Exercise Interventions and Dietary Advice in Fibromyalgia and IBS

Fibromyalgia symptom assesment

To evaluate the effectiveness of an exercise intervention on IBS symptoms as measured by a change in the Fibromyalgia Impact Questionnaire, modified version (FIQ-R) scores from baseline. The FIQ serves as a tool for assessing and evaluating the condition of patients with fibromyalgia (FM) and tracking their progress and outcomes. Specifically designed to gauge the aspects of health status most impacted by FM, the FIQ comprises ten items. The initial item consists of 11 questions about physical functioning, each rated on a 4-point Likert-type scale. The subsequent items (2 and 3) prompt patients to indicate the number of days they felt well and the days they were unable to engage in work or housework due to FM symptoms. Items 4 through 10 feature horizontal linear scales with ten increments, allowing patients to rate work difficulty, pain, fatigue, morning tiredness, stiffness, anxiety, and depression.

IBS symptoms assessment

To evaluate the effectiveness of an exercise intervention on IBS symptoms as measured by a change in the IBS-Symptom Severity Scale (IBS-SSS) questionnaire score from baseline. The IBS-SSS is a validated questionnaire for gastrointestinal symptoms and provides a global measure of symptom severity by assessing five items ("severity of abdominal pain", "frequency of abdominal pain", "severity of abdominal distension", "dissatisfaction with bowel habits", "impact of symptoms on quality of life") on a visual analog scale. The values of the five items are added together to give a total score between 0 and 500. Cases are then classified as 'mild' (75 to 175), 'moderate' (175 to 300) and 'severe' (\>300).

Physical Fitness assessment

Field tests to assess participants' physical fitness include the 2 km Walk Test, which evaluates cardiovascular fitness by recording heart rate and walking time before and after the test. The Six-Minute Walk Test measures aerobic fitness and functional capacity, requiring participants to walk as far as possible in 6 minutes, with heart rate monitored and exertion assessed using the Borg Scale. The Hand Grip Test assesses maximum hand and forearm strength using a dynamometer, with three tests per hand and the average recorded. The Sit and Reach Test measures flexibility in the back and legs, recording the best of two attempts. The 30-second Sit to Stand Test evaluates lower limb strength and endurance by counting the number of complete sit-to-stand movements in 30 seconds without using arms for support. The Step Test assesses cardiovascular endurance and lower limb function by having participants repeatedly step onto a standard-height step for 3 minutes, with recovery heart rate record

Psychological Assessment:

The Symptom Checklist (SCL)-90-R questionnaire will evaluate the psychological profile The Symptom Checklist-90-Revised (SCL-90-R) is a widely employed self-report questionnaire in clinical and research settings. It aims to evaluate diverse psychological symptoms and distress in individuals. Comprising 90 items, the SCL-90-R addresses dimensions of psychological well-being and psychopathology, including somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Respondents use a Likert scale ranging from 0 (not at all) to 4 (extremely) to rate the extent of their experience with each symptom over a specified timeframe, typically the past week. This questionnaire offers a comprehensive profile of an individual's psychological symptoms, aiding in identifying areas of distress or dysfunction.

Evaluation of Barrier Peptide Integrity

Zonulin, I-FABP, DAO, and D-lactate assays will be performed using commercially available ELISA assays for each peptide.

Intestinal microbiota analysis

Any differences in the intestinal microbial population in the different disease patterns considered will be evaluated using appropriate genetic and molecular investigations (Illumina/Solexa Genetic Analyzer HiSeq) on the patient's stool samples.