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Vol. 21. Issue 3.
(March 2025)
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Vol. 21. Issue 3.
(March 2025)
Original article
The feasibility and acceptability of outdoor sessions as an add-on of an online multicomponent program (FIBROWALK) for fibromyalgia: A pilot randomized controlled trial
Viabilidad y aceptabilidad de añadir sesiones al aire libre como complemento de un programa multicomponente online (FIBROWALK) para la fibromialgia: un ensayo piloto controlado y aleatorizado
Mayte Serrata,1, Jaime Navarreteb,c,d,1,
Corresponding author
jaime.navarrete@sjd.es

Corresponding authors.
, Carla Rodríguez-Freireb,c, Estíbaliz Royuela-Colomerb,c, Miriam Almiralla, Rubén Nietof,2, Jesús Montero-Marínb,c,d,2, Juan V. Lucianob,c,d,e,2, Albert Feliu-Solere,d,2,
Corresponding author
albert.feliu@uab.cat

Corresponding authors.
a Unitat d’Expertesa en Síndromes de Sensibilització Central, Servei de Reumatologia, Vall d’Hebron Hospital, Pg. de la Vall d’Hebron, 119, Horta-Guinardó, 08035 Barcelona, Spain
b Institut de Recerca Sant Joan de Déu, C/ de Sta. Rosa, 39, 08950 Esplugues de Llobregat, Spain
c Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ del Dr. Antoni Pujadas, 42, 08830, St. Boi de Llobregat, Spain
d CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
e Department of Clinical and Health Psychology, Faculty of Psychology, Autonomous University of Barcelona, C/ de la Fortuna, s/n, 08193 Bellaterra, Spain
f eHealth Lab Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rbla. del Poblenou, 154-156, 08018 Barcelona, Spain
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Tables (3)
Table 1. Sociodemographic and clinical characteristics of the participants.
Tables
Table 2. Expectancy and opinion of participants about online and blended FIBROWALK.
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Table 3. Descriptive statistics and between-group differences for study outcomes (completers analysis).
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Abstract
Introduction and objectives

The given text describes a pilot randomized controlled trial aimed at evaluating the feasibility and acceptability of outdoor sessions as an add-on to an online multicomponent program (FIBROWALK) for fibromyalgia (FM) patients.

Materials and methods

The trial involved 110 participants with FM (99% women; mean age of 51.89±1.89 years) from a tertiary hospital in Spain who were randomly assigned to either the online FIBROWALK program (n=38) or the blended FIBROWALK program arm (n=61; online FIBROWALK plus 4 outdoor sessions).

Results

Overall, attrition was minimal (14.01%) and adherence to the outdoor session was modest (52% of the group attended at least one outdoor session). Participants’ expectations and opinions were positive. Paired-samples t-tests for examining within-group differences showed that participants in each arm had significantly improved functional impairment, anxious-depressive symptomatology, physical function, and fear of pain symptoms. Analysis of covariance for examining between-group differences showed that the blended FIBROWALK had a significantly higher effect on psychological distress than the online FIBROWALK (F(1,96)=4.23; p=.042; Cohen's d=.60).

Conclusions

These results suggest that the blended program was feasible, secure, and acceptable to the participants. Although the online FIBROWALK program alone may be sufficient for managing fibromyalgia symptoms, the addition of outdoor sessions may provide significant additional benefits. Future definitive randomized controlled trials are warranted.

Keywords:
Fibromyalgia
Multicomponent intervention
Online
Blended treatment
FIBROWALK
Resumen
Introducción y objetivos

El presente estudio es un ensayo piloto controlado y aleatorizado que tiene como objetivo evaluar la viabilidad y la aceptabilidad de añadir sesiones de terapia realizadas al aire libre (outdoor) a un programa multicomponente en formato online (FIBROWALK) para pacientes con fibromialgia (FM).

Métodos

El ensayo involucró a 110 participantes con FM (99% mujeres; edad media de 51,89±1,89 años) de un hospital terciario en España, quienes fueron asignados aleatoriamente al programa FIBROWALK online (n=38) o a la rama del programa FIBROWALK combinado (n=61; FIBROWALK online más 4 sesiones al aire libre).

Resultados

En general, la tasa de abandono fue mínima (14,01%) y la adherencia a las sesiones al aire libre fue modesta (el 52% del grupo asistió al menos a una sesión al aire libre). Las expectativas y las opiniones de los participantes fueron positivas en ambas ramas de tratamiento. Las pruebas t de muestras emparejadas para examinar las diferencias dentro de cada grupo mostraron que los participantes de ambas ramas del estudio mejoraron significativamente en cuanto a la discapacidad funcional, la sintomatología ansioso-depresiva, la función física y el miedo al dolor. El análisis de covarianza mostró que los participantes asignados al programa FIBROWALK combinado experimentaron mejoras significativamente superiores en malestar psicológico en comparación a los asignados al programa FIBROWALK online (F(1,96)=4,23; p=0,042; d de Cohen=0,60).

Conclusión

El programa combinado fue viable, seguro y aceptable para los participantes. Aunque el programa FIBROWALK online por sí solo parecería ser útil para los pacientes con fibromialgia, la adición de sesiones al aire libre podría proporcionar beneficios adicionales significativos. Es necesario realizar ensayos controlados aleatorizados definitivos.

Palabras clave:
Fibromialgia
Intervención multicomponente
En línea
Tratamiento combinado
FIBROWALK

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