severity than those not meeting guidelines (bouted or non-bouted) and those meeting non-bouted physical activity guidelines (all, P≤.008).

Conclusions: Patterns of MVPA performed in bouts ≥10 minutes were overall consistently and independently associated with core symptoms (pain and fatigue) in fibromyalgia and the overall disease severity, regardless of ST or PF. The results suggest that longer bouts of continuous MVPA are associated with better symptoms profile in this population, which needs to be corroborated in longitudinal research.
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http://dx.doi.org/10.1016/j.apmr.2018.12.019DOI Listing
July 2019

Effects of 12-week Aerobic Exercise on Arterial Stiffness, Inflammation, and Cardiorespiratory Fitness in Women with Systemic LUPUS Erythematosus: Non-Randomized Controlled Trial.

J Clin Med 2018 Nov 24;7(12). Epub 2018 Nov 24.

Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, 18014 Granada, Spain.

This study assessed the effect of 12-week aerobic exercise on arterial stiffness (primary outcome), inflammation, oxidative stress, and cardiorespiratory fitness (secondary outcomes) in women with systemic lupus erythematosus (SLE). In a non-randomized clinical trial, 58 women with SLE were assigned to either aerobic exercise ( = 26) or usual care ( = 32). The intervention comprised 12 weeks of aerobic exercise (2 sessions × 75 min/week) between 40⁻75% of the individual's heart rate reserve. At baseline and at week 12, arterial stiffness was assessed through pulse wave velocity (PWV), inflammatory (i.e., high-sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TFN-α], and inteleukin 6 [IL-6]) and oxidative stress (i.e., myeloperoxidase [MPO]) markers were obtained from blood samples, and cardiorespiratory fitness was assessed (Bruce test). There were no between-group differences in the changes in arterial stiffness (median PWV difference -0.034, 95% CI -0.42 to 0.36 m/s; = 0.860) or hsCRP, TNF-α, IL-6, and MPO (all > 0.05) at week 12. In comparison to the control group, the exercise group significantly increased cardiorespiratory fitness (median difference 2.26 minutes, 95% CI 0.98 to 3.55; = 0.001). These results suggest that 12 weeks of progressive treadmill aerobic exercise increases cardiorespiratory fitness without exacerbating arterial stiffness, inflammation, or oxidative stress in women with SLE.
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http://dx.doi.org/10.3390/jcm7120477DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306776PMC
November 2018

Sedentary time, physical activity, and sleep quality in fibromyalgia: The al-Ándalus project.

Scand J Med Sci Sports 2019 Feb 30;29(2):266-274. Epub 2018 Oct 30.

Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.

Purpose: To get insight into the potential significance of objectively measured sedentary time (ST), and physical activity (PA) intensity levels on sleep quality (SQ) in women with fibromyalgia; and to assess whether those who meet moderate-to-vigorous PA (MVPA) recommendations have better SQ than their counterparts.

Methods: Four-hundred and nine women with fibromyalgia (age range 30-65 years old) from Andalusia (southern Spain) were included in this cross-sectional study. Sedentary time, PA intensity levels (light, moderate, and MVPA), and total PA were assessed with accelerometers during seven consecutive days. Sleep quality was measured with the Pittsburgh Sleep Quality Index self-report questionnaire.

Results: Higher ST was associated with worse subjective SQ, sleep duration, sleep disturbances, daytime dysfunction, and SQ global score (all, P < 0.05). All PA levels were associated with better subjective SQ and sleep latency and with less sleep medication and daytime dysfunction (all, P < 0.05). In addition, light and total PA were associated with better sleep efficiency, SQ global score, and less sleep disturbances (all, P < 0.05). Finally, women meeting bouted PA recommendations displayed better SQ than patients not meeting the recommendations (bouted or non-bouted).

Conclusion: Lower ST and greater PA levels are associated with better SQ in women with fibromyalgia. This result demonstrates that those patients with fibromyalgia who reduce periods of inactivity and perform PA could be better sleepers, which might contribute to a lower severity of the disease. It is noteworthy that meeting bouted PA recommendations is associated with better SQ.
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http://dx.doi.org/10.1111/sms.13318DOI Listing
February 2019

Systemic Low-Grade Inflammation and Cardiovascular Disease in Systemic Lupus Erythematosus: Reply.

Angiology 2019 04 27;70(4):376-377. Epub 2018 Sep 27.

1 Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain.

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http://dx.doi.org/10.1177/0003319718802637DOI Listing
April 2019