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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. The role of lifestyle factors in the association between education and self-reported fibromyalgia: a mediation analysis. BMC Womens Health 2024; 24:244. [PMID: 38632566 PMCID: PMC11022321 DOI: 10.1186/s12905-024-03060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Socioeconomic status as measured by education, income, or occupation, has been associated with fibromyalgia but the underlying mechanism and the role of lifestyle factors are unclear. Thus, we examine the role of modifiable lifestyle factors (body mass index, physical activity, alcohol consumption and smoking) in the association between education and self-reported fibromyalgia. METHODS We used data from 74,157 participants in the population-based prospective Norwegian Women and Cancer (NOWAC) study. Socioeconomic position, operationalized as years of educational attainment, and lifestyle factors were assessed via self-reported questionnaires. Multiple mediation analysis was used to decompose total effects into direct and indirect effects. Estimates were reported as hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS The cumulative incidence of fibromyalgia was 3.2% after a median follow up time of 13 years. Fibromyalgia was inversely associated with years of educational attainment for ≤ 9 years (HR = 2.56; 95% CI 2.32-2.91) and for 10-12 years (HR = 1.84; 95% CI 1.72-2.02), compared with ≥ 13 years of education. Overall, all lifestyle factors together jointly mediated 17.3% (95% CI 14.3-21.6) and 14.1% (95% CI 11.3-18.9) of the total effect for ≤ 9 years and 10-12 years of education, respectively. Smoking and alcohol consumption contributed the most to the proportion mediated, for ≤ 9 years (5.0% and 7.0%) and 10-12 years (5.6% and 4.5%) of education. CONCLUSION The association between education and self-reported fibromyalgia was partly explained through lifestyle factors, mainly smoking and alcohol consumption.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Gerdle B, Dahlqvist Leinhard O, Lund E, Lundberg P, Forsgren MF, Ghafouri B. Pain and the biochemistry of fibromyalgia: patterns of peripheral cytokines and chemokines contribute to the differentiation between fibromyalgia and controls and are associated with pain, fat infiltration and content. FRONTIERS IN PAIN RESEARCH 2024; 5:1288024. [PMID: 38304854 PMCID: PMC10830731 DOI: 10.3389/fpain.2024.1288024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Objectives This explorative study analyses interrelationships between peripheral compounds in saliva, plasma, and muscles together with body composition variables in healthy subjects and in fibromyalgia patients (FM). There is a need to better understand the extent cytokines and chemokines are associated with body composition and which cytokines and chemokines differentiate FM from healthy controls. Methods Here, 32 female FM patients and 30 age-matched female healthy controls underwent a clinical examination that included blood sample, saliva samples, and pain threshold tests. In addition, the subjects completed a health questionnaire. From these blood and saliva samples, a panel of 68 mainly cytokines and chemokines were determined. Microdialysis of trapezius and erector spinae muscles, phosphorus-31 magnetic resonance spectroscopy of erector spinae muscle, and whole-body magnetic resonance imaging for determination of body composition (BC)-i.e., muscle volume, fat content and infiltration-were also performed. Results After standardizing BC measurements to remove the confounding effect of Body Mass Index, fat infiltration and content are generally increased, and fat-free muscle volume is decreased in FM. Mainly saliva proteins differentiated FM from controls. When including all investigated compounds and BC variables, fat infiltration and content variables were most important, followed by muscle compounds and cytokines and chemokines from saliva and plasma. Various plasma proteins correlated positively with pain intensity in FM and negatively with pain thresholds in all subjects taken together. A mix of increased plasma cytokines and chemokines correlated with an index covering fat infiltration and content in different tissues. When muscle compounds were included in the analysis, several of these were identified as the most important regressors, although many plasma and saliva proteins remained significant. Discussion Peripheral factors were important for group differentiation between FM and controls. In saliva (but not plasma), cytokines and chemokines were significantly associated with group membership as saliva compounds were increased in FM. The importance of peripheral factors for group differentiation increased when muscle compounds and body composition variables were also included. Plasma proteins were important for pain intensity and sensitivity. Cytokines and chemokines mainly from plasma were also significantly and positively associated with a fat infiltration and content index. Conclusion Our findings of associations between cytokines and chemokines and fat infiltration and content in different tissues confirm that inflammation and immune factors are secreted from adipose tissue. FM is clearly characterized by complex interactions between peripheral tissues and the peripheral and central nervous systems, including nociceptive, immune, and neuroendocrine processes.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
| | - Olof Dahlqvist Leinhard
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
- Radiation Physics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- AMRA Medical AB, Linköping, Sweden
| | - Eva Lund
- Radiation Physics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Peter Lundberg
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Fredrik Forsgren
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
- Radiation Physics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- AMRA Medical AB, Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Tharwat S, Mosad NR, Abdelmessih KE, Moatamed E, Rihan M, Osama N, Sallam N, Elsayed Y. Prevalence of fibromyalgia among university students and its impact on their health-related quality of life: a survey-based study from Egypt. BMC Public Health 2023; 23:2437. [PMID: 38057749 PMCID: PMC10702101 DOI: 10.1186/s12889-023-17329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/24/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND University students are more likely to experience stress, anxiety, and depression. All these factors are regarded as psychological contributors to fibromyalgia syndrome (FMS). AIM To investigate the prevalence and determinants of FMS among university students and its impact on their health-related quality of life (HRQoL). METHODS This online survey-based study involved 2146 university students who were recruited from various faculties at several Egyptian universities. The participants' demographics, medical history, academic pursuits, and sleep data were collected. To identify the existence of FMS, the 2016 updates to the 2010/2011 FMS diagnostic criteria were used. Additionally, the participants completed the Short-Form Health Survey-36 (SF-36). RESULTS The mean age was 21.26 ± 2.015 years and 76% were females. Of 2146 students, 266 (12.4%) fulfilled the criteria of FMS. FMS group had a significantly lower age (p < 0.001) with predominant female gender (89.5% vs. 74.1%, p < 0.001), positive family history of FMS (8.6% vs. 3.7%, p < 0.001), previous history of traffic accident (10.2% vs. 6.8%, p = 0.045), lower level of physical activity (p = 0.002),higher time spent in study per week (p = 0.002), lower sleep time (p = 0.002), with frequent walk up (p < 0.001) and snoring (p < 0.001) during sleep. Regarding HRQoL, students with FMS had significantly lower scores than students without in all domains. CONCLUSION FMS is prevalent among Egyptian university students and is linked to female gender, positive family history, lower levels of physical activity, and more time spent studying each week. FMS has a negative impact on HRQoL. Therefore, early detection and treatment are recommended.
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Affiliation(s)
- Samar Tharwat
- Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
- Department of Internal Medicine, Faculty of Medicine, Horus University, New Damietta, Egypt.
| | | | | | - Eman Moatamed
- Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Mohamed Rihan
- Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Nouran Osama
- Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Norhan Sallam
- Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Yara Elsayed
- Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study. BMC Public Health 2023; 23:1967. [PMID: 37821848 PMCID: PMC10566054 DOI: 10.1186/s12889-023-16773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors. METHODS We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21-1.47) and 1.62 (95% CI 1.41-1.87), respectively, compared to women with normal weight (BMI 18.5-24.9 kg/m2). Very low physical activity level (1-2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09-1.57) when compared to moderate physical activity level (5-6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0-10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45-2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23-1.54) higher among those with low consumption (0.1-3.9 g/day). CONCLUSIONS Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Ciaffi J, Lisi L, Mari A, Mancarella L, Brusi V, Pignatti F, Ricci S, Vitali G, Stefanelli N, Assirelli E, Neri S, Naldi S, Faldini C, Ursini F. Efficacy, safety and tolerability of very low-calorie ketogenic diet in obese women with fibromyalgia: a pilot interventional study. Front Nutr 2023; 10:1219321. [PMID: 37502721 PMCID: PMC10369071 DOI: 10.3389/fnut.2023.1219321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction Obesity can worsen fibromyalgia (FM) and very low-calorie ketogenic diet (VLCKD) is a potential therapeutic option for diseases that share clinical and pathophysiological features with FM. In this pilot interventional study, we investigated the effects of VLCKD in obese women with FM. Methods Female patients with FM and a body mass index (BMI) ≥ 30 kg/m2 were eligible for VLCKD. The ketogenic phase (T0 to T8) was followed by progressive reintroduction of carbohydrates (T8 to T20). Changes in BMI, Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), EuroQol 5D (EQ-5D) and 36-item Short Form Health Survey (SF-36) were evaluated. A change of 14% in FIQ was considered clinically relevant. The longitudinal association between BMI and patient-reported outcomes (PROs) was assessed using generalized estimating equations. Results Twenty women were enrolled. Two discontinued the intervention. The mean age of the 18 patients who reached T20 was 51.3 years and mean BMI was 37.2 kg/m2. All patients lost weight during the first period of VLCKD and this achievement was maintained at T20. Mean BMI decreased from 37.2 kg/m2 at T0 to 34.8 kg/m2 at T4, 33.5 kg/m2 at T8 and 32.1 kg/m2 at T20 (p < 0.001). A significant reduction of mean FIQ from 61.7 at T0 to 37.0 at T4 and to 38.7 at T8 (p < 0.001) was observed and it was maintained at T20 with a mean FIQ of 39.1 (p = 0.002). Similar results were obtained for HADS, EQ-5D and SF-36. Analysing each participant, the reduction of FIQ was clinically meaningful in 16 patients (89%) at T4, in 13 (72%) at T8 and in 14 (78%) at T20. No significant association was observed between change in BMI and improvement of the PROs over time. Adverse effects were mild and transient. No major safety concerns emerged. Conclusion These are the first data on the efficacy of VLCKD in FM. All patients achieved improvement in different domains of the disease, which was maintained also after carbohydrate reintroduction. Our results suggest that ketosis might exert beneficial effects in FM beyond the rapid weight loss. Clinical trial registration This trial is registered on ClinicalTrials.gov, number NCT05848544.
