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

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.

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What Does the Psychological Flexibility Model Contribute to the Relationship Between Depression and Disability in Chronic Pain? The Role of Cognitive Fusion and Pain Acceptance

Clinical Nursing Research ◽

10.1177/10547738211034307 ◽

2021 ◽

pp. 105477382110343

Author(s):

Carmen Ecija ◽

Patricia Catala ◽

Irene Lopez-Gomez ◽

Dolores Bedmar ◽

Cecilia Peñacoba

Keyword(s):

Depressive Symptoms ◽

Cognitive Fusion ◽

Pain Acceptance ◽

Mediation Analyses ◽

Activity Avoidance ◽

Mediator Role ◽

Low Levels ◽

Acceptance Levels ◽

The Relationship

This study examines the mediator role of cognitive fusion between depressive symptoms, activity avoidance and excessive persistence at different levels of pain acceptance (moderator) among fibromyalgia patients (FM). Using a sample of 231 women, multiple and moderate mediation analyses were conducted with PROCESS. Results showed that depression was positively associated with activity avoidance and excessive persistence. Furthermore, cognitive fusion and pain acceptance were found to mediate the effect of depression in both patterns. Additionally, pain acceptance was found to play a contextual role in cognitive fusion, as a moderator, between depressive symptoms and maladaptive patterns. Specifically, FM patients with high acceptance levels and low levels of depression presented the strongest associations between depression and cognitive fusion. Techniques aimed at reducing cognitive fusion, could be especially beneficial to FM women with high pain acceptance.

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Positive pain? An ICF model of character strength and chronic pain acceptance in rehabilitation

PsycEXTRA Dataset ◽

10.1037/e551962014-001 ◽

2014 ◽

Author(s):

Phillip S. Keck ◽

Scott Fernelius ◽

Sharon L. Bowman ◽

Jacob Yui-Chung Chan

Keyword(s):

Chronic Pain ◽

Character Strength ◽

Pain Acceptance ◽

Icf Model

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Chronic Pain Acceptance Questionnaire-8--Spanish Version

PsycTESTS Dataset ◽

10.1037/t74285-000 ◽

2018 ◽

Author(s):

Elisabet Sánchez‐Rodríguez ◽

Rocío de la Vega ◽

Mélanie Racine ◽

Rubén Roy ◽

Mark P. Jensen ◽

...

Keyword(s):

Chronic Pain ◽

Spanish Version ◽

Pain Acceptance

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Pain acceptance and its impact on function and symptoms in fibromyalgia

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0049 ◽

2020 ◽

Vol 20 (4) ◽

pp. 727-736 ◽

Cited By ~ 1

Author(s):

Synne Flatlandsmo Tangen ◽

Anne-Sofie Helvik ◽

Hilde Eide ◽

Egil A. Fors

Keyword(s):

Chronic Pain ◽

Linear Regression ◽

Burden Of Illness ◽

Longitudinal Design ◽

Fibromyalgia Impact Questionnaire ◽

Experimental Studies ◽

Outcome Variable ◽

Unknown Etiology ◽

Cross Sectional ◽

Pain Acceptance

AbstractObjectivesFibromyalgia is a chronic widespread pain (CWP) syndrome of unknown etiology with substantial burden of illness and functional impairment. Pain acceptance has emerged as an interesting target of therapy in chronic pain populations, but few studies have yet been done on the effect of pain acceptance on patients with fibromyalgia. The aim of the present study was to examine the relationship between pain acceptance and its impact on function and symptoms in fibromyalgia with both a cross-sectional and longitudinal design.MethodsThree hundred and sixty five participants aged 22–70 with fibromyalgia were recruited from the Norwegian Fibromyalgia Association (NFA). They filled out a questionnaire containing the Fibromyalgia Impact Questionnaire (FIQ), measurement of function and symptoms, and Chronic Pain Acceptance Questionnaire (CPAQ), measurement of pain acceptance, in addition to sociodemographic and clinical variables such as degree of fibromyalgia, depression and pain duration (T1 measures). One year after, 87 of the participants filled out the FIQ and clinical measures once again (T2 measures). Unadjusted and adjusted linear regression analyses were performed both for cross-sectional measures at T1 and for longitudinal measures from T1 to T2, with FIQ score as the outcome variable and CPAQ score at T1 as one of the main independent variables.ResultsHigher CPAQ score was significantly associated with a lower FIQ score at T1, also when adjusting for age, education, work, depression and Fibromyalgianess Score (p<0.01). Lower FIQ score indicate less impact of fibromyalgia on functioning. In addition, two adjusted linear regression models found higher pain acceptance (CPAQ score) at T1 to be associated with lower negative impact of fibromyalgia on function and symptoms (FIQ score) at T2 (p<0.01).ConclusionsHigher pain acceptance is associated with better functional level and less symptoms in fibromyalgia, both cross-sectionally and when measurements are separated in time. Further research should include experimental studies with acceptance-based interventions for this patient group.

