Ganoderma lucidum improves physical fitness in women with fibromyalgia

Abstract

Introduction: Fibromyalgia is a chronic disease characterized by generalized pain, stiffness, poor physical conditioning, non-restorative sleep and poor health-related quality of life. Ganoderma lucidum a type of mushroom that has demonstrated several benefits in different populations. Ceratonia siliqua is a natural therapy rich in antioxidants with potential benefits on health.
Objective: to evaluate the effects of 6-week treatment of Ganoderma lucidum and Ceratonia siliqua on physical fitness in patients suffering from fibromyalgia.
Methods: Sixty-four women with fibromyalgia participated in the study. They took 6g of Ganoderma lucidum or Ceratonia siliqua per day for 6 weeks. Different fitness tests were selected in order to evaluate functional capacity.
Results: After the 6-week treatment period, Ganoderma lucidum significantly improved aerobic endurance, lower body flexibility, and velocity (p<.05). No significant improvement in any physical test was observed in the Ceratonia siliqua group.
Discussion and conclusion: Ganoderma lucidum may improve physical fitness in women with fibromyalgia, whereas, Ceratonia siliqua seemed to be ineffective at increasing physical fitness. These results may indicate that Ganoderma lucidum might be a useful dietary supplement to enhance physical performance of the patients suffering from fibromyalgia.

Full text

2126
Nutr Hosp. 2015;32(5):2126-2135
ISSN 0212-1611 • CODEN NUHOEQ
S.V.R. 318
Original / Alimentos funcionales
Ganoderma lucidum improves physical fitness in women with fibromyalgia
Daniel Collado Mateo1, Francesco Pazzi1, Francisco J. Domínguez Muñoz1,
Juan Pedro Martín Martínez1, Pedro R. Olivares2, Narcis Gusi1 and José C. Adsuar1
1Faculty of Sport Science, University of Extremadura, Cáceres, Spain. 2Institutode Actividad Física y Salud, Universidad
Autónoma de Chile, Chile.
Abstract
Introduction: fibromyalgia is a chronic disease charac-
terized by generalized pain, stiffness, poor physical con-
ditioning, non-restorative sleep and poor health-related
quality of life. Ganoderma lucidum a type of mushroom
that has demonstrated several benefits in different po-
pulations. Ceratonia siliqua is a natural therapy rich in
antioxidants with potential benefits on health.
Objective: to evaluate the effects of 6-week treatment
of Ganoderma lucidum and Ceratonia siliqua on physical
fitness in patients suffering from fibromyalgia.
Methods: sixty-four women with fibromyalgia partici-
pated in the study. They took 6 g of Ganoderma lucidum
or Ceratonia siliqua per day for 6 weeks. Different fitness
tests were selected in order to evaluate functional capa-
city.
Results: after the 6-week treatment period, Ganoder-
ma lucidum significantly improved aerobic endurance,
lower body flexibility, and velocity (p < .05). No signifi-
cant improvement in any physical test was observed in
the Ceratonia siliqua group.
Discussion and conclusion: Ganoderma lucidum may
improve physical fitness in women with fibromyalgia,
whereas, Ceratonia siliqua seemed to be ineffective at in-
creasing physical fitness. These results may indicate that
Ganoderma lucidum might be a useful dietary supple-
ment to enhance physical performance of the patients
suffering from fibromyalgia.
(Nutr Hosp. 2015;32:2126-2135)
DOI:10.3305/nh.2015.32.5.9601
Key words: Chronic pain. Reishi. Ceratonia siliqua. Ga-
noderma lucidum. Nutrition. Endurance. Velocity.
GANODERMA LUCIDUM MEJORA LA
CONDICIÓN FÍSICA EN MUJERES CON
FIBROMIALGIA
Resumen
Introducción: la fibromialgia es una enfermedad cróni-
ca caracterizada por dolor crónico general, rigidez, con-
dición física pobre, sueño no reparador y mala calidad
de vida relacionada con la salud. Ganoderma lucidum es
un tipo de hongo que ha demostrado tener diferentes be-
neficios en diversas poblaciones. La harina de algarrobo
(Ceratonia siliqua) es una fuente natural de antioxidantes
con potenciales beneficios para la salud.
Objetivo: evaluar los efectos sobre la condición física
en mujeres con fibromialgia de un tratamiento de seis se-
manas con Ganoderma lucidum y compararlos con los de
un tratamiento con Ceratonia siliqua.
Métodos: sesenta y cuatro mujeres con fibromialgia
participaron en el estudio. Se hicieron dos grupos, el
primer grupo tomó 6 g diarios de Ganoderma lucidum,
mientras que el segundo tomó 6 g diarios de Ceratonia
siliqua. Se evaluó la condición física mediante diferentes
test físicos validados.
