title: The prevalence and characteristics of fibromyalgia in the general population. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale Six-month and one-year followup of 23 weeks of aerobic exercise for individuals with fibromyalgia. Six- and 24-month follow-up of pool exercise therapy and education for patients with fibromyalgia Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. Responsiveness of fibromyalgia clinical trial outcome measures.
abstract: OBJECTIVE To determine the prevalence and characteristics of fibromyalgia in the general population . METHODS A r and om sample of 3,006 persons in Wichita , KS , were characterized according to the presence of no pain , non-widespread pain , and widespread pain . A sub sample of 391 persons , including 193 with widespread pain , were examined and interviewed in detail . RESULTS The prevalence of fibromyalgia was 2.0 % ( 95 % confidence interval [ 95 % CI ] 1.4 , 2.7 ) for both sexes , 3.4 % ( 95 % CI 2.3 , 4.6 ) for women , and 0.5 % ( 95 % CI 0.0 , 1.0 ) for men . The prevalence of the syndrome increased with age , with highest values attained between 60 and 79 years ( > 7.0 % in women ) . Demographic , psychological , dolorimetry , and symptom factors were associated with fibromyalgia . CONCLUSION Fibromyalgia is common in the population , and occurs often in older persons . Characteristic features of fibromyalgia -- pain threshold and symptoms -- are similar in community and clinic population s , but overall severity , pain , and functional disability are more severe in the clinic population & NA ;  Pain intensity is frequently measured on an 11‐point pain intensity numerical rating scale ( PI‐NRS ) , where 0=no pain and 10=worst possible pain . However , it is difficult to interpret the clinical importance of changes from baseline on this scale ( such as a 1‐ or 2‐point change ) . To date , there are no data driven estimates for clinical ly important differences in pain intensity scales used for chronic pain studies . We have estimated a clinical ly important difference on this scale by relating it to global assessment s of change in multiple studies of chronic pain . Data on 2724 subjects from 10 recently completed placebo‐controlled clinical trials of pregabalin in diabetic neuropathy , postherpetic neuralgia , chronic low back pain , fibromyalgia , and osteoarthritis were used . The studies had similar design s and measurement instruments , including the PI‐NRS , collected in a daily diary , and the st and ard seven‐point patient global impression of change ( PGIC ) , collected at the endpoint . The changes in the PI‐NRS from baseline to the endpoint were compared to the PGIC for each subject . Categories of ‘ much improved ’ and ‘ very much improved ’ were used as determinants of a clinical ly important difference and the relationship to the PI‐NRS was explored using graphs , box plots , and sensitivity/specificity analyses . A consistent relationship between the change in PI‐NRS and the PGIC was demonstrated regardless of study , disease type , age , sex , study result , or treatment group . On average , a reduction of approximately two points or a reduction of approximately 30 % in the PI‐NRS represented a clinical ly important difference . The relationship between percent change and the PGIC was also consistent regardless of baseline pain , while higher baseline scores required larger raw changes to represent a clinical ly important difference . The application of these results to future studies may provide a st and ard definition of clinical ly important improvement in clinical trials of chronic pain therapies . Use of a st and ard outcome across chronic pain studies would greatly enhance the comparability , validity , and clinical applicability of these studies OBJECTIVE To measure mood and physical function of individuals with fibromyalgia , 6 and 12 months following 23 weeks of supervised aerobic exercise . METHODS This is a followup report of individuals who were previously enrolled in 23 weeks of l and -based and water-based aerobic exercise classes .  Outcomes included the 6-minute walk test , Beck Depression Inventory ( BDI ) , State-Trait Anxiety Inventory , Arthritis Self-Efficacy Scale ( ASES ) , Fibromyalgia Impact Question naire ( FIQ ) , tender point count , patient global assessment score , and exercise compliance . Outcomes were measured at the start and end of the exercise classes and 6 and 12 months later . RESULTS Analyses were conducted on 29 ( intent-to-treat ) or 18 ( efficacy ) subjects .  Six-minute walk distances and BDI total scores were improved at followup ( all analyses ) . BDI cognitive/affective scores were improved at the end of 23 weeks of exercise ( both analyses ) and at the 12-month followup ( efficacy analysis only ) . BDI somatic scores were improved at 6-month ( both analyses ) and 12-month followup ( intent-to-treat only ) . FIQ and ASES function were improved at all followup points . ASES pain was improved in efficacy analyses only ( all followup points ) . Tender points were unchanged after 23 weeks of exercise and at followup . Exercise duration at followup ( total minutes of aerobic plus anaerobic exercise in the preceding week ) was related to gains in physical function ( 6- and 12-month followup ) and mood ( 6-month followup ) . CONCLUSION Exercise can improve physical function , mood , symptom severity , and aspects of self efficacy for at least 12 months . Exercising at followup was related to improvements in physical function and perhaps mood Objective . To follow patients with fibromyalgia six and 24 months after they finished a six-month treatment programme . The programme comprised pool exercise therapy , adjusted to the patients ' limitations , and education based on their health problems . Methods . Twenty-six patients were examined six and 24 months after the completion of the treatment programme  with the Fibromyalgia Impact Question naire ( FIQ ) , SF-36 , the 6-minute walk test , and the Grippit measure . The values obtained at the follow-up examinations