@misc{10481/58642,
year = {2019},
url = {http://hdl.handle.net/10481/58642},
abstract = {Objectives: Previous research suggested isolated associations of physical and psychological factors with
fibromyalgia severity. Integration of physical and psychological, experienced and observed, modifiable
factors associated with fibromyalgia severity in a single model will reveal therapeutic paths toward less
severity of disease. We aimed to examine an encompassing model of determinants of fibromyalgia
severity.
Methods: This observational, population-based cross-sectional study included 569 people with
fibromyalgia. An integrative model of fibromyalgia severity was tested by using structural equation
modelling. This model included 8 factors: resilience, catastrophizing, active lifestyle, declarative
memory, subjective fitness, objective fitness, psychological distress, and physical fatigue.
Results: Two core paths were associated with reduced fibromyalgia severity: 1) a psychological path
connecting high resilience and low catastrophizing with low distress and 2) a physical path, connecting a
more active lifestyle (directly and via high objective and subjective physical fitness) with low fatigue.
Additional interconnecting paths especially suggested a connection from the psychological to physical
path. Our model explained 83% of the fibromyalgia severity.
Conclusions: The present model integrated the complexity of mutually influencing factors of fibromyalgia
severity, which may help to better understand the disease. It emphasised the importance of: 1) physical
factors and psychological factors and their interconnections, 2) patients’ experiences and clinical
measurements, and 3) positive and negative signs such as physical fitness and distress. Future
longitudinal and experimental research should aim at testing the causal direction of the associations in
the model as well as the clinical implications suggested by the model. For instance, to reduce fatigue,
exercise should enhance not only objective fitness but also fitness-related perceptions. Reducing distress
and fatigue seems crucial for lowering fibromyalgia severity.},
organization = {This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+i DEP2010-15639, I+D+I DEP2013-40908, I+D+I PSI2015-65241-R, and BES-2014-067612] and the Spanish Ministry of Education [FPU15/00002]. This study was funded in part by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Fund (ref. SOMM17/6107/UGR) and University of Jaén, Plan de Apoyo a la Investigación 2017-2019 [EI_SEJ07_2017]. The funders did not have any role in the study design, data collection and analyses, decision to publish, or preparation of the manuscript.},
publisher = {Elsevier Masson SAS},
keywords = {Adaptation},
keywords = {Fibromyalgia impact},
keywords = {Physical activity},
keywords = {Quality of life},
keywords = {Rheumatic diseases},
keywords = {Musculoskeletal diseases},
title = {Physical and psychological paths toward less severe fibromyalgia: A structural equation model},
doi = {10.1016/j.rehab.2019.06.017},
author = {Pulido-Martos, M. and Luque-Reca, Octavio and Segura-Jiménez, V. and Álvarez-Gallardo, Inmaculada C. and Soriano‑Maldonado, Alberto and Acosta Manzano, Pedro and Gavilán Carrera, Blanca and McVeigh, Joseph G. and Geenen, Rinie and Delgado Fernández, Manuel and Estévez-López, Fernando},
}