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 randomised controlled trial
Författare och institution:
Annie Palstam (Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering); Anette Larsson (Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning & Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)); Löfgren Monica (-); Ernberg Malin (-); Jan Bjersing (Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning); Indre Bileviciute-Ljungar (-); Björn Gerdle (-); Kosek Eva (-); Kaisa Mannerkorpi (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering & Centrum för personcentrerad vård vid Göteborgs universitet (GPCC))
Arthritis Research & Therapy, 18 ( 1 ) s. Article number: 116
Artikel, refereegranskad vetenskaplig
Background: Fibromyalgia (FM) is characterized by persistent widespread pain, increased pain sensitivity and
tenderness. Women with FM also report disability, in terms of negative consequences on activities of daily living.
Our recent randomized controlled trial (RCT) is the first study of resistance exercise to show positive effects on pain
disability. The resistance exercise program of our RCT emphasized active involvement of participants in planning
and progression of the exercise, using the principles of person-centeredness, to support each participant’s ability to
manage the exercise and the progress of it. The aim of this sub-study was to investigate explanatory factors for
reduced pain disability in women with FM participating in a 15-week person-centered progressive resistance
Methods: A total of 67 women with FM were included in this sub-study of an RCT examining the effects of
person-centered progressive resistance exercise performed twice a week for 15 weeks. Tests of physical capacity
and health-related questionnaires were assessed at baseline and after the intervention period. Multivariable
stepwise regression was used to analyze explanatory factors for improvements in pain disability.
Results: Reduced pain disability was explained by higher pain disability at baseline together with decreased
fear avoidance beliefs about physical activity (R2 = 28, p = 0.005). The improvements in the disability domains of
recreation and social activity were explained by decreased fear avoidance beliefs about physical activity together
with higher baseline values of each disability domain respectively (R2 = 32, p = 0.025 and R2 = 30, p = 0.017). The
improvement in occupational disability was explained by higher baseline values of occupational disability (R2 = 19,
p = 0.001). Conclusion: The person-centered resistance exercise intervention, based on principles of self-efficacy, had a positive
effect on recreational, social and occupational disability. The reduced pain disability seemed to be mediated by
decreased fear avoidance beliefs. Age, symptom duration, pain intensity, and muscle strength at baseline had no
explanatory value for reduced pain disability, indicating that the person-centered resistance exercise program has the potential to work for anyone with FM who has interest in physical exercise.
ClinicalTrials.gov identification number: NCT01226784.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Annan medicin och hälsovetenskap
Fibromyalgia, Pain, Disability, Resistance exercise, Person-centered
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