scholarly journals THE IMPACT OF 3 MONTHS OF SUPERVISED EXERCISE ON CHANGE IN FUNCTION: COMPARISONS BY ARTHRITIS STATUS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S34-S35
Author(s):  
Lauren M Abbate ◽  
Katherine Hall ◽  
Megan Pearson ◽  
Richard Sloane ◽  
Kelli D Allen ◽  
...  
Keyword(s):  
Physical Function ◽  
Upper Body ◽  
Lower Body ◽  
Time Points ◽  
Supervised Exercise ◽  
Mean Differences ◽  
The Impact ◽  
Usual Gait Speed ◽  
Minute Walk

Abstract Physical activity is an established intervention for the management of arthritis. This study evaluated the effect of 3 months of participation in Gerofit on physical function by arthritis status. Participants, 519 Veterans aged ≥ 65 years self-reported either no arthritis (NA) (49%), upper body arthritis (UB) (8.2%), lower body arthritis (LB) (12.7%), or both upper and lower body arthritis (UB&LB) (30.4%) upon enrollment. Physical function measures [10-meter usual gait speed (m/s) (GS), arm curls (AC), chair stands (CS), and 6-minute walk (yards) (SMW)] were assessed at baseline and follow-up. Mean differences between time points were calculated. At baseline, compared to NA, LB and UB&LB had slower GS (1.10 and 1.06 vs 1.13) and shorter SMW distance (468.8 and 448.8 vs 490.7). All groups tended to increase physical function, with greatest improvement among LB (GS=0.27, AC=2.06, CS=2.52, SMW=42.53). Participation in Gerofit is associated with functional gains, regardless of burden of disease.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

scholarly journals Supervised exercise rehabilitation in survivors of critical illness: A randomised controlled trial

2018 ◽  
Vol 20 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Ceri Battle ◽  
Karen James ◽  
Paul Temblett ◽  
Hayley Hutchings
Keyword(s):  
Hospital Discharge ◽  
Controlled Trial ◽  
Unit Length ◽  
Exercise Programme ◽  
Anxiety And Depression ◽  
Six Minute Walk Test ◽  
Supervised Exercise ◽  
Randomised Controlled ◽  
Minute Walk

Objectives To investigate the impact of a six-week supervised exercise programme on cardiopulmonary fitness, balance, muscle strength and anxiety and depression in patients who have been discharged home from hospital following an intensive care unit length of stay of greater than 48 h. To investigate patients' perceptions of a six-week supervised exercise programme delivered at three months post hospital discharge. Design A single centre parallel, randomised controlled trial. Setting Outpatient department of a university teaching hospital in the UK. Participants Sixty adult survivors of critical illness, at three months post-hospital discharge. Intervention A six-week individually prescribed and supervised exercise program, with associated advice to home exercise modification. Twice weekly exercise sessions were individualised to participant's functional status and included cardiopulmonary, balance and strengthening exercises. Follow up at seven weeks, six months and 12 months. Outcome measures Six-Minute Walk Test, BERG balance test, grip strength and Hospital Anxiety and Depression Scale. A pre-designed survey was used to explore patient perceptions of the programme. Results Sixty participants ( n = 30 received allocated programme in both control and treatment groups) were randomised. Loss to follow up resulted in n = 34 participants for intention to treat analysis at 12 months follow up (leaving n = 19 in control group, n = 15 in treatment group). Median participant age at enrolment was 62 years (interquartile range: 49–72), with a median intensive care unit length of stay of nine days (interquartile range: 4–17). No significant differences were found for the Six-Minute Walk Test at any time point ( p > 0.05). Anxiety levels and balance were significantly improved in the treatment group at 12 months ( p = 0.006 and p = 0.040, respectively). Conclusions Further research is needed into appropriate interventions and outcome measures, target patient populations and timing of such intervention post-hospital discharge.

