title: Association of Physical Fitness with Depression in Women with Fibromyalgia.
abstract: The aim of this study was to examine the association between physical fitness and depressive symptoms in women with fibromyalgia (FM). We also assessed whether different fitness components present independent relationships with depressive symptoms.
  
  
  
  Cross-sectional study.
  
  
  
  University facilities and FM associations.
  
  
  
  Four hundred and forty-four patients with FM according to the 1990 American College of Rheumatology criteria.
  
  
  
  Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility) was assessed using the standardized Senior Fitness Test battery and the handgrip strength test. A standardized composite score for fitness was computed and divided into quintiles.
  
  
  
  Overall, the fitness tests presented inverse associations with the total BDI-II score (P < 0.05). The patients in the highest fitness quintile had 8.4% lower depressive symptoms than the patients in the lowest fitness quintile (P = 0.014). The odds of severe symptoms of depression were between 3.7% and 16.9% lower for each performance unit in the back-scratch, handgrip, arm-curl, and eight-feet up-and-go tests. When all the fitness tests were simultaneously considered, the back-scratch test was the only one independently associated with the total BDI-II score (P = 0.001; R(2) = 0.023).
  
  
  
  Although higher physical fitness was generally associated with lower symptoms of depression in women with FM, the observed associations were somewhat weak and inconsistent, differing from those previously observed in healthy adults. Further research to determine the clinical relevance of the association between physical fitness and depression in FM is warranted.
authors.affiliation: *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; asm@ugr.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Soriano-Maldonado
authors.affiliation: *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;
authors.forename: Fernando
authors.initials: F
authors.lastname: Estévez-López
authors.affiliation: Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain; *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain;
authors.forename: Víctor
authors.initials: V
authors.lastname: Segura-Jiménez
authors.affiliation: Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Spain; Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands;
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Aparicio
authors.affiliation: *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain;
authors.forename: Inmaculada C
authors.initials: IC
authors.lastname: Álvarez-Gallardo
authors.affiliation: *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain;
authors.forename: Manuel
authors.initials: M
authors.lastname: Herrador-Colmenero
authors.affiliation: *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain;
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.affiliation: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Marius
authors.initials: M
authors.lastname: Henriksen
authors.affiliation: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Kirstine
authors.initials: K
authors.lastname: Amris
authors.affiliation: *Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain;
authors.forename: Manuel
authors.initials: M
authors.lastname: Delgado-Fernández
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010809:Physical Fitness
keywords: Chronic Pain; Depression; Exercise; Pain Management; Physical Function; Quality of Life