Physical exercise is recognized as a component of the evidence-based guidelines for treatment of fibromyalgia. Walking is a low-moderate intensity exercise easily adaptable to a fibromyalgia patient's situation. The present study aims to estimate the prevalence of unsupervised walking for exercise in women with fibromyalgia, to describe their level of physical activity and to identify their predictors among socio-demographic, symptom perception and medical advice to walk. A cross-sectional survey with 920 women (all members of fibromyalgia associations) completed the International Physical Activity Questionnaire-Short Form and self-reported scales to assess symptom perception, walking, medical advice to walk and physical comorbidity. The prevalence of reported walking regularly as physical exercise was 30.8 % and it was predicted by medical advice (odds ratio, OR 1.876), age (OR 1.021) and fatigue intensity (OR 0.912). The prevalence of physical activity was 16 % for high-intensity activity, 40 % for moderate activity and 44 % for low activity. Predictors of low versus moderate and high physical activity were pain intensity (OR 1.171) and fatigue impact perception (OR 1.076). Evidence shows a low percentage of women with fibromyalgia walking regularly for physical exercise. Most reported low or moderate physical activity. The results indicate the importance of doctors' advice in promoting walking. Symptom perception and socio-demographic characteristics were weak predictors. Further work is required to examine other determinants of these low levels.

BackgroundFibromyalgia patients are often advised to engage in regular low- to moderate-intensity physical exercise. The need of fibromyalgia patients to walk has been stressed in previous research. Behavioral self-regulation theories suggest that a combination of motivational aspects (to develop or strengthen a behavioral intention: Theory of Planned Behavior) and volitional aspects (engagement of intention in behavior: implementation intentions) is more effective than a single intervention. In this paper, we describe a protocol for identifying the motivational processes (using the Theory of Planned Behavior) involved in the practice of walking (phase I) and for studying the efficacy of an intervention that combines motivational and volitional contents to enhance the acquisition and continuation of this exercise behavior (phase II). The paper also shows the characteristics of eligible individuals (women who do not walk) and ineligible populations (women who walk or do not walk because of comorbidity without medical recommendation to walk). Both groups consist of members of any of four patients’ associations in Spain who are between 18 and 70 years of age and meet the London Fibromyalgia Epidemiology Study Screening Questionnaire criteria for fibromyalgia. Furthermore, using this study protocol, we will explore the characteristics of participants (eligible women who agreed to participate in the study) and nonparticipants (eligible women who refused to participate).Methods/designTwo studies will be conducted: Phase I will be a cross-sectional study, and phase II will be a triple-blind, randomized longitudinal study with two treatment groups and one active control group. The questionnaires were sent to a total of 2,227 members of four patients’ associations in Spain. A total of 920 participants with fibromyalgia returned the questionnaires, and 582 were ultimately selected to participate.DiscussionThe first data gathered have allowed us to identify the characteristics of the study population and they support the appropriateness of the inclusion criteria.. When the study is complete, the results will enable us to establish whether this kind of intervention can be used as a self-regulation tool for increasing and maintaining walking as unsupervised physical exercise of low to moderate intensity in fibromyalgia patients.Trial registrationTrial registration number: ISRCTN68584893

Título: Andar como forma de ejercicio físico en la Fibromialgia: un estudio de identificación de creencias desde la Teoría de la Acción Planeada. Resumen Este estudio corresponde a la primera fase de investigación formativa recomendada en la teoría de la Acción Planeada para desarrollar una intervención. Nuestros objetivos son identificar las creencias modales sobre la realización de una pauta de ejercicio en personas con fibromialgia, probar los ítems para la evaluación directa de los constructos predictivos y explorar sus relaciones con la conducta. Evaluamos a 46 mujeres con fibromialgia. El análisis de contenido mostró un mayor número de consecuencias positivas que negativas asociadas a la ejecución de la pauta de ejercicio (creencias comportamentales); la familia y los amigos son los referentes importantes (creencias normativas) y se detectaron factores facilitadores e inhibidores de la ejecución de la conducta de ejercicio, relacionados con aspectos de la fibromialgia (creencias de control) como el dolor, la fatiga y el estado de ánimo. El índice de consistencia interna más bajo fue el de la escala de norma subjetiva (α= .78). Los resultados confirman el sedentarismo de la muestra (conducta previa: Media=3.67; rango=1-7) aunque también sugieren que estas personas tienen intención de realizar la conducta (Media= 5.67). Las relaciones obtenidas entre los constructos son las esperadas desde la teoría, apoyando la pertinencia de aplicarla en la conducta y población seleccionada. Palabras clave: Andar; creencias; fibromialgia; teoría de la acción planeada; investigación formativa; estudio de identificación.Abstract: This study is the first phase of the formative research recommended in the Theory of Planned Behavior for the development of an intervention. Our aims are to identify modal beliefs about the performance of an exercise pattern in people with fibromyalgia, to test the items designed for direct evaluation of the predictive constructs and to explore their relationships with the behavior. We assessed 46 women with fibromyalgia. Content analysis showed more positive than negative consequences related to the performance of exercise guidelines (behavioral beliefs). Families and friends are the important referents (normative beliefs) and we identified facilitating and inhibiting factors in the performance of exercise behavior related to aspects of fibromyalgia (control beliefs) such as pain, fatigue and emotional state. The subjective norm scale showed the lowest internal consistency (α= .78). The results confirmed the sedentary lifestyle of the participants (previous behavior: Mean=3.67; rank=1-7) although they also suggested that participants intended to perform the behavior (Mean=5.67). The relationships between constructs are coherent with the theory, and support the relevance of applying it to the selected behavior and population.

Purpose The aim of the study was to analyze the profile of fibromyalgia patients receiving medical advice to walk and who complied with the advice according to a specific clinical pattern. A further aim has been to analyze the elements that increase adherence to walking. Design A cross-sectional study with 920 women with fibromyalgia. Methods Sociodemographic and clinical variables, walking behavior, and medical advice to walk were assessed. Findings and Conclusions Patients who adhere to walking have a lower likelihood of being tired. Regular walkers (patients who walk according to a specific clinical pattern) have a lower likelihood of comorbidity. Patients who receive medical advice to walk are more likely to walk more than 30 minutes and to take a break between bouts. Clinical Relevance Nurses caring for people with fibromyalgia should include strategies to promote walking, especially in patients with low adherence profiles, paying attention to all elements of behavior.

Background: Preoperative anxiety is a frequent event that depends on multiple factors. One is the prior information to the patient, which must be simple, understandable and reliable. The aim of this study is to establish the relationship between the degree of information of the surgical procedure and the level of preoperative anxiety in patients scheduled for surgery. Material and methods: Cross-sectional study of 99 randomly selected patients scheduled for surgery at the Hospital Royo Villanova (sector I at Zaragoza). APAIS and STAI-AE scales were used to assess the preoperative anxiety level and the degree of prior information. The statistical analysis was performed using SPSS v.21.0, with the Chi-square test, ANOVA test and the nonparametric Kruskal Wallis to study the association between the different questions and the degree of anxiety. To assess the association of the two scales Pearson correlation test was used. Results: The educational level, type of surgery, previous surgery, specialty and previous surgery variables do not show statistical significance (p <0.05) compared to the anxiety level variable. It has been shown that there is an association between the degree of information and level of anxiety. Conclusions: The data shown in the present study support the hypothesis that patients who believe they need more knowledge about the surgical procedure have higher anxiety levels than patients who believe they need less.