Do Cognitive Abilities Influence Physical and Mental Fatigue in Patients with Chronic Pain after Walking..., 2021, Catala et al

Full title: Do Cognitive Abilities Influence Physical and Mental Fatigue in Patients with Chronic Pain after Walking According to a Clinical Guideline for Physical Exercise?

Abstract

The objective of this study is to explore the mediator role of cognitive fusion and chronic pain acceptance on the effects that the walking pattern, following an established clinical guideline for physical exercise, can have on fatigue (physical and mental) in patients with chronic pain.

The sample consisted of a total of 231 women with fibromyalgia with a mean age of 56.91 years (Standard Deviation SD = 9.58 years, range 30−78 years). The results show a significant indirect effect of the walking pattern on both physical and mental fatigue through cognitive fusion and chronic pain acceptance. Specifically, walking predicted less cognitive fusion, which predicted greater chronic pain acceptance, which, in turn, predicted less mental and physical fatigue (Beta-B- = −0.04, Standard Error SE = 0.02, 95% Confidence Interval 95% CI = [−0.09, −0.02]; B = −0.09, SE = 0.05, 95% CI = [−0.22, −0,15], respectively).

It can be concluded that the walking pattern is linked to both physical and mental fatigue through cognitive defusion and chronic pain acceptance. These cognitive abilities would allow fibromyalgia patients to perceive an improvement in both physical and mental fatigue by carrying out the walking pattern. Emphasizing the training of cognitive defusion and pain acceptance would improve the adherence of these patients to walking.

Open access, https://www.mdpi.com/1660-4601/18/24/13148/htm

 

Ah, I see. Wow this is dense. They're trying to understand why patients with FM don't regularly walk other than because of pain. Which is the reason, of course. Basically: "other than the incident, how was the play, Madame Lincoln?".

Nice word salad, though. But trying to understand the context of something while explicitly ignoring its context is... absurd. But there's always funding for that, it just never ends, no matter how close to a real life Deepak Chopra simulator the whole field has become. There's just always money for the jobs program.

 

Simplistic, reductionist. Though interesting to learn the term cognitive fusion/defusion (dare I say: confusion?).

What affects walking (for me) when it is a given that I highly desire to walk in nature (it's spiritual, puts me in a good mood) and I am highly motivated to increase the time I can spend walking?

The effects of weather (temperature, both hot and cold), what activity was done prior to walking (i.e. leg muscle activity), general stress levels and other factors involved in the human endeavor of living with a chronic illness, AND most importantly, have I walked on previous consecutive days?

Most good clinicians who specialize(d) in treating FM advise against walking two days in a row, that walking 2-3 times a week as a goal.

 

I read this like five times, yet am still unable to figure out how their findings bring them to this conclusion. Looks like they are interpreting the results in a way that confirms their pre-held beliefs...Or maybe my walking patterns aren't good enough to understand this genius-level research.

 

Yep.
It' s truly amazing that so many research " "ships" have preprogrammed destinations

Did they do satnav testing ? ( sarcasm)

 

By that you mean mean catastrophization, right?
(Kidding of course)

 

Sedentary women could have been sedentary prior to onset of FM, or they prefer other movement (dancing, housework) to walking.

Also, walking is not the panacea that psych and PT think it is, IMHO as a person with FM. It can boost mood, but it can also lead to more pain and fatigue, and yes, doing the 30 minutes walking even with built in "little rests."

And so, again, it's out of the realm of the 'professionals' this type of learning to cope and improve things (if and when possible) with your FM. Ho-hum.

 

Another "therapy" to add to the list of how to reduce pain. Article refers to chronic back pain, but will no doubt spread to any pain, where the cause is not yet understood.
https://jamanetwork.com/journals/ja...term=mostread&utm_content=olf-widget_01052022

"Key Points

Question Can a psychological treatment based on the reappraisal of primary chronic back pain as due to nondangerous central nervous system processes provide substantial and durable pain relief?

Findings In this randomized clinical trial, 33 of 50 participants (66%) randomized to 4 weeks of pain reprocessing therapy were pain-free or nearly pain-free at posttreatment, compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care, with gains largely maintained through 1-year follow-up. Treatment effects on pain were mediated by reduced beliefs that pain indicates tissue damage, and longitudinal functional magnetic resonance imaging showed reduced prefrontal responses to evoked back pain and increased resting prefrontal-somatosensory connectivity in patients randomized to treatment relative to patients randomized to placebo or usual care.

Meaning Psychological treatment focused on changing beliefs about the causes and threat value of primary chronic back pain may provide substantial and durable pain relief."