Effects of Aquatic Exercises for Women with Rheumatoid Arthritis: A 12-Week Intervention in a Quasi-Experimental Study with Pain as a Mediator of Depression.

BACKGROUND: Rheumatoid arthritis (RA) is characterized by low physical fitness, pain, and depression. The present study aimed to examine the effects of a supervised aquatic exercise program on physical fitness, depression, and pain in women with RA and determine whether decreases in pain mediate depression. METHODS: Forty-three women with RA, divided into an experimental group (EG; n = 21) and a control group (CG; n = 23), participated in a 12-week exercise program. Treatment effects were calculated via standardized difference or effect size (ES) using ANCOVA adjusted for baseline values (ES, 95% confidence interval (CI)). A simple panel of mediation was executed to determine whether changes in pain mediated improvements in depression after controlling for confounding variables, such as age, physical activity, and body mass index (BMI). RESULTS: The aquatic exercise program had trivial and small effects on physical fitness, large effects on pain, and moderate effects on depression. The mediation model confirmed the indirect effect of pain on the decrease of depression in the participants of the aquatic exercise program. CONCLUSIONS: Participants with RA in the aquatic exercise program experienced improvements in physical fitness, depression, and joint pain. Moreover, the improvements in joint pain mediated improvements in depression.

High Fragmented Physical Activity as an Early Risk Indicator of Frailty and Mortality in Adults Aged 50 Years and Over.

INTRODUCTION: This study aimed to explore the associations of activity fragmentation with frailty status and all-cause mortality in a representative US sample of people 50 years and over. METHODS: This prospective study used data from the 2003-2006 waves of the National Health and Nutrition Examination Survey (NHANES). Participants 50 years or over were included in the study (n = 2,586). Frailty status was assessed using a valid modification of the Fried criteria. Linked data from the National Death Index registry were used to ascertain mortality. Physical activity fragmentation was measured by accelerometry. To calculate activity fragmentation, an active-to-sedentary transition probability was calculated as the number of physical activity bouts divided by the total sum of minutes spent in physical activity. Age, gender, ethnicity, education, mobility issues, drinking status, smoking status, BMI, and self-reported chronic diseases were reported in the NHANES study. RESULTS: An increment of 1 SD in activity fragmentation was associated with an increased likelihood of frailty (odds ratio [95% confidence interval] = 1.36 [1.13-1.664]). Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity and low activity fragmentation/high physical activity categories were associated with a lower likelihood of frailty. We found a nonlinear association between activity fragmentation and all-cause mortality. Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity, low activity fragmentation/high physical activity, and high activity fragmentation/high physical activity categories were associated with a lower mortality risk. Participants with a low fragmented activity pattern may also overcome some of the detrimental effects associated with sedentary behavior. CONCLUSIONS: Our results suggest that a high fragmented physical activity pattern is associated with frailty and risk of mortality in adults and older adults. This association was independent of total volume of physical activity and time spent sedentary.

Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study.

(1) Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon's index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power.

Normative Values for the Short Physical Performance Battery (SPPB) and Their Association With Anthropometric Variables in Older Colombian Adults. The SABE Study, 2015.

Background: The short physical performance battery (SPPB) is a physical performance test of lower extremity function designed for non-disabled older adults. We aimed to establish reference values for community-dwelling Colombian adults aged 60 years or older in terms of (1) the total score; (2) the three subtest scores (walking speed, standing balance performance, and five times sit-to-stand test); and (3) the time to complete the five times sit-to-stand test, s and the walking speed test. Additionally, we sought to explore how much of the variance in the SPPB subtest scores could be explained by anthropometric variables (age, body mass, height, body mass index, and calf circumference). Methods: Participants were men and women aged 60 years or older who participated in the Health and Well-being and Aging Survey in Colombia, 2015. A sample of 4,211 participants (57.3% women) completed the SPPB test, and their anthropometric variables were evaluated. Age-specific percentiles were calculated using the LMS method (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles). Results: The mean SPPB total score for the entire sample was 8.73 (2.0) points. On average, the total SPPB score was 0.85 points greater in men than in women (p < 0.001). Significant sex differences were observed in all three age groups tested (60-69, 70-79, and 80+ years). In the full sample, our findings suggested that age, body mass, height, body mass index, and calf circumference are significant contributors to walking speed (p < 0.001) after controlling for confounding factors, including ethnicity, socioeconomic status, and urbanicity. Conclusions: Percentile values are of interest to identify target populations for primary prevention and to estimate the proportion of high or low values for SPPB measures in community-dwelling Colombians aged at least 60 years.