scholarly journals What is the Responsiveness and Quality of Life “Utility” for PROMIS Outcomes in Foot and Ankle Patients Following Physical Therapy?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0036
Author(s):  
Christopher G. Neville ◽  
Judith F. Baumhauer ◽  
Jeff Houck
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Physical Function ◽  
Health State ◽  
Foot And Ankle ◽  
T Score ◽  
The Impact ◽  
Utility Scores

Category: Other Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes in quality of life. Methods: The PROMIS PF scale was available at the start and end of physical therapy treatment for 352 patients with foot and ankle ICD10 codes. PF was chosen as a good outcome measure to assess overall outcome from physical therapy care. Changes from baseline to post-care were examine using Cohen’s d to remove dependence on sample size and was interpreted as d=0.20 as a small effect, d=0.05 as a medium effect, and d=0.80 as a large effect. Using available isotonic regression with linear interpolation functions, health state utility scores were calculated from the PROMIS PF scores. These scores represent a health state between 0, representing ‘being dead’, and 1 being the utility of ‘full health’. This methodology has been shown to be reliable and valid for assessing overall health quality of life from changes in physical function. Repeated measures ANOVA models were used to compare outcomes across time. Results: A significant improvement (p<0.01) in PF scores was seen across the sample following physical therapy (PF t-score; baseline 38.6+-8.8; follow-up 45+-9.1). This change was associated with a moderate to large ES of 0.75. The average ES for those subjects with a starting t-score less than 45 (n=294) was 0.86 (large effect) while for those with a starting t-score of greater than 45 (n=58) was 0.27 (small effect). There was also a significant (p<0.01) improvement in utility scores following physical therapy (utility score; baseline 0.58+-0.2; follow-up 0.72+-0.2). Conclusion: There is a general improvement in reported physical function following physical therapy but the magnitude of this effect depends on baseline function. Lower function is associated with greater changes. Improvement in physical function was associated with an overall improvement in quality of life. The non-linear nature of utility scores suggests some patients may have large increases in quality of life with small changes in physical function.

Minimizing Variability in Interpretation Modality Among Spanish-Speaking Patients With Limited English Proficiency

2019 ◽  
Vol 18 (1) ◽  
pp. 32-39
Author(s):  
Seiichi Villalona ◽  
Christian Jeannot ◽  
Mery Yanez Yuncosa ◽  
W. Alex Webb ◽  
Carol Boxtha ◽  
...  
Keyword(s):  
Limited English Proficiency ◽  
English Proficiency ◽  
Cross Sectional ◽  
Time Points ◽  
Spanish Speaking ◽  
History Of ◽  
Vas Scores ◽  
Communication Modalities ◽  
The Impact

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.

Hemiparetic Positioning of Patients With Hemiplegia

2017 ◽  
Vol 10 (2) ◽  
pp. 129-134
Author(s):  
Rhonda Winegar ◽  
Helen Lach ◽  
Rebecca Lorenz ◽  
Debra Henderson
Keyword(s):  
Evaluation Criteria ◽  
Interdisciplinary Team ◽  
Functional Independence ◽  
Upper Body ◽  
Lower Body ◽  
Rehabilitation Hospital ◽  
Improved Outcomes ◽  
Written Materials ◽  
Functional Independence Measurement

Nature and scope of the project: Patients with hemiplegia may develop pain, decreased strength, sensation, and tone impacting functional ability of the affected arm when patients are not positioned correctly. The purpose of this quality improvement (QI) project was to evaluate improvements in the function of patients with hemiplegia in a rehabilitation hospital after implementing a hemiparetic positioning program. Project implementation: Education on hemiparetic positioning developed by an interdisciplinary team was offered to all nursing and therapy staff over a 1-month with follow-up and written materials. Evaluation criteria: The outcome measures for this project were Functional Independence Measurement (FIM) scores. Changes in FIM scores of patients hospitalized 3 months before the project were compared with a sample hospitalized after the project to see if outcomes improved. Outcomes: The sample consisted of 91 (pre-QI = 27, post-QI = 64) hospitalized patients with hemiplegia. All patients had significant improvements in FIM scores from admission to discharge. There were no significant differences observed between the groups on FIM change scores using Mann–Whitney U test: transfers from bed/chair/wheelchair (z = −.822, p = .411), upper body dressing (z = −.104, p = .917), lower body dressing (z = −1.120, p = .263), and toileting (z = −1.259, p = .208).

