Why do some people with severe chronic pain adhere to walking prescriptions whilst others won’t? A cross-sectional study exploring clinical and psychosocial predictors in women with fibromyalgia

Catalá, Patricia; López-Roig, Sofía; Écija, Carmen; Suso‐Ribera, Carlos; Puente, Cecilia Peñacoba

doi:10.1007/s00296-020-04719-w

Cited by 22 publications

(25 citation statements)

References 21 publications

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“…Hence, LPA and MVPA were not influenced by the patients’ clinical profile, keeping the motivational variables relevant. This important finding is not in line with previous studies in women with fibromyalgia that showed significant associations of pain and fibromyalgia impact with objective PA [ 14 ] or with walking exercise [ 60 ]. The long-lasting pain of our sample could explain the difference, because our participants could have “normalized” or integrated their painful status into their daily life.…”

Section: Discussioncontrasting

confidence: 91%

Motivational Determinants of Objective Physical Activity in Women with Fibromyalgia Who Attended Rehabilitation Settings

Pastor-Mira

López-Roig

Martínez-Zaragoza

et al. 2021

JCM

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Being physically active has positive effects on fibromyalgia functioning. However, promoting an active lifestyle in these patients continues to be a relevant clinical challenge. Our aim was to test a motivational model to explain light (LPA) and moderate-vigorous physical activity (MVPA). A cross-sectional prospective study was conducted at a tertiary level of care. Participants completed sociodemographic, clinical, motivational (physical activity self-efficacy and goal preferences) and behavioral measures (activity avoidance). LPA and MVPA were measured with triaxial accelerometers, starting the same day of the aforementioned assessment. Out of 211 women, 183 completed this measure. Structural models were performed. Our results show that the best fit indices (CFI = 0.97, SRMR = 0.04) showed a model with direct influence of PA self-efficacy on MVPA (p < 0.01) and indirect influence on LPA (p < 0.001). LPA received the influence of PA self-efficacy mainly through activity avoidance (p < 0.01). Clinical variables did not have any effect on PA intensities. Thus, the motivational variables showed different paths to explain two PA intensities. Targeting PA self-efficacy in rehabilitation settings is needed to enhance both daily LPA and MVPA intensities.

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Section: Discussioncontrasting

confidence: 91%

Motivational Determinants of Objective Physical Activity in Women with Fibromyalgia Who Attended Rehabilitation Settings

Pastor-Mira

López-Roig

Martínez-Zaragoza

et al. 2021

JCM

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“…Depending on the condition, different health-related aspects will be linked to lower adherence. In this regard, chronic diseases that involve pain or fatigue may reduce the attendance and adherence of patients [ 78 , 79 ]. Furthermore, those patients with depression will also be more likely to abandon the exercise program [ 43 , 72 , 80 ].…”

Section: Discussionmentioning

confidence: 99%

Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review

Collado-Mateo

Lavín-Pérez

Peñacoba

et al. 2021

IJERPH

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334

176

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Physical inactivity is a major concern and poor adherence to exercise programs is often reported. The aim of this paper was to systematically review published reviews on the study of adherence to physical exercise in chronic patients and older adults and to identify those adherence-related key factors more frequently suggested by reviews for that population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results were classified considering the target population and participants’ characteristics to identify the most repeated factors obtained for each condition. Fifty-five articles were finally included. Fourteen key factors were identified as relevant to increase adherence to physical exercise by at least ten reviews: (a) characteristics of the exercise program, (b) involvement of professionals from different disciplines, (c) supervision, (d) technology, (e) initial exploration of participant’s characteristics, barriers, and facilitators, (f) participants education, adequate expectations and knowledge about risks and benefits, (g) enjoyment and absence of unpleasant experiences, (h) integration in daily living, (i) social support and relatedness, j) communication and feedback, (k) available progress information and monitoring, (l) self-efficacy and competence, (m) participant’s active role and n) goal setting. Therefore, adherence to physical exercise is affected by several variables that can be controlled and modified by researchers and professionals.

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“…It is important to note that FM patients vary a great deal in the functional impact of their pain; we know that pain intensity is inversely associated with physical functioning, but this relationship is modest at best [ 32 ]. That is, while in general FM patients with higher levels of pain intensity report more disability, some patients with relatively high levels of pain intensity are able to function reasonably well physically, and some patients with relatively low levels of pain intensity report being highly disabled by their pain [ 33 ]. It is likely that psychosocial factors impact the relationship of pain to functioning; illuminating this interplay requires a comprehensive understanding of the psychosocial factors affecting functioning in FM.…”

Section: Introductionmentioning

confidence: 99%

Modifiable Psychological Factors Affecting Functioning in Fibromyalgia

Paschali

Lazaridou

Paschalis

et al. 2021

JCM

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Objective: To examine the role of several interrelated, potentially modifiable psychological factors (i.e., mindfulness and catastrophizing) in influencing patient-reported functioning. Methods: In this cross-sectional study, 107 patients with fibromyalgia completed self-report assessments of pain severity, functioning and impact of symptoms, mindfulness, and pain catastrophizing. Linear regression and bootstrapping mediation analyses were performed to assess the relationships between these factors. Results: Pain intensity was significantly and positively associated with pain catastrophizing and impact of fibromyalgia on functioning. Linear regression analyses indicated that pain intensity, catastrophizing, and mindfulness affect functioning in fibromyalgia. Follow-up mediation analysis revealed a significant indirect effect of pain catastrophizing on the relationship between pain intensity and fibromyalgia functioning. Conclusion: Individuals with fibromyalgia who have higher levels of pain and catastrophizing, and lower levels of mindfulness, are more likely to experience impaired functioning. Our findings suggest that pain catastrophizing appears to be an especially important variable contributing to reduced functioning in women with fibromyalgia. Therefore, catastrophizing-reducing treatments (e.g., cognitive behavioral therapy) are likely to have direct, beneficial impacts on functioning.

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Why do some people with severe chronic pain adhere to walking prescriptions whilst others won’t? A cross-sectional study exploring clinical and psychosocial predictors in women with fibromyalgia

Cited by 22 publications

References 21 publications

Motivational Determinants of Objective Physical Activity in Women with Fibromyalgia Who Attended Rehabilitation Settings

Motivational Determinants of Objective Physical Activity in Women with Fibromyalgia Who Attended Rehabilitation Settings

Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review

Modifiable Psychological Factors Affecting Functioning in Fibromyalgia

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