Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women With Fibromyalgia

Velasco, Lilian; López‐Gómez, Irene; Gutiérrez, Lorena; Écija, Carmen; Catalá, Patricia; Peñacoba, Cecilia

doi:10.1097/ajp.0000000000001010

Cited by 11 publications

(8 citation statements)

References 67 publications

(162 reference statements)

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“…The serial multiple mediation (SMM) analyses performed confirmed this hypothesis. Following the fear-avoidance models [ 12 , 15 ], our results pointed out that pain catastrophizing beliefs stop patients from engaging in physical activity, and this increases FM impact [ 9 , 16 , 17 ]. Previous research has also shown that pain catastrophizing is related to higher levels of pain and fatigue [ 13 ].…”

Section: Discussionmentioning

confidence: 72%

“…Based on previous literature [ 16 , 17 ], we propose two serial multiple mediation models (SMM) defined by pain catastrophizing (M 1 ) and impact of FM (M 2 ) on pain (SMM 1 ) and fatigue after 6-MWT as outcome variables (SMM 2 ). All indirect effects were significant in both models for regular walking behavior on pain/fatigue.…”

Section: Resultsmentioning

confidence: 99%

“…We hypothesized that pain catastrophizing and FM impact will mediate the relationship between regular walking behavior and the level of pain and fatigue after walking. Following the fear-avoidance models [ 12 , 15 ], we hypothesized that pain catastrophizing would be the first mediator as research has shown that it increases FM impact [ 10 , 16 , 17 ]. In turn, FM impact would be the second mediator of the model proposed.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact

et al. 2022

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Introduction Walking is an effective treatment for symptoms’ management in patients with fibromyalgia. However, despite its benefits, fibromyalgia patients face a variety of obstacles that result in reduced ability to sustain physical exercise. The main goal of the study was to analyze the role of pain catastrophizing and fibromyalgia impact in the relationship between regular walking behavior and pain and fatigue experienced after a laboratory walking test. Method The study has an observational analytical laboratory design. A total of 100 women were contacted by the research team. Seventy-six women diagnosed with fibromyalgia aged 18 years and older (mean age = 55.05, SD = 7.69) participated. Results Significant correlations were found among regular walking behavior, pain catastrophizing, impact of fibromyalgia, pain intensity after walking, and fatigue intensity after walking. The serial multiple mediation analyses confirmed that pain catastrophizing and impact of fibromyalgia mediated the relationship between regular walking behavior and the level of pain (beta B = 0.044, 95% CI = [0.01–0.012]) and fatigue (beta B = 0.028, 95% CI = [0.01–0.08]) after the laboratory walking test. Also, the participants that walked less regularly experienced more pain and fatigue after the 6-Minute Walk Test. Conclusions Considering cognitive variables alongside the impact of fibromyalgia will help understand the inhibitors of engaging in physical activity. Therapeutic walking programs must be tailored to patients with fibromyalgia to reduce pain and fatigue related to physical activity and to promote better functioning and quality of life. Key Points• Regular walking behavior was associated with fibromyalgia impact, pain catastrophizing, and less pain and fatigue after physical activity.• When patients catastrophize pain, they usually interpret physical activity as threatening, which generates more pain and fatigue after doing exercise.• Therapeutic programs should be designed to reduce pain catastrophizing and fibromyalgia impact.

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Section: Discussionmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact

et al. 2022

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“…In women with fibromyalgia, from a motivational approach, the roles of catastrophizing and goal preferences have been explored in functional limitations. However, fatigue avoidance was one of the goal preferences relative to other achievement goals focused on several daily life tasks (work and homework) [67].…”

Section: Discussionmentioning

confidence: 99%

Pain-Related Worrying and Goal Preferences Determine Walking Persistence in Women with Fibromyalgia

Pastor-Mira

López-Roig

Toribio³

et al. 2022

IJERPH

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Physical activity and exercise are relevant behaviors for fibromyalgia health outcomes; however, patients have difficulties undertaking and maintaining an active lifestyle. With a cross-sectional design, this study explored the role of pain-related worrying and goal preferences in the walking persistence of women with fibromyalgia. The sample included 111 women who attended a tertiary health setting. We adapted the Six-Minute Walk Test where participants decided either to stop or continue walking in five voluntary 6 min bouts. Women who were categorized higher in pain-related worrying reported higher preference for pain avoidance goals (t = −2.44, p = 0.02) and performed worse in the walking task (LongRank = 4.21; p = 0.04). Pain avoidance goal preference increased the likelihood of stopping after the first (OR = 1.443), second (OR = 1.493), and third (OR = 1.540) 6 min walking bout, and the risk of ending the walking activity during the 30 min task (HR = 1.02, [1.0–1.03]). Influence of pain-related worrying on total walking distance was mediated by goal preferences (ab = −3.25). In interventions targeting adherence in physical activity and exercise, special attention is needed for women who are particularly worried about pain to help decrease their preference for short-term pain avoidance goals relative to long-term goals such as being active through walking.

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“…However, it is often difficult to facilitate motivation for more PA in PwF when pain and related symptoms such as worrying and catastrophizing are present. 43,44 As indicated in the current review, lack of motivation to be physically active is a barrier for reducing SB. In these very complex situations where PA is less tolerated, PwF should be encouraged to at least interrupt SB by standing up regularly.…”

Section: General Findingsmentioning

confidence: 96%

Correlates of sedentary behavior in people with fibromyalgia: A systematic review

et al. 2023

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Introduction Understanding the correlates of sedentary behavior (SB) is important in the development of interventions which reduce and interrupt SB in people with fibromyalgia (PwF). This systematic review aimed to investigate the correlates of SB in PwF using the socio‐ecological model. Methods Three databases (Embase, CINAHL and PubMed) were search from inception until July 21, 2022 using “sedentary” or different types of SB and “fibromyalgia” or “fibrositis” as keywords. The data collected was then analyzed using summary coding. Results Out of 23 SB correlates retrieved from 7 reports (n = 1698), no correlates were consistently reported (ie, reported in 4 or more studies). Higher pain intensity was the most commonly reported barrier for reducing/interrupting SB (reported in 3 reports). Other reported barriers to reducing/interrupting SB were experiencing physical and mental fatigue, a more severe disease impact, and a lack of motivation to be physically active (all reported in 1 study). A better experienced social and physical functioning and more vitality were facilitators for reducing/interrupting SB (all reported in 1 study). To date, in PwF no correlates of SB at the interpersonal, environmental and policy levels have been explored. Conclusion Research on correlates of SB in PwF is still in its infancy. The current preliminary evidence suggests that clinicians should consider physical and mental barriers when aiming to reduce or interrupt SB in PwF. Further research on modifiable correlates at all levels of the socio‐ecological model is required to inform future trials aiming to modify SB in this vulnerable population.

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Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women With Fibromyalgia

Cited by 11 publications

References 67 publications

Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact

Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact

Pain-Related Worrying and Goal Preferences Determine Walking Persistence in Women with Fibromyalgia

Correlates of sedentary behavior in people with fibromyalgia: A systematic review

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