Physical and psychological paths toward less severe fibromyalgia : A structural equation model / Manuel Pulido-Martos in Annals of physical and rehabilitation medicine, Vol. 63, n°1 (Janvier 2020)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 46-52 Titre : Physical and psychological paths toward less severe fibromyalgia : A structural equation model Type de document : texte imprimé Auteurs : Manuel Pulido-Martos ; Octavio Luque-Reca ; Victor Segura-Jimenez ; Immaculada C. Alvarez-Gallardo ; Alberto Soriano-Maldonado ; Pedro Acosta-Manzano ; Blanca Gavilan-Carrera ; Joseph G. McVeigh ; Rinie Geenen ; Manuel Delgado-Fernandez ; Fernando Estevez-Lopez Année de publication : 2020 Article en page(s) : p. 46-52 Note générale : doi.org/10.1016/j.rehab.2019.06.017 Langues : Anglais (eng) Mots-clés : Adaptation  Fibromyalgia impact  Physical activity  Quality of life  Rheumatic and musculoskeletal diseases Résumé : 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. Permalink : ./index.php?lvl=notice_display&id=90687 [article] Physical and psychological paths toward less severe fibromyalgia : A structural equation model [texte imprimé] / Manuel Pulido-Martos ; Octavio Luque-Reca ; Victor Segura-Jimenez ; Immaculada C. Alvarez-Gallardo ; Alberto Soriano-Maldonado ; Pedro Acosta-Manzano ; Blanca Gavilan-Carrera ; Joseph G. McVeigh ; Rinie Geenen ; Manuel Delgado-Fernandez ; Fernando Estevez-Lopez . - 2020 . - p. 46-52. doi.org/10.1016/j.rehab.2019.06.017 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 46-52 Mots-clés : Adaptation  Fibromyalgia impact  Physical activity  Quality of life  Rheumatic and musculoskeletal diseases Résumé : 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. Permalink : ./index.php?lvl=notice_display&id=90687

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