Physical fitness is associated with anxiety levels in women with fibromyalgia: the al-Ándalus project.
OBJECTIVE
To assess the independent associations of individual physical fitness components with anxiety in women with fibromyalgia and to test which physical fitness component shows the greatest association.


METHODS
This population-based cross-sectional study included 439 women with fibromyalgia (age 52.2 ± 8.0 years). Anxiety symptoms were measured with the State Trait Anxiety Inventory (STAI) and the anxiety item of the Revised Fibromyalgia Impact Questionnaire (FIQR). Physical fitness was assessed through the Senior Fitness Test battery and handgrip strength test.


RESULTS
Overall, lower physical fitness was associated with higher anxiety levels (all, p < 0.05). The coefficients of the optimal regression model (stepwise selection method) between anxiety symptoms and physical fitness components adjusted for age, body fat percentage and anxiolytics intake showed that the back scratch test (b = -0.18), the chair sit-and-reach test (b = -0.12; p = 0.027) and the 6-min walk test (b = -0.02; p = 0.024) were independently and inversely associated with STAI. The back scratch test and the arm- curl test were associated with FIQR-anxiety (b = -0.05; p < 0.001 and b = -0.07; p = 0.021, respectively).


CONCLUSIONS
Physical fitness was inversely and consistently associated with anxiety in women with fibromyalgia, regardless of the fitness component evaluated. In particular, upper-body flexibility was an independent indicator of anxiety levels, followed by cardiorespiratory fitness and muscular strength.
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
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Córdoba-Torrecilla
Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences and Institute of Nutrition and Food Technology, University of Granada, Campus Universitario de Cartuja s/n, Granada, 18071, Spain. virginiaparicio@ugr.es.|VU University and EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands. virginiaparicio@ugr.es.
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Aparicio
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
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Soriano-Maldonado
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.|Department of Clinical and Health Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands.
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Estévez-López
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
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Segura-Jiménez
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
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Álvarez-Gallardo
Department of Statistics and OR (Section of Biostatistics, School of Medicine), University of Granada, Granada, Spain.
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Femia
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
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Delgado-Fernández
D000328:Adult; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D010809:Physical Fitness / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016138:Walking
Chronic pain; Flexibility; Functional capacity; Mental health