Using motivational and volitional interventions to promote unsupervised walking in women with fibromyalgia

Abstract

Background: Our aim is to test the efficacy of a motivational plus implementation intention (MIIC) intervention in increasing walking behaviour at short, medium and long term, comparing to a control condition (CC) and to only implementation intention intervention (IIC). Methods: A triple-blind, randomized longitudinal study was conducted. In the first appointment 190 women with fibromyalgia attended for baseline assessment and were randomly assigned to experimental conditions: IIC (n=73), MIIC (n=59), CC (n=58). Participants completed measurements post-intervention, at seven, 12, and 36. Only 53% of MIIC and 38% of II completed properly the formulation of intentions. We performed hierarchical mixed effects univariate regression two-level models with repeated measures analysis. Findings: Models showed time as fixed and random effects. Adherence to a fixed walking program, assessed by daily logs, was explained by time (F(2, 316)=37.199, p<.001) and by MIIC (F(1,104)=6.986, p<.001). No effects were found in steps assessed by pedometer. In secondary outcomes, distance (6MWT) was explained by time (F(1,238)=17.228, p<.001), MIIC (F(1,118)=9.498, p<.01) and by their interaction (F(1,238)=3.213, p=.07). Pain and distress were explained by time (F(1,251)=19.706, p<.001; F(1,251)=18.260, p<.001, respectively) and MIIC (F(1,124)=4.518, p<.05; F(1,124)=8.540, p<.01). Discussion: MII intervention significantly increased self-reported walking behaviour and women in this condition were better than the other two groups in secondary outcomes. Supported by Spanish Ministry of Economy and Competitiveness (Grant: PSI 2011-25132).