Resultados: después de seis semanas de tratamiento,
Ganoderma lucidum mejoró significativamente la resis-
tencia aeróbica, la flexibilidad del miembro inferior y la
velocidad (p < 0,05). Por otro lado, Ceratonia siliqua no
mejoró la condición física.
Discusión y conclusiones: Ganoderma lucidum puede
mejorar la condición física en mujeres con fibromialgia,
mientras que Ceratonia siliqua parece no ser efectivo
para este propósito. Estos resultados pueden indicar que
6 g diarios de Ganoderma lucidum podrían ser un suple-
mento útil para mejorar la condición física en esta po-
blación.
(Nutr Hosp. 2015;32:2126-2135)
DOI:10.3305/nh.2015.32.5.9601
Palabras clave: Dolor crónico. Reishi. Ceratonia siliqua.
Ganoderma lucidum. Nutrición. Resistencia. Velocidad.
Correspondence: Pedro R. Olivares.
Institutode Actividad Física y Salud,
Universidad Autónoma de Chile, Chile.
E-mail: olivares.pedro@gmail.com
Recibido: 7-VII-2015.
Aceptado: 7-VIII-2015.
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Nutr Hosp. 2015;32(5):2126-2135Ganoderma lucidum improves physical
fitness in women with fibromyalgia
Introduction
Fibromyalgia (FM) is a chronic rheumatic disease
of unknown etiology. It is characterized by generalized
pain, stiffness, and tenderness in at least 11 of 18 spe-
cific points1. In addition, FM is associated with a range
of symptoms, such as muscular stiffness, depression,
non-refreshing sleep, and cognitive impairments2,3. In
European population, the estimated prevalence of FM
is around 3% to 5% of the general population4.
Differences in physical fitness between FM and
healthy women were compared in previous studies.
FM patients showed worse results in upper and lower
limb strength, balance, flexibility, and aerobic endu-
rance5,6. FM is also associated with high prevalence
of overweight and obesity. In this regard, a recent
study reported that approximately 72% of women
with fibromyalgia are overweight or obese7. This an-
thropometric difference could be given because FM
patients are more prone to physical inactivity than
healthy people8. This sedentary tendency may be in-
creased by FM symptoms like pain, fatigue, stiffness
or depression, while at the same time some of these
symptoms could be worsened by physical inactivity,
i.e. poor physical conditioning or depression9. All of
this can lead a reduction in health-related quality of
life (HRQoL)10.
Recommended therapies in FM include pharmaco-
logical and non-pharmacological therapies. Among
non-pharmacological treatments, physical therapies
were reported to be effective at increasing well-being
and physical function11. Natural and nutritional the-
rapies are currently being studied in this syndrome
because these could be helpful at improving different
symptoms12.
Among those alternative therapies, Ganoderma lu-
cidum (GL), also known as reishi or linghzi, has been
widely used and studied in different populations. It is
a type of mushroom that has demonstrated his efficacy
at increasing vital energy, stimulating the immune sys-
tem, and promoting health13. Previous research investi-
gated its effect as a treatment of different diseases, like
cancer14, diabetes15, Human Immuno Virus16, or hepa-
titis17. Different properties and effects were also repor-
ted, such as anti-inflammatory18, anti-oxidant15, antivi-
ral19, neuroprotective20, and hypotensive21. Effects of
GL on physical conditioning still remain unknown in
humans. To our knowledge, only one investigation22
assessed the effects of GL on physical fitness, and
they concluded that the antioxidant effect of GL could
protect endurance athletes from overtraining. Effec-
tiveness in increasing antioxidant enzymes activities
was also investigated in mice23. This study shown the
evidence that GL possessed protective effects against
a strenuous exercise that could induce oxidative stress.
Furthermore, relevant effects on physical condition
and fatigue were reported in breast cancer patients24.
However, the mechanism under these improvements
remains unknown.
Ceratonia siliqua (CS) is a natural therapy that has
been consumed in many Mediterranean countries in
culinary preparations of beverages and confectionery.
It is also called carob tree and it is obtained from the
fruit of the CS tree. CS flour is rich in polyphenols
and it acts as an antioxidant in the body25,26. Given its
low prize, CS can be considered a “low cost” source
of antioxidants. In mice, antidepressant effects were
also reported in previous studies27. However, to our
knowledge, those results have not been studied in hu-
man samples.
Recent studies hypothesized that oxidative stress
may have a relevant role in the pathophysiology of
FM28. This, along with the effects of oxidative stress in
physical condition22, suggests that antioxidant sources
could improve physical fitness in FM patients.
