Future

Future high throughput screening compounds studies could also evaluate the concurrent validity of submaximal exercise tests, compared to maximal tests, in people with chronic pain, fibromyalgia and chronic

fatigue disorders. However, the lack of studies of maximal testing of people with chronic pain, fibromyalgia and chronic fatigue disorders may be due to difficulties with such tests.27 Concurrent validity with other physiological measures, such as heart rate variability could also be investigated. Heart rate variability is related to emotional arousal48 and might be important in the assessment of physical capacity in this population. In conclusion, there is moderate evidence of the reliability, validity and acceptability of the evaluated submaximal exercise tests in people with chronic pain, fibromyalgia and chronic fatigue disorders. There is no evidence, however, about maximal exercise tests in this population. What is already known on this topic: Guidelines recommend graded activity in the treatment of chronic pain, fibromyalgia and chronic fatigue disorders. Self-reports of physical disability often do not correlate with pain severity, so objective assessment 3-MA cost of physical capacity is recommended. What this study adds: Although little is known

about maximal exercise tests in this population, moderate evidence exists that several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia and chronic fatigue disorders. eAddenda: Appendices 1 and 2 can be found online at doi:10.1016/j.jphys.2014.06.011 Ethics approval: Nil. Competing interests: There are no conflicts of interests. Source(s) of support: No sources of support. Acknowledgements: We are grateful to our friends, family and colleagues. Correspondence: Julia Ratter, Physiotherapy,

Hospital Rivierenland Tiel, The Netherlands. Email: [email protected]
“Physical activity has a range of physical and psychological health benefits for people of all ages.1 Structured Carnitine dehydrogenase exercise programs are a type of physical activity and have been found to be beneficial in older people. Carefully designed, structured exercise programs can prevent falls,2 increase muscle strength3 and enhance balance in older people.4 The benefits of exercise depend on continued participation; however, a change in lifestyle to include regular exercise is difficult for many people of all ages. Older adults have more co-morbidity, less social support, and more disability and depression than the general population; these factors have all been associated with lower exercise adherence in people with particular health conditions.5 and 6 Studies of exercise interventions in older people have demonstrated declining levels of adherence over time.

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