Minimal Residual Disease Assessed by NPM1 Mutation Specific RQ-PCR Is the Most Relevant Prognostic Parameter in NPM1-Mutated AML and Highly Useful to Guide Therapy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 698-698 ◽  
Author(s):  
Susanne Schnittger ◽  
Wolfgang Kern ◽  
Tamara Weiss ◽  
Claudia Tschulik ◽  
Frank Dicker ◽  
...  
Keyword(s):  
Minimal Residual Disease ◽  
Residual Disease ◽  
Npm1 Mutation ◽  
Time Points ◽  
Prognostic Parameter ◽  
Paired Samples ◽  
The Impact ◽  
Minimal Residual ◽  
Mutation Type

Abstract The aim of this study was to further evaluate the impact of minimal residual disease (MRD) in NPM1 mutated AML in comparison to other factors like FAB, cytogenetics, FLT3 mutations, NPM1 mutation type and age. In total 1002 samples of 219 NPM1 mutated (NPM1mut) patients (pts) were analysed at diagnosis, during, and after therapy. Pts were treated within different AML trials, and follow-up samples were referred to perform an NPM1 specific RQ-PCR for MRD. The cohort was comprised of 112 females and 107 males, median age was 58.8 years (range: 20–79 years). 207 had de novo AML (M0: n=5; M1: n=49; M2: n=55; M4=57; M5: n=28, M5: n=6; M7: n=1, nd: n=6), 4 s-AML and 5 t-AML. Cytogenetic data was available in 215 pts: 178 with normal (NK) and 37 with aberrant karyotypes (+4: n=4; +8: n=7; +21: n=2, two or more trisomies: n=4; -Y: n=4; del(7q): n=2; del(9q): n=3; del(20q): n=2; rare translocations: n=9). At diagnosis 87/219 pts (39.7%) had FLT3-ITDs in addition to the NPM1mut. FLT3-TKD status was available in 206 cases (14 mutated (6.7%) and 192 WT). The NPM1 mutation types were A (n=174), B (n=13), D (n=14), I: (n=4), L: (n=2), R: (n=4) and 8 with individual rare types. Univariate analysis for overall survival (OS) revealed unfavourable impact for age (p=0.049), and for FLT3-ITD (p=0.002), favourable impact for FLT3-TKD (p=0.046), and no impact for FAB, chromosomal aberrations or NPM1 mutation type. For MRD assessment for all 14 different NPM1 mutation types mRNA based RQ-PCR assays were established with sensitivities of 10,000–1,000,000. For each patient 2–17 samples (spls) were analyzed (median: 4) spanning a median follow up time of 252 days (range: 18–2347 days). Paired samples of diagnosis and relapse were available in 71 pts, in 8 pts also from second relapse. At relapse all cases had high NPM1 levels comparable to those at diagnosis. The FLT3-ITD status was mutated (+/+) at both time points in 25 pts and −/− in another 25 pts. 10 pts gained FLT3-ITD at relapse and 3 lost it. For 48 paired samples cytogenetics was available for both time points. A normal karyotype (NK) at both time points was detected in 36 pts, 7 cases showed a normal or aberrant karyotype (AK) at diagnosis and and AK at relapse (two of these gained additional aberrations at relapse), 2 different AK at both time points in were detected in 3 cases and a regression from AK to NK in 2 cases. These data show that NPM1 seems to be the primary genetic aberration in these cases and detection of NPM1 is more reliable to detect relapse than cytogenetics. To analyse the impact of NPM1 mutation levels on prognosis four different follow-up intervals were defined: interval 1: days 21–60 after start of therapy; interval 2: days 61–120; interval 3: days 121–365, 4: >365 days. First a set of 605 samples referred for analysis during first line treatment were analysed. Using Cox regression analysis a significant impact of MRD levels (as continuous variable) on EFS was detected for interval 2 (128 spls, p=0.008), interval 3 (214 spl; p<0.001), interval 4 (171 spls; p<0.001) but not for the early interval up to day 60 showing that early molecular response is not relevant for long time outcome. A multivariate analysis showed that MRD was the most significant prognostic parameter (p<0.001) (p-values for interval 3), followed by age (p=0.003), and pretreatment FLT3-ITD status (p=0.065). The same analysis was performed for a second set of 183 spls taken from 50 pts during salvage therapy after relapse. The most relevant interval for this group was between days 30–60 (26 spls; p=0.003). In a third set 87 spls from 28 pts after allogeneic bone marrow transplantation were analyzed. A prognostic impact of MRD could be shown for interval 2 (17 spls; p=0.005) and 3 (23 spls; p=0.006) (no samples from later intervals available). Of the total cohort 325 spls were analysed in parallel with RQ-PCR for NPM1 and genescan for the FLT3-ITD. A high correlation of both follow up markers was observed (r=0.807, p<0.001). Although the method for NPM1 detection is 3–4 log ranges more sensitive our data suggest parallel assessment for FLT3-ITD for high risk patients as many of them aquired FLT3-ITD as additional marker during progression. In conclusion, MRD is the most relevant prognostic marker in NPM1 mutated AML and it is a very useful tool to assess therapy response and to guide therapy.