were compared with the baseline and post-treatment values . Results . As compared with baseline , symptom severity ( FIQ , SF-36 ) , physical function ( FIQ , SF-36 , 6-minute walk test ) and quality of life ( SF-36 ) still showed improvements six months after the completion of treatment ( p<0.05 ) . Pain ( FIQ , SF-36 ) , fatigue ( FIQ , SF-36 ) , walking ability , and social function ( SF-36 ) still showed improvements 2 years after the completion of the programme as compared with the baseline values ( p<0.05 ) . No significant changes were found for these variables , when the values obtained at the two follow-up examinations were compared with those of the post-treatment examination . Conclusions . Improvements in symptom severity , physical function and social function were still found six and 24 months after the completed treatment programme Within the context of a double blind r and omized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs , we vali date d WOMAC , a new multidimensional , self-administered health status instrument for patients with osteoarthritis of the hip or knee . The pain , stiffness and physical function subscales fulfil conventional criteria for face , content and construct validity , reliability , responsiveness and relative efficiency . WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials OBJECTIVE To determine the effects of moderate-intensity exercise training on self-rated ( subjective ) sleep quality among healthy , sedentary older adults reporting moderate sleep complaints . DESIGN R and omized controlled trial of 16 weeks ' duration . SETTING General community . PARTICIPANTS Volunteer sample of 29 women and 14 men ( of 67 eligible subjects ) aged 50 to 76 years who were sedentary , free of cardiovascular disease , and reported moderate sleep complaints . No participant was withdrawn for adverse effects . INTERVENTION R and omized to 16 weeks of community-based , moderate-intensity exercise training or to a wait-listed control condition . Exercise consisted primarily of four 30- to 40-minute endurance training sessions ( low-impact aerobics ; brisk walking ) prescribed per week at 60 % to 75 % of heart rate reserve based on peak treadmill exercise heart rate . MAIN OUTCOME MEASURE Pittsburgh Sleep Quality Index ( PSQI ) . RESULTS Compared with controls ( C ) , subjects in the exercise training condition ( E ) showed significant improvement in the PSQI global sleep score at 16 weeks ( baseline and posttest values in mean [ SD ] for C=8.93 [ 3.1 ] and 8.8 [ 2.6 ] ; baseline and posttest values for E=8.7 [ 3.0 ] and 5.4 [ 2.8 ] ; mean posttest difference between conditions=3.4 ; P<.001 ; 95 % confidence interval , 1.9 - 5.4 ) , as well as in the sleep parameters of rated sleep quality , sleep-onset latency ( baseline and posttest values for C=26.1 [ 20.0 ] and 23.8 [ 15.3 ] ; for E=28.4 [ 20.2 ] and 14.6 [ 13.0 ] ; net improvement=11.5 minutes ) , and sleep duration baseline and posttest scores for C=5.8 [ 1.1 ] and 6.0 [ 1.0 ] ; for E=6.0 [ 1.1 ] and 6.8 [ 1.2 ] ; net improvement=42 minutes ) assessed via PSQI and sleep diaries ( P=.05 ) . CONCLUSIONS Older adults with moderate sleep complaints can improve self-rated sleep quality by initiating a regular moderate-intensity exercise program OBJECTIVE To assess the responsiveness of the Fibromyalgia Impact Question naire ( FIQ ) , patient ratings of pain intensity , number of tender points , and total tender point pain intensity score to perceived changes in clinical status in patients with fibromyalgia ( FM ) . METHODS Using data from a r and omized  placebo controlled study evaluating efficacy of magnetic therapy in patients with FM , the ability of primary outcomes to detect clinical ly meaningful changes over a 6 month period was assessed by : ( 1 ) degree of association between outcome change scores and patient global ratings of symptom change ( Spearman rank-order correlations ) ; ( 2 ) ability of these scores to discriminate among groups of patients whose perceived health status had changed to varying degrees ( ANOVA ) ; ( 3 ) ability of these scores , individually and jointly , to discriminate between patients who had reported improvement and those who did not ( logistic regression ) ; ( 4 ) effect size , st and ardized response mean , and Guyatt 's statistic were calculated to quantify responsiveness . RESULTS Correlations showed the outcome measures were moderately responsive to perceived symptomatic change . For FIQ , pain intensity ratings and number of tender points , differences in change scores between globally improved and unchanged groups and between globally improved and worsened groups were significant ; for total tender point pain intensity , the globally improved differed from worsened group . FIQ outperformed the other measures in discriminating between patients who reported improvement from those who did not . Summary statistics were consistent with discriminatory analyses , indicating the measures were sensitive to improvement , but relatively unresponsive to decline . CONCLUSION The FIQ was the most responsive measure to perceived clinical improvement and we recommend its inclusion as a primary endpoint in FM clinical trials
target: There is ' gold ' level evidence ( www.cochranemsk.org ) that supervised aerobic exercise training has beneficial effects on physical capacity and FMS symptoms .
  Strength training may also have benefits on some FMS symptoms .
background: BACKGROUND Fibromyalgia ( FMS ) is a syndrome expressed by chronic widespread body pain which leads to reduced physical function and frequent use of health care services .
  Exercise training is commonly recommended as a treatment .
  This is an up date of a review published in Issue 2 , 2002 .
  OBJECTIVES The primary objective of this systematic review was to evaluate the effects of exercise training including cardiorespiratory ( aerobic ) , muscle strengthening , and /or flexibility exercise on global well-being , selected signs and symptoms , and physical function in individuals with FMS .