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Fluid Cognitive Abilities Are Important for Learning and Retention of a New, Explicitly Learned Walking Pattern in Individuals After Stroke

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211001025 ◽

2021 ◽

pp. 154596832110010

Author(s):

Margaret A. French ◽

Matthew L. Cohen ◽

Ryan T. Pohlig ◽

Darcy S. Reisman

Keyword(s):

Cognitive Abilities ◽

Step Length ◽

Cognitive Measures ◽

Retention Models ◽

Wechsler Memory Scale ◽

Walking Pattern ◽

Learning Principles ◽

The Relationship ◽

Sequential Regression ◽

Neurologically Intact

Background There is significant variability in poststroke locomotor learning that is poorly understood and affects individual responses to rehabilitation interventions. Cognitive abilities relate to upper extremity motor learning in neurologically intact adults, but have not been studied in poststroke locomotor learning. Objective To understand the relationship between locomotor learning and retention and cognition after stroke. Methods Participants with chronic (>6 months) stroke participated in 3 testing sessions. During the first session, participants walked on a treadmill and learned a new walking pattern through visual feedback about their step length. During the second session, participants walked on a treadmill and 24-hour retention was assessed. Physical and cognitive tests, including the Fugl-Meyer-Lower Extremity (FM-LE), Fluid Cognition Composite Score (FCCS) from the NIH Toolbox -Cognition Battery, and Spatial Addition from the Wechsler Memory Scale-IV, were completed in the third session. Two sequential regression models were completed: one with learning and one with retention as the dependent variables. Age, physical impairment (ie, FM-LE), and cognitive measures (ie, FCCS and Spatial Addition) were the independent variables. Results Forty-nine and 34 participants were included in the learning and retention models, respectively. After accounting for age and FM-LE, cognitive measures explained a significant portion of variability in learning ( R2 = 0.17, P = .008; overall model R2 = 0.31, P = .002) and retention (Δ R2 = 0.17, P = .023; overall model R2 = 0.44, P = .002). Conclusions Cognitive abilities appear to be an important factor for understanding locomotor learning and retention after stroke. This has significant implications for incorporating locomotor learning principles into the development of personalized rehabilitation interventions after stroke.

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Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽

10.1093/pm/pnab102 ◽

2021 ◽

Author(s):

Ludwig Ohse ◽

Ronald Burian ◽

Eric Hahn ◽

Hannah Burian ◽

Thi Minh Tam Ta ◽

...

Keyword(s):

Chronic Pain ◽

Mental Disorders ◽

Clinical Outcomes ◽

Acceptance And Commitment Therapy ◽

Psychological Flexibility ◽

Post Treatment ◽

Interdisciplinary Treatment ◽

Pain Acceptance ◽

Acceptance And Commitment ◽

Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

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Impact of Physical Exercise Programs on Women Diagnosed with Breast Cancer: Repercussion on Chronic Pain

10.47829/coo.2021.4202 ◽

2021 ◽

Vol 04 (02) ◽

Author(s):

Benitez-Jimenez MB ◽

Rodriguez-Navarro MA ◽

Cartagena J ◽

Castillo JA ◽

Valverde A ◽

...

Keyword(s):

Breast Cancer ◽

Chronic Pain ◽

Physical Exercise ◽

Exercise Programs

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The Relationship Between Lifestyle with Chronic Pain and Pain Acceptance in Elderly with Stroke

Archives of Neuroscience ◽

10.5812/ans.83717 ◽

2018 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Masoud Hatefi ◽

Asma Tarjoman ◽

Milad Borji

Keyword(s):

Chronic Pain ◽

Pain Acceptance ◽

The Relationship

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Pain Resilience: Issues of Modeling Dynamic Adaptation in Chronic Pain

Escritos de Psicología / Psychological Writings ◽

10.24310/espsiescpsi.v9i3.13213 ◽

2016 ◽

Vol 9 (3) ◽

pp. 15-27

Author(s):

John A. Sturgeon ◽

Chloe J. Taub

Keyword(s):

Chronic Pain ◽

Empirical Evidence ◽

Dynamic Process ◽

Individual Characteristics ◽

Dynamic Adaptation ◽

Psychological Interventions ◽

Affective States ◽

Pain Acceptance ◽

Empirical Inquiry ◽

Pain Adaptation

In recent years, there has been increasing interest in processes and characteristics that may underlie resilient adaptation to chronic pain. With this recent increase in empirical inquiry, there has emerged a degree of ambiguity in terms between pain resilience and other constructs previously connected to effective pain adaptation, such as pain acceptance, psychological flexibility, and pain self-efficacy. Objectives of the current paper included reviewing recent clinical and empirical evidence in the area of chronic pain resilience and offering a synthesis of these findings, with a specific focus on issues of defining and operationalizing this construct, compared to other constructs relevant to pain adaptation. We conclude that resilience is best defined as a dynamic process related to both stable individual characteristics and contextual and state factors, such as goal contexts and affective states. Finally, the implications of this model are discussed in the context of the extant literature on psychological interventions for chronic pain.

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