Given the potential effects of GL and CS, not only
as antioxidant sources (especially the GL, which may
have other benefits cited above), the aim of the pre-
sent study was to evaluate the effects of GL and CS
on physical fitness in patients suffering from FM. A
secondary objective was to evaluate the safety of GL
and CS treatments.
Methods
Participants
All participants were recruited from three FM as-
sociations. The following inclusion criteria were set:
1) be diagnosed with FM by a rheumatologist; 2) be
able to communicate effectively with study staff; 3)
be older than 18 years old; 4) Give written-informed
consent. On the other hand, exclusion criteria were
the following: 1) be pregnant; 2) change their daily
activity during the 6 weeks of treatment; 3) be taking
immunosuppressive; 4) be suffering from diabetes; 5)
be participating in other investigations; 6) be taking C
vitamin supplementation; 7) be taking anticoagulants,
and 8) have taken GL and/or CS as a treatment be-
fore. Additionally, an algometer (PainTest™ FPX 25
Algometer. Wagner Instruments, Greenwich, USA)
was used in order to check FM diagnosis. Participants
without acute painful response in at least 11 of 18 spe-
cified tender points stimulated with a pressure of 4 kg/
cm2 were excluded.
Figure 1 shows the flow diagram of participants. A
total of 70 subjects were initially recruited. Sixty-se-
ven of them were women and 3 were men. Five par-
ticipants were excluded because they did not meet the
inclusion criteria and 1 declined to participate. A total
of 64 women took part in the study. All of them signed
the informed consent in accordance with the updated
Declaration of Helsinki.
This study was approved by the Biomedical Ethics
Committee of the University. The trial was registered
in the Australian New Zealand Clinical Trials, register
number: ACTRN12614001201662.
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2128 Nutr Hosp. 2015;32(5):2126-2135 Daniel Collado-Mateo et al.
Procedures
The current study is a randomized, double blind,
clinical trial. Participants were randomly assigned to
one of the following two groups: GL group (GLG) or
CS group (CSG). Subjects were informed about the
existence of both group, but they did not know which
group they were in. Randomization and allocation pro-
cesses were conducted by one of the researchers using
random code numbers. This researcher was not invol-
ved in data acquisition or statistical analysis. Thus, the
following people were blinded: a) people receiving the
treatment; b) people administering the treatment; c)
people assessing the outcomes; and finally, d) people
analyzing the results.
After initial measurement, participants took GL or
CS during a period of 6 weeks. GLG ingested 3g of GL
dissolved in warm water twice a day (6g per day). The
first intake was at breakfast; whereas the second one
was at dinner. CSG took 6 daily grams of CS with the
same administration indications. The company “Mun-
doReishi” provided the substances, and the Chair of
Mycology of the University of Valladolid (Spain) was
responsible to analyze GL.
Data collection
In order to evaluate functional capacity and physical
fitness, the following well-known tests were selected:
– Upper Body Muscular Strength: It was assessed
using two tests: the handgrip test and the arm
curl test. The handgrip strength was measured
using a hand dynamometer (Takei TKK 5401
Digital Handgrip Dynamometer, Tokyo Ja-
pan). Patients had to squeeze the dynamometer
with an optimal grip-span29. The better of two
attempts for each hand was used in the analy-
ses. The second tool was the “Arm curl test”30.
It quantifies the number of repetitions that the
patient is able to lift a hand weight (2.3 kg) in
Enrollment
Allocation
Follow-Up
Analysis
Assessed for eligibility (n=70)
Randomized (n=64)
Excluded (n=6)
•Not meeting inclusion criteria (n=5)
•Declined to participate (n=1)
Allocated to Ceratonia Siliqua Group (n=32)
•Received allocated intervention (n=31)
• Did not receive allocated intervention
(decided not to start treatment) (n=1)
Lost to follow-up (did not come the day when
physical tests were performed) (n=1)
Discontinued intervention (did not comply with the
treatment for more than 80% of the dose) (n=5)
Analysed (n=23)
• Excluded from analysis (receiving other non usual
care therapies) (n=2)
Allocated to Ganoderma lucidum Group (n=32)
•Received allocated intervention (n=32)
•Did not receive allocated intervention (n=0)
Lost to follow-up (did not answer the calls) (n=1)
Discontinued intervention (did not comply with the
treatment for more than 80% of the dose) (n=5)
Analysed (n=25)
•Excluded from analysis (severe back pain) (n=1)
Fig. 1.—Flow Diagram of participants.
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Nutr Hosp. 2015;32(5):2126-2135Ganoderma lucidum improves physical
fitness in women with fibromyalgia
30 seconds. One trial with each hand was perfor-
med by the patients.
