Ramifications of Kinesiophobia in Fibromyalgia: From Acute Exercise Intervention to Changes in Body Composition

Giovanni Berardi; Christine Eble; Marie Hoeger Bement

doi:10.1016/j.apmr.2019.10.105

Objective Investigate the influence of kinesiophobia (fear of movement) on perceived pain and exertion with acute resistance exercise and body composition in patients with fibromyalgia. Design Randomized crossover intervention study. Setting University Pain Research Laboratory. Participants (or Animals, Specimens, Cadavers) Forty-seven participants with fibromyalgia (51±12yr., 2-male) completed 3 sessions, [1-familiarization and 2-exercise]. Interventions Participants performed two intermittent, submaximal exercise (isometric or concentric) protocols for 10-minutes to the elbow flexors matched for intensity and duty-cycle, separated by 1-week in randomized order. Main Outcome Measure(s) During session 1, Tampa Scale of Kinesiophobia-11 (TSK-11) was completed. During session 2, body composition was measured with a GE Lunar iDXA. During exercise sessions (2 & 3) self-reported arm pain during, 1-day, and 3-days after exercise were measured with a 10-cm Visual Analogue Scale. Perceived exertion was measured during exercise with modified-Borg Rating of Perceived Exertion Scale (RPE). Results Participants were overweight/obese (BMI: 30.2±6.9) with varying kinesiophobia (24.4±7.2, range: 11-44). During exercise participants reported minimal-to-severe pain and very weak-to-extremely strong exertion; minimal-to-severe pain continued up to 3-days after exercise. Kinesiophobia correlated with BMI (r=0.535, p<0.001), fat mass (r=0.546, p<0.001), lean mass (r=0.330, p=0.025), and visceral adipose tissue (r=0.366, p=0.012). Kinesiophobia correlated with RPE [(r=0.448, p=0.002), (r=0.301, p=0.040)] and self-reported pain [(r=0.460, p=0.002), (r=0.334, p=0.022)] during isometric and concentric exercise respectively. Kinesiophobia correlated with self-reported arm pain immediately [(r=0.459, p=0.001), (r=0.337, p=0.021)], 1-day [(r=0.425, p=0.004), (r=0.563, p<0.001)], and 3-days after [(r=0.416, p=0.005), (r=0.557, p<0.001)] isometric and concentric exercise respectively. Conclusions Elevated levels of kinesiophobia in patients with fibromyalgia has immediate consequences of higher pain and perceived exertion during exercise and long-term ramifications on body composition. Further interdisciplinary research is needed to investigate treatment strategies that lower kinesiophobia when prescribing exercise in patients with fibromyalgia.

Ramifications of Kinesiophobia in Fibromyalgia: From Acute Exercise Intervention to Changes in Body Composition

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