Effects of an exercise program linked to primary care on depression in elderly: fitness as mediator of the improvement.

PURPOSE: The present study aimed to analyse the effects of 12 months of participation in a public physical activity program linked to primary care on depression level and fitness, and to determine which fitness components were responsible for the improvement in depression using mediation analysis. METHODS: Participants of this program were 2768 middle-aged and older adults from 67 municipalities throughout the Spanish region of Extremadura. In the analysis only participants with depression and without any missing values for fitness variables were included. This sample was 303 for exercise group and 74 for control group. Socio-demographic data, Geriatric Depression Scale and some fitness tests were applied at baseline and 1 year later. Exercise group performed the program 3 days/week for 50-60 min per session involving brisk walking with intermittent flexibility, strength and balance activities/exercises. Socializing within the group was encouraged in all sessions. Data analysis included analysis of covariance, chi-squared and effect size statistics. Additionally, a parallel model of mediation analysis was performed to determine the indirect effect of the participation in the exercise program on depression through improvements in fitness. RESULTS: A considerable reduction from mild, moderate or severe depression to non-depression were obtained for exercise group (68%) P-value < .05. The parallel mediation analysis showed that flexibility (sit-and-reach [ß - 0.04 (- 0.07 to - 0.01)], back scratch [ß - 0.06 (- 0.12 to - 0.02)]) and cardiorespiratory fitness (6-min walk [ß - 0.09 (- 0.15 to - 0.04)]) were mediators of the reduction in depression. CONCLUSION: This exercise program was effective in improving depression in older adults. Integrating aerobic and flexibility exercises in a group-based program of physical activity programs could improve the severity of depression in this population.

Fitness as a Mediator of the Enhancement of Quality of Life after a 6-Months Exercise Program.

Purpose: The study aimed to test whether improvement in fitness components, mediates the changes in Health-related Quality of Life (HRQoL) after exercise intervention in overweight and obese children. Methods and design: 170 obese and overweight children (121 exercise group and 49 control group) participated in a public exercise program based on sports practice for 6 months, 2 h per week. Anthropometry, physical fitness, and HRQoL were measured. Magnitude-based inferences and Cohen's effect size were performed to analyze the program effect. To know which physical fitness components mediated the improvement on children's HRQoL, multiple mediation analyses were performed. Results: the analysis showed a moderate effect on some fitness components and a moderate and small effect on HRQoL. The improvement of agility or cardiorespiratory fitness showed a significant indirect effect on the enhancements in some HRQoL dimensions. Conclusion: after a 6-months exercise program in overweight and obese children, all physical fitness components improved, being responsible for the improvement of the HRQoL, agility and cardiorespiratory fitness.

Gait speed moderates the adverse effect of obesity on dependency in older Colombian adult.

INTRODUCTION: Gait speed worsens with the presence of obesity, and is a powerful marker of functional dependence. Accordingly, gait speed could be a factor that improves or worsens the relationship between obesity and dependence in activities of daily living (ADL). However, to date this potential role has not been examined and the minimum gait speed threshold in the relationship between obesity and ADL is not known. The aim of this study was to determine whether speed moderates the association between obesity and dependence in ADL, and also define the gait speed threshold of this relationship. METHODS: A total of 20,507 community-dwelling older adults from a cross-sectional analysis of national survey data - the Colombian Health, Well-being and Aging study (SABE, 2015) - were surveyed. The research data were collected using structured questionnaires, including basic information, ADL measured using the Barthel Index, body mass index, and gait speed (3 m). The Johnson-Neyman technique was applied to determine the gait speed threshold adjusted for age, sex and comorbidities. RESULTS: Regression analysis showed a significant detrimental effect of obesity on dependence in ADL, which was moderated by gait speed (ß = 0.081; 95%CI: 0.045 to 0.117; p < 0.001). Adjusted for major covariates, the Johnson-Neyman technique defined two gait speed thresholds: < 0.77 m/s, indicating an aggravated adverse effect; and >1.06 m/s, indicating a positive effect. CONCLUSIONS: The adverse effect of obesity on dependence in ADL is moderated by gait speed. Considering these thresholds, the distribution of older adults in each of the proposed areas of significance were: below 0.77 (m/s) = 14,324 (70.0%), above 1.06 (m/s) = 1553 older adults (7.5%) and between areas = 4630 older adults (22.5%).

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living.

