Effects of Walking as Physical Exercise on Functional Limitation through Pain in pwFM—How Does Catastrophic Thinking Contribute? 2022 Catalá et al

Abstract

Background: Aerobic exercise has a beneficial impact on physical and mental health. However, patients with fibromyalgia do not always report perceiving these improvements.

Objective: The aim of this study was to examine whether catastrophic thinking moderated the effects of perceived pain severity once an active and regular lifestyle had been established on functional limitation in chronic pain patients, in particular in fibromyalgia patients.

Methods: The sample consisted of a total of 491 women with fibromyalgia diagnosed according to the criteria of the American College of Rheumatology. Participants completed an ad-hoc item about lifestyle related to walking pattern, the Brief Pain Inventory, the Pain Catastrophization Scale, and the Fibromyalgia Impact Questionnaire-Revised. To examine the relationship between the variables, a moderate mediation analysis was performed through the macro PROCESS (model 14). Results: The relationship between the performance of the recommended walking pattern and functional limitation was mediated by the severity of pain (B = −5.19, SE = 1.59, t = −3.25, 95% CI = [−4.06, −0.28], p < 0.001). Furthermore, it was found that the mediating effect of pain severity was moderated by catastrophic thinking (Index = −0.014, SE = 0.007, 95% CI [0.002, 0.030]).

Conclusions: The positive effect of walking on functionality through the reduction of pain levels is favored when patients present low catastrophizing, which affects the relevance of including interventions focused on the reduction of catastrophizing in the prescription of physical exercise in patients with fibromyalgia as the treatment of choice.

Open access, https://www.mdpi.com/1660-4601/20/1/190

 

There is something very disturbing about this statement. Obviously when subjective benefits aren't matched by objective evidence, it's likely that the evaluation is wrong. And given how poor and unreliable things are in clinical psychology and EBM, this is expected. It's a standard problem in science: you have to actually measure real things in order to get a real measurement, and avoiding measurements obviously doesn't fix that problem.

But here they are actually claiming that there are objective benefits, I guess they just can't figure out how to measure them but they "know" they're real, it's just that the patients aren't reporting them. Usually you have no objective benefits and iffy reports of vague, generic subjective benefits. But here it asserts there must be objective benefits, it's the subjective reporting that is wrong because it's not positive enough based on their flawed expectations. Just a bias sundae dripping with bias sauce.

This is a level of twisting facts about on the level of headphone cord that was forgotten in the washing machine, it basically has to reach into invisible dimensions twisted on themselves.

And it really looks like the EBM answer to the crisis of replicability is to lower quality even further and put out even more garbage research. It really has to be said but things won't change on their own, this is the same problem as enacting electoral reform: people successful in a system don't want to change to a different system in which they may not be as successful.

Academia is just as career-first as politicians, sometimes even worse. I'd even suggest it's probably more likely for politicians to do the right thing at personal cost than in academia, as politics usually doesn't involve such a dramatic career change, it's often just for a few years.

 

I wonder whether it's occurred to them to do this study on people with chronic pain caused by cancer, or inflammatory arthritis, or basically anything that isn't a maligned disease like FM?

Thought not. Cancer wouldn't stop you publicly lampooning halfwits who suggest that walking isn't curing your pain due to catastrophic thinking.