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Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Lucia Lisi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Anna Mari
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luana Mancarella
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Veronica Brusi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Federica Pignatti
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Susanna Ricci
- Dietetic Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giorgia Vitali
- Dietetic Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Elisa Assirelli
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Simona Neri
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Susanna Naldi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Cesare Faldini
- 1st Orthopaedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Pinto AM, Luís M, Geenen R, Palavra F, Lumley MA, Ablin JN, Amris K, Branco J, Buskila D, Castelhano J, Castelo-Branco M, Crofford LJ, Fitzcharles MA, Häuser W, Kosek E, López-Solà M, Mease P, Marques TR, Jacobs JWG, Castilho P, da Silva JAP. Neurophysiological and Psychosocial Mechanisms of Fibromyalgia: A Comprehensive Review and Call for An Integrative Model. Neurosci Biobehav Rev 2023:105235. [PMID: 37207842 DOI: 10.1016/j.neubiorev.2023.105235] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/21/2023]
Abstract
Research into the neurobiological and psychosocial mechanisms involved in fibromyalgia has progressed remarkably in recent years. Despite this, current accounts of fibromyalgia fail to capture the complex, dynamic, and mutual crosstalk between neurophysiological and psychosocial domains. We conducted a comprehensive review of the existing literature in order to: a) synthesize current knowledge on fibromyalgia; b) explore and highlight multi-level links and pathways between different systems; and c) build bridges connecting disparate perspectives. An extensive panel of international experts in neurophysiological and psychosocial aspects of fibromyalgia discussed the collected evidence and progressively refined and conceptualized its interpretation. This work constitutes an essential step towards the development of a model capable of integrating the main factors implicated in fibromyalgia into a single, unified construct which appears indispensable to foster the understanding, assessment, and intervention for fibromyalgia.
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Affiliation(s)
- Ana Margarida Pinto
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal; University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; University of Coimbra, Psychological Medicine Institute, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal.
| | - Mariana Luís
- Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal.
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Martinus J. Langeveldgebouw, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands; Altrecht Psychosomatic Medicine Eikenboom, Vrijbaan 2, 3705 WC Zeist, the Netherlands.
| | - Filipe Palavra
- Centre for Child Development, Neuropediatric Unit. Pediatric Hospital, Coimbra Hospital and University Centre, Avenida Afonso Romão, 3000-602 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal.
| | - Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Suite 7908, Detroit, MI 48202, USA.
| | - Jacob N Ablin
- Internal Medicine H, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel.
| | - Kirstine Amris
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Jaime Branco
- Rheumatology Department, Egas Moniz Hospital - Lisboa Ocidental Hospital Centre (CHLO-EPE), R. da Junqueira 126, 1349-019 Lisbon, Portugal; Comprehensive Health Research Center (CHRC), Chronic Diseases Research Centre (CEDOC), NOVA Medical School, NOVA University Lisbon (NMS/UNL), Campo Mártires da Pátria 130, 1169-056 Lisbon, Portugal.
| | - Dan Buskila
- Ben Gurion University of the Negev Beer-Sheba, Israel.
| | - João Castelhano
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
| | - Mary-Ann Fitzcharles
- Division of Rheumatology, Department of Medicine, McGill University, 1650 Cedar Ave, Montreal, Quebec, Canada, H3G 1A4.
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany.
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Marina López-Solà
- Serra Hunter Programme, Department of Medicine and Health Sciences, University of Barcelona.
| | - Philip Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, WA, USA; University of Washington School of Medicine, Seattle, WA, USA.
| | - Tiago Reis Marques
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Hammersmith Hospital, Imperial College London, South Kensington, London SW7 2BU, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Strand, London WC2R 2LS, UK.
| | - Johannes W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal.
| | - José A P da Silva
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal
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Fibromyalgia syndrome in medical students. THE EGYPTIAN RHEUMATOLOGIST 2023. [DOI: 10.1016/j.ejr.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Catalá P, Peñacoba C, López-Roig S, Pastor-Mira MA. Effects of Walking as Physical Exercise on Functional Limitation through Pain in Patients with Fibromyalgia-How Does Catastrophic Thinking Contribute? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:190. [PMID: 36612511 PMCID: PMC9819620 DOI: 10.3390/ijerph20010190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
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.
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Affiliation(s)
- Patricia Catalá
- Department of Psychology, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
| | - Sofía López-Roig
- Department of Behavioral Sciences and Health, Miguel Hernandez University, Elche, 03550 Alicante, Spain
| | - María Angeles Pastor-Mira
- Department of Behavioral Sciences and Health, Miguel Hernandez University, Elche, 03550 Alicante, Spain
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Saat NZM, Hanawi SA, Farah NMF, Hanafiah H, Zuha AA. Relationship between physical activity and musculoskeletal disorders among low income housewives in Kuala Lumpur: A cross sectional study. PLoS One 2022; 17:e0274305. [PMID: 36201510 PMCID: PMC9536588 DOI: 10.1371/journal.pone.0274305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
Housewives play a crucial role in their families’ and communities’ quality of life. However, musculoskeletal disorders are common among housewives due to housework and lack of physical activity. These musculoskeletal problems have been associated to leisure physical activity. As a result, the goal of this study was to determine the incidence of musculoskeletal problems and their association to physical activity among low-income women in Kuala Lumpur. A cross-sectional research was done among 82 housewives in Kuala Lumpur’s low-income housing area. Housewives were asked to fill out a sociodemographic questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), and body mass index were measured by researcher. The total prevalence of musculoskeletal problems was found to be 89.0%, with the lowest frequency in the lower back (35%), followed by the knee (31%), ankle or foot (31%), and elbow (1% %). The subjects spent an average of 117.6 + 474.8 minutes per week on MVPA and 524 + 810.3 MET minutes per week on physical activity. A total of 88% of the participants had a low level of physical activity, 8.5 percent had a moderate level of activity, and 3.7% had a high level of activity. In a Chi-square test, there was no significant association between musculoskeletal problems and physical activity. The primary sociodemographic factors impacting musculoskeletal diseases were body mass index and household income, while the primary variables influencing physical activity were household income and education level, according to a logistic regression test. In a Poisson regression test, only body mass index had a significant relationship with number of musculoskeletal disorders. In conclusion, housewives are likely to suffer from musculoskeletal problems, with a high incidence in the lower back, knees, ankles, and feet, and the majority of them engage in little physical activity. Furthermore, the high percentage of musculoskeletal problems in this study varies with the findings of other research based on the type of housework done by housewives in low-cost housing areas. Future research should look at identifying the sorts of household tasks and positions employed, as well as the amount of hours spent on housework each week.
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Affiliation(s)
- N. Z. M. Saat
- Biomedical Science Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | - Siti Aishah Hanawi
- SOFTAM, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Nor M. F. Farah
- Occupational Therapy Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hazlenah Hanafiah
- Faculty of Computer and Mathematical Science, Universiti Teknologi MARA Sabah Branch, Sabah, Malaysia
| | - Anis Afiqah Zuha
- Biomedical Science Programme, Centre of Community Health (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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10
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Gerdle B, Dahlqvist Leinhard O, Lund E, Bengtsson A, Lundberg P, Ghafouri B, Forsgren MF. Fibromyalgia: Associations Between Fat Infiltration, Physical Capacity, and Clinical Variables. J Pain Res 2022; 15:2517-2535. [PMID: 36061487 PMCID: PMC9434492 DOI: 10.2147/jpr.s376590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Obesity is a risk factor for the development of fibromyalgia (FM) and generally most studies report increased Body Mass Index (BMI) in FM. Obesity in FM is associated with a worse clinical presentation. FM patients have low physical conditioning and obesity further exacerbates these aspects. Hitherto studies of FM have focused upon a surrogate for overall measure of fat content, ie, BMI. This study is motivated by that ectopic fat and adipose tissues are rarely investigated in FM including their relationships to physical capacity variables. Moreover, their relationships to clinical variables including are not known. Aims were to 1) compare body composition between FM and healthy controls and 2) investigate if significant associations exist between body composition and physical capacity aspects and important clinical variables. Methods FM patients (n = 32) and healthy controls (CON; n = 30) underwent a clinical examination that included pressure pain thresholds and physical tests. They completed a health questionnaire and participated in whole-body magnetic resonance imaging (MRI) to determine body composition aspects. Results Abdominal adipose tissues, muscle fat, and BMI were significantly higher in FM, whereas muscle volumes of quadriceps were smaller. Physical capacity variables correlated negatively with body composition variables in FM. Both body composition and physical capacity variables were significant regressors of group belonging; the physical capacity variables alone showed stronger relationships with group membership. A mix of body composition variables and physical capacity variables were significant regressors of pain intensity and impact in FM. Body composition variables were the strongest regressors of blood pressures, which were increased in FM. Conclusion Obesity has a negative influence on FM symptomatology and increases the risk for other serious conditions. Hence, obesity, dietary habits, and physical activity should be considered when developing clinical management plans for patients with FM.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Correspondence: Björn Gerdle, Tel +46763927191, Email
| | - Olof Dahlqvist Leinhard
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- AMRA Medical AB, Linköping, Sweden
| | - Eva Lund
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Ann Bengtsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Peter Lundberg
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Mikael Fredrik Forsgren
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- AMRA Medical AB, Linköping, Sweden
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11
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Coping and Beliefs as Predictors of Functioning and Psychological Adjustment in Fibromyalgia Subgroups. Pain Res Manag 2022; 2022:1066192. [PMID: 35463626 PMCID: PMC9023200 DOI: 10.1155/2022/1066192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/04/2022] [Accepted: 03/18/2022] [Indexed: 11/19/2022]
Abstract
Objectives Research has pointed to two profiles of persons with fibromyalgia according to differences in functionality, thus distinguishing between functional and dysfunctional patients. The role of psychological factors underlying such clusters is unclear. This study aims to explore the contribution of pain beliefs and coping on fibromyalgia clustering. Methods A cluster analysis was performed to classify 238 women with fibromyalgia using the Fibromyalgia Impact Questionnaire and the Beck Depression Inventory as clustering variables. Cluster differences in physical functioning, depression, pain beliefs, coping, and age were then calculated (Student's t-test). Finally, a binary logistic regression was conducted to study the unique contribution of age, beliefs, and coping on cluster classification. Results Two clusters were revealed. Cluster 1 had a poor adaptation to fibromyalgia regarding physical functioning and depression. They generally embraced less adaptive beliefs (i.e., disability, harm, emotion, and requests) and coping strategies (i.e., guarding, resting, and asking for assistance). Cluster 2 showed a better adaptation to fibromyalgia and adopted more favorable beliefs (i.e., control) and coping strategies (i.e., exercise and task persistence). Cluster differences in age were significant but small. The backward binary logistic regression suggested a final model with six predictors (guarding, task persistence, harm, emotion, solicitude, and age) that explained 31% of the variance of group membership. Discussion. These results suggest that only a subset of psychological variables uniquely and independently contribute to functional/dysfunctional group membership. The results support the need to address psychological components in the management of fibromyalgia and point to a subset of preferred target beliefs and coping strategies.