– Lower body muscular strength. The 30s-Chair
stand test was used. Participants started this test
seated on a chair with their hands over their
shoulders. They should stand-up and sit-down as
fast as possible within 30 seconds31. The number
of times they stand-up were recorded.
– Upper Body Flexibility was assessed using the
back scratch test32. In this test, the distance be-
tween fingers behind the back is measured and
the overlap is scored positively.
– Lower Body Flexibility: it was measured using
the chair-sit-and-reach test30. In this test, partici-
pants were seated on a chair and they had to ex-
tend their legs: first, the right leg, and second, the
other one. Then, they were instructed to reach the
extended leg with the middle finger of the corres-
ponding hand and hold this position. Best score
was registered.
– Balance and agility: the 3 meters version of the
Timed-Up-and-Go Test (TUG)33 was used to as-
sess agility and dynamic balance. Participants
were asked to sit on a chair, placing their back
against the backrest of the chair. At the signal,
they should walk to a line 3 meters away, turn
around, walk back to the chair and sit-down. Best
score of two trials was used in the analyses.
– Aerobic Endurance was measured using the
6-min walking test30. This test aims to determine
the maximum distance that participants were able
to walk in 6 minutes. It was performed around a
square measuring 20 meters each side.
– Velocity: Participants were asked to walk 20 me-
ters as fast as possible. Mean velocity was calcu-
lated dividing the 20 meters by the time taken to
complete this 20 meters34.
– Balance: it was measured using Biodex Balance
System (Shirley, NY, USA). This device objecti-
vely measures the ability of a subject to stabilize
himself. It also quantifies the tilt about each axis
during static and dynamic conditions. Clinical
Test of Sensory Integration of Balance (CTSIB)
protocol was used. This test was performed with
different devices by previous studies35. However,
it is the first time, to our knowledge, that this pro-
tocol is carried out with Biodex Balance System.
In all tests, patients maintained their feet on the
platform during 30 seconds with a rest of 10 se-
conds between each test. The following tests were
performed to quantify postural sway under four
different sensory conditions according to the CT-
SIB:
• Eyes open on firm surface to measure somato-
sensory, visual and vestibular sensory inputs.
• Eyes closed on firm surface to estimate somato-
sensory and vestibular inputs, since visual input
is not available.
• Eyes open on unstable surface. In this test so-
matosensory capacity is compromised, thus vi-
sual and vestibular inputs are measured.
• Eyes closed on unstable surface. Only vesti-
bular information was estimated by compro-
mising somatosensory information and visual
feedback.
– Trunk Endurance was evaluated by using the Ito,
Shirado method36. Flexor endurance was assessed
at first. Patients started the test in supine position
and they should raise their lower extremities with
90º flexion of the hip and knees joints. For ex-
tensor muscles, participants should be in prone
position while holding their sternum off the floor.
Subjects must maintain these positions as long as
possible in both tests.
Statistical analysis
Values of descriptive variables were calculated in
order to characterize the two groups. Student’s t test
for independent samples was used to compare the cha-
racteristics of GLG and CSG at baseline. Distribution
of data was checked using the Kolmogorov-Smirnov
test with Lilliefors significance.
The analysis of variance (ANOVA) for repeated
measures was used to calculate the effects of the treat-
ment on the physical fitness outcomes. Paired t test
was calculated in order to estimate the changes of both
groups comparing from baseline.
In addition to the efficacy analysis, which compri-
ses the participants who took at least 80% of the do-
ses and completed the task, an intent-to-treat analysis
was performed. It comprises the 64 initial participants.
Data of all participants that came to the post-treatment
measures were utilized, including data coming from
the people who did not take at least 80% of the do-
ses (n=10). Post-treatment data of the remainder of
the sample (n=6) was imputed according to the mean
change of their group. The level of significance was
set at p<.05. Analyses were performed using SPSS sof-
tware (version 21).
Results
Characteristics of participants at baseline are shown
in table I. No statistically significant difference was
observed between GLG and CSG at baseline.
Initially, 64 women were randomly allocated in 2
equal groups. However, final sample comprised 48
women: 25 belonging to GLG and 23 belonging to
CSG. Starting from these 64 patients, a total of 5 par-
ticipants of each group did not took at least 80% of
the dose and were excluded; 1 subject decided not to
start the treatment after the randomization was per-
formed; another woman did not answer the calls and
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2130 Nutr Hosp. 2015;32(5):2126-2135 Daniel Collado-Mateo et al.
was lost; 2 women considerably changed their usual
therapies and were excluded too; 1 woman was not
able to complete physical fitness tests because she
had an acute musculoskeletal injury; 1 woman did not
show up when measurements was performed (Fig. 1).
