Physical fitness is associated with anxiety levels in women with fibromyalgia: the al-Ándalus project

PURPOSE: 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).

CONCLUSION: 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.