Effectivity of virtual reality physical exercise program in brain and motor aging in fibromyalgia

1. Health related quality of life is measured using EQ-5D-5L and Whoqol – Brief questionnaires at baseline and 24 weeks
2. Impact of fibromyalgia is measured using Fibromyalgia Impact Questionnaire (FIQ) and its revised version, the FIQ-R at baseline and 24 weeks
3. Cost-effectiveness is measured using EQ-5D-5L and Whoqol – Brief questionnaires at baseline and 24 weeks
4. Activities of daily living and physical fitness (with and without dual-task) are measured at baseline and 24 weeks by:
4.1. Lower limb strength using 30s chair stand test and the 10-step stair climbing test with and without carrying a load
4.2. Hand-grip strength using a grip-strength dynamometer (TKK 5401 Model)
4.3. Aerobic endurance using the Canadian Aerobic Fitness Test and 6 min walking
4.4. Upper body strength using the “Arm Curl Test”
4.5. Balance using Biodex Balance System. This device measures, in degrees, the tilt about each axis during static and dynamic conditions and calculates a mediolateral stability index, an anteroposterior stability index, and an overall stability index
4.6. Chair sit-and-reach and Back scratch to evaluate upper and lower body flexibility
4.7. Cognitive tasks tested using a wireless motion capture device "Functional Assessment of Biomechanics (FAB)" and a wireless electroencephalography (EEG) system (Enobio, Neuroelectrics) in order to assess the motor and brain pattern of the activities of daily living
5. Electrical activity and volumes of important structures of the brain measured at baseline and 24 weeks by:
5.1. Electrical activity at rest using Enobio (Neuroelectrics, Cambridge, MA, USA)
5.2. Volumes of structures such as hippocampus or pineal gland using Magnetic Resonance Imaging (MRI)

1. Cognitive impairment is measured using the Mini-Mental State Examination (MMSE) and executive function with the Stroop test at baseline and 24 weeks
2. Psychophysiological response to daily life activities is measured using EEG register while they are watching a video where people are doing different daily activities with and without pain at baseline and 24 weeks
3. Pain-related fear measured using the Tampa Scale for Kinesiophobia (TSK- 11SV) at baseline and 24 weeks
4. Cortisol and melatonin levels are measured using saliva samples at baseline and 24 weeks
5. Pain is measured using the Visual Analog Scale (VAS) and with an algometer on the fibromyalgia-specific tender points at baseline and 24 weeks
6. Depression is assessed using the Geriatric Depression Scale (GDS) at baseline and 24 weeks
7. Body composition is measured using a bioelectrical impedance analysis (Tanita BC-415) and waist to hip ratio at baseline and 24 weeks
8. Perceived effort using a Borg Scale is measured at each session (after finishing each session)
9. Drug treatment is measured using questionnaires at baseline and 24 weeks
10. Cost-effectiveness analysis is measured using the number of visits to the health care system in the last six months at baseline and 24 weeks
11. Self-reported work absence is assessed by a single question asking the number of days that participants had to miss work in the last 6 months at baseline and 24 weeks
12. Fear of falling will be assessed with a VAS from 0 (no fear) to 100 (extreme fear) and using the FES-I questionnaire at baseline and 24 weeks
13. Number of falls are recorded as the self-reported number of falls in the last year and in the last six months at baseline and 24 weeks
14. Volume of physical activity in their free time is measured using the international physical activity questionnaire (IPAQ) at baseline and 24 weeks
15. Covariables are measured at baseline and 24 weeks using:
15.1. Sociodemographic variables: gender, age, education level, profession, income level, religiosity, postal code and familiar situation.
15.2. Other diseases
15.3. Current treatment and therapies, years since diagnosis of FM and years since the first symptoms
15.4. Current pain “at today”
16. Sleep quality, latency, duration, efficiency, disturbances, use of sleep medication is measured using the Pittsburgh Sleep Quality Index at baseline and 24 weeks
17. Health habits are assessed using the EUROPALIQ questionnaire at baseline and 24 weeks