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12
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The interplay between multisite pain and insomnia on the risk of anxiety and depression: the HUNT study. BMC Psychiatry 2022; 22:124. [PMID: 35172768 PMCID: PMC8851694 DOI: 10.1186/s12888-022-03762-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal pain and insomnia frequently co-occur and are known independent risk factors for anxiety and depression. However, the interplay between these two conditions on the risk of anxiety and depression has not been explored. METHODS A population-based prospective study of 18,301 adults in the Norwegian HUNT Study without anxiety or depression at baseline (2006-2008). We calculated adjusted risk ratios (RRs) with 95% confidence intervals (CIs) for anxiety and/or depression at follow-up (2017-2019), associated with i) number of chronic pain sites, and ii) chronic pain and insomnia symptoms jointly. RESULTS At follow-up, 2155 (11.8%) participants reported anxiety and/or depression. The number of pain sites was positively associated with risk of anxiety and/or depression (Ptrend, < 0.001). Compared to people without chronic pain and insomnia symptoms, people with ≥5 pain sites and no insomnia symptoms had a RR of 1.52 (95% CI: 1.28 to 1.81) for anxiety and/or depression, those with no chronic pain but with insomnia had a RR of 1.78 (95% CI: 1.33 to 2.38), whereas the RR among people with both ≥5 pain sites and insomnia was 2.42 (95% CI: 1.85 to 3.16). We observed no synergistic effect above additivity for the combination of ≥5 pain sites and insomnia on risk of anxiety and/or depression. CONCLUSIONS This study shows that people with multisite chronic pain who also suffer from insomnia are at a particularly high risk for anxiety and/or depression, suggesting that insomnia symptoms are important contributors to the association between multisite pain and common mental health problems.
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13
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Brooks BD, Kaniuka AR, Rabon JK, Sirois FM, Hirsch JK. Social Support and Subjective Health in Fibromyalgia: Self-Compassion as a Mediator. J Clin Psychol Med Settings 2022; 29:375-383. [PMID: 35001253 DOI: 10.1007/s10880-021-09832-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/27/2022]
Abstract
Individuals with fibromyalgia report lower levels of health-related quality of life (HRQL) compared to other chronically ill populations and interpersonal factors (i.e., social support) may influence risk. What is less understood is how intrapersonal factors (i.e., self-compassion) may impact the social support-HRQL linkage. We examined the association between social support and HRQL in a sample of persons with fibromyalgia and tested the potential mediating role of self-compassion. Self-identified adults in the United States with fibromyalgia (N = 508) were recruited from state, regional, and national organizations and support groups and completed an online battery of self-report questionnaires including: Multidimensional Health Profile-Psychosocial Functioning Index, Short-Form 36 Health Survey, and Self-Compassion Scale-Short Form. Individuals with greater subjective social support reported higher levels of self-compassion and, in turn, higher mental HRQL. These findings provide greater information about psychosocial constructs and HRQL and extend our understanding of self-compassion among individuals living with fibromyalgia.
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Affiliation(s)
- Byron D Brooks
- Department of Psychology, Loyola University Chicago, 1032 West Sheridan Rd, Chicago, IL, 60660, USA. .,Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
| | - Andrea R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Fuschia M Sirois
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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14
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Haddad HW, Mallepalli NR, Scheinuk JE, Bhargava P, Cornett EM, Urits I, Kaye AD. The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review. Pain Ther 2021; 10:827-848. [PMID: 33909266 PMCID: PMC8586285 DOI: 10.1007/s40122-021-00266-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The multifaceted clinical presentation of fibromyalgia (FM) supports the modern understanding of the disorder as a more global condition than one simply affecting pain sensation. The main pharmacologic therapies used clinically include anti-epileptics and anti-depressants. Conservative treatment options include exercise, myofascial release, psychotherapy, and nutrient supplementation. METHODS Narrative review. RESULTS Nutrient supplementation is a broadly investigated treatment modality as numerous deficiencies have been linked to FM. Additionally, a proposed link between gut microbiome patterns and chronic pain syndromes has led to studies investigating probiotics as a possible treatment. Despite positive results, much of the current evidence regarding this topic is of poor quality, with variable study designs, limited sample sizes, and lack of control groups. CONCLUSIONS The etiology of FM is complex, and has shown to be multi-factorial with genetics and environmental exposures lending influence into its development. Preliminary results are promising, however, much of the existing evidence regarding diet supplementation is of poor quality. Further, more robust studies are needed to fully elucidate the potential of this alternative therapeutic option.
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Affiliation(s)
| | - Nikita Reddy Mallepalli
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - John Emerson Scheinuk
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Pranav Bhargava
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Elyse M. Cornett
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
- Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
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15
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Elkfury JL, Antunes LC, Dal Moro Angoleri L, Sipmann RB, de Souza A, da Silva Torres IL, Caumo W. Dysfunctional eating behavior in fibromyalgia and its association with serum biomarkers of brain plasticity (BDNF and S100B): an exploratory study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:713-722. [PMID: 34591410 PMCID: PMC10065384 DOI: 10.20945/2359-3997000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess disordered eating, hunger and satiety perceptions in women with fibromyalgia (FM) compared to healthy controls (HC) and their association with biomarkers of brain plasticity (brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100B)). METHODS Cross-sectional exploratory study. The sample included FM (n = 20) and HC (n = 19), matched to age and waist perimeter. Dysfunctional eating was assessed through the Three Factor Eating Questionnaire and Eating Disorders Examination with a questionnaire. Hunger and satiety levels were rated by a Numerical Scale. Serum leptin, S100B and BDNF were analyzed. RESULTS The MANCOVA analysis showed that the mean of Emotional Eating rates was 30.65% higher in FM compared to HC (p = 0.015). Eating, shape and weight concerns were 77.77%, 57.14% and 52.22% higher in FM (p = <0.001) compared to HC, respectively. Moreover, the FM group reported higher scores for feeling of hunger "[5.2 (±2.9) vs. 4.8 (±2.0); p = 0.042] and lower scores for satiety [7.0 (±1.7) vs. 8.3 (±1.0); p = 0.038]. In the FM group, serum BDNF was negatively associated with hunger (r = - 0.52; p = 0.02), while S100B was positively associated with hunger scores (r = 0.463; p = 0.004). CONCLUSION The present findings support the hypothesis that the association between FM and obesity can be mediated by a hedonistic pathway. Further research is needed.
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Affiliation(s)
- Jéssica Lorenzzi Elkfury
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Luciana C Antunes
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Centro de Ciências da Saúde, Divisão de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Letícia Dal Moro Angoleri
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Raquel Busanello Sipmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andressa de Souza
- Programa de Pós-graduação em Saúde e Desenvolvimento Humano, LaSalle, Canoas, RS, Brasil
- Programa de Pós-graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Iraci Lucena da Silva Torres
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Wolnei Caumo
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Abstract
OBJECTIVES Fibromyalgia (FM) patients have an increased risk for glucose metabolism disturbances, and impaired glucose tolerance may be associated with symptom severity. Elevated levels of plasma lactate have been detected in FM patients. Both pyruvate and lactate are produced in glucose metabolism and reflect oxidative metabolism. The objective of our study was to analyse disturbances in glucose, pyruvate, or lactate metabolism in FM patients. METHODS We measured plasma levels of glucose, pyruvate, and lactate during an oral glucose tolerance test in 40 non-diabetic, female FM patients and 30 age- and gender-matched healthy controls. RESULTS FM patients showed a higher glycaemic response to the glucose load at 1 hour (F [1,68] = 10.4, P = .006) and 2 hours (F [1,68] = 7.80, P = .02), and higher glucose area under the curve (13.8 [SD 2.92] vs 11.6 [SD 2.31], P < .01), than healthy controls. Group differences were explained by higher body mass index and percentage of smokers among the FM patients. Pyruvate and lactate levels were similar in both groups. DISCUSSION Impaired glucose regulation in FM patients is likely not due to FM itself, but to associated lifestyle factors. Our results highlight the importance of assessing the glucose regulation status and the lifestyle factors affecting glucose regulation in FM patients for prevention or early treatment of diabetes and associated complications. TRIAL REGISTRATION ClinicalTrials.gov (NCT03300635).
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Affiliation(s)
- Teemu Zetterman
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; City of Vantaa Health Centre, Vantaa, Finland
| | - Ritva Markkula
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
- Sleepwell Research Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Abstract
Facial emotion recognition (FER) is extensively investigated in psychological sciences in healthy individuals and clinical conditions. In this paper, we analyzed those studies in which FER was assessed in the case of obesity or fibromyalgia, in relation to the levels of alexithymia. Crucially, these two conditions frequently co-occur; however, no study has explored FER considering both fibromyalgia and obesity. Studies were identified using the electronic search engine of PubMed. The last research was run on 23 July 2021. Two independent lists were generated for the two clinical conditions. Six records were reviewed about obesity, while three records about fibromyalgia. The evidence relative to FER in obesity was not conclusive, whereas the evidence about an altered FER in fibromyalgia seemed more straightforward. Moreover, the role of alexithymia on FER in these clinical conditions was not extensively investigated. In our discussion, we highlighted those factors that should be carefully addressed in investigating FER in these clinical conditions. Moreover, we underlined methodological criticisms that should be overcome in future research.
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18
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Catala P, Suso-Ribera C, Gutierrez L, Perez S, Lopez-Roig S, Peñacoba C. Is Thought Management a Resource for Functioning in Women with Fibromyalgia Irrespective of Pain Levels? PAIN MEDICINE 2021; 22:1827-1836. [PMID: 33595650 DOI: 10.1093/pm/pnab073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to examine the relationship between cognitive factors (cognitive fusion and catastrophizing) and functional limitation experienced by patients with fibromyalgia across different levels of pain severity (i.e., moderation). METHODS The sample comprised 226 women with fibromyalgia. Their mean age was 56.91 years (standard deviation = 8.94; range = 30 to 78 years). RESULTS Pain severity, cognitive fusion, and all components of catastrophizing (i.e., rumination, magnification, and helplessness) contributed to greater fibromyalgia impact on functioning in the multivariate analyses (all P < 0.001). A moderation effect was also found in the relationship between cognitive fusion and fibromyalgia impact on functioning (B = -0.12, t = -2.42, P = 0.016, 95% confidence interval: -0.22 to -0.02) and between magnification and fibromyalgia impact (B = -0.37, t = -2.21, P = 0.028, 95% confidence interval: -0.69 to -0.04). This moderation was not observed for rumination and helplessness. CONCLUSIONS The results suggest that in interventions to improve functioning in people with fibromyalgia, some maladaptive forms of thought management (i.e., cognitive fusion and magnification) preferably should be challenged at milder levels of pain severity. According to our findings, cognitive fusion and magnification might have less room to impact functioning at higher levels of pain severity; therefore, rumination and helplessness, which had comparable associations with functioning irrespective of pain levels, would be preferable targets in psychological interventions in patients with fibromyalgia experiencing more severe pain levels.
