PHYSICAL ACTIVITY AND DEPRESSION IN FIBROMYALGIA Shayna McDaniel

PHYSICAL ACTIVITY AND DEPRESSION IN FIBROMYALGIA Shayna McDaniel

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
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
populationsPurpose
Evidence about the impact of PA on
To compare effect of self-reported PA
FM
depressive
symptoms
is
levels on depressive symptoms in FM
inconsistent
subjects
age 50 and above with agematched healthy persons

Methods
Data (2014) from longitudinal/observational
study examining cognitive and physical
performance in adults 50+ with/without FM

0-13

Minimal
depression

14-19

Mild
depression

Sample

20-28

Moderate
depression

Beck Depression II
Inventory Scores

92 participants, 47 with FM, 45 without

29-63

Functionally independent, communitydwelling

Assess relationship between PA and
depressive symptoms in both
cohorts

Definition

Examples

Light

Heart beats slightly
faster than normal (can
still talk and sing)

Walking leisurely,
stretching, vacuuming

Moderate Heart beats faster than Fast walking, aerobics
normal (can still talk but class, strength
not sing)
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)

Sedentary

Rarely or never do any PA

Underactive

Some light or moderate PA, not every week

Underactive, light

Some light PA every week

Beck Depression II Inventory (BDI-II)
Active
30 min/day of moderate PA, 5 days/week
21-items rated on a 4-point
(or) 20 min/day of vigorous PA, 3 days/week
scale
Rapid Assessment of Physical Activity
(RAPA)
Results
9-item questionnaire
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) = -6.535, p < .0001. 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 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 (University of Washington Health Promotion Research Center, 2006) Mean Depression Scores and Physical Activity Levels: FM and Non-FM Cohorts 30 Mean Depression Scores and Physical Activity Level in Both Cohorts Combined 29 30 25 20 18.13 15.8 15 13.25 10 12.27 Non-FM 8.5 4.6 5 0 d Se e ry a nt d Un ve ti ac r e FM 4.75 ... g re , , ve ve ti ti ac ac r r e d de n n U U Level Physical Activity t h g li 4.55 ve ti Ac Mean BDI-II Depression Scores Compare levels of PA between healthy adults > 50 and those with
FM

Level

Rapid Assessment of Physical Activity (RAPA) Scoring

Measures

Mean BDI-II Depression Scores

Compare severity of depressive
symptoms in people > 50 with FM
with a healthy cohort

Rapid Assessment of Physical Activity PA Levels

Severe
depression

(Beck, Steer, & Brown, 1996)

25

Specific Aims

Conclusion

20
15
10
5
0

Physical Activity Level

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

Implications

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

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