86. Prehabilitation Behavioral Change Intervention and Physical Activity in People With Fibromyalgia Syndrome: a Proof-of-Concept Study

Fernando Estevez-Lopez, Ciara Hughes, Nicola Adams, Brona Fullen, Gareth Davison, Ashley Montgomery, Fiona Cramp, Denis Martin, Christina Maestre Cascales, Joseph G McVeigh

Research output: Contribution to conferenceAbstractpeer-review


Fibromyalgia (FM) is a common chronic pain syndrome that has a significant impact on quality of life. Guidelines recommend physical activity for this population1,2 , however, patients find physical activity challenging3 . The aims of this proof-of-concept study were to develop the content of a 4-week prehabilitation behavioral change intervention and to pilot that intervention in combination with a 6-week self-paced walking programme (with weekly telephone support) in people with FM. Methods A prehabilitation behavioral change intervention consisting of a patient group meeting once per week for 1.5 hours for four weeks was developed by a multidisciplinary and international team. Awareness sessions were educational and experiential. Using the principles of Acceptance and Commitment Therapy, participants were taught how to set values-based SMART goals (specific, meaningful, adaptable realistic and timed), reflecting what was valuable or meaningful to themselves. Education topics included general information about fibromyalgia, biopsychosocial model of pain, mindfulness, values-based goal setting and the benefits of physical activity. Participants were invited to identify a ‘committed action’ linked to their values based goal which was revisited throughout the programme. After the 4-week prehabilitation behavioral change programme, the participants engaged in a 6- week self-paced walking programme (with weekly telephone support). Participants recorded daily step count using a pedometer and sedentary time was recorded using the International Physical Activity Questionnaire and the Sedentary Behavior Questionnaire. The success of the prehabilitation programme was determined according to (i) number of sessions attended, (ii) number of drop outs (iii) number of screening questionnaires completed and returned and (iv) the Treatment Acceptability and Credibility Questionnaire4 . Secondary outcomes included measures to demonstrate proof-of-concept (e.g., pain, fatigue, and sleep quality) and daily activity and sedentary time. Exit interviews were conducted with participants at the end of the programme. Results Eleven participants (10 women) were recruited and nine (80%) attended at least three education sessions. Two participants dropped out, one due to lack of time, the other due to finding the self-paced walking programme as excessively stressful. Six participants (55%) completed all questionnaires at all the time points (i.e., at baseline, after the prehabilitation programme and after the self-paced walking programme). The Treatment Acceptability and Credibility Questionnaire4 indicated that the prehabilitation intervention was logical, acceptable and credible, and that participants would be confident in recommending this intervention to a friend who experienced similar problems. The participants thought (cognitive component) that the intervention would improve their symptoms by 30% and they felt (affective component) that their symptoms would improve (27.5%). Participants engaged in the walking programme with sedentary time (mean (SD)) decreasing from 702.5 (200.9) minutes per day at baseline, to 617.5 (294.0) minutes at the end of the programme. There was some suggestion that overall impact of FM also decreased with the FM Impact Questionnaire Revised reducing from 72.0 (16.0) at baseline to 68.0 (16.2) at the end of the programme. There was a slight change in pain as measured by a Numerical Rating Scale (6.7 (2.0) to 6.0 (1.8)), however, energy seemed to improve more, 8.2 (1.9) at baseline to 6.5 (3.4) at the end of the programme. During exit interviews it was suggested that physical activities other than walking (e.g. yoga, mindful movement) should be available for participants. Participants also indicated that they would have liked their progression to be monitored and to have their walking plan revised, not only on the phone but also face-to-face with the researchers. Conclusions A prehabilitation behavioral change programme is acceptable to people with FM. While participants engaged with the self-paced supported walking programme a choice of alternative physical activities may encourage greater engagement and adherence with physical activity.
Original languageEnglish
Publication statusPublished (in print/issue) - 2021
EventIASP word congress on Pain. -
Duration: 9 Jun 2021 → …


ConferenceIASP word congress on Pain.
Period9/06/21 → …


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