scholarly journals Kung Fu Training Improves Physical Fitness Measures in Overweight/Obese Adolescents: The “Martial Fitness” Study

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Tracey W. Tsang ◽  
Michael R. Kohn ◽  
Chin Moi Chow ◽  
Maria Antoinette Fiatarone Singh
Keyword(s):  
Physical Fitness ◽  
Cardiovascular Fitness ◽  
Upper Body ◽  
Muscle Endurance ◽  
Lower Body ◽  
Obese Adolescents ◽  
Kung Fu ◽  
Body Muscle ◽  
Physical Measurements

Aim. To examine the efficacy of a six-month Kung Fu (KF) program on physical fitness in overweight/obese adolescents.Methods. Subjects were randomly assigned to the KF or sham exercise (Tai Chi, TC) control group. Physical measurements in cardiovascular fitness and muscle fitness occurred at baseline and after 6 months of training thrice weekly.Results. Twenty subjects were recruited. One subject was lost to follow-up, although overall compliance to the training sessions was46.7±27.8%. At follow-up, the cohort improved in absolute upper (P=.002) and lower (P=.04) body strength, and upper body muscle endurance (P=.02), without group differences. KF training resulted in significantly greater improvements in submaximal cardiovascular fitness (P=.03), lower body muscle endurance (P=.28; significant 95% CI: 0.37–2.49), and upper body muscle velocity (P=.03) relative to TC training.Conclusions. This short-term KF program improved submaximal cardiovascular fitness, lower body muscle endurance, and muscle velocity, in overweight/obese adolescents with very low baseline fitness.

Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery

2021 ◽  
pp. 107110072110078
Author(s):  
Peter Y. Joo ◽  
Judith F. Baumhauer ◽  
Olivia Waldman ◽  
Samantha Hoffman ◽  
Jeffrey Houck ◽  
...  
Keyword(s):  
Physical Function ◽  
Hallux Rigidus ◽  
Pain Interference ◽  
Measurement Information ◽  
Complication Rates ◽  
Time Points ◽  
Phone Survey ◽  
Patient Reported ◽  
The Mean

