Fibromyalgia
Conditions
Keywords
Lifestyle, Education, Self-management, Physical Activity, Proof-of-concept study
Brief summary
Twelve people with FM will be recruited from the FM patient support groups. The investigators will develop and test a 4-week prehabilitation educational programme (i.e., a behavioural change intervention) consisting of meeting once per week (each approximately 1 - 1.5 hours). These dynamic and interactive meetings will focus on education and skills training in: exercise, activity cycling, pacing, causes of symptoms in FM (pain, fatigue, sleep dysfunction) and their management. Participants will be taught to set specific, measurable, achievable, realistic and timed goals (SMART principle) that are valuable or meaningful to them. To do so, the participants will identify a 'committed action' plan. The principles of cognitive behavioural therapy will be used to address maladaptive thoughts (e.g., catastrophizing and fear avoidance) and to manage stress (e.g., skills of relaxation). Participants will learn how to use of pedometers to monitor physical activity. After the 4-week prehabilitation educational programme, the participants will be encouraged to engage in a 6-week gentle self-paced walking programme (with weekly telephone support). The 6-week walking programme will consist of a simple pedometer-driven intervention. Furthermore, the research team will telephone each participant at a prearranged time each week to discuss progress, to document mean daily step count and to discuss a new physical activity target (step count) for the subsequent week. Participants will record daily step counts (pedometer-derived) in a walking dairy which will be used as raw data and mean steps per day calculated. Where a participant declines telephone support, an alternative weekly email or text/WhatsApp messages will be offered instead, where the same information will be given and requested. Before (baseline measurements) and right after the completion of the 4-week prehabilitation educational programme as well as the 6-week gentle self-paced walking programme the same measurements will be taken. By doing so, the investigators will evaluate short and mid-term changes promoted by the prehabilitation programme. The participants will fill out the following questionnaires: the Revised FM Impact Questionnaire, Pain Catastrophizing Scale, Multidimensional Fatigue Inventory, Short-Form 36-item Health Survey, International Physical Activity Questionnaire, Sedentary Behaviour Questionnaire, Exercise Self Efficacy Questionnaire, Pittsburgh Sleep Quality Index questionnaire, and the modified 2011 preliminary FM criteria questionnaire. Right after the completion of the prehabiliation intervention, all the participants will fill out the treatment acceptability and credibility questionnaire. Right after the completion of the walking programme, participants will be interviewed (semistructured face-to-face exit interview lasting about 30-45 minutes) to explore their experiences of the study including barriers to participation. The main outcome of the study will be acceptability and credibility of the prehabilitation intervention (treatment acceptability and credibility questionnaire. Additionally, the success of the prehabilitation programme will be based on (i) number of sessions attended (\>80%), (ii) number of drop outs (\<15%) and reasons for early withdrawal, (iii) number of screening questionnaires completed and returned (\>80%).
Interventions
BEHAVIORALPrehabilitation for behavioural change
The 4-week prehabilitation educational programme will consist of a meeting for one session (approximately 1 - 1.5 hours) per week. This behavioural change programme will involve a mixture of interactive and didactic sessions, facilitated by a physiotherapist, psychologists, and other health professionals. The purpose of the initial prehabilitation programme is to gain participant 'buy-in' to the programme, to assist participants engage with exercise, to help participants overcome barriers to exercise and improve self-efficacy for exercise. The prehabilitation phase will also enable participants to understand why and how to perform gentle self-paced exercise. After the prehabilitation programme, participants will be advised to engage in a 6-week gentle self-paced walking programme; i.e., a simple pedometer-driven walking programme with weekly telephone support.
Sponsors
University of Ulster
Universidad de Granada
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participants must have been diagnosed with FM by a medical practitioner, which will be confirmed by the research team -i.e., the modified 2011 preliminary FM criteria questionnaire (Appendix 14) by satisfying 'widespread pain index' (WPI) and 'symptom severity scale' (SS) as follows, either WPI ≥7 and the SS ≥5, or the WPI is 3-6 and the SS ≥9.
Exclusion criteria
* Younger than 16 years old. * Not able to communicate in English. * Mobilise dependently/aided. * Have any medical condition that would make exercise participation unsafe (for example; heart disease, stroke, respiratory disease, severe mobility problems, severe arthritis or inflammatory joint disease). * Are involved in ongoing litigation involving FM. * Are currently under active treatment by a physiotherapist or involved in any other research studies. * Are pregnant.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability and credibility of the prehabilitation intervention | Time point(s): once, right after the education programme. Time frame: An average of the past 4 weeks | The treatment acceptability and credibility questionnaire |
| Number of sessions attended | Time point(s): once, right after the education programme. Time frame: The past 4 weeks | Percentage of participants attending to more than 80% of the education sessions |
| Number of drop outs and reasons for early withdrawal | Time point(s): once, right after the education programme. Time frame: The 4 past weeks | Percentage of participants that do complete the study |
| Number of questionnaires completed and returned | Time point(s): once, right after the education programme. Time frame: The 4 past weeks | Percentage of participants that complete and return, at least, 80% of the questionnaires |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| health related quality of life | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: in general, an average of the past 4 weeks. | the Short-Form Health Survey |
| physical activity | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: the past 7 days | the International Physical Activity Questionnaire |
| Severity of fibromyalgia (also know as, impact of fibromyalgia) | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: The past week | the Revised FM Impact Questionnaire |
| exercise self-efficacy | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: in general, an average of the past 4 weeks. | the Exercise Self Efficacy Questionnaire |
| sleep quality | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: in general, an average of the past 4 weeks. | the Pittsburgh Sleep Quality Index questionnaire |
| Sedentary Behaviour | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: the past week | Sedentary Behaviour Questionnaire |
| Pain intensity | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: The past week | 0-10 NRS |
| Pain catastrophizing | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: in general, an average of the past 4 weeks. | Pain catastrophizing is the tendency to describe a pain experience in more exaggerated terms than the average person, to ruminate on it more (e.g., I kept thinking 'this is terrible'), and/or to feel more helpless about the experience (I thought it was never going to get better). Pain catastrophizing will be measured by means of the Pain Catastrophizing Scale is a 13-item questionnaire in which patients are asked to reflect on past painful experiences and indicate their thoughts or feelings about pain, on a 5-point scale. For this study, the total score (range 0-52) was used, where higher scores represent a more negative appraisal of pain. |
| Fatigue | Time point(s): 3 (baseline, 4th and 10th weeks). Time frame: The past week | the Multidimensional Fatigue Inventory |
Countries
United Kingdom
Outcome results
None listed