The Role of Catastrophizing in the Benefits of Walking on Fatigue in Women with Fibromyalgia

Abstract Background Walking is one of the most beneficial treatments for fibromyalgia patients. On the other hand, pain catastrophizing is one of the main cognitive processes that these patients present. However, it is not known how this process may affect the relationship between walking and fatigue. Therefore our goal is to analyze the associations between fatigue, catastrophizing, and walking in fibromyalgia patients, and to explore the moderation effect of walking in the association between catastrophizing and fatigue. Methods A cross-sectional study was carried out with 234 women with fibromyalgia older than 18 years. We use Multidimensional Fatigue Inventory for asses fatigue and Pain Catastrophizing Scale for pain catastrophizing (differentiating between its three dimensions, namely rumination, magnification, and helplessness). An ad-hoc self-reported item was used to evaluate walking. We perform the moderation analyses with walking as moderator. Results Walking moderated the relationship between rumination and fatigue (Beta = 0.21 t = 2.24, p = 0.26) and that of magnification with fatigue (Beta = 0.26, t = 2.1, p = .036). Specifically, that rumination and magnification only contributed to more fatigue when patients engaged in walking behavior. Helplessness contributed to more fatigue independently of adherence to walking (Beta = 0.12, t = 2.1, p = .036). Conclusions Patients who did not walk were highly fatigued irrespective of their cognitive profile (rumination and magnification only contributed to fatigue when patients walked). Therefore, in the field of personalized treatments, different recommendations should be provided about fatigue management in implementing walking and in its maintenance in the long term in fibromyalgia patients.