1. PHYSICAL ACTIVITY AND DEPRESSION IN FIBROMYALGIA
Shayna McDaniel
Nursing Student
California State University, Fullerton
Dana N. Rutledge
Professor of Nursing
California State University, Fullerton
Background
Methods
Conclusion
Fibromyalgia (FM) is a chronic musculoskeletal syndrome involving persistent widespread pain and multiple co-morbid symptoms
Depression and depressive symptoms are more likely in persons with FM than in the general population
Co-occurrence of depression and FM may exacerbate pain, impair daily function, and decrease quality of life
Successful treatment of depression results in significant improvement in FM symptomology
Physical activity (PA) acts as a protective factor against depression in both the general and older adult populations
Evidence about the impact of PA on FM depressive symptoms is inconsistent
Data (2014) from longitudinal/observational study examining cognitive and physical performance in adults with/without FM
Sample
92 participants, 47 with FM, 45 without
Functionally independent, community-dwelling
Measures
Beck Depression II Inventory (BDI-II)
21-items rated on a 4-point scale
Rapid Assessment of Physical Activity (RAPA)
9-item questionnaire
Participants with FM suffered from greater severity of depressive symptoms than the healthy cohort
Higher levels of PA were associated with lower levels of depressive symptom severity in both cohorts & collectively
Although small, PA has a significant impact on depression symptom scores
Beck Depression II Inventory Scores
0-13
Minimal depression
14-19
Mild depression
20-28
Moderate depression
29-63
Severe depression
Rapid Assessment of Physical Activity PA Levels
Level
Definition
Examples
Light
Heart beats slightly faster than normal (can still talk and sing)
Walking leisurely, stretching, vacuuming
Moderate
Heart beats faster than normal (can still talk but not sing)
Fast walking, aerobics class, strength training, swimming
Vigorous
Large increase in heart rate (talking broken up by large breaths)
Jogging, running, tennis, racquetball, stair machine
(University of Washington Health Promotion Research Center, 2006)
(Beck, Steer, & Brown, 1996)
Rapid Assessment of Physical Activity (RAPA) Scoring
Sedentary
Rarely or never do any PA
Underactive
Some light or moderate PA, not every week
Underactive, light
Some light PA every week
Underactive, regular
Moderate PA every week, <30 min/day or <5 days/week
(or) Vigorous PA every week, <20 min/day or <3 days/week
Active
≥ 30 min/day of moderate PA, ≥ 5 days/week
(or) ≥ 20 min/day of vigorous PA, ≥ 3 days/week
Implications
(University of Washington Health Promotion Research Center, 2006)
PA may be a protective factor against depressive symptoms
Findings support potential use of PA as a recommendation for people with FM
Providers should be aware of the need to encourage PA in persons with FM, especially those with depression
Nurses can incorporate this evidence in providing patient education to those with FM by explaining benefits of PA, encouraging participation in PA, and helping to identify barriers to PA
Results
Depression scores significantly higher for the FM cohort (M = 15.72, SD = 10.22) compared to healthy controls (M = 4.78, SD = 5.13), t(68.410) = , p <
Weak, negative correlation was found between PA levels and depression scores, r(92) = -.257, p = .014.
Multiple regression: both FM status and PA levels predicted depression severity.
FM status, R2 = 31%, p < .0001
PA, additional R2 = 3%, p < .05
Purpose
To compare effect of self-reported PA levels on depressive symptoms in FM subjects age 50 and above with age-matched healthy persons
Specific Aims
Compare severity of depressive symptoms in people > 50 with FM with a healthy cohort
Compare levels of PA between healthy adults > 50 and those with FM
Assess relationship between PA and depressive symptoms in both cohorts
Mean Depression Scores and Physical Activity Levels: FM and Non-FM Cohorts
Mean Depression Scores and Physical Activity Level in Both Cohorts Combined