• Fernando Estévez-López, Víctor Segura-Jiménez, Inmaculada C Álvarez-Gallardo, Milkana Borges-Cosic, Manuel Pulido-Martos, Ana Carbonell-Baeza, Virginia A Aparicio, Rinie Geenen, and Manuel Delgado-Fernández.
• Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
• Rheumatology (Oxford). 2017 Nov 1; 56 (11): 2015-2024.

ObjectivesThe aim of this study was to identify subgroups in terms of adaptation to FM and to test differences in FM severity between these subgroups.MethodsThe al-Ándalus project made it possible to perform a comprehensive population-based cross-sectional study in 486 FM patients including multiple assessments of modifiable (could be targeted in therapy) resilience and vulnerability factors, measured by objective and subjective assessments, related to psychological and physical function. FM severity was assessed by means of FM impact (total score of the Revised Fibromyalgia Impact Questionnaire) and distress (Polysymptomatic Distress Scale of the modified 2011 preliminary criteria for FM). Exploratory factor analysis, cluster analysis and analysis of variance were conducted.ResultsFactor analysis yielded eight factors: three included objective measures (declarative memory, active lifestyle and objective physical fitness) and five included subjective measures (fatigue, psychological distress, catastrophizing, resilience and subjective physical fitness). Cluster analysis based on these eight factors identified five profiles: Adapted (16%), Fit (18%), Poor performer (20%), Positive (20%) and Maladapted (26%). Most profile comparisons revealed different levels of FM severity varying from Adapted (the most favourable profile) to Maladapted (the most unfavourable profile) with Fit, Poor performer and Positive obtaining intermediate positions.ConclusionsHeterogeneity of FM was shown by five clinically meaningful profiles of modifiable factors that were associated with FM severity. It is of clinical interest to examine whether these profiles are associated with FM prognosis and the effectiveness of interventions, which would enhance the development of customized interventions based on adaptation profiles in FM.© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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