Patient's Perception and Real Execution of Walking as Physical Exercise: Looking at Self-Efficacy as a Key Variable in Adherence in Patients with Fibromyalgia

Adherence to physical exercise is especially low in patients with fibromyalgia, and there is a tendency to overestimate its performance. This study explores the relationship between perceived and actual walking behavior in patients with fibromyalgia, including self-efficacy as a mediating variable. A prospective study with two time points (with one week between them) was carried out on 132 women diagnosed with fibromyalgia. Self-efficacy towards exercise was assessed at the first time point, and perceived intensity of physical activity and "objective" walking amount (accelerometer) in relation to the previous week were assessed at the second point. Physical and emotional symptoms and the consumption of drugs were also evaluated as covariates. The results show that perception of vigorous-intensity exercise was related to walking (accelerometer) (effort greater than 6 METs). This relationship was explained by the mediating effect of self-efficacy and was not interfered with either by the symptoms or by the consumption of drugs. High self-efficacy regarding physical exercise was directly related to walking behavior despite patients' interpretation of this activity as a vigorous physical exercise. In intervention and rehabilitation programs, it would be interesting to take into account and promote the self-efficacy of patients in relation to physical exercise in order to maintain adherence to walking.