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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

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Abstract

Fibromyalgia (FM) is a highly disabling condition characterized by widespread chronic pain. Physical exercise, such as walking, has been recommended as the treatment of choice for FM. However, adherence to physical exercise tends to be poor. Pain is one of the main inhibitors to adhere to walking in FM patients. The main objective of this study has been to determine whether there is a clinical and psychosocial profile to help predict individual differences in adherence to walking in a sample of patients with FM with severe pain levels. In this cross-sectional study, the sample was composed of 172 women with FM and severe pain levels (> 7 in an 11-point numerical scale). Women were classified into two groups: (1) those who walked regularly and (2) patients who rarely or never walked. Group differences regarding clinical outcomes (e.g., FM impact, anxiety, depression, cognitive fusion, catastrophizing, affect, and personality), sociodemographic variables, and medical history were analyzed. Patients who walked despite pain significantly reported less impact of FM, anxiety, depression, catastrophizing, cognitive fusion, negative affect, openness to experience, agreeableness, and conscientiousness. The unique predictors of group membership (walking versus no walking) in a binary regression were FM impact and negative affect. The results show that adherence to exercise might be influenced and predicted by the clinical profile of the patient, which suggests that personalized motivational interventions should be addressed to this at-risk subgroup.

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Funding

This work was funded by the Health Research Fund (Fondo de Investigación en Salud), Grant number PI17/00858 from the Instituto de Salud Carlos III (Spain). López-Roig, S. contribution was supported by a research grant from MINECO (PSI2016-79566-C2-1-R). Suso-Ribera, C. also received support from the Jaume I University to conduct the present work (Reference E-2019-06).

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Authors and Affiliations

  1. Department of Psychology, Rey Juan Carlos University, Avda. de Atenas S/N, 28922, Alcorcón, Madrid, Spain

    Patricia Catala, Carmen Ecija & Cecilia Peñacoba Puente

  2. Department of Behavioral Sciences and Health, Universidad Miguel Hernández, Alicante, Spain

    Sofia Lopez-Roig

  3. Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain

    Carlos Suso-Ribera

Authors
  1. Patricia Catala
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  2. Sofia Lopez-Roig
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  3. Carmen Ecija
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  4. Carlos Suso-Ribera
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  5. Cecilia Peñacoba Puente
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Corresponding author

Correspondence to Cecilia Peñacoba Puente.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Rey Juan Carlos University (Reference 160520165916; PI17/00858).

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Informed consent was obtained from all individual participants included in the study.

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Catala, P., Lopez-Roig, S., Ecija, C. et al. 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. Rheumatol Int 41, 1479–1484 (2021). https://doi.org/10.1007/s00296-020-04719-w

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  • DOI: https://doi.org/10.1007/s00296-020-04719-w

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