Finally, 48 women were included in the efficacy
analysis (GLG=25; CSG=23), whereas 64 (GLG=32;
CSG=32) were taken in consideration of intent to treat
analysis.
Effects of GLG and CSG on physical fitness are
represented in table II. After the 6-week treatment
period, a statistically significant difference in aerobic
endurance was observed between both groups (p<.05).
Furthermore, GLG obtained significant improvements
(p<.05) in lower body flexibility and velocity in effi-
cacy analysis compared with CSG. However, only the
improvement in lower body flexibility was significant
in the intent to treat analysis (Table III).
Discussion
The main finding of the current paper was that 6g/
day of GL for 6 weeks improved the physical fitness of
women suffering from FM. Specifically, we observed
improvements on aerobic endurance, walking veloci-
ty, and lower limb flexibility. On the other hand, CS
seemed to be rather ineffective in improving physical
fitness in FM patients. To our knowledge, this is the
first study that assesses the effects of CS and/or GL on
physical condition in FM patients.
Given the lack of studies about the potential mecha-
nism of GL and CS in physical fitness, it is difficult
to explain how GL may improve aerobic endurance,
velocity, or flexibility. The best explanation based on
previous studies is the antioxidant effect37,38. In addi-
tion, the oxidative/antioxidative status was suggested
to be a critical factor in physical and mental health of
FM patients28,39. However, both GL and CS are antioxi-
dant sources. Therefore, based on our results, there can
be no assurance that the reported improvements are
caused by an antioxidant effect. In this context, further
researches on the physiological effects of GL in the
physical condition are needed.
Although the current study is not able to precisely
explain how physical condition is improved, the rele-
vance of our findings is very large. To our knowledge,
this is the first study that investigates the effects of GL
and/or CS on the physical fitness of a population with
a specific disease. Therefore, this study lays the foun-
dation for future research focused on the GL effects on
physical fitness in pathologies characterized by poor
physical conditioning. At the same time, findings from
the previous study in cyclists are confirmed22. In this
way, the current study is also an important entry point
for future studies on the effects of GL in sport perfor-
mance.
The relevance of the physical condition in women
suffering from FM is widely known. In fact, it is clo-
sely related with the satisfaction with life and wellbe-
ing40, because it is obviously related with the ability of
perform activities of daily living. Furthermore, aerobic
endurance and flexibility are extremely related with
HRQoL. The reported treatment effect in velocity is
higher than the minimal real change, which was calcu-
lated in patients with chronic pain (osteoarthritis) and
it was 0.07 m/s34.
Safety of both GL and CS were also demonstrated
in the current paper. A total of 10 participants did not
complete the minimum 80% of the treatment. Of the-
se, 5 belonged to the GLG and other 5 to the CSG,
which means a 15.63% of the total sample. The most
common complaint in those 10 participants were mild
nausea, diarrhea, discomfort, and nervousness. Some
participants opined that the reason of those reactions
were the bad taste. In all cases the reactions were mild
or moderate and the participants were asked to reduce
the dose to 3 grams per day. However, no one of the
patients that reduced the dose were able to continue the
treatment and all of them ceased it. This could suggest
that the daily amount of GL and CS is not the cause of
those complaints.
The current study has several limitations. The most
important limitation is the lack of previous studies that
Table I
Characteristics at baseline of the two groups
GLG (n=25) CSG (n=23) p
Age (years) 56.25 (8.05) 53.62 (11.75) .367
Height (cm) 157.16 (4.63) 156.13 (6.16) .514
Weight (kg) 64.21 (9.87) 61.50 (13.50) .429
Muscular mass (%) 62.00 (7.31) 64.76 (8.77) .245
Fat mass (%) 34.80 (7.67) 32.33 (7.92) .285
BMI 26.00 (3.82) 25.20 (4.83) .522
Date when fibromyalgia symptoms started 1993 (12.09) 1992 (12.76) .652
*Values expressed as mean (SD). BMI: Body Mass Index. GLG: Ganoderma lucidum group. CSG: Ceratonia siliqua group.