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Affiliation(s)
- Patricia Catala
- Department of Psychology, Rey Juan Carlos University, Alcorcón (Madrid), Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain
| | - Lorena Gutierrez
- Department of Psychology, Rey Juan Carlos University, Alcorcón (Madrid), Spain
| | - Soledad Perez
- Department of Psychology, Rey Juan Carlos University, Alcorcón (Madrid), Spain
| | - Sofia Lopez-Roig
- Department of Behavioral Sciences and Health, Miguel Hernandez University, Alicante, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Alcorcón (Madrid), Spain
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19
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Freidin MB, Stalteri MA, Wells PM, Lachance G, Baleanu AF, Bowyer RCE, Kurilshikov A, Zhernakova A, Steves CJ, Williams FMK. An association between chronic widespread pain and the gut microbiome. Rheumatology (Oxford) 2021; 60:3727-3737. [PMID: 33331911 PMCID: PMC8328510 DOI: 10.1093/rheumatology/keaa847] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/12/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Chronic widespread musculoskeletal pain (CWP) is a characteristic symptom of fibromyalgia, which has been shown to be associated with an altered gut microbiome. Microbiome studies to date have not examined the milder CWP phenotype specifically nor have they explored the role of raised BMI. The aim of this study was to investigate whether the microbiome is abnormal in CWP. METHODS CWP was assessed using a standardized screening questionnaire in female volunteers from the TwinsUK cohort including 113 CWP cases and 1623 controls. The stool microbiome was characterized using 16S rRNA amplicon sequencing and amplicon sequence variants, and associations with CWP examined using linear mixed-effects models adjusting for BMI, age, diet, family relatedness and technical factors. RESULTS Alpha diversity was significantly lower in CWP cases than controls (Mann-Whitney test, P-values 2.3e-04 and 1.2e-02, for Shannon and Simpson indices respectively). The species Coprococcus comes was significantly depleted in CWP cases (Padj = 3.04e-03). A genome-wide association study (GWAS) performed for C. comes in TwinsUK followed by meta-analysis with three Dutch cohorts (total n = 3521) resulted in nine suggestive regions, with the most convincing on chromosome 4 near the TRAM1L1 gene (rs76957229, P = 7.4e-8). A Mendelian randomization study based on the results of the GWAS did not support a causal role for C. comes on the development of CWP. CONCLUSIONS We have demonstrated reduced diversity in the microbiome in CWP, indicating an involvement of the gut microbiota in CWP; prospectively the microbiome may offer therapeutic opportunities for this condition.
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Affiliation(s)
- Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Maria A Stalteri
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Philippa M Wells
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Genevieve Lachance
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Andrei-Florin Baleanu
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Alexander Kurilshikov
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alexandra Zhernakova
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
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How Does Fibromyalgia Affect Sleep and Quality of Life in Metabolic Syndrome. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2021. [DOI: 10.21673/anadoluklin.937198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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21
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Migliorini F, Maffulli N, Eschweiler J, Tingart M, Driessen A, Colarossi G. BMI but not age and sex negatively impact on the outcome of pharmacotherapy in fibromyalgia: a systematic review. Expert Rev Clin Pharmacol 2021; 14:1029-1038. [PMID: 33990169 DOI: 10.1080/17512433.2021.1929923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The impact of sex, age, body mass index (BMI) in fibromyalgia is still unclear. A systematic review was conducted to investigate whether sex, age and BMI influence the clinical outcomes and rate of adverse events. METHODS The present study was performed according to the PRISMA guidelines. The literature search was performed in February 2021. All the RCTs investigating pharmacological strategies for fibromyalgia were accessed. RESULTS Data from 51 RCTs (17,311 patients) were collected. Short Form 36 emotional, Social function and physical role subscales showed evidence of a negative association with BMI (P = 0.02, P = 0.002 and P = 0.0001, respectively). Depression and anxiety subscales of the Hospital Anxiety and Depression score demonstrated evidence of a positive association with age (P = 0.04 and P = 0.001, respectively) and sex (P = 0.00005 and P = 0.0001, respectively). Visual analog scale evidenced a positive association with BMI (P = 0.04). Clinical Global Impression Severity scale demonstrated evidence of a negative association with BMI (P = 0.02). CONCLUSION Irrespective from the pharmacological approach, a higher BMI is negatively associated with a favorable outcome in patients with fibromyalgia. The association with sex and age remains controversial. LEVEL OF EVIDENCE I, systematic review of RCTs.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London, UK
| | - Jörg Eschweiler
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Markus Tingart
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Arne Driessen
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Giorgia Colarossi
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
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Rahman MS, Winsvold BS, Chavez Chavez SO, Børte S, Tsepilov YA, Sharapov SZ, Aulchenko YS, Hagen K, Fors EA, Hveem K, Zwart JA, van Meurs JB, Freidin MB, Williams FM. Genome-wide association study identifies RNF123 locus as associated with chronic widespread musculoskeletal pain. Ann Rheum Dis 2021; 80:1227-1235. [PMID: 33926923 PMCID: PMC8372387 DOI: 10.1136/annrheumdis-2020-219624] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/18/2022]
Abstract
Background and objectives Chronic widespread musculoskeletal pain (CWP) is a symptom of fibromyalgia and a complex trait with poorly understood pathogenesis. CWP is heritable (48%–54%), but its genetic architecture is unknown and candidate gene studies have produced inconsistent results. We conducted a genome-wide association study to get insight into the genetic background of CWP. Methods Northern Europeans from UK Biobank comprising 6914 cases reporting pain all over the body lasting >3 months and 242 929 controls were studied. Replication of three independent genome-wide significant single nucleotide polymorphisms was attempted in six independent European cohorts (n=43 080; cases=14 177). Genetic correlations with risk factors, tissue specificity and colocalisation were examined. Results Three genome-wide significant loci were identified (rs1491985, rs10490825, rs165599) residing within the genes Ring Finger Protein 123 (RNF123), ATPase secretory pathway Ca2+transporting 1 (ATP2C1) and catechol-O-methyltransferase (COMT). The RNF123 locus was replicated (meta-analysis p=0.0002), the ATP2C1 locus showed suggestive association (p=0.0227) and the COMT locus was not replicated. Partial genetic correlation between CWP and depressive symptoms, body mass index, age of first birth and years of schooling were identified. Tissue specificity and colocalisation analysis highlight the relevance of skeletal muscle in CWP. Conclusions We report a novel association of RNF123 locus and a suggestive association of ATP2C1 locus with CWP. Both loci are consistent with a role of calcium regulation in CWP. The association with COMT, one of the most studied genes in chronic pain field, was not confirmed in the replication analysis.
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Affiliation(s)
- Md Shafiqur Rahman
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Bendik S Winsvold
- Department of Research, Innovation and Education,Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Department of Neurology, Oslo universitetssykehus Ullevål, Oslo, Norway.,K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sergio O Chavez Chavez
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Sigrid Børte
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Research and Communication Unit for Musculoskeletal Health (FORMI), Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yakov A Tsepilov
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,PolyOmica, 's-Hertogenbosch, PA, The Netherlands.,Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 10 Lavrentiev Avenue, Novosibirsk, 630090, Russia
| | - Sodbo Zh Sharapov
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 10 Lavrentiev Avenue, Novosibirsk, 630090, Russia
| | | | - Yurii S Aulchenko
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,PolyOmica, 's-Hertogenbosch, PA, The Netherlands
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Research Unit Central Norway, St Olavs University Hospital, Trondheim, Norway
| | - Egil A Fors
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Hveem
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - John Anker Zwart
- Department of Research, Innovation and Education,Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Clinical Medicine,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Joyce B van Meurs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Frances Mk Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
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Alciati A, Cirillo M, Masala IF, Sarzi-Puttini P, Atzeni F. Differences in depression, anxiety and stress disorders between fibromyalgia associated with rheumatoid arthritis and primary fibromyalgia. Stress Health 2021; 37:255-262. [PMID: 32991777 DOI: 10.1002/smi.2992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 11/09/2022]
Abstract
Fibromyalgia (FM) was frequently observed in patients with rheumatoid arthritis (RA). We aimed to evaluate the differences in psychiatric comorbidities and life adversities between patients with Rheumatoid arthritis + FM (secondary fibromyalgia [SFM]) and people with primary FM (PFM). In a cross-sectional, observational study, patients with PFM and SFM underwent a structured interview for the lifetime diagnosis of major depression (MDD), panic disorder (PD) and post-traumatic stress disorder (PTSD) and were assessed for childhood/adulthood adversities and FM-related symptoms severity. Thirty patients with PFM and 40 with SFM were recruited. The univariate analysis showed that the lifetime rates of MDD were significantly higher in PFM versus SFM (76.7 % and 40%, respectively, p < 0.003), as well as the rates of PD (50 % and 15%, respectively, p < 0.003), whereas there was no difference in PTSD rates. The rates of sexual abuse and physical neglect were significantly higher in PFM patients versus SFM patients (p < 0.005 and p < 0.023). Life events occurring before FM onset were different in PFM and SFM groups. In the logistic regression model, lifetime PD and physical neglect remain independent risk factors for PFM. PFM and SFM differ in psychiatric comorbidities and environmental adversities, suggesting that common pathogenesis may develop through different pathways.
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Affiliation(s)
- Alessandra Alciati
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa S. Benedetto Menni Hospital, Albese (Como), Italy.,Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | | | | | | - Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
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24
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Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51:409-424. [PMID: 33676126 DOI: 10.1016/j.semarthrit.2021.02.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/30/2021] [Accepted: 02/15/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Obesity has been associated with several complications, including musculoskeletal disorders. Aim of the present systematic review was to identify all available evidence on the relationship between fibromyalgia (FM) and obesity, including epidemiological association, impact of obesity on FM severity and effect of weight loss strategies on FM symptoms. METHODS MedLine, Cochrane Central Register of Controlled Trials and Web of Science databases were searched up to September 2020 to identify eligible articles. Data from studies reporting the prevalence of obesity in FM patients were pooled using a random-effects model. RESULTS After removal of duplicate records, 393 studies proceeded to review. A total of 41 articles were deemed eligible for inclusion in final synthesis. Quality assessment revealed that the overall risk of bias was high. The overall prevalence of obesity in FM was 35.7% (95% CI: 31.8 - 39.9%), with higher figures reported for USA. The majority of studies included demonstrated that obesity is associated with different domains of the disorder, including composite measures of activity, pain severity, tender point count, stiffness, fatigue, physical functioning/disability, sleep, cognitive dysfunction, and quality of life; the strength of correlation was weak on average. Inconsistent data were available regarding the correlation with depression and anxiety. Only few studies addressed the effect of therapeutic weight loss in FM, either by bariatric surgery, diet/exercise combination or behavioral weight loss, providing preliminary evidence for a potential benefit of weight loss in ameliorating FM symptoms. CONCLUSIONS Available data support a potential interplay between obesity and FM-related symptoms. Weight management should be encouraged in patients with FM.
