Review Article

Clinical Rheumatology

, Volume 32, Issue 8, pp 1121-1129

Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice

  • Jo NijsAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselDepartment of Physical Medicine and Physiotherapy, University Hospital Brussels Email author 
  • , Nathalie RousselAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselChronic Pain and Chronic Fatigue Research Group (CHROPIVER), Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College AntwerpDepartment of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp
  • , Jessica Van OosterwijckAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselChronic Pain and Chronic Fatigue Research Group (CHROPIVER), Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College AntwerpRehabilitation Sciences and Physiotherapy, Ghent University
  • , Margot De KooningAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselDepartment of Physical Medicine and Physiotherapy, University Hospital Brussels
  • , Kelly IckmansAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselDepartment of Physical Medicine and Physiotherapy, University Hospital Brussels
  • , Filip StruyfAffiliated withPain in Motion research group, Department of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselChronic Pain and Chronic Fatigue Research Group (CHROPIVER), Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College AntwerpDepartment of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp
  • , Mira MeeusAffiliated withChronic Pain and Chronic Fatigue Research Group (CHROPIVER), Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College AntwerpRehabilitation Sciences and Physiotherapy, Ghent University
  • , Mari LundbergAffiliated withUniversity of Gothenburg

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Abstract

Severe exacerbation of symptoms following physical activity is characteristic for chronic-fatigue syndrome (CFS) and fibromyalgia (FM). These exacerbations make it understandable for people with CFS and FM to develop fear of performing body movement or physical activity and consequently avoidance behaviour toward physical activity. The aims of this article were to review what measures are available for measuring fear of movement and avoidance behaviour, the prevalence fear of movement and avoidance behaviour toward physical activity and the therapeutic options with fear of movement and avoidance behaviour toward physical activity in patients with CFS and FM. The review revealed that fear of movement and avoidance behaviour toward physical activity is highly prevalent in both the CFS and FM population, and it is related to various clinical characteristics of CFS and FM, including symptom severity and self-reported quality of life and disability. It appears to be crucial for treatment (success) to identify CFS and FM patients displaying fear of movement and avoidance behaviour toward physical activity. Individually tailored cognitive behavioural therapy plus exercise training, depending on the patient’s classification as avoiding or persisting, appears to be the most promising strategy for treating fear of movement and avoidance behaviour toward physical activity in patients with CFS and FM.

Keywords

Chronic-fatigue syndrome Chronic pain Fear avoidance Fear of movement Fibromyalgia Kinesiophobia