FUNCIONALIDADE E SARCOPENIA EM MULHERES COM FIBROMIALGIA SEGUNDO NÍVEL DE ATIVIDADE FÍSICA

Abstract

Introduction: Fibromyalgia is a chronic condition of unknown cause, characterized by widespread pain sensitivity and fatigue. There is evidence that fibromyalgia, regardless of age, causes harm to the individual's physical functional performance. Furthermore, it is known that sarcopenia and the level of physical activity can interfere with physical functional performance; however, to date, there is a lack of studies evaluating the association of these variables in individuals with fibromyalgia. Objective: To evaluate and compare physical functional performance and secondary sarcopenia in women with and without fibromyalgia according to their level of physical activity. Methods: Cross-sectional study, carried out at the Integrated School Clinic of the Federal University of Mato Grosso do Sul (CEI/UFMS). The sample was composed of 50 women aged between 20 and 50 years, divided into two groups, fibromyalgia (GF; n= 25) and control (GC; n= 25), matched by age. The participants were evaluated regarding the practice of physical activity (PA) through self-report using the International Physical Activity Questionnaire - IPAQ short version, and by objective method through the use of a pedometer. The combination of the results of the objective and subjective assessments of physical activity (IPAQ and pedometer) was used to classify the PA level of the CG and GF participants into active and inactive (inactive GC; active GC; inactive GF; active GF). Physical functional performance was assessed using WHODAS 2.0. To assess the occurrence of sarcopenia, all participants were evaluated for muscle strength through the five repetition sit-to-stand test (5STS), appendicular skeletal muscle mass (ASMM) through bioimpedance analysis (BIA) and physical performance through the Timed-Up and Go Test (TUG Test). The symptomatology of the disease was assessed using the Fibromyalgia Impact Questionnaire - QIF and the assessment of pain intensity measured using the Numerical Rating Scale (NRS). Ethical Aspects: Research protocol approved under protocol nº 5.265.046 and CAAE nº 53942021.4.0000.0021. Results: There was no difference in total energy expenditure calculated from self-reported physical activity between the GC and the GF, but there was a lower participation of the GF in vigorous physical activity (GC: 800(120-1440); GF: 0(0-960), p=0.029). There was no significant difference between groups for physical activity objectively assessed using a pedometer (GC: 7349±3278; GF: 5700±3147 steps/day, p= 0.07). The occurrence of pre-sarcopenia was significantly higher in the fibromyalgia group (60%) than in the control group (8%; p<0.001). However, there was no occurrence of sarcopenia and severe sarcopenia in any of the groups. The GF had worse level of disability, between moderate and severe (GC:14±10; GF:54±23, p<0.001), lower muscle strength (GC:10±3; GF: 17,5±6,5; p<0.001), and worse functional capacity (GC: 6.5±0.8; GF: 9.0±2.5, p<0.001) when compared to the CG. After subdividing the groups by PA level (IPAQ and pedometer), we found that fibromyalgia, as an independent factor, significantly worsened the 5STS, TUG Test and WHODAS variables. There was no significant interaction between disease and physical activity level for any of the variables. The level of AF, as an isolated factor, significantly influenced only the phase angle variable in the bioimpedance analysis. We observed a moderate and significant correlation between physical functional performance and aspects related to sarcopenia, such as muscle strength (r= 0.720, p<0.001) and physical performance (r= 0.714, p<0.001). Conclusion: Adult women with fibromyalgia have worse functioning and a higher occurrence of pre-sarcopenia when compared to women without fibromyalgia of similar age. The PA level, as an isolated factor, did not influence muscle strength, muscle mass and physical functional performance in both groups.