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Table II
Effects of 6 weeks of GL vs CS treatment on physical conditioning
Outcome measure Test
GLG CSG
Mean (SD)
at baseline
Mean
(SD) after
treatment PaIntra-Group
Effect Size Mean (SD)
at baseline
Mean
(SD) after
treatment PaIntra-Group
Effect Size F PbTreatment
effect Mean
(95% CI)
Global
Effect
Size
Upper Body Stren-
gth
Right Handgrip (kg)
GLG (n=25)
CSG (n=23)
19.58
(4.98) 19.92
(4.33) .601 -0.072 20.36
(4.09) 20.28
(5.68) .910 0.016 0.201 .656 -0.42
(-1.47 to 2.32) 0.132
Left Handgrip (kg)
GLG (n=24)
CSG (n=23)
18.33
(4.92) 18.91
(3.85) .482 -0.131 18.73
(3.99) 19.39
(5.11) .420 -0.143 0.005 .946 0.07
(-2.37 to 2.21) 0.021
Arm Curl Right (reps)
GLG (n=25)
CSG (n=23)
10.20
(3.55) 13.36
(4.04) <.001 -0.830 10.09
(2.99) 12.91
(3.42) .001 -0.877 0.145 .705 -0.34
(-1.43 to 2.09) 0.112
Arm Curl Left (reps)
GLG (n=24)
CSG (n=23)
10.48
(4.11) 13.81
(4.40) <.001 -0.782 10.41
(3.64) 12.67
(2.96) .001 0.681 1.784 .188 -1.07
(-0.54 to 2.68) 0.398
Upper Body
Flexibility
Back Scratch (cm)
GLG (n=25)
CSG (n=22)
-4.12
(10.99) -3.80
(10.63) .761 -0.029 -5.36
(8.71) -5.86
(8.35) .754 0.058 0.197 .659 -0.82
(-2.90 to 4.54) 0.133
Lower body
flexibility
Chair Sit and Reach (cm)
GLG (n=25)
CSG (n=23)
-0.20
(8.69) 4.00
(9.85) <.001 -0.452 -0.35
(9.39) -.22
(8.98) .893 -0.014 9.060 .004 -4.06
(1.38 to 6.75) 0.887
Balance and agility Timed-Up-Go (s)
GLG (n=25)
CSG (n=22)
7.29
(1.29) 6.85
(1.02) .007 0.378 7.31
(1.10) 7.00
(1.30) .329 0.257 0.144 .706 0.13
(-0.80 to 0.54) 0.113
Aerobic endurance 6 m Walking (m)
GLG (n=25)
CSG (n=22)
507.00
(73.88) 528.97
(72.08) .006 -0.301 477.73
(79.69) 469.49
(120.45) .643 0.080 4.260 .045 -30.19
(-6.33 to 66.75) 0.497
Lower body strength Chair stand Test (reps)
GLG (n=25)
CSG (n=22)
10.26
(1.71) 11.14
(2.08) .005 -0.462 10.22
(2.03) 10.86
(2.52) .051 -0.279 0.343 .561 -0.25
(-0.59 to 1.08) 0.175
Velocity 20-m walk test (m/s)
GLG (n=25)
CSG (n=23)
3.35
(0.52) 3.54
(0.54) .002 0.254 3.26
(0.42) 3.24
(0.52) .883 -0.059 4.491 .040 0.30
(-0.72 to .11) 0.625
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2132 Nutr Hosp. 2015;32(5):2126-2135 Daniel Collado-Mateo et al.
Table II (cont.)
Effects of 6 weeks of GL vs CS treatment on physical conditioning
Outcome measure Test
GLG CSG
Mean (SD)
at baseline
Mean
(SD) after
treatment PaIntra-Group
Effect Size Mean (SD)
at baseline
Mean
(SD) after
treatment PaIntra-Group
Effect Size F PbTreatment
effect Mean
(95% CI)
Global
Effect
Size
Balance. Eyes Open
Firm Surface
GLG (n=25) Stability Index (º) 4.63
(1.68) 4.77
(1.42) .478 -0.090 4.72
(1.62) 4.32
(2.26) .238 0.203 2.066 .157 -0.54
(-0.21 to 1.30) 0.424
CSG (n=23) Swing Index (º) 0.78
(0.59) 0.51
(0.24) .021 0.599 0.73
(0.44) 0.62
(0.45) .255 0.247 1.239 .271 0.16
(-0.43 to 0.12) 0.329
Balance Eyes Closed
Firm Surface
GLG (n=25) Stability Index (º) 4.83
(1.50) 4.70
(1.61) .591 0.083 4.66
(1.66) 4.20
(2.06) .205 0.245 0.657 .422 -0.33
(-0.49 to 1.15) 0.239
CSG (n=23) Swing Index (º) 1.19
(0.62) 0.99
(0.50) .080 0.355 1.01
(0.56) 0.90
(0.45) .136 0.216 0.348 .558 0.08
(-0.34 to 0.18) 0.174
Balance Eyes Open
Unstable Surface
GLG (n=25) Stability Index (º) 4.02
(1.65) 4.14
(1.41) .635 -0.078 3.97
(1.52) 4.38
(1.83) .210 -0.243 0.483 .490 0.28
(-1.09 to 0.53) 0.205
CSG (n=23) Swing Index (º) 1.42
(0.63) 1.26
(0.65) .218 0.249 1.22
(0.44) 1.05
