Adolescents with fibromyalgia who are physically active report lower levels of pain and disability

Led by researchers at Cincinnati Children's Hospital, this study is the first to use actigraphy-based physical activity monitoring to measure the relationship of pain, perceived functional impairment and depressive symptoms in adolescents with juvenile primary fibromyalgia syndrome (JPFS). For the research, 104 adolescents ages 11-18 were fitted with hip-mounted actigraphs for one week. The battery-powered device measures the amount and intensity of human physical activity.

The research objectives were to measure physical activity levels in adolescents with JPFS, examine differences and characteristics of high and low activity subjects, and explore the impact of psychiatric disorders on physical activity. The objective activity measurements were intended to address concerns about the reliability of self reports on the impact of pain on physical activity, and validate observations that some JPFS patients remain vigorously active while enduring significant pain.

Results showed that adolescents with JPFS did not engage in physical activities and aerobic exercise at levels recommended by their physicians. Just 23 percent of the subjects participated in 30 minutes of daily moderate-to-vigorous physical exercise, and only one adolescent engaged in 60 minutes of exercise every day. Low levels of exercise in these patients are troubling to clinicians who view exercise as a major component for improved pain management.

Another key finding was that higher pain intensity ratings were not significantly associated with lower levels of activity in the group as a whole. The authors noted that adolescents with JPFS have other symptoms that may diminish interest in physical activity, such as fatigue and impaired sleep. The authors also noted that higher pain levels in the least active group may be related to their decreased activity or vice versa.

Further, the inactive group had higher levels of depressive symptoms and functional disability, according to parent reports. However, in the small number of JPFS patients who maintained very high levels of physical exercise, the reported pain levels were lower than the inactive group, perhaps due to exercising, and their parents reported they had lower depressive symptoms and disability than inactive subjects.