Promoting unsupervised walking in women with fibromyalgia: a randomized controlled trial

Global mapping of physical activity promotion strategies in Fibromyalgia- A comprehensive methodological scoping review protocol

Fibromyalgia Syndrome (FMS) is a chronic, broad, diffuse, and non-inflammatory musculoskeletal condition. Several studies were conducted on the effects of physical activity (PA) and strategies to promote it in people with FMS. The resulting scoping review will provide an analysis of the strategies being researched and executed. This study outlines the protocol for a scoping review to collect, analyse and compile the promotion strategies for PA in FMS. The proposed protocol will be guided by Arksey and O'Malley's framework and advanced methodology study by Levac et al. The search method will comprise of terms pertaining to FMS, PA, and its promotion. To ascertain relevant studies, predetermined inclusion and exclusion criteria will be used. Studies included must be performed on FMS patients with PA as the intervention with an outcome related to quality of life, pain, and fatigue. Data extraction of the included studies will be done through three investigators using Rayyan software. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used to describe the study.

Adherence Support Strategies for Physical Activity Interventions in People With Chronic Musculoskeletal Pain-A Systematic Review and Meta-Analysis

BACKGROUND

Chronic musculoskeletal (MSK) pain significantly impacts individuals' quality of life. Regular physical activity is an important key to therapy. However, adherence to exercise is often below the intended levels. This systematic review aims to assess the effectiveness of adherence support strategies in physical activity randomized controlled trials (RCTs) for patients with chronic MSK pain, to address the challenge of motivation and adherence in this population.

METHODS

Ovid and CINAHL databases were searched for MSK "chronic pain," "adherence" and "physical activity" (in various synonyms) for RCTs with a follow-up of at least 6 months. After a screening process that included several team members, a narrative synthesis and a meta-analysis on adherence and effect sizes of different outcomes were performed.

RESULTS

An initial database output of 5816 articles resulted in 76 RCTs that remained for analysis. These RCTs showed high heterogeneity of intervention design and outcome data. Adherence to exercise varied widely, with 21 RCTs achieving rates of 80% or higher using strategies like education, goal setting, self-monitoring, and personal feedback. The meta-analysis, based on 29 out of 76 RCTs, indicated a nonsignificant correlation between adherence levels and an improved outcome (eg, pain or quality of life). No individual strategy emerged as superior, emphasizing the complexity and diversity of intervention designs.

CONCLUSIONS

This review offers strategies, such as information/education and individual goal setting/feedback that may be beneficial for enhancing physical activity in patients with chronic MSK pain. Future research should focus on including promising adherence support strategies and providing data for adherence calculations.

Preference for Hedonic Goals in Fibromyalgia; Is It Always an Avoidance Mechanism? Looking the Relationship with Pain Acceptance from a Positive Psychology Perspective

The aim of this study was to analyze the effect of openness to experience on pain acceptance through positive affect (PA) considering the moderating role of preference for mood management goals in women with fibromyalgia (FM). A cross-sectional study (n = 231) was carried out. A simple mediation model and a moderate mediation model were conducted by SPSS macro-PROCESS. Results showed that PA mediated positively the effect of openness to experience on acceptance (B = 0.46, SE = 0.80, t = 5,59; 95% CI = [0.3016, 0.6298], p < .001) and that the contribution of openness to experience to PA varied at different values of mood management goals (medium: - .04; ß = .40, p < .001; high: .95; ß = .61, p<.001). Findings may serve as a foundation for tailored interventions to promote activity through acceptance focusing on PA and mood management goals among women with medium to high level of hedonic goals.

When It Hurts, a Positive Attitude May Help. The Moderating Effect of Positive Affect on the Relationship Between Walking, Depression, and Symptoms in Women with Fibromyalgia

BACKGROUND

Increased exercise is a marker of health in fibromyalgia (FM). However, patients frequently avoid physical activity as a way of minimizing the pain they feel. This deprives them of opportunities to obtain positive reinforcement, increasing functional impact.

AIMS

This study examines the mediating role of depressive symptoms between walking (as physical exercise), functional impact, and pain, at different levels of positive affect (PA) among women with fibromyalgia.

DESIGN

Cross-sectional correlational study.

SETTINGS

Mutual aid associations for fibromyalgia in Spain.

PARTICIPANTS

231 women diagnosed with FM.

METHODS

Moderate mediation analyses were conducted using PROCESS.

RESULTS

First, a simple mediation model showed that depression mediated the effect of walking on functional impact, but not on pain. Additionally, the moderated mediated model showed that this effect was significant at medium and high levels of PA, but not when levels of PA were low.

CONCLUSIONS

Provision of resources focused on positive affect seem to increase the positive effects of walking on functional impact through the reduction of depressive symptoms. Nurses can improve adherence of patients with FM to walking behavior through increasing positive affect.

The Role of Walking in the Relationship between Catastrophizing and Fatigue in Women with Fibromyalgia

Walking is one of the most beneficial treatments for fibromyalgia patients. However, adherence to walking behavior is low due to the initially associated symptoms (including pain and fatigue). Although the association of catastrophism with greater symptoms is known, the results regarding fatigue have not always been consistent. Nevertheless, it is unknown whether the association between catastrophism and fatigue could, in turn, be conditioned by whether the patients walk or not. Therefore, our goal was to explore the moderating effect of walking on the association between catastrophizing and fatigue in patients with fibromyalgia. A cross-sectional study was carried out with 203 women with fibromyalgia. We used the Multidimensional Fatigue Inventory to assess fatigue and the Pain Catastrophizing Scale to assess pain catastrophizing (differentiating between its three dimensions). An ad hoc item was used to evaluate walking (moderator). Lower scores for fatigue and pain catastrophizing were found among patients who walked versus those who did not. Walking moderated the relationship between rumination and fatigue (Beta = 0.16, t = 1.96, p = 0.049) and between magnification and fatigue (Beta = 0.22, t = 21.83, p = 0.047). Helplessness showed no direct or interaction effect for fatigue. Nevertheless, higher rumination and magnification were associated with higher fatigue only in patients who walked. Therefore, to promote adherence to walking and reduce the effects of catastrophizing on fatigue, it seems necessary to manage rumination and magnification among patients who walk.

Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures

This study analyzes the degree of agreement between three self-report measures (Walking Behavior, WALK questionnaire and logbooks) assessing adherence to walking programs through reporting their components (minutes, rests, times a week, consecutive weeks) and their concordance with a standard self-report of physical activity (IPAQ-S questionnaire) and an objective, namely number of steps (pedometer), in 275 women with fibromyalgia. Regularized partial correlation networks were selected as the analytic framework. Three network models based on two different times of assessment, namely T1 and T2, including 6 weeks between both, were used. WALK and the logbook were connected with Walking Behavior and also with the IPAQ-S. The logbook was associated with the pedometers (Z-score > 1 in absolute value). When the behavior was assessed specifically and in a detailed manner, participants’ results for the different self-report measures were in agreement. Specific self-report methods provide detailed information that is consistent with validated self-report measures (IPAQ-S) and objective measures (pedometers). The self-report measures that assess the behavioral components of physical activity are useful when studying the implementation of walking as physical exercise.