Effectiveness of the FIBROWALK multicomponent therapy in online and outdoor formats for fibromyalgia : a randomized controlled trial (The On & Out study)
Serrat López, Mayte (Universitat Autònoma de Barcelona)
Royuela-Colomer, Estíbaliz (Parc Sanitari Sant Joan de Déu)
Auer, William (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Ferrés Puigdevall, Sònia (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Almirall, Míriam (Hospital Universitari Vall d'Hebron)
Neblett, Randy (PRIDE Research Foundation)
Nijs, Jo (Vrije Universiteit Brussel)
Sanabria Mazo, Juan Pablo (Parc Sanitari Sant Joan de Déu)
Borràs, Xavier (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Luciano, Juan Vicente (Parc Sanitari Sant Joan de Déu)
Feliu-Soler, Albert (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut

Fecha:	2025
Descripción:	90 pàg.
Resumen:	This study evaluated the effectiveness of FIBROWALK multicomponent intervention, delivered online (FIBRO-On) or outdoors (FIBRO-Out), compared to treatment as usual (TAU) in reducing fibromyalgia (FM) severity measured by FIQR, which assesses functional impairment, symptom intensity, and overall impact. A total of 225 individuals with FM were randomly assigned to 12 weeks of FIBRO-On (plus TAU), FIBRO-Out (plus TAU), or TAU alone. Assessments were conducted at baseline, mid-intervention (6 weeks), post-intervention (12 weeks), and 6-months (3 months post-intervention). Results from linear mixed-effects models indicated that FIBRO-On (ꞵ = -10. 68, 95% CI = -15. 13, -6. 23) and FIBRO-Out (ꞵ = 9. 91, 95% CI = -14. 4, -5. 42) were more effective than TAU in reducing FM severity at postintervention. FIBRO-On (ꞵ = -6. 02, 95% CI = -10. 78, -1. 27) was more effective than TAU in reducing FM severity at 6 months, whereas FIBRO-Out showed no such advantage. No significant differences were observed between FIBRO-On and FIBRO-Out for any clinical measure at any time point. Clinically meaningful improvement was observed in 36. 3% of FIBRO-On and 37. 2% of FIBRO-Out post-intervention and ~20% at follow-up. Reductions in psychological inflexibility and kinesiophobia after the intervention mediated the effects of FIBROWALK on FM severity at 6-month follow-up, supporting the inclusion of acceptance and commitment therapy components in future versions. Low dropout rates, minimal adverse effects, and significant improvements across clinical outcomes highlight the feasibility and effectiveness of both formats. These findings support FIBROWALK, particularly FIBRO-On, as a scalable FM intervention. Future research should optimize long-term outcomes and explore personalized treatment delivery.
Ayudas:	Agencia Estatal de Investigación PID2020-117667RA-I00 Instituto de Salud Carlos III PI22/00829
Nota:	Altres ajuts: Co-financed with European Union ERDF funds. ERC has a postdoctoral contract with specific funding for the project On&Out (2022DILEUA125). JPS-M has a PFIS contract from the ISCIII (FI20/00034). The authors are grateful to the CIBER of Epidemiology and Public Health (CIBERESP; CB22/02/00052)
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió acceptada per publicar
Materia:	Fibromyalgia ; Multicomponent intervention ; FIBROWALK ; Online ; Outdoor ; RCT
Publicado en:	Journal of pain, Publicat online (03 September 2025) art. e105514, ISSN 1528-8447

DOI: 10.1016/j.jpain.2025.105514
PMID: 40905891

Disponible a partir de: 2026-12-03

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