BACKGROUND: Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. METHODS: A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to 'SABE Survey 2015'. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). RESULTS: Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and non-sarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (ß = -0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect (-0.009 to -0.004). CONCLUSIONS: The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia.

EQ-5D-Y-5L: developing a revised EQ-5D-Y with increased response categories.

PURPOSE: EQ-5D-Y is a generic measure of health status for children and adolescents aged 8-15 years. Originally, it has three levels of severity in each dimension (3L). This study aimed to develop a descriptive system of EQ-5D-Y with an increased number of severity levels and to test comprehensibility and feasibility. METHODS: The study was conducted in Germany, Spain, Sweden and the UK. In Phase 1, a review of existing instruments and focus group interviews were carried out to create a pool of possible labels for a modified severity classification. Participants aged 8-15 rated the severity of the identified labels in individual sorting and response scaling interviews. In Phase 2, preliminary 4L and 5L versions were constructed for further testing in cognitive interviews with healthy participants aged 8-15 years and children receiving treatment for a health condition. RESULTS: In Phase 1, a total of 233 labels was generated, ranging from 37 (UK) to 79 labels (Germany). Out of these, 7 to 16 possible labels for each dimension in the different languages were rated in 255 sorting and response scaling interviews. Labels covered an appropriate range of severity on the health continuum in all countries. In Phase 2, the 5L version was generally preferred (by 68-88% of the participants per country) over the 4L version. CONCLUSIONS: This multinational study has provided a version of the EQ-5D-Y with 5 severity levels in each dimension. This extended version (EQ-5D-Y-5L) requires testing its psychometric properties and its performance compared to that of the original EQ-5D-Y-3L.

Fitness as mediator between weight status and dimensions of health-related quality of life.

BACKGROUND: There is evidence that overweight and obesity in children is associated with poor Physical Fitness and consequently lower Health-related Quality of Life (HRQoL). However, this linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Therefore, need to know, through mediation analysis, how operate the Physical Fitness between weight status and HRQoL dimensions. PURPOSE: The aim of this study was to determine which HRQoL dimensions are mediated through Physical Fitness in obese (including overweight) and normal weight children. The study also examined the association between Physical Fitness, Body Mass Index (BMI) and HRQoL. METHODS: A total of 233 overweight/obese children and 105 normal-weight children participated in the study. Children were recruited from public educational centers and a public weight loss program. BMI, Physical Fitness (upper limb, central body and lower limb strength; agility and range of motion) and HRQoL (PedsQL and VAS) were measured. Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status (normal weight or overweight/obesity) and HRQoL dimensions. \itionally, unequal-variances t statistics were executed to know differences in BMI, Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL. RESULTS: Our results, indicated association between the Physical Fitness z-score and HRQoL dimensions in overweight/obese children. Regarding to mediation analysis, the results showed that the negative association between overweight/obesity and HRQoL is softened by the level of Physical Fitness. Therefore Physical Fitness is a mediator in the relationship between overweight/obesity children and the most of dimensions of HRQoL, except the School functioning in boys and the School and Emotional functioning in girls. CONCLUSIONS: The negative effect of overweight or obesity on HRQoL inn children, is mitigated by Physical Fitness. Consequently, the Physical Fitness is a mediator on HRQoL in most dimensions, especially daily living, in schoolchildren.

Does anthropometric and fitness parameters mediate the effect of exercise on the HRQoL of overweight and obese children/adolescents?

BACKGROUND: There is sufficient evidence about the effects of physical exercise programs on health-related quality of life (HRQoL) in obese and overweight children. OBJECTIVES: The purpose of this study was to observe the effects on physical fitness and HRQoL in overweight and obesity children and their parents and find out whether the effect of intervention on anthropometric and physical fitness parameters mediated the improvements found in the proxies' perception of participant quality of life. METHODS: 151 overweight and obese children (106 intervention and 45 control) participated in a public exercise program. Anthropometrics characteristics, physical fitness, and HRQoL (EQ-5D-Y) were measured. Analysis of Covariance and effect size were performed to analyze the improvement. Mediation analyzed with bootstrap to observe whether anthropometric or physical fitness improvements mediate of the changes in the proxies' assessment of HRQoL. RESULTS: Significant improvements were found in waist circumference, physical fitness, and HRQoL. The improvement of waist circumference showed a significant indirect effect on the change in the proxy perception of quality of life. CONCLUSION: The reduction of waist circumference mediates the change on proxies' perception of quality of life and not by the improvement in physical fitness. TRIAL REGISTRATION: ISRCTN97887613.