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25
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Lima TM, Coelho DA. Gender differences in associating musculoskeletal complaints, housework, electronic device usage and physical exercise for administrative workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1189-1197. [PMID: 33468020 DOI: 10.1080/10803548.2021.1878695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. This study assessed musculoskeletal complaints (MSCs) in administrative workers, associating MSCs with non-paid housework, home use of electronic devices and physical exercise, while keeping a distinctive gender approach. This may promote the development of more effective preventive measures, by meeting the specific strengths and weaknesses of each gender. Methods. Ninety-six administrative workers (58 women and 38 men) who used computers more than 50% of their working time participated in a cross-sectional study. A questionnaire concerning individual socio-demographic data, habits and lifestyle, and including the Nordic musculoskeletal questionnaire (NMQ), was deployed. Gender-based odds ratios for MSCs in body areas over the previous 12 months and correlation coefficients between habits and lifestyle variables and NMQ variables were computed. Results. Women did not incur a higher risk of MSCs than men. Analysis of the association did not yield meaningful associations for either gender. Results suggest giving future consideration to development of gender-specific preventive measures. Conclusion. Computerized work performed concomitantly with physical exposures outside the workplace showed mixed associations with MSCs, according to gender and depending on the kind of exposure. Results are indicative of the need for development of gender-specific preventive measures.
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Affiliation(s)
- Tânia M Lima
- C-MAST - Centre for Mechanical and Aerospace Science and Technologies, Department of Electromechanical Engineering, University of Beira Interior, Covilhã, Portugal
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26
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Meaza H, Temesgen MH, Redae G, Hailemariam TT, Alamer A. Prevalence of Musculoskeletal Pain Among Academic Staff of Mekelle University, Ethiopia. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2021; 13:1179544120974671. [PMID: 33488132 PMCID: PMC7768833 DOI: 10.1177/1179544120974671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022]
Abstract
Background: Musculoskeletal pain is a leading cause of morbidity, low productivity. Thus; not only affecting the individual’s quality of life; it also creates a burden in the health system and affects the productivity of their institution and the country at large. The prevalence of musculoskeletal pain among academic staff in developed countries ranges from 47% to 85%. However, there was a scarce of studies in developing country, particularly in the study area. Purpose: the aim of the research was to assess the burden of musculoskeletal pain and associated factors among Mekelle University academic staff. Patients and Methods: An institutional based cross-sectional study was enrolled on 449 participants with a response rate of 92.2%. Multistage sampling technique was deployed to select representatives. Participants under the selected schools, institutes and departments were selected using random sampling method. Data was collected through face to face interview using structured and standardized Nordic questionnaire by trained data collectors at Mekelle University. Binary logistic regression was used to assess the association between dependent and independent variables. In bivariate logistic regression variables which have P value of <.25 were modeled to multivariate logistic regression. Those variables with P-value of <.05 with 95% CI in multivariate model were taken as statistically significant. Results: This study found that burden of musculoskeletal pain among Mekelle University academic staff in the previous 12 month was 65.2%, and in the last 7 days was 29%. Neck pain (41.5%) was most prevalent followed by low back pain (40.3%). Female gender (OR = 3.02, 95% CI: 1.58-5.76), Body mass index ⩾25 (OR = 3.68, 95% CI: 1.15-11.39), working hours per day (OR = 3.1, 95% CI: 1.54-6.38), and physical inactivity (OR = 3.48, 95% CI: 1.69-7.16), were the independent factors positevly associated with musculoskeletal pain. Conclusion: The burden of musculoskeletal pain among Mekelle University academic staff was common. Female gender, being overweight and obese, working >5 hours per day, and being physically inactive increase the odds of experiencing musculoskeletal pains among academicians. Therefore the university authorities and all academicians are recommended that to take preventable measures of musculoskeletal pain.
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Affiliation(s)
- Habtamu Meaza
- School of Medicine, College of Health Sciences, Department of Physiotherapy, Mekelle University, Mekelle, Ethiopia
| | - Melaku Hailu Temesgen
- School of Medicine, College of Health Sciences, Department of Physiotherapy, Mekelle University, Mekelle, Ethiopia
| | - Getachew Redae
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Abayneh Alamer
- School of Medicine, College of Health Sciences, Department of Physiotherapy, Mekelle University, Mekelle, Ethiopia
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27
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Estévez-López F, Rodriguez-Ayllon M, Soriano-Maldonado A, Acosta-Manzano P, Segura-Jiménez V, Álvarez-Gallardo IC, Pulido-Martos M, Herrador-Colmenero M, Geenen R, Carbonell-Baeza A, Delgado-Fernández M. Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Ándalus Project. PAIN MEDICINE 2020; 20:2506-2515. [PMID: 30698774 DOI: 10.1093/pm/pny304] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association. DESIGN Cross-sectional study in 420 women with fibromyalgia. SETTING Fibromyalgia associations from southern Spain. METHODS Physical fitness was measured by performance-based tests, and questionnaires were used to measure positive affect, negative affect, and different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). Age, body mass index, and current pain level were included as potential confounders in all analyses. RESULTS Physical fitness was independently associated with general fatigue, physical fatigue, and reduced activity (all P ≤ 0.02). Positive affect was independently associated with all fatigue dimensions (all P < 0.001). Negative affect was independently associated with general fatigue, physical fatigue, reduced motivation, and mental fatigue (all P ≤ 0.04). The interaction of overall physical fitness and positive affect was related to general fatigue and physical fatigue (all P ≤ 0.02). Women with fibromyalgia with higher levels of overall physical fitness and positive affect showed the lowest general fatigue and physical fatigue. CONCLUSIONS In women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.
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Affiliation(s)
- Fernando Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Northern Ireland, UK.,Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - María Rodriguez-Ayllon
- PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | | | - Manuel Pulido-Martos
- Department of Psychology, Faculty of Humanities and Sciences of Education, University of Jaén, Jaén, Spain
| | - Manuel Herrador-Colmenero
- PROmoting FITness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ana Carbonell-Baeza
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
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28
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Galvez-Sánchez CM, Montoro CI, Duschek S, Reyes Del Paso GA. Depression and trait-anxiety mediate the influence of clinical pain on health-related quality of life in fibromyalgia. J Affect Disord 2020; 265:486-495. [PMID: 32090776 DOI: 10.1016/j.jad.2020.01.129] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/22/2019] [Accepted: 01/20/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a chronic pain condition associated with a substantial decrease in health-related quality of life (HRQoL). This study investigated the relationships of HRQoL with clinical parameters of FMS (pain, insomnia and fatigue) and affective variables (depression and anxiety). METHODS Women with FMS (n=145) and healthy women (n=94) completed the Short-Form Health Survey (SF-36) to evaluate HRQoL, and self-report questionnaires pertaining to clinical pain, symptoms of anxiety and depression, fatigue and insomnia. Patterns of associations were assessed by correlation, multiple linear regression, and mediation analyses. RESULTS FMS patients showed lower scores on all SF-36 scales than healthy individuals. Clinical and emotional factors were inversely associated with SF-36 scores. Although depression was the strongest predictor of global HRQoL (explaining 36% of its variance), clinical pain and fatigue were the main predictors of physical components of HRQoL; depression and trait-anxiety were the main predictors of mental HRQoL components. Results of mediation analysis showed that depression, trait-anxiety and fatigue mediated the effect of clinical pain on HRQoL. Additionally, depression, trait-anxiety and fatigue mutually influenced each other, increasing their negative effects on the different areas of HRQoL. LIMITATIONS Among all emotional factors, only anxiety and depression were considered. CONCLUSIONS Our results suggest that FMS pain and related functional disability may increase depression and anxiety, in turn aggravating the primary symptoms of FMS and indirectly increasing the negative influence of pain on HRQoL. These results showed the need to evaluate and treat negative affective states in FMS.
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Affiliation(s)
| | | | - Stefan Duschek
- Department of Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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29
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Andretta A, Schieferdecker MEM, Petterle RR, Dos Santos Paiva E, Boguszewski CL. Relations between serum magnesium and calcium levels and body composition and metabolic parameters in women with fibromyalgia. Adv Rheumatol 2020; 60:18. [PMID: 32171334 DOI: 10.1186/s42358-020-0122-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 02/17/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Correlate serum magnesium (Mg) and Calcium (Ca) levels with body composition and metabolic parameters in women with fibromyalgia (FM). PATIENTS AND METHODS Cross-sectional study compared with a control group paired by age and body mass index (BMI) of adult women diagnosed with fibromyalgia. All participants went through assessment of their body composition through dual-energy X-ray absorptiometry (DXA) and had blood samples collected for dosing of Mg, Ca, C-reactive Protein (CRP), lipidogram and glycemia. RESULTS 53 women with FM (average age 48.1 ± 8.2 years, average BMI 26.6 ± 4.5 kg/m2) and 50 control women (average age 47.1 ± 9.9 years, average BMI 25.6 ± 3.6 kg/m2) participated in the study. Serum levels turned out to have inverse correlation with CRP in the FM group (r = - 0.29, p = 0.03) and with BMI and glycemia in the control group (r = 0.31; p = 0.02 and r = 0.48; p = 0.0004 respectively). Serum levels of calcium correlated with triglycerides (r = 0.29; p = 0.03) in the FM group and with glycemia in the control group (r = 0.64; p = 0.0001). CONCLUSIONS In patients with FM, magnesemia turned out to have inverse correlation with CRP and calcemia had positive association with triglycerides.
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Affiliation(s)
- Aline Andretta
- Department of Internal Medicine, Federal University of Parana (UFPR), Curitiba, PR, Brazil. Rua General Carneiro, 181, Curitiba, PR, 80060-900, Brazil.
| | | | | | | | - César Luiz Boguszewski
- Endocrine Division (SEMPR), Department of Internal Medicine, Federal University of Parana (UFPR), Curitiba, PR, Brazil
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30
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Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-Ándalus Project. J Clin Med 2020; 9:jcm9030733. [PMID: 32182753 PMCID: PMC7141225 DOI: 10.3390/jcm9030733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/21/2020] [Accepted: 03/04/2020] [Indexed: 01/10/2023] Open
Abstract
To examine the associations of prolonged sedentary time (ST) with disease severity in women with fibromyalgia, and to analyse the combined association of total ST and prolonged ST with the disease severity in this population. Women (n = 451; 51.3 ± 7.6 years old) with fibromyalgia participated. Sedentary time and moderate-to-vigorous physical activity (MVPA) were measured using triaxial accelerometry and ST was processed into 30- and 60-min bouts. Dimensions of fibromyalgia (function, overall, symptoms) and the overall disease impact were assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Body fat percentage was assessed using a bio-impedance analyser, and physical fitness was assessed with the Senior Fitness Tests Battery. Greater percentage of ST in 30-min bouts and 60-min bouts were associated with worse function, overall, symptoms and the overall impact of the disease (all, P < 0.05). Overall, these associations were statistically significant when additionally controlling for MVPA and overall physical fitness. Participants with low levels of total ST and prolonged ST (>60-min bouts) presented lower overall impact compared to participants with high levels of total ST and prolonged ST (mean difference = 6.56; 95% confidence interval (CI) = 1.83 to 11.29, P = 0.002). Greater percentage of ST accumulated in 30- and 60-min bouts and a combination of high levels of total and prolonged ST are related to worse disease severity. Although unable to conclude on causality, results suggest it might be advisable to motivate women with fibromyalgia to break prolonged ST and reduce their total daily ST.