Background: Hallux rigidus is a common and painful degenerative condition of the great toe limiting a patient’s physical function and quality of life. The purpose of this study was to investigate pre- and postoperative physical function (PF) and pain interference (PI) levels of patients undergoing synthetic cartilage implant hemiarthroplasty (SCI) vs arthrodesis (AD) for treatment of hallux rigidus using the Patient-Reported Outcomes Measurement Information System (PROMIS). Methods: PROMIS PF and PI t scores were analyzed for patients who underwent either SCI or AD. Postoperative final PROMIS t scores were obtained via phone survey. Linear mixed model analysis was used to assess differences in PF and PI at each follow-up point. Final follow-up scores were analyzed using independent sample t tests. Results: Total 181 (59 SCI, 122 AD) operatively managed patients were included for analysis of PROMIS scores. Final phone survey was performed at a minimum of 14 (mean 33, range, 14-59) months postoperatively, with 101 patients (40 SCI, 61 AD) successfully contacted. The mean final follow-up was significantly different for SCI and AD: 27 vs 38 months, respectively ( P < .01). The mean age of the SCI cohort was lower than the AD cohort (57.5 vs 61.5 years old, P = .01). Average PF t scores were higher in the SCI cohort at baseline (47.1 and 43.9, respectively, P = .01) and at final follow-up (51.4 vs 45.9, respectively, P < .01). A main effect of superior improvement in PF was noted in the SCI group (+4.3) vs the AD group (+2) across time intervals ( P < .01). PI t scores were similar between the 2 procedures across time points. Conclusion: The SCI cohort reported slightly superior PF t scores preoperatively and at most follow-up time points compared with the arthrodesis group. No differences were found for PI or complication rates between the 2 treatment groups during this study time frame. Level of Evidence: Level III.

scholarly journals Prehabilitation for Frail Patients Undergoing Colorectal Surgery: Lessons Learnt From a Randomised Feasibility Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Claire Furyk ◽  
Siva Senthuran ◽  
Dia Nye ◽  
Yik H. Ho ◽  
Anthony S. Leicht
Keyword(s):  
Randomised Controlled Trial ◽  
Colorectal Surgery ◽  
Controlled Trial ◽  
Activity Level ◽  
Surgical Patients ◽  
Supervised Exercise ◽  
Frail Patients ◽  
Randomised Controlled ◽  
The Impact

There is substantial interest by clinicians to improve the health outcomes of older and frail patients following major surgery, with prehabilitation a potential and important component of future standard patient care. We studied the feasibility of a randomised controlled trial of pre-operative prehabilitation in frail patients scheduled for colorectal surgery in regional Australia. We conducted a single blind, parallel arm, randomised controlled trial in a regional referral centre where colorectal surgical patients aged over 50 were invited to participate and screened for frailty. Frail patients were randomised to undertake either a 4-week supervised exercise program with dietary advice, or usual care. The primary outcome was 6-min-walk-distance at baseline, pre-surgery (4 weeks later) and at follow-up (4–6 weeks post-operation). Secondary outcomes included physical activity level, health-related quality of life, and post-surgical complications. Feasibility outcomes were numbers of patients reaching each stage and barriers or reasons for withdrawal. Of 106 patients eligible for screening during the 2-year study period, only five were able to be randomised, of which one alone completed the entire study to follow-up. Fewer patients than expected met the frailty criteria (23.6%), and many (22.6%) were offered surgery in a shorter timeframe than the required 4 weeks. Physical and psychological aspects of frailty and logistical issues were key for patients declining study participation and/or not complying with the intervention and/or all outcome assessments. Feasibility for a large randomised controlled trial of prehabilitation for frail colorectal patients was poor (~5%) for our regional location. Addressing barriers, examination of a large, dense population base, and utilisation of a frailty-screening tool validated in surgical patients are necessary for future studies to identify the impact of prehabilitation for frail patients.

