Pain Catastrophization and Fear of Movement Are Potential Moderators for Response to Treatment in Women With Fibromyalgia: Secondary Analyses of Randomized Controlled Trial.

IF 3.7 2区 医学 Q1 REHABILITATION
Felipe Araya-Quintanilla, Héctor Gutiérrez-Espinoza, Joaquín Salazar-Méndez, Erick Atenas-Nuñez, Mayte Serrat, Robinson Ramírez-Vélez
{"title":"Pain Catastrophization and Fear of Movement Are Potential Moderators for Response to Treatment in Women With Fibromyalgia: Secondary Analyses of Randomized Controlled Trial.","authors":"Felipe Araya-Quintanilla, Héctor Gutiérrez-Espinoza, Joaquín Salazar-Méndez, Erick Atenas-Nuñez, Mayte Serrat, Robinson Ramírez-Vélez","doi":"10.1016/j.apmr.2025.07.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To examine whether psychological and behavioral factors-specifically pain intensity, pain catastrophizing, fear of movement, and sleep quality at the end of the intervention-as well as baseline characteristics including physical activity levels, age, and nutritional status, moderate the effects of a multicomponent treatment on health-related quality of life and functional status in individuals with fibromyalgia (FM).</p><p><strong>Design: </strong>Secondary analysis of randomized clinical trial.</p><p><strong>Setting: </strong>The study was conducted in RehabilitarCenter.</p><p><strong>Participants: </strong>Women (N=65) with a clinical diagnosis of FM were randomly allocated (1:1) into 2 groups.</p><p><strong>Interventions: </strong>The experimental group (n=33) received a novel multicomponent treatment combining graded motor imagery and therapeutic neuroscience education, whereas the control group (n=32) received standard treatment, including pharmacotherapy and standard physician education.</p><p><strong>Main outcome measures: </strong>The primary outcome was health-related quality of life and functional status, assessed using the Fibromyalgia Impact Questionnaire (FIQ). Potential moderators included pain catastrophizing, assessed with the Pain Catastrophizing Scale (PCS); kinesiophobia, assessed with the 17-item Tampa Scale of Kinesiophobia (TSK-17); sleep quality, assessed with the Pittsburgh sleep quality index; pain intensity, assessed with a visual analog scale; and physical activity levels, assessed with the global physical activity.</p><p><strong>Results: </strong>The analysis revealed a significant relationship between the intervention effect and FIQ change when the PCS and TSK-17 scores decreased by more than -14.0 points and -11.4 points. Therefore, when the PCS and TSK-17 score changes exceeded -14.0 and -11.4 points, the effect of the intervention on FIQ was statistically significant. By contrast, baseline measurements did not moderate the intervention effects.</p><p><strong>Conclusions: </strong>Pain catastrophizing and kinesiophobia are moderators of health-related quality of life and functional status in women with FM, whereas pain intensity and sleep quality do not show statistically significant interactions. Additionally, baseline measurements are not significant moderators. Further long-term studies are needed to confirm these findings.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2025.07.012","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To examine whether psychological and behavioral factors-specifically pain intensity, pain catastrophizing, fear of movement, and sleep quality at the end of the intervention-as well as baseline characteristics including physical activity levels, age, and nutritional status, moderate the effects of a multicomponent treatment on health-related quality of life and functional status in individuals with fibromyalgia (FM).

Design: Secondary analysis of randomized clinical trial.

Setting: The study was conducted in RehabilitarCenter.

Participants: Women (N=65) with a clinical diagnosis of FM were randomly allocated (1:1) into 2 groups.

Interventions: The experimental group (n=33) received a novel multicomponent treatment combining graded motor imagery and therapeutic neuroscience education, whereas the control group (n=32) received standard treatment, including pharmacotherapy and standard physician education.

Main outcome measures: The primary outcome was health-related quality of life and functional status, assessed using the Fibromyalgia Impact Questionnaire (FIQ). Potential moderators included pain catastrophizing, assessed with the Pain Catastrophizing Scale (PCS); kinesiophobia, assessed with the 17-item Tampa Scale of Kinesiophobia (TSK-17); sleep quality, assessed with the Pittsburgh sleep quality index; pain intensity, assessed with a visual analog scale; and physical activity levels, assessed with the global physical activity.

Results: The analysis revealed a significant relationship between the intervention effect and FIQ change when the PCS and TSK-17 scores decreased by more than -14.0 points and -11.4 points. Therefore, when the PCS and TSK-17 score changes exceeded -14.0 and -11.4 points, the effect of the intervention on FIQ was statistically significant. By contrast, baseline measurements did not moderate the intervention effects.

Conclusions: Pain catastrophizing and kinesiophobia are moderators of health-related quality of life and functional status in women with FM, whereas pain intensity and sleep quality do not show statistically significant interactions. Additionally, baseline measurements are not significant moderators. Further long-term studies are needed to confirm these findings.

疼痛灾难化和运动恐惧是纤维肌痛女性治疗反应的潜在调节因素:随机对照试验的二次分析。
目的:本研究的目的是检查心理和行为因素(特别是疼痛强度、疼痛灾难化、运动恐惧和干预结束时的睡眠质量)以及基线特征(包括体力活动水平、年龄和营养状况)是否能调节多组分治疗对纤维肌痛(FM)患者健康相关生活质量和功能状态的影响。设计:随机临床试验的二次分析。环境:研究在圣地亚哥康复基金会进行。智利。参与者:65名临床诊断为FM的女性随机分为两组(1:1)。干预措施:实验组(n=33)采用分级运动意象与治疗性神经科学教育相结合的新型多组分治疗,对照组(n=32)采用包括药物治疗和标准医师教育在内的标准治疗。主要结局指标:主要结局是健康相关的生活质量和功能状态,使用纤维肌痛影响问卷(FIQ)进行评估。潜在的调节因素包括疼痛灾难化,用疼痛灾难化量表(PCS)评估;运动恐惧症,用17项坦帕运动恐惧症量表(TSK-17)评估;睡眠质量,用匹兹堡睡眠质量指数评估;疼痛强度,用视觉模拟量表评估;和身体活动水平,通过全球身体活动评估。结果:分析发现,当PCS和TSK-17得分分别下降-14.0分和-11.4分以上时,干预效果与FIQ变化之间存在显著的关系。因此,当PCS和TSK-17评分变化超过-14.0分和-11.4分时,干预对FIQ的影响具有统计学意义。相比之下,基线测量并没有减缓干预效果。结论:疼痛灾难化和运动恐惧症是FM女性健康相关生活质量和功能状态的调节因子,而疼痛强度和睡眠质量没有统计学上显著的相互作用。此外,基线测量并不是显著的调节因子。需要进一步的长期研究来证实这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信