RT journal article
T1 Physical and psychological paths toward less severe fibromyalgia: A structural equation model
A1 Pulido Martos, Manuel
A1 Luque Reca, Octavio
A1 Segura Jiménez, Víctor
A1 Álvarez Gallardo, Inmaculada Concepción
A1 Soriano Maldonado, Alberto
A1 Acosta Manzano, Pedro
A1 Gavilán Carrera, Blanca
A1 McVeigh, Joseph G.
A1 Geenen, Rinie
A1 Delgado Fernández, Manuel
A1 Estévez  López, Fernando
A2 Didáctica de la Educación FísicaPlástica y Musical
K1 Adaptation
K1 Fibromyalgia impact
K1 Physical activity
K1 Quality of life
K1 Rheumatic and musculoskeletal diseases
AB ObjectivesPrevious 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.MethodsThis 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.ResultsTwo 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.ConclusionsThe 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.
PB Elsevier
SN 1877-0657
YR 2020
FD 2020
LK http://hdl.handle.net/10498/30574
UL http://hdl.handle.net/10498/30574
LA eng
NO We acknowledge Elsevier and Francis Ltd and Annals of Physical and Rehabilitation Medicine for publishing our scientific article: Pulido-Martos, M., Luque-Reca, O., Segura-Jiménez, V., Álvarez-Gallardo, I. C., Soriano-Maldonado, A., Acosta-Manzano, P., Gavilán-Carrera, B., McVeigh, J. G., Geenen, R., Delgado-Fernández, M., & Estévez-López, F. (2020). Physical and psychological paths toward less severe fibromyalgia: A structural equation model. Annals of Physical and Rehabilitation Medicine, 63(1), 46-52. https://doi.org/10.1016/J.REHAB.2019.06.017
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026