Discrepancia en la evaluación de la calidad de vida relacionada con la salud entre niños y padres a través del cuestionario EQ-5D-Y / Parent-child discrepancy in the assessment of health-related quality of life using the EQ-5D-Y questionnaire

Introducción. La evaluación de la calidad de vida relacionada con la salud (CVRS) permite detectar cambios en el tiempo en la salud de pacientes y posibilita realizar un análisis de coste-efectividad de tratamientos. En niños con características especiales de salud que no pueden autoevaluarse, existe la posibilidad de evaluar su CVRS a través de padres o cuidadores. Hasta la fecha, no se ha analizado la discrepancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y entre niños con parálisis cerebral (PC) y sus padres. El objetivo del presente estudio fue analizar el grado de concordancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y y su versión Proxy entre niños con PC y sus padres o cuidadores. Población y métodos. Participaron, en el estudio, niños y adolescentes con PC, así como sus padres y madres, procedentes de un centro de educación especial de la región de Extremadura (España). Se utilizó el cuestionario EQ-5D-Y para los niños y el EQ-5D-Y Proxy para los padres. Las entrevistas fueron llevabas a cabo durante el primer trimestre de 2015. Se analizó la concordancia en las respuestas mediante el nivel de acuerdo con kappa de Cohen para las 5 dimensiones que componen el EQ-5D-Y y el coeficiente de correlación intraclase para la escala visual analógica. Resultados. Participaron 62 niños con PC con afectación leve y/o moderada de su capacidad funcional, sus padres y madres. Hubo una pobre concordancia en la evaluación de la CVRS entre niños y padres en todas las dimensiones del cuestionario (< 0, 20) y justo o pobre (< 0, 60) en la escala visual analógica. Conclusiones. Existe un alto desacuerdo en la evaluación de la CVRS entre padres e hijos en población con PC a través del cuestionario EQ-5D-Y.

Introduction. The assessment of health-related quality of life (HRQoL) serves to detect changes over time in patients' health status and allows to do a cost-effectiveness analysis of treatments. When children with special health features cannot perform a self-assessment, it is possible to assess their HRQoL through their parents or caregivers. To date, the discrepancy in the assessment of HRQoL using the EQ-5D-Y questionnaire among children with cerebral palsy (CP) and their parents has not been analyzed. The objective of this study was to analyze the level of agreement in the HRQoL assessment using the EQ-5D-Y questionnaire and its proxy version among children with CP and their parents or caregivers. Population and methods. Children and adolescents with CP, and their parents, from a special education school in the region of Extremadura (Spain) participated in the study. The EQ-5D-Y questionnaire was used for children and the EQ-5D-Y proxy version, for parents. Interviews were conducted in the first quarter of 2015. The level of agreement in the responses was analyzed using the Cohen's kappa coefficient for the five domains of the EQ-5D-Y and the intraclass correlation coefficient for the visual analogue scale. Results. Sixty-two children with CP and mild and/or moderate functional capacity impairment, and their parents, participated in the study. The level of agreement was poor in the HRQoL assessment between children and parents in all the questionnaire domains (<0.20) and fair or poor (<0.60) in the visual analogue scale. Conclusions. A high level of parent-child disagreement was observed in the HRQoL assessment in the population with CP using the EQ-5D-Y questionnaire.

Parent-child discrepancy in the assessment of health- related quality of life using the EQ-5D-Y questionnaire. / Discrepancia en la evaluación de la calidad de vida relacionada con la salud entre niños y padres a través del cuestionario EQ-5D-Y.

INTRODUCTION: The assessment of health-related quality of life (HRQoL) serves to detect changes over time in patients' health status and allows to do a cost-effectiveness analysis of treatments. When children with special health features cannot perform a self-assessment, it is possible to assess their HRQoL through their parents or caregivers. To date, the discrepancy in the assessment of HRQoL using the EQ-5D-Y questionnaire among children with cerebral palsy (CP) and their parents has not been analyzed. The objective of this study was to analyze the level of agreement in the HRQoL assessment using the EQ-5D-Y questionnaire and its proxy version among children with CP and their parents or caregivers. POPULATION AND METHODS: Children and adolescents with CP, and their parents, from a special education school in the region of Extremadura (Spain) participated in the study. The EQ-5D-Y questionnaire was used for children and the EQ-5D-Y proxy version, for parents. Interviews were conducted in the first quarter of 2015. The level of agreement in the responses was analyzed using the Cohen's kappa coefficient for the five domains of the EQ-5D-Y and the intraclass correlation coefficient for the visual analogue scale. RESULTS: Sixty-two children with CP and mild and/or moderate functional capacity impairment, and their parents, participated in the study. The level of agreement was poor in the HRQoL assessment between children and parents in all the questionnaire domains ( <0.20) and fair or poor ( <0.60) in the visual analogue scale. CONCLUSIONS: A high level of parent-child disagreement was observed in the HRQoL assessment in the population with CP using the EQ-5D-Y questionnaire.