(0.37) .001 0.418 0.008 .931 -0.01
(-0.26 to 0.29) 0.026
Eyes Closed on
Unstable Surface
GLG (n=25) Stability Index (º) 4.90
(1.37) 4.92
(1.50) .933 -0.013 4.57
(1.85) 4.89
(2.45) .279 -0.147 0.469 .497 0.29
(-1.14 to 0.56) 0.202
CSG (n=23) Swing Index (º) 3.22
(0.97) 3.22
(1.24) .997 0.000 2.93
(1.07) 2.82
(.99) .562 0.106 0.157 .693 -0.10
(-0.43 to 0.65) 0.117
Trunk Endurance
GLG (n=25)
CSG (n=19)
Abdominal (s) 46.18
(39.47) 54.55
(39.80) .321 -0.211 39.45
(34.69) 41.49
(37.74) .817 -0.056 0.272 .605 -6.33 (-18.19
to 30.87) 0.242
Lumbar (s) 54.01
(40.84) 59.36
(45.81) .666 -0.123 49.73
(41.22) 46.41
(40.75) .777 0.081 0.261 .612 -8.66 (-25.58
to 42.92) 0.168
GLG: ganoderma lucidum group; CSG: ceratonia siliqua group; ap of t-test; bp-values of analysis of variance for repeated measures to compare differences between groups after treatment; CI: confidence
interval.
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2133
Nutr Hosp. 2015;32(5):2126-2135Ganoderma lucidum improves physical
fitness in women with fibromyalgia
Table III
Effects of 6 weeks of GL or CS treatments on physical conditioning. Intent-to-treat analysis
Outcome measure Test
GLG (n=32) CSG (n=32)
Mean (SD)
at base line
Mean
(SD) after
treatment PaIntra-Group
Effect Size Mean (SD)
at base line
Mean
(SD) after
treatment paIntra-Group
Effect Size F PbTreatment
effect Mean
(95% CI)
Global
Effect
Size
Upper Body
Strength
Right Handgrip (kg) 19.81
(4.87) 18.17
(4.82) .885 0.338 19.98
(4.33) 18.51
(4.16) .571 0.346 0.042 .838 0.28
(-1.92 to 1.37) 0.052
Left Handgrip (kg) 18.17
(4.82) 18.56
(4.37) .535 -0.084 18.51
(4.16) 19.47
(4.72) .147 -0.215 0.399 .530 0.56
(-2.35 to 1.22) 0.160
Right arm curl (reps) 9.76
(3.44) 12.82
(3.95) .000 -0.826 9.06
(3.34) 12.45
(4.08) .000 -0.909 0.182 .672 0.32
(-1.83 to 1.19) 0.108
Left arm curl (reps) 10.36
(3.87) 13.65
(4.23) .000 -0.811 9.92
(3.83) 12.65
(3.89) .000 -0.707 0.674 .415 -0.56
(-0.80 to 1.93) 0.209
Upper Body
Flexibility Back Scratch (cm) -4.00
(11.02) -3.50
(10.87) .560 -0.045 -5.00
(10.39) -6.25
(10.55) .282 0.119 1.514 .223 -1.74
(-1.09 to 4.58) 0.313
Lower body
flexibility Chair Sit and Reach (cm) -0.28
(8.38) 3.02
(9.20) .000 -0.375 -0.34
(11.62) 0.43
(10.16) .397 -0.070 4.312 .044 -2.53
(0.06 to 4.99) 0.527
Balance and agility Timed-Up-Go (s) 7.25
(1.18) 6.89
(1.05) .010 0.322 7.43
(1.49) 7.18
(1.62) .288 0.160 0.163 .688 0.09
(-0.64 to 0.42) 0.103
Aerobic endurance Six minutes walking test
(m) 505.59
(71.40) 524.76
(70.89) .008 -0.269 484.46
(80.52) 474.79
(117.4) .478 0.096 3.661 .060 -28.84
(-1.29 to 58.99) 0.486
Lower Body strength Chair stand test (reps) 10.29
(1.72) 11.04
(2.03) .007 -0.398 10.03
(2.40) 10.75
(2.81) .003 -0.275 0.006 .940 -0.02
(-0.65 to 0.70) 0.020
Velocity 20-m walk test (m/s) 3.36
(0.50) 3.51
(0.56) .006 -0.282 3.27
(0.47) 3.25
(0.58) .808 0.037 3.581 .063 -0.15
(-0.01 to 0.33) 0.481
Balance Eyes Open
Firm Surface Stability Index(º) 4.60
(1.78) 4.82
(1.51) .318 -0.133 4.60
(1.56) 4.49
(2.32) .726 0.055 0.740 .393 -0.33
(-0.43 to 1.09) 0.218
Swing Index(º) 0.79
(0.62) 0.53
(0.30) .005 0.533 0.80
(0.51) 0.68
(0.58) .087 0.219 1.628 .207 0.14
(-0.35 to 0.07) 0.324
Balance Eyes Closed
Firm Surface Stability Index(º) 4.93
(1.65) 4.84
(1.77) .660 0.052 4.64
(1.65) 4.37
(1.94) .330 0.149 0.268 .607 -0.17
(-0.50 to 0.86) 0.131
Swing Index(º) 1.19
(0.68) 0.96
