The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions. The al-Ándalus project

Fernando Estévez-López, Inmaculada C. Álvarez-Gallardo, Víctor Segura-Jiménez, Alberto Soriano-Maldonado, Milkana Borges-Cosic, Manuel Pulido-Martos, Virginia A. Aparicio, Ana Carbonell-Baeza, Manuel Delgado-Fernández, Rinie Geenen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods: This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. Results: In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions: Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.

Original languageEnglish
Pages (from-to)329-337
Number of pages9
JournalDisability and Rehabilitation
Volume40
Issue number3
DOIs
Publication statusPublished - 30 Jan 2018

Cite this

Estévez-López, Fernando ; Álvarez-Gallardo, Inmaculada C. ; Segura-Jiménez, Víctor ; Soriano-Maldonado, Alberto ; Borges-Cosic, Milkana ; Pulido-Martos, Manuel ; Aparicio, Virginia A. ; Carbonell-Baeza, Ana ; Delgado-Fernández, Manuel ; Geenen, Rinie. / The discordance between subjectively and objectively measured physical function in women with fibromyalgia : association with catastrophizing and self-efficacy cognitions. The al-Ándalus project. In: Disability and Rehabilitation. 2018 ; Vol. 40, No. 3. pp. 329-337.
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title = "The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions. The al-{\'A}ndalus project",
abstract = "Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods: This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. Results: In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions: Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.",
keywords = "Chronic pain, disability, functional capacity, functional fitness, observed physical function, self-reported physical function",
author = "Fernando Est{\'e}vez-L{\'o}pez and {\'A}lvarez-Gallardo, {Inmaculada C.} and V{\'i}ctor Segura-Jim{\'e}nez and Alberto Soriano-Maldonado and Milkana Borges-Cosic and Manuel Pulido-Martos and Aparicio, {Virginia A.} and Ana Carbonell-Baeza and Manuel Delgado-Fern{\'a}ndez and Rinie Geenen",
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Estévez-López, F, Álvarez-Gallardo, IC, Segura-Jiménez, V, Soriano-Maldonado, A, Borges-Cosic, M, Pulido-Martos, M, Aparicio, VA, Carbonell-Baeza, A, Delgado-Fernández, M & Geenen, R 2018, 'The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions. The al-Ándalus project' Disability and Rehabilitation, vol. 40, no. 3, pp. 329-337. https://doi.org/10.1080/09638288.2016.1258737

The discordance between subjectively and objectively measured physical function in women with fibromyalgia : association with catastrophizing and self-efficacy cognitions. The al-Ándalus project. / Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C.; Segura-Jiménez, Víctor; Soriano-Maldonado, Alberto; Borges-Cosic, Milkana; Pulido-Martos, Manuel; Aparicio, Virginia A.; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel; Geenen, Rinie.

In: Disability and Rehabilitation, Vol. 40, No. 3, 30.01.2018, p. 329-337.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The discordance between subjectively and objectively measured physical function in women with fibromyalgia

T2 - association with catastrophizing and self-efficacy cognitions. The al-Ándalus project

AU - Estévez-López, Fernando

AU - Álvarez-Gallardo, Inmaculada C.

AU - Segura-Jiménez, Víctor

AU - Soriano-Maldonado, Alberto

AU - Borges-Cosic, Milkana

AU - Pulido-Martos, Manuel

AU - Aparicio, Virginia A.

AU - Carbonell-Baeza, Ana

AU - Delgado-Fernández, Manuel

AU - Geenen, Rinie

PY - 2018/1/30

Y1 - 2018/1/30

N2 - Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods: This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. Results: In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions: Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.

AB - Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods: This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means and SD of the control group. Results: In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions: Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitation Rehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function. In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments. In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction. When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function.

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KW - disability

KW - functional capacity

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