INTRODUCCIÓN: La evaluación de la calidad de vida relacionada con la salud (CVRS) permite detectar cambios en el tiempo en la salud de pacientes y posibilita realizar un análisis de coste-efectividad de tratamientos. En niños con características especiales de salud que no pueden autoevaluarse, existe la posibilidad de evaluar su CVRS a través de padres o cuidadores. Hasta la fecha, no se ha analizado la discrepancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y entre niños con parálisis cerebral (PC) y sus padres. El objetivo del presente estudio fue analizar el grado de concordancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y y su versión Proxy entre niños con PC y sus padres o cuidadores. POBLACIÓN Y MÉTODOS: Participaron, en el estudio, niños y adolescentes con PC, así como sus padres y madres, procedentes de un centro de educación especial de la región de Extremadura (España). Se utilizó el cuestionario EQ-5D-Y para los niños y el EQ-5D-Y Proxy para los padres. Las entrevistas fueron llevabas a cabo durante el primer trimestre de 2015. Se analizó la concordancia en las respuestas mediante el nivel de acuerdo con kappa de Cohen para las 5 dimensiones que componen el EQ-5D-Y y el coeficiente de correlación intraclase para la escala visual analógica. RESULTS: Participaron 62 niños con PC con afectación leve y/o moderada de su capacidad funcional, sus padres y madres. Hubo una pobre concordancia en la evaluación de la CVRS entre niños y padres en todas las dimensiones del cuestionario (< 0,20) y justo o pobre (< 0,60) en la escala visual analógica. CONCLUSIONS: Existe un alto desacuerdo en la evaluación de la CVRS entre padres e hijos en población con PC a través del cuestionario EQ-5D-Y.

Fiabilidad de un test isométrico de rodilla en mujerescon fibromialgia mediante test-retest de 12 semanas / Reliability of an isometric knee test in women with fibromialgia using the 12-week test-retest

Propósito: El objetivo de este estudio fue analizar la fiabilidad del pico torque obtenido conun protocolo de valoración de la fuerza isométrica de flexores y extensores de rodilla.Material y método: Un total de 16 mujeres con fibromialgia (FM) (edad 54,9 ± 12,1) participaronen este estudio. El diseño consistió en un test-retest de 12 semanas de duración y laevaluación del pico torque isométrico se realizó con un dinamómetro isocinético (Biodexsystem 3). La evaluación consistió en 3 acciones máximas de contracción isométrica de losmúsculos extensores y flexores de rodilla. Se calcularon los índices de fiabilidad relativa(mediante coeficiente de correlación intraclase o CCI) y absoluta (mediante error estándarde medida o SEM y mínima diferencia real o SRD).Resultados y conclusión: El pico torque isométrico evaluado a través del dinamómetro isocinéticoes replicable tanto para los flexores como para los extensores de la rodilla. Este estudio muestradatos sobre el mínimo cambio real del pico torque en acciones isométricas de los extensoresy flexores de rodilla, que pueden ayudar en la interpretación de los resultados obtenidos enterapias basadas en actividad física, en personas con FM, de varias semanas de duración.

Objective: The aim of this study was to analyze the reliability of peak torque assessed using an isometric strength protocol of knee flexor and extensor muscles.Material and methods: A total of 16 women with Fibromyalgia (FM) (aged 54.9 ± 12.1) participated in this study. The design consisted of a 12-week test-retest, and isometric peak torque was assessed using an isokinetic dynamometer (Biodex system 3). The evaluation consisted of 3 maximal isometric contractions of knee extensor and flexor muscles. Relative intraclass correlation coefficient ICC) and absolute (standard error of measurement SEM and smallest real difference SRD) reliability indices were calculated.Result and conclusions: Isometric peak torque assessed using isokinetic dynamometer is reliable in knee flexor and extensor muscles. This study presents data on the smallest real difference of peak torque in isometric actions of knee flexor and extensor muscles, which can help interpreting results obtained in physical activity based therapies in individuals with FM of several weeks duration.