Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial

Palstam, Annie; Larsson, Anette; Löfgren, Monika; Ernberg, Malin; Bjersing, Jan; Bilevičiūtė-Ljungar, Indrė; Gerdle, Björn; Mannerkorpi, Kaisa

doi:10.1186/s13075-016-1007-0

Cited by 30 publications

(27 citation statements)

References 48 publications

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“…Since there is evidence for graded exposure treatment to reduce fear‐avoidance in long‐term back pain , future studies are motivated to evaluate its feasibility and outcome in patients with RA. In addition, the effectiveness of person‐centered, progressive resistance exercise to reduce fear‐avoidance beliefs in patients with fibromyalgia may be applicable in RA as well.…”

Section: Discussionmentioning

confidence: 99%

“…Such treatment includes patient education and systematic exposure to feared activities with gradually increasing difficulty, tailored to each patient . Progressive, person‐centered resistance exercise has also proven effective in reducing fear‐avoidance beliefs in women with fibromyalgia . However, if not addressed with appropriate treatment, fear‐avoidance beliefs seem persistent in patients with chronic low back pain, while they are spontaneously reduced over time in patients with acute back pain .…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis

Demmelmaier

Björk²,

Dufour

et al. 2018

Arthritis Care & Research

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ObjectiveTo identify and describe 2‐year trajectories of fear‐avoidance beliefs on physical activity and to identify predictors of these trajectories in people with rheumatoid arthritis (RA).MethodsWe included 2,569 persons with RA (77% women, mean age 58 years). Data on fear‐avoidance beliefs (Fear‐Avoidance Beliefs Questionnaire physical activity subscale [FABQ‐PA]; range 0–24), sociodemographics, disease‐related variables, self‐efficacy, and health‐enhancing physical activity (HEPA) were collected from registers and by questionnaires at baseline, 14, and 26 months. K‐means cluster analysis was used to identify fear‐avoidance trajectories, and multinomial logistic regression was used to identify predictors of trajectory membership.ResultsThree trajectories of fear‐avoidance beliefs were identified: low (n = 1,060, mean FABQ‐PA = 3), moderate (n = 1,043, mean FABQ‐PA = 9), and high (n = 466, mean FABQ‐PA = 15). Consistent predictors of being in the high fear‐avoidance trajectory versus the other 2 trajectories were high activity limitation, male sex, income below average, not performing current HEPA, and elevated anxiety/depression. In addition, less consistent predictors such as shorter education, more pain, and low exercise self‐efficacy were also identified.ConclusionStable trajectories of fear‐avoidance beliefs on physical activity exist among people with RA. Fear‐avoidance may be targeted more effectively by tailoring physical activity promotion to vulnerable socioeconomic groups, men, and those with high activity limitation and anxiety/depression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis

Demmelmaier

Björk²,

Dufour

et al. 2018

Arthritis Care & Research

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“…21,55,56 We also found some effect of the intervention on patients' fear, which is an important outcome because fear is involved in pain perception. 57 No previous studies have addressed fear responses.…”

Section: Discussionmentioning

confidence: 99%

Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

Papathanassoglou¹,

Hadjibalassi²,

Miltiadous³

et al. 2018

Am J Crit Care

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Background Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based nonpharmacological approaches for pain treatment in critically ill patients have been developed. Objectives To investigate the effects of a multimodal integrative intervention on the incidence of pain and on secondary outcomes: intensity of pain, hemodynamic indices (systolic and mean arterial pressure, heart rate), anxiety, fear, relaxation, optimism, and sleep quality. Methods A randomized, controlled, double-blinded repeated-measures trial with predetermined eligibility criteria was conducted. The intervention included relaxation, guided imagery, moderate pressure massage, and listening to music. The primary outcome was incidence of pain (score on Critical Care Pain Observation Tool > 2). Other outcomes included pain ratings, hemodynamic measurements, self-reported psychological outcomes, and quality of sleep. Repeated-measures models with adjustments (baseline levels, confounders) were used. Results Among the 60 randomized critically ill adults in the sample, the intervention group experienced significant decreases in the incidence (P = .003) and ratings of pain (P < .001). Adjusted models revealed a significant trend for lower incidence (P = .002) and ratings (P < .001) of pain, systolic arterial pressure (P < .001), anxiety (P = .01), and improved quality of sleep (P = .02). Conclusion A multimodal integrative intervention may be effective in decreasing pain and improving painrelated outcomes in critically ill patients. (American Journal of Critical Care. 2018; 27:172-185) EFFECTS OF Unrelieved pain is common among ICU patients and may compromise outcomes, by contributing to unstable hemodynamic parameters, hypercatabolism, hyperglycemia, infections, delirium, and posttraumatic stress. 2 Pain in ICU patients may also be part of a vicious circle implicating anxiety 3 and insomnia. 4 Moreover, pain has been linked to the post-ICU syndrome 5 and may become chronic in survivors, a situation associated with poor quality of life and poor psychological and physiological outcomes. 6Management of pain in patients with a critical illness is challenging.7 Opioids, the drug class of choice, are associated with marked side effects, including respiratory depression, hypotension, decreased gastrointestinal motility, delirium, and higher costs due to increased use of resources and prolonged stay in the ICU.8 Nociception, the perception of painful stimuli, entails a complex interaction among sensory, affective, and social components.9 Moreover, anxiety, fear, and negative expectations are common in critically ill patients and may contribute to heightened perception of pain.10 Thus, the multifactorial nature of ICU pain calls for approaches that address both physiological and psychosocial responses to pain. Current guidelines highlight the need to test and implement nonpharmacological strategies for pain treatment in critically ill patients.2 Interventions that elicit a relaxation ...

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“…In the first study of Palstam et al, 25 it was found that elevated perceived exertion at work increased FA beliefs of patients with FM. Moreover, the second study of Palstam et al 26,27 considered FA beliefs as a treatment parameter. Furthermore, Sánchez-Herán et al 7 evaluated the relationship between FA beliefs and the postural stability in OA of hip and knee.…”

Section: Discussionmentioning

confidence: 99%

High Disease Activity May Increase Fear-Avoidance Beliefs in Rheumatoid Arthritis

et al. 2017

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Objectives:This study aims to compare fear-avoidance (FA) beliefs of rheumatoid arthritis (RA) patients with osteoarthritis (OA) of hand patients and fibromyalgia (FM) patients and evaluate its relationship with RA activity and duration. Patients and methods:The study included 206 patients with RA (34 males, 172 females; mean age 49 years; range 20 to 72 years), 57 patients with FM (57 females; mean age 48 years; range 20 to 71 years), and 50 patients with OA of hand (4 males, 46 females; mean age 43 years; range 43 to 77 years). FA beliefs were assessed with modified Fear-Avoidance Belief Questionnaire (mFABQ). RA patients were dichotomized according to disease activity and disease duration separately; cutoff values were disease activity score 28 of 3.2 and six months of disease activity, respectively. Results: Modified Fear-Avoidance Belief Questionnaire scores were similar in patients with RA, OA of hand, and FM. RA patients in non-remission group had higher mFABQ scores. Moreover, mFABQ scores were similar in RA patients with early and established disease groups. Conclusion: Fear-avoidance beliefs of patients with RA were similar with OA of hand patients and FM patients. However, higher disease activity in RA was related with escalated FA beliefs. Further studies focusing on pathophysiology of FA beliefs in patients with RA are warranted for effective pain management of RA.

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Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial

Cited by 30 publications

References 48 publications

Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis

Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis

Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

High Disease Activity May Increase Fear-Avoidance Beliefs in Rheumatoid Arthritis

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