Distress, fear of movement, walking behaviour and disability in fibromyalgia

Abstract

Background: Walking regularly is a simple, safe and accessible exercise that can be self-managed by fibromyalgia patients. However, adherence to exercise guidelines is low. Our aim is to study the role of distress and fear of movement on walking behaviour and disability perception in fibromyalgia women. Methods: Self-reported measures of fear of movement, pain, disability, anxiety, depression and walking behaviour were completed by 277 women with fibromyalgia. Findings: 51.6% of patients do not walk, 18.9% were regular walkers (between 2-4 times a week, over 50 minutes, in bouts of 30 minutes, with a small rest between bouts, over six consecutive weeks) and 29.5% walk below the minimum (at least twice a week over 30 minutes over six consecutive weeks). Significant differences were found between groups in pain (p=.002) and disability perception (p=.006), anxiety (p= .04) and depression (p=.002). Depression was the only significant predictor of walking meeting the minimum (p=.04) and disability (p <.000). Fear of movement was a significant predictor of anxiety (p <.000) and depression (p <.000). Discussion: Fear of movement has been studied as an important inhibitor of activity in fibromyalgia and chronic pain patients. However, in this study the main role was for depression. It is worth underlying the role of fear of movement only on emotional variables. Interventions to increase walking adherence and reduce disability in these patients should focus on reducing levels of depression. This can be reached decreasing fear of movement. This study has been supported by MINECO (PSI2011-25152)