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Viabilidad de la utilizacion de intenciones de implementacion para aumentar el ejercicio fisico andando en mujeres con fibromialgia (Feasibility of using implementation intentions to increase physical exercise walking in women with fibromyalgia) [Spanish]
Pastor-Mira MA, Lopez-Roig S, Penacoba C, Lledo-Boyer A
Revista de la Sociedad Espanola del Dolor 2018;25(Suppl 1):4-13
clinical trial
2/10 [Eligibility criteria: No; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIMS: Implementation intentions (II) are "if... then..." plans that have shown their efficacy in solving self-regulation problems related to goal striving. They are usually applied individually. This study aims to analyze their pertinence and feasibility in a group intervention setting to increase non-supervised walking as physical exercise, in fibromyalgia women. MATERIALS AND METHODS: In the context of an experimental, randomized, triple blind study with an active control group, 117 women with fibromyalgia received an intervention based on II. They belonged to five patient associations from Alicante, Elche, Madrid and Talavera de la Reina. A sub-group (n = 59) also received a motivational intervention. The researcher in charge of the application of the II intervention was unaware of the experimental condition of the women. The Universidad Miguel Hernandez ethics committee approved the study. The participants went to the labs at the university to receive the interventions as well as the pre- and post-experimental assessment. All of them signed informed consent forms. The group session for II was approximately 30 minutes long. During the pre-experimental session, we assessed distress, perceived fibromyalgia impact and pain intensity. In the postexperimental session, we assessed satisfaction and perceived usefulness of the intervention. RESULTS: Of the participants, 83.6% selected one inhibitor from the three we presented (if component). Fatigue was the most frequently chosen (n = 37; 31.9%), followed by pain (n = 31; 26.7%) and have 'a bad day' for the illness (n = 29; 25%). The strategy (then component) most frequently chosen was acceptance and commitment (n = 55; 47.42%), but differences weren't significant regarding the choice of the other strategies. Women who selected the pain inhibitor presented significantly higher pain scores (F = 3.09, p = 0.05) and general painful scores (F = 4.32; p = 0.02) in the FIQ-R. Women who chose acceptance and commitment as strategy, scored significantly lower on the function sub-scale of the same questionnaire than those who opted for task persistence (F = 3.528; p = 0.03). Of the participants, 25.9% (n = 30) did not write the 'if' component in the final II and 22.4% (n = 26) did not do so for the 'then' component. There were errors in the creation of this last component related especially with the incomplete writing of the corresponding self-instruction (persistence of the task: n = 7; acceptance and commitment: n = 3; relaxation: n = 5). Mean satisfaction with the intervention was 8.96 over 10, and all except for one participant would recommend the intervention to other fibromyalgia patients. CONCLUSIONS: It was found that both the behavioural inhibitors for exercise as well as the strategies for management are pertinent and 'significant' for the participants. Group application also seems to be an appropriate procedure as long as it is carried out in groups whose size allows individual supervision of the II. This is important to avoid errors that could affect quality. In general terms, we can conclude that II is a viable and acceptable strategy for women with fibromyalgia.

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