THU0470 EFFECT OF LAND AND WATER-BASED EXERCISE ON PHYSICAL FUNCTION IN WOMEN WITH FIBROMYALGIA: PRELIMINARY FINDINGS FROM THE AL-ÁNDALUS RANDOMISED CONTROL TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 472.1-472
Author(s):  
V. Segura-Jiménez ◽  
B. Gavilán Carrera ◽  
M. Borges Cosic ◽  
P. Acosta-Manzano ◽  
V. A. Aparicio ◽  
...  
Keyword(s):  
Physical Function ◽  
Cardiorespiratory Fitness ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Upper Body ◽  
Control Group ◽  
Lower Body ◽  
Exercise Interventions ◽  
Body Strength ◽  
Water Based

Background:Previous evidence has shown physical function (PF) improvements after physical exercise programs in fibromyalgia1. However, research comparing the efficacy of land vs. water-based programs is scarce.Objectives:This study aimed at comparing the effects of two exercise interventions (land- and water-based) on PF in patients with fibromyalgia.Methods:A total of 262 women were initially randomized and 152 (age:50.6 ±7.7 years) completed all the assessments with an attendance ≥70% (control n=62, land-based n=48, water-based n=42). The intervention groups trained three non-consecutive days/week (60 min/session) during 24 weeks. Every session consisted of exercises focused on improving cardiorespiratory fitness, muscle strength, and flexibility. Physical function components were assessed with the Functional Senior Fitness Test battery, and a standardized global PF index was calculated. Pre-, post- and re-test (12-week detraining) assessments were conducted. Groups did not differ in sex, sociodemographic characteristics, disease duration, drugs intake, and body mass index. Analysis of covariance was used to test the differences in changes from baseline (post-test vs. pre-test and re-test vs. pre-test) between groups using age, pain sensitivity, and baseline outcomes values as covariates.Results:Land- and water-based exercise groups improved lower body strength (mean difference; 95% confidence interval=2.8; 1.8, 3.8 and 1.7; 0.6, 2.8, respectively), upper body strength (4.8; 2.8, 6.8 and 3.5; 1.4, 5.6, respectively), and agility (-0.8; -1.2, -0.4 and -0.4; -0.8, -0.0, respectively) compared to the control group (all, P≤0.033). Additionally, land-based exercise group improved lower body flexibility and cardiorespiratory fitness compared to both the control (6.4; 2.8, 9.9 and 55.0; 31.0, 79.2, respectively) and water-based (5.4; 1.7, 9.2 and 37.5; 11.4, 63.6, respectively) groups (all, P≤0.002). Global PF improved in the land-based compared to the control group (0.4; 0.2, 0.5, P<0.001) and the water-based group (0.2; 0.0, 0.4, P=0.019). After the detraining period, land- and water-based groups maintained improvements in upper body strength (3.1; 1.2, 5.0 and 2.2; 0.1, 4.2, respectively) compared to the control group (all, P≤0.032). Land-based exercise group maintained improvements in lower body flexibility (5.1; 1.5, 8.8), lower body strength (1.7; 0.8, 2.6), agility (-0.6; -1.0, -0.3) and cardiorespiratory fitness (31.0; 6.8, 55.2) compared to control group (all, P≤0.007), and agility (-0.5; -0.9, -0.1) and cardiorespiratory fitness (40.2; 11.7, 68.7) compared to the water-based group (all, P≤0.014). The improvements in global PF were maintained in the land-based group compared to the control group (0.1; 0.0, 0.3, P=0.049).Conclusion:Land- and water-based exercise interventions are overall effective to improve PF in patients with fibromyalgia. However, the land-based exercise intervention presented greater effectiveness compared to the water-based exercise intervention. Improvements were overall sustained in the land-based group after a 12-week detraining period.References:[1]Macfarlane, G.J.; Kronisch, C.; Dean, L.E.; Atzeni, F.; Häuser, W.; Fluß, E.; Choy, E.; Kosek, E.; Amris, K.; Branco, J.; et al. EULAR revised recommendations for the management of fibromyalgia. Ann. Rheum. Dis. 2017, 76, 318–328.Acknowledgments:This study was supported by the Spanish Ministry of Economy and Competitiveness (I+D+i DEP2010-15639; I+D+I DEP2013-40908-R) and the Spanish Ministry of Education, Culture and Sport (FPU15/00002).Disclosure of Interests: :None declared

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