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Abstract
Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.
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Affiliation(s)
- Matthew J Bair
- Richard L. Roudebush VA Medical Center, Indianapolis, Indiana (M.J.B.)
| | - Erin E Krebs
- Minneapolis VA Health Care System, Minneapolis, Minnesota (E.E.K.)
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32
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Rasmussen S, Jensen CT, Rosendal M, Vægter HB, Søndergaard J, Jarbøl DE. Multiple physical symptoms and individual characteristics - A cross-sectional study of the general population. J Psychosom Res 2020; 131:109941. [PMID: 32050120 DOI: 10.1016/j.jpsychores.2020.109941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Multiple physical symptoms not attributable to known organic disease are common in all medical fields and associated with major personal and social consequences. This study investigated multiple physical symptoms according to the construct of bodily distress syndrome (BDS) and associated individual characteristics in the general adult population. METHODS A nationwide, population-based study of 100,000 randomly selected individuals aged 20 years and older, conducted in 2012. A web-based questionnaire formed the basis of the study and was combined with Danish national registry data on socioeconomic factors and medication and healthcare use. RESULTS 49,706 individuals completed the questionnaire. After exclusion of women indicating pregnancy, respondents reporting chronic disease and respondents over 65 years of age, 23,331 remained for analysis. Of these 23,331 individuals, 15.5% fulfilled the criteria for BDS. BDS positives were more often younger (20-40 years) and female. Self-rated health and self-reported functional capacity were impaired among these individuals. Fulfilling the BDS criteria was significantly associated with current or former smoking, overweight and obesity, low educational level and income, and unemployment. Moreover, individuals with BDS were more often from ethnic minorities and had higher use of healthcare and medication. CONCLUSION Multiple physical symptoms, as captured by the concept of BDS, are common in the general adult population, especially among younger women. Fulfilling the BDS criteria is associated with substantial negative impact on self-perceived health and socioeconomic parameters. Fulfilling BDS criteria is positively associated with health risk behaviors (smoking, overweight and obesity) and higher use of healthcare and medication.
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Affiliation(s)
- Sanne Rasmussen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B Winsløwsvej 9A, 5000 Odense C, Denmark.
| | - Cecilie Thit Jensen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B Winsløwsvej 9A, 5000 Odense C, Denmark
| | - Marianne Rosendal
- Functional Disorders, Aarhus University Hospital, Nørrebrogade 44, bygn. 2, 8000 Aarhus C, Denmark; Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Henrik Bjarke Vægter
- Pain Center, University Hospital Odense, Heden 7-9, entrance 200, 1st floor, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B Winsløws Vej 19, 3(rd) floor, 5000 Odense C, Denmark.
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B Winsløwsvej 9A, 5000 Odense C, Denmark.
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B Winsløwsvej 9A, 5000 Odense C, Denmark.
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33
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Zadro JR, Nilsen TIL, Shirley D, Amorim AB, Ferreira PH, Lier R, Mork PJ. Parental Multisite Chronic Pain and the Risk of Adult Offspring Developing Additional Chronic Pain Sites: Family-Linkage Data From the Norwegian HUNT Study. THE JOURNAL OF PAIN 2020; 21:968-978. [PMID: 31904500 DOI: 10.1016/j.jpain.2019.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/11/2019] [Accepted: 12/03/2019] [Indexed: 10/25/2022]
Abstract
We investigated if parental multisite chronic pain increases the risk of adult offspring developing additional chronic pain sites, and if offspring body mass index (BMI) and leisure time physical activity modify this association. We used longitudinal data on 7,654 offspring linked with their parents who participated in the population-based HUNT Study (Norway) in 1995 to 1997 and 2006 to 2008. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence interval (CI). One-third of offspring (n = 2,573) developed additional chronic pain sites. Having both parents with 1-2 chronic pain sites increased the risk of developing additional pain sites compared to having parents free of chronic pain (OR = 1.33; 95% CI 1.05-1.68), with larger effects observed when both parents had ≥3 chronic pain sites (OR = 1.46; 95% CI 1.17-1.82). These associations were largely driven by maternal pain, that is, there was no association between paternal chronic pain and risk of additional pain sites in offspring. The parent-offspring transfer of additional pain sites (when both parents had ≥3 pain sites) strengthened when offspring were obese (OR = 2.56; 95% CI 1.75-3.75) or physically inactive (OR = 1.73; 95% CI 1.33-2.27). In conclusion, parental multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly those with obesity or inactivity. PERSPECTIVE: This longitudinal analysis investigated the parent-offspring transmission of multisite chronic pain, and whether lifestyle behaviors in offspring modify this association. The findings suggest that having parents with multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly if offspring are obese or inactive.
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Affiliation(s)
- Joshua R Zadro
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Institute for Musculoskeletal Health, Sydney, New South Wales, Australia.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Anesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Debra Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Anita B Amorim
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Ragnhild Lier
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Cerón Lorente L, García Ríos MC, Navarro Ledesma S, Tapia Haro RM, Casas Barragán A, Correa-Rodríguez M, Aguilar Ferrándiz ME. Functional Status and Body Mass Index in Postmenopausal Women with Fibromyalgia: A Case-control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224540. [PMID: 31744126 PMCID: PMC6888241 DOI: 10.3390/ijerph16224540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/10/2019] [Accepted: 11/14/2019] [Indexed: 12/16/2022]
Abstract
Reduced functional capacity is a common characteristic of fibromyalgia (FMS). We aimed to investigate the relationship between functional status and body mass index (BMI) in a population with and without FMS. A pilot case–control study was performed in 34 women with FMS and 22 healthy controls which were classified according to their BMI. The main outcome measures were: Balance (MiniBestest, One Leg Stance Test), functional mobility (Timed up and Go), physical disability (Health Assessment Questionnaire Disability Index), spinal range of motion (Spinal Mouse), level of physical activity at work (Leisure Time Physical Activity Instrument), and home and leisure time (Physical Activity at Home and Work). Statistical differences were observed between overweight/obese healthy controls and women with FMS for several indicators of functional capacity. FMS patients reported worse dynamic (p = 0.001) and static balance (right: p = 0.002, left: p = 0.001), poorer functional mobility (p = 0.008), and higher levels of physical disability (p = 0.001). Functional status is altered in FMS women compared to the healthy control group, independently of nutritional status; therefore, BMI is unlikely to play a main role in functional capacity indicators in postmenopausal FMS women. Only dynamic balance seems to reduce the obesity status in this population.
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Affiliation(s)
- Laura Cerón Lorente
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
| | - María Carmen García Ríos
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18014 Granada, Spain
| | - Santiago Navarro Ledesma
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
| | - Rosa María Tapia Haro
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
| | - Antonio Casas Barragán
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18014 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain
- Correspondence:
| | - María Encarnación Aguilar Ferrándiz
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), 18016 Granada, Spain; (L.C.L.); (M.C.G.R.); (S.N.L.); (R.M.T.H.); (A.C.B.); (M.E.A.F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18014 Granada, Spain
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Türkoğlu G, Selvi Y. The relationship between chronotype, sleep disturbance, severity of fibromyalgia, and quality of life in patients with fibromyalgia. Chronobiol Int 2019; 37:68-81. [DOI: 10.1080/07420528.2019.1684314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Gözde Türkoğlu
- Department of Physical Medicine and Rehabilitation, Konya Training and Research Hospital, Konya, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
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Skarpsno ES, Nilsen TIL, Sand T, Hagen K, Mork PJ. The joint effect of insomnia symptoms and lifestyle factors on risk of self-reported fibromyalgia in women: longitudinal data from the HUNT Study. BMJ Open 2019; 9:e028684. [PMID: 31444184 PMCID: PMC6707686 DOI: 10.1136/bmjopen-2018-028684] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To investigate the association between insomnia symptoms and risk of self-reported fibromyalgia in women, and to explore whether leisure time physical activity and body mass index (BMI) modify this association. DESIGN Prospective cohort study. SETTING We used longitudinal data from the Norwegian Nord-Trøndelag Health Study collected in 1995-1997 (baseline) and 2006-2008 (follow-up). PARTICIPANTS A total of 14 172 women who reported to be free from fibromyalgia at baseline. PRIMARY OUTCOME MEASURES We estimated adjusted risk ratios (RRs) with 95% CI for self-reported fibromyalgia at follow-up associated with baseline insomnia symptoms, leisure time physical activity and BMI. RESULTS Overall, 466 incident cases of fibromyalgia were reported during the follow-up period of approximately 11 years, corresponding to a crude absolute risk (AR) of 3.3%. Compared with women without insomnia symptoms (crude AR=2.8%), women who reported one, two or three symptoms had RRs of fibromyalgia of 1.39 (95% CI: 1.08 to 1.80), 1.86 (95% CI: 1.33 to 2.59) and 2.66 (95% CI: 1.75 to 4.06), respectively. Compared with highly physically active women without insomnia symptoms (crude AR=2.7%), women with one or more insomnia symptoms had a RR of fibromyalgia of 1.90 (95% CI: 1.30 to 2.79) if they reported low physical activity and a RR of 1.55 (95% CI: 1.12 to 2.13) if they reported high physical activity. We found no synergistic effect between insomnia symptoms and BMI on risk of fibromyalgia; however, overweight and obese women with one or more insomnia symptoms had RRs of 2.35 (95% CI: 1.73 to 3.21) and 2.18 (95% CI: 1.42 to 3.35) compared with the reference group of normal weight women without insomnia symptoms (crude AR=2.3%). CONCLUSIONS Insomnia symptoms are strongly and positively associated with risk of fibromyalgia in adult women. Leisure time physical activity may compensate for some of the adverse effect of insomnia symptoms on risk of fibromyalgia.
