Proof of concept of prehabilitation: a combination of education and behavioural change, to promote physical activity in people with fibromyalgia

Javier Courel-Ibáñez, Fernando Estévez-López, Ciara Hughes, Nicola Adams, Brona M Fullen, Gareth Davison, Ashley Montgomery, Fiona Cramp, Cristina Maestre, Denis Martin, Joseph G McVeigh

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Objectives: To establish proof of concept of a prehabilitation intervention, a combination of education and behavioural change, preceding a physical activity programme in people with fibromyalgia (FM).

Settings: Open-label, feasibility clinical trial.

Participants: Eleven people with FM (10 women).

: The prehabilitation intervention consisted of 4 weeks, 1 weekly session (~1 to 1.5 hours), aimed to increase self-efficacy and understand why and how to engage in a gentle and self-paced physical activity programme (6 weeks of walking with telephone support).

Primary and secondary outcome measures: Primary outcome was the acceptability and credibility of the intervention by means of the Credibility/Expectancy Questionnaire. Secondary outcomes comprised scales to measure FM severity, specific symptoms and sedentary behaviour. An exit interview was conducted to identify the strengths and weaknesses and barriers to the intervention.

: One participant dropped out due to finding the walking programme excessively stressful. Participants expected the intervention would improve their symptoms by 22%–38% but resulted in 5%–26% improvements. Participants would be confident in recommending this intervention to a friend who experiences similar problems. The interviews suggested that the fluctuation of symptoms should be considered as an outcome and that the prehabilitation intervention should accomodate these fluctuation. Additional suggestions were to incorporate initial interviews (patient-centred approach), to tailor the programmes to individuals’ priorities and to offer a variety of physical activity programmes to improve motivation.

: This feasibility study demonstrated that our novel approach is acceptable to people with FM. Future interventions should pay attention to flexibility, symptoms fluctuation and patients support.

Trial registration number: NCT03764397.
Original languageEnglish
Article number070609
Pages (from-to)1-8
Number of pages8
JournalBMJ Open
Issue number7
Early online date14 Jul 2023
Publication statusPublished online - 14 Jul 2023

Bibliographical note

Funding Information:
This study was supported by the Health and Social Care Public Health Agency, Northern Ireland (STL/5268/16 to CH and JGM). FE-L was supported by the Ramón y Cajal 2021 Excellence Research Grant action from the Spanish Ministry of Science and Innovation (FSE/AGENCIA ESTATAL DE INVESTIGACIÓN, RYC2021-034311-I).

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.




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