Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcón, Madrid, Spain.
Clin Rheumatol. 2023 Jan;42(1):225-232. doi: 10.1007/s10067-022-06342-5. Epub 2022 Aug 31.
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.
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.
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.
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.
行走是管理纤维肌痛患者症状的有效治疗方法。然而，尽管有这些好处，纤维肌痛患者面临着各种障碍，导致他们维持体力活动的能力下降。本研究的主要目的是分析疼痛灾难化和纤维肌痛影响在规律行走行为与实验室步行试验后疼痛和疲劳之间关系中的作用。
该研究采用观察性分析性实验室设计。研究小组联系了 100 名女性。共有 76 名年龄在 18 岁及以上的纤维肌痛诊断女性（平均年龄 55.05 岁，标准差 7.69 岁）参与了研究。
在规律行走行为、疼痛灾难化、纤维肌痛影响、步行后疼痛强度和步行后疲劳强度之间发现了显著相关性。系列多重中介分析证实，疼痛灾难化和纤维肌痛影响介导了规律行走行为与实验室步行试验后疼痛（β B=0.044，95%置信区间 [0.01-0.012]）和疲劳（β B=0.028，95%置信区间 [0.01-0.08]）水平之间的关系。此外，规律行走行为较少的参与者在 6 分钟步行试验后经历了更多的疼痛和疲劳。
考虑到认知变量和纤维肌痛的影响，将有助于理解参与体力活动的抑制剂。治疗性步行计划必须针对纤维肌痛患者量身定制，以减轻与体力活动相关的疼痛和疲劳，促进更好的功能和生活质量。关键点 • 规律行走行为与纤维肌痛影响、疼痛灾难化和体力活动后疼痛和疲劳减少相关。 • 当患者对疼痛进行灾难化时，他们通常会将体力活动解释为威胁，从而在进行运动后产生更多的疼痛和疲劳。 • 治疗计划应旨在减少疼痛灾难化和纤维肌痛影响。