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Affiliation(s)
- Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Trond Sand
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Knut Hagen
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St. Olavs Hospital, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Umeda M, Kim Y. Gender Differences in the Prevalence of Chronic Pain and Leisure Time Physical Activity Among US Adults: A NHANES Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060988. [PMID: 30893869 PMCID: PMC6466318 DOI: 10.3390/ijerph16060988] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 01/02/2023]
Abstract
Gender disparities in chronic pain are well documented in the literature. However, little is known regarding the relationship between physical activity (PA) and gender disparities in chronic pain. This study described gender differences in prevalence of chronic pain and PA, and identified a type of leisure time PA that individuals frequently chose in a nationally representative sample of US adults (N = 14,449). Data from the National Health Nutrition Examination Survey 1999⁻2004 were analyzed. Individuals were categorized into no chronic pain (NCP), localized chronic pain (LCP), and widespread chronic pain (WCP) groups based on responses to a pain questionnaire. A self-report PA questionnaire was used to estimate the time spent in different types of PA. Women showed higher prevalence of LCP and WCP compared to men. Men spent more hours per week for leisure time PA compared to women, but men and women showed similar prevalence of sufficient PA to meet a PA recommendation (≥150 min/week of moderate-to-vigorous intensity PA) across chronic pain categories. However, the prevalence of sufficient PA was substantially higher among men and women with NCP compared to men and women with LCP and WCP. Additionally, both men and women chose walking as the primary type of leisure time PA. Together, gender disparities exist in the prevalence of chronic pain and hours spent for leisure time PA. More research is needed to explore the role of increasing leisure time PA, such as walking, in reducing gender disparities in chronic pain.
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Affiliation(s)
- Masataka Umeda
- Department of Kinesiology, Health, and Nutrition, the University of Texas at San Antonio, San Antonio, TX 78249, USA.
| | - Youngdeok Kim
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79424, USA.
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Galvez-Sánchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag 2019; 12:117-127. [PMID: 30858740 PMCID: PMC6386210 DOI: 10.2147/prbm.s178240] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread and persistent musculoskeletal pain and other frequent symptoms such as fatigue, insomnia, morning stiffness, cognitive impairment, depression, and anxiety. FMS is also accompanied by different comorbidities like irritable bowel syndrome and chronic fatigue syndrome. Although some factors like negative events, stressful environments, or physical/emotional traumas may act as predisposing conditions, the etiology of FMS remains unknown. There is evidence of a high prevalence of psychiatric comorbidities in FMS (especially depression, anxiety, borderline personality, obsessive-compulsive personality, and post-traumatic stress disorder), which are associated with a worse clinical profile. There is also evidence of high levels of negative affect, neuroticism, perfectionism, stress, anger, and alexithymia in FMS patients. High harm avoidance together with high self-transcendence, low cooperativeness, and low self-directedness have been reported as temperament and character features in FMS patients, respectively. Additionally, FMS patients tend to have a negative self-image and body image perception, as well as low self-esteem and perceived self-efficacy. FMS reduces functioning in physical, psychological, and social spheres, and also has a negative impact on cognitive performance, personal relationships (including sexuality and parenting), work, and activities of daily life. In some cases, FMS patients show suicidal ideation, suicide attempts, and consummated suicide. FMS patients perceive the illness as a stigmatized and invisible disorder, and this negative perception hinders their ability to adapt to the disease. Psychological interventions may constitute a beneficial complement to pharmacological treatments in order to improve clinical symptoms and reduce the impact of FMS on health-related quality of life.
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Affiliation(s)
| | - Stefan Duschek
- Department of Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Andrade CP, Zamunér AR, Forti M, Tamburús NY, Silva E. Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial. Eur J Phys Rehabil Med 2019; 55:79-88. [DOI: 10.23736/s1973-9087.18.05041-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ahmed S, Khattab S, Haddad C, Babineau J, Furlan A, Kumbhare D. Effect of aerobic exercise in the treatment of myofascial pain: a systematic review. J Exerc Rehabil 2018; 14:902-910. [PMID: 30656147 PMCID: PMC6323330 DOI: 10.12965/jer.1836406.205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/11/2018] [Indexed: 12/28/2022] Open
Abstract
Myofascial pain is prevalent chronic pain disorder that is comorbid with many conditions. Strengthening and stretching exercises are capable of inducing hypoalgesic effects in people with myofascial pain syndrome. The goal of this systematic review was to summarize the effects of aerobic exercise on the management of myofascial pain. A comprehensive database search was conducted. A total of 1,331 articles were identified for review. One article was eligible for inclusion after full screening. Risk of bias was assessed using the Downs and Black quality assessment questionnaire (1998). Mean difference scores were calculated for continuous variables. The identified study had a low risk of bias. It was a randomized controlled trial assessing the influence of an 8-week water aerobic exercise program on myofascial pain in breast cancer patients. Visual analogue scale pain intensity ratings and the number of myofascial trigger points present in the neck and shoulder/axillary area of participants significantly decreased in the exercise group compared to those in the control group. Pain pressure thresholds significantly increased in muscle areas of the cervical spine in the water exercise group. Aerobic exercise presents a potential treatment modality for managing myofascial pain. Additional research is necessary.
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Affiliation(s)
- Sara Ahmed
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shereen Khattab
- Department of Psychology, McMaster University, Hamilton, ON, Canada
| | - Chris Haddad
- Department of Physical Education & Kinesiology, University of Toronto, Toronto, ON, Canada
| | - Jessica Babineau
- Department of Library & Information Services, University Health Network - Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Andrea Furlan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dinesh Kumbhare
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Häuser W, Welsch P, Klose P, Derry S, Straube S, Wiffen PJ, Moore RA. Pharmacological therapies for fibromyalgia in adults ‐ an overview of Cochrane Reviews. Cochrane Database Syst Rev 2018; 2018:CD013151. [PMCID: PMC6516969 DOI: 10.1002/14651858.cd013151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
This is a protocol for a Cochrane Review (Overview). The objectives are as follows: To provide an overview of the therapeutic efficacy of pharmacological therapies for fibromyalgia, and to report on adverse events associated with their use. The major comparison of interest will be with placebo.
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Affiliation(s)
- Winfried Häuser
- Technische Universität MünchenDepartment of Psychosomatic Medicine and PsychotherapyLangerstr. 3MünchenGermanyD‐81675
| | - Patrick Welsch
- Health Care Center for Pain Medicine and Mental HealthSaarbrückenGermany
| | - Petra Klose
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34 aEssenGermanyD‐45276
| | | | - Sebastian Straube
- University of AlbertaDepartment of Medicine, Division of Preventive Medicine5‐30 University Terrace8303‐112 StreetEdmontonCanadaT6G 2T4
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Abstract
BACKGROUND Fibromyalgia is a clinically defined chronic condition of unknown etiology characterised by chronic widespread pain, sleep disturbance, cognitive dysfunction, and fatigue. Many patients report high disability levels and poor quality of life. Drug therapy aims to reduce key symptoms, especially pain, and improve quality of life. The tetracyclic antidepressant, mirtazapine, may help by increasing serotonin and noradrenaline in the central nervous system (CNS). OBJECTIVES To assess the efficacy, tolerability and safety of the tetracyclic antidepressant, mirtazapine, compared with placebo or other active drug(s) in the treatment of fibromyalgia in adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, SCOPUS, the US National Institutes of Health, and the World Health Organization (WHO) International Clinical Trials Registry Platform for published and ongoing trials, and examined reference lists of reviewed articles, to 9 July 2018. SELECTION CRITERIA Randomised controlled trials (RCTs) of any formulation of mirtazapine against placebo, or any other active treatment of fibromyalgia, in adults. DATA COLLECTION AND ANALYSIS Two review authors independently extracted study characteristics, outcomes of efficacy, tolerability and safety, examined issues of study quality, and assessed risk of bias, resolving discrepancies by discussion. Primary outcomes were participant-reported pain relief (at least 50% or 30% pain reduction), Patient Global Impression of Change (PGIC; much or very much improved), safety (serious adverse events), and tolerability (adverse event withdrawal). Other outcomes were health-related quality of life (HRQoL) improved by 20% or more, fatigue, sleep problems, mean pain intensity, negative mood and particular adverse events. We used a random-effects model to calculate risk difference (RD), standardised mean difference (SMD), and numbers needed to treat. We assessed the evidence using GRADE and created a 'Summary of findings' table. MAIN RESULTS Three studies with 606 participants compared mirtazapine with placebo (but not other drugs) over seven to 13 weeks. Two studies were at unclear or high risk of bias in six or seven of eight domains. We judged the evidence for all outcomes to be low- or very low-quality because of poor study quality, indirectness, imprecision, risk of publication bias, and sometimes low numbers of events.There was no difference between mirtazapine and placebo for any primary outcome: participant-reported pain relief of 50% or greater (22% versus 16%; RD 0.05, 95% confidence interval (CI) -0.01 to 0.12; three studies with 591 participants; low-quality evidence); no data available for PGIC; only a single serious adverse event for evaluation of safety (RD -0.00, 95% CI -0.01 to 0.02; three studies with 606 participants; very low-quality evidence); and tolerability as frequency of dropouts due to adverse events (3% versus 2%; RD 0.00, 95% CI -0.02 to 0.03; three studies with 606 participants; low-quality evidence).Mirtazapine showed a clinically-relevant benefit compared to placebo for some secondary outcomes: participant-reported pain relief of 30% or greater (47% versus 34%; RD 0.13, 95% CI 0.05 to 0.21; number needed to treat for an additional beneficial outcome (NNTB) 8, 95% CI 5 to 20; three studies with 591 participants; low-quality evidence); participant-reported mean pain intensity (SMD -0.29, 95% CI -0.46 to -0.13; three studies with 591 participants; low-quality evidence); and participant-reported sleep problems (SMD -0.23, 95% CI -0.39 to -0.06; three studies with 573 participants; low-quality evidence). There was no benefit for improvement of participant-reported improvement of HRQoL of 20% or greater (58% versus 50%; RD 0.08, 95% CI -0.01 to 0.16; three studies with 586 participants; low-quality evidence); participant-reported fatigue (SMD -0.02, 95% CI -0.19 to 0.16; two studies with 533 participants; low-quality evidence); participant-reported negative mood (SMD -0.67, 95% CI -1.44 to 0.10; three studies with 588 participants; low-quality evidence); or withdrawals due to lack of efficacy (1.5% versus 0.1%; RD 0.01, 95% CI -0.01 to 0.02; three studies with 605 participants; very low-quality evidence).There was no difference between mirtazapine and placebo for participants reporting any adverse event (76% versus 59%; RD 0.12, 95 CI -0.01 to 0.26; three studies with 606 participants; low-quality evidence). There was a clinically-relevant harm with mirtazapine compared to placebo: in the number of participants with somnolence (42% versus 14%; RD 0.24, 95% CI 0.18 to 0.30; number needed to treat for an additional harmful outcome (NNTH) 5, 95% CI 3 to 6; three studies with 606 participants; low-quality evidence); weight gain (19% versus 1%; RD 0.17, 95% CI 0.11 to 0.23; NNTH 6, 95% CI 5 to 10; three studies with 606 participants; low-quality evidence); and elevated alanine aminotransferase (13% versus 2%; RD 0.13, 95% CI 0.04 to 0.22; NNTH 8, 95% CI 5 to 25; two studies with 566 participants; low-quality evidence). AUTHORS' CONCLUSIONS Studies demonstrated no benefit of mirtazapine over placebo for pain relief of 50% or greater, PGIC, improvement of HRQoL of 20% or greater, or reduction of fatigue or negative mood. Clinically-relevant benefits were shown for pain relief of 30% or greater, reduction of mean pain intensity, and sleep problems. Somnolence, weight gain, and elevated alanine aminotransferase were more frequent with mirtazapine than placebo. The quality of evidence was low or very low, with two of three studies of questionable quality and issues over indirectness and risk of publication bias. On balance, any potential benefits of mirtazapine in fibromyalgia were outweighed by its potential harms, though, a small minority of people with fibromyalgia might experience substantial symptom relief without clinically-relevant adverse events.