(0.49) .037 0.388 1.08
(0.60) 0.93
(0.59) .029 0.252 0.306 .582 0.07
(-0.31 to 0.17) 0.141
Balance Eyes Open
Unstable Surface Stability Index(º) 4.18
(1.59) 4.41
(1.50) .311 -0.148 3.93
(1.42) 4.35
(1.74) .117 -0.264 0.279 .599 0.18
(-0.88 to 0.51) 0.134
Swing Index(º) 1.42
(0.59) 1.25
(0.60) .105 0.285 1.30
(0.53) 1.16
(0.67) .029 0.231 0.078 .781 0.03
(-0.27 to 0.20) 0.078
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2134 Nutr Hosp. 2015;32(5):2126-2135 Daniel Collado-Mateo et al.
Table III (cont.)
Effects of 6 weeks of GL or CS treatments on physical conditioning. Intent-to-treat analysis
Outcome measure Test
GLG (n=32) CSG (n=32)
Mean (SD)
at base line
Mean
(SD) after
treatment PaIntra-Group
Effect Size Mean (SD)
at base line
Mean
(SD) after
treatment paIntra-Group
Effect Size F PbTreatment
effect Mean
(95% CI)
Global
Effect
Size
Eyes Closed on
Unstable Surface Stability Index(º) 4.97
(1.48) 5.02
(1.54) .845 -0.033 4.60
(1.68) 4.93
(2.18) .171 -0.169 0.681 .413 0.28
(-0.96 to 0.40) 0.210
Swing Index(º) 3.32
(1.02) 3.32
(1.24) .995 0.000 2.98
(1.00) 2.95
(1.13) .870 0.028 0.013 .910 -0.02
(-0.42 to 0.48) 0.029
Trunk Endurance Abdominal(s) 45.55
(36.52) 53.90
(36.98) .209 -0.227 36.36
(34.10) 40.62
(37.16) .434 -0.119 0.235 .630 -4.09 (-12.78
to 20.96) 0.123
Lumbar(s) 53.82
(38.69) 58.86
(44.09) .598 -0.121 47.66
(39.08) 49.17
(41.05) .858 -0.037 0.079 .780 -3.54 (-21.71
to 28.80) 0.071
GLG: ganoderma lucidum group; CSG: ceratonia siliqua group; ap of t-test; bp-values of analysis of variance for repeated measures to compare differences between groups after treatment; CI: confidence
interval.
could explain the mechanisms under the differences
observed. In addition, given that the two treatments
were antioxidant sources, it is impossible to conclu-
de whether the changes are based on the antioxidant
effects or not. The second is the lack of knowledge
about the most adequate dose of both GL and CS in
adult women. Furthermore, the dose and indications of
both treatments had to be the same in order to keep the
double-blind. Third, duration of the treatment could be
insufficient to increase some physical fitness variables.
Finally, although no statistically significant differences
in many physical tests were observed, treatment effects
could not be discarded due to the small sample size.
Despite all these limitations, it can be concluded that
GL may be effective in improving endurance, lower
body flexibility, and velocity. On the other hand, CS
seemed to be ineffective in improving physical fitness
in women suffering from FM. However, more studies
with longer intervention periods and different doses
of GL and CS are required. Similarly, further studies
focused on the mechanisms under the reported impro-
vements are needed.
Acknowledgments
The authors acknowledge Juan Andrés Oria de Rue-
da for the support in the study protocol design. The
company “MundoReishi” provided the Ganoderma lu-
cidum and Ceratonia siliqua utilized in the study. The
author DCM was supported by a Predoctoral Fellows-
hip from the “Fundación Tatiana Pérez de Guzmán el
Bueno”. The authors acknowledge the assistance of
the local associations of Palencia, Salamanca and Chi-
piona.
Conflict of Interest
The authors declare there are not competing finan-
cial interests existing.
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