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Affiliation(s)
- Patrick Welsch
- Health Care Center for Pain Medicine and Mental Health, Saarbrücken, Germany
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Koçyiğit BF, Okyay RA. The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia. PeerJ 2018; 6:e4917. [PMID: 29868295 PMCID: PMC5978395 DOI: 10.7717/peerj.4917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/16/2018] [Indexed: 12/16/2022] Open
Abstract
Background Obesity is a possible factor which affects severity of symptoms and disease activity in fibromyalgia syndrome (FMS). The aim of our study was to determine the association between body mass index (BMI) and pain, tender point count (TPC), disease activity, anxiety and depression in patients with FMS. Methods This was a descriptive study. A total of 124 female FMS patients between 18 and 55 years of age were enrolled. FMS patients were evaluated with visual analog scale (VAS), fibromyalgia impact questionnaire (FIQ), Hamilton anxiety scale (HAM-A) and Hamilton depression scale (HAM-D). Patients were divided into three groups according to BMI levels: normal weight, overweight and obese. Normal weight was defined as BMI 18.5-24.9, overweight as BMI 25.0-29.9 and obesity as BMI ≥ 30. We assessed the BMI status and its association with symptom severity in patients with FMS. Results Significant differences were detected in VAS, TPC, FIQ and HAM-D among the groups (p < 0.05). There were no significant differences between the groups in HAM-A (p = 0.328). The highest scores were found in the obese group. Significant positive correlations were determined between BMI levels and VAS, TPC, FIQ and HAM-D (r = 0.277, p = 0.002; r = 0.384, p < 0.001; r = 0.292, p = 0.001; r = 0.357, p < 0.001). Discussion Obese female FMS patients had higher levels of pain, TPC, disease activity and depression. BMI was significantly and positively correlated with clinical manifestations of FMS. Therefore, FMS treatment programs should include weight loss strategies.
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Affiliation(s)
- Burhan Fatih Koçyiğit
- Department of Physical Medicine and Rehabilitation, Kahramanmaras Sütcü Imam University, Kahramanmaras, Turkey
| | - Ramazan Azim Okyay
- Department of Public Health, Kahramanmaras Sütcü Imam University, Kahramanmaras, Turkey
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Zadro JR, Nilsen TIL, Shirley D, Amorim AB, Ferreira PH, Mork PJ. Parental chronic widespread pain and the association with chronic widespread pain in adult offspring: Family-linkage data from the Norwegian HUNT Study. Eur J Pain 2018; 22:1485-1493. [PMID: 29704885 DOI: 10.1002/ejp.1237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individuals experiencing chronic widespread pain (CWP) have greater disability and poorer quality of life compared to those with other chronic painful conditions; although research identifying risk factors for CWP is lacking. We aimed to investigate whether parental CWP increases the risk of offspring CWP, and if offspring body mass index (BMI) and leisure time physical activity modify this association. METHODS We included 6589 parent-offspring trios participating in the Norwegian HUNT Study in 1995-1997 and 2006-2008. Logistic regression was used to calculate adjusted odd ratios (ORs) (95% confidence intervals, CIs) as estimates of relative risk for offspring CWP. We analysed the joint effect of parental CWP and offspring BMI or leisure time physical activity on offspring risk of CWP and calculated the relative excess risk due to interaction (RERI). RESULTS In total, 886 (13.5%) offspring developed CWP during follow-up. Having one (OR = 1.23, 95% CI, 1.05-1.44) or both parents with CWP (OR = 1.89, 95% CI, 1.50-2.38) increased the risk of offspring CWP. In analyses of joint effects, ORs were 1.84 (95% CI, 1.31-2.56) and 3.35 (95% CI, 1.94-5.77) in normal weight and obese offspring, respectively, when both parents had CWP. The estimate of RERI suggested some synergistic effect (RERI = 1.19, 95% CI, -0.68 to 3.05), although precision was low. Risk of CWP was similar in active (OR = 2.05, 95% CI, 1.56-2.70) and inactive (OR = 1.96, 95% CI, 1.31-2.91) offspring when both parents had CWP. CONCLUSION Parental CWP increases the risk of CWP in adult offspring, particularly if both parents have CWP and offspring are obese. This highlights a familial predisposition for CWP and an important target group for preventive measures. SIGNIFICANCE The parent-offspring transmission of CWP is stronger in obese offspring (particularly when both parents have CWP). This study is the first to investigate the interaction between modifiable lifestyle factors, familial factors and CWP.
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Affiliation(s)
- J R Zadro
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - T I L Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Norway
| | - D Shirley
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - A B Amorim
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - P H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - P J Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Iversen VM, Vasseljen O, Mork PJ, Gismervik S, Bertheussen GF, Salvesen Ø, Fimland MS. Resistance band training or general exercise in multidisciplinary rehabilitation of low back pain? A randomized trial. Scand J Med Sci Sports 2018; 28:2074-2083. [PMID: 29603805 DOI: 10.1111/sms.13091] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/13/2022]
Abstract
Multidisciplinary biopsychosocial rehabilitation has been recommended for chronic low back pain (LBP), including physical exercise. However, which exercise modality that is most advantageous in multidisciplinary biopsychosocial rehabilitation is unclear. In this study, we investigated whether multidisciplinary biopsychosocial rehabilitation could be more effective in reducing pain-related disability when general physical exercise was replaced by strength training in the form of progressive resistance training using elastic resistance bands. In this single-blinded (researchers), randomized controlled trial, 99 consenting adults with moderate-to-severe non-specific LBP were randomized to three weeks of multidisciplinary biopsychosocial rehabilitation with either general physical exercise or progressive resistance band training and were then instructed to continue with their respective home-based programs for nine additional weeks, in which three booster sessions were offered. The primary outcome was between-group difference in change on the Oswestry Disability Index (ODI) at 12 weeks. Due to early dropouts, data from 74 participants (mean age: 45 years, 57% women, mean ODI: 30.4) were obtained at baseline, 61 participants were followed-up at 3 weeks, and 46 at 12 weeks. There was no difference in the change in ODI score between groups at 12 weeks (mean difference 1.9, 95% CI: -3.6, 7.4, P = .49). Likewise, the change in secondary outcomes did not differ between groups, except for the patient-specific functional scale (0-10), which favored general physical exercise (mean difference 1.4, 95% CI: 0.1, 2.7, P = .033). In conclusion, this study does not support that progressive resistance band training compared to general physical exercise improve outcomes in multidisciplinary biopsychosocial rehabilitation for patients with non-specific LBP.
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Affiliation(s)
- V M Iversen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - O Vasseljen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - P J Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Gismervik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - G F Bertheussen
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ø Salvesen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - M S Fimland
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
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Larsson A, Palstam A, Bjersing J, Löfgren M, Ernberg M, Kosek E, Gerdle B, Mannerkorpi K. Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia. BMC Musculoskelet Disord 2018; 19:121. [PMID: 29673356 PMCID: PMC5907704 DOI: 10.1186/s12891-018-2047-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/12/2018] [Indexed: 01/27/2023] Open
Abstract
Background Health and physical capacity are commonly associated with disease, age, and socioeconomic factors. The primary objective of this study was to investigate the degree to which physical capacity, defined as muscle strength and walking ability, is decreased in women with fibromyalgia (FM), as compared to healthy women, who are matched for age and level of education. The secondary aim was to investigate whether muscle strength and walking ability are associated with age, symptom duration, activity limitations and, Body Mass Index (BMI) in women with FM and control subjects. Methods This controlled, cross-sectional, multi-center study comprised 118 women with FM and 93 age- and education-level-matched healthy women. The outcome measures were isometric knee-extension force, isometric elbow-flexion force, isometric hand-grip force, and walking ability. Differences between the groups were calculated, and for the women with FM analyses of correlations between the measures of physical capacity and variables were performed. Results The women with FM showed 20% (p < 0.001) lower isometric knee-extension force, 36% (p < 0.001) lower isometric elbow-flexion force, 34% (p < 0.001) lower isometric hand-grip force, and 16% lower walking ability (p < 0.001), as compared to the healthy controls. All measures of muscle strength in women with FM showed significant weak to moderate relationship to symptom duration (rs = − 0.23–0.32) and walking ability (rs = 0.25–0.36). Isometric knee-extension force correlated with activity limitations, as measured using the SF-36 Physical function subscale (rs=0.23, p = 0.011). Conclusions Physical capacity was considerably decreased in the women with FM, as compared to the age- and education-level-matched control group. All measures of physical capacity showed a significant association with symptom duration. Knee-extension force and walking ability were significantly associated with activity limitations, age, and BMI. It seems important to address this problem and to target interventions to prevent decline in muscle strength. Assessments of muscle strength and walking ability are easy to administer and should be routinely carried out in the clinical setting for women with FM. Trial registration ClinicalTrials.gov identification number: NCT01226784, Oct 21, 2010.
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Affiliation(s)
- Anette Larsson
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Box 430, 40530, Gothenburg, Sweden. .,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
| | - Annie Palstam
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Bjersing
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute and Stockholm Spine Center, Stockholm, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Box 430, 40530, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.,Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Genome-wide methylation analysis of a large population sample shows neurological pathways involvement in chronic widespread musculoskeletal pain. Pain 2018; 158:1053-1062. [PMID: 28221285 PMCID: PMC5427989 DOI: 10.1097/j.pain.0000000000000880] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Chronic widespread musculoskeletal pain (CWP), has a considerable heritable component, which remains to be explained. Epigenetic factors may contribute to and account for some of the heritability estimate. We analysed epigenome-wide methylation using MeDIPseq in whole blood DNA from 1708 monozygotic and dizygotic Caucasian twins having CWP prevalence of 19.9%. Longitudinally stable methylation bins (lsBINs), were established by testing repeated measurements conducted ≥3 years apart, n = 292. DNA methylation variation at lsBINs was tested for association with CWP in a discovery set of 50 monozygotic twin pairs discordant for CWP, and in an independent dataset (n = 1608 twins), and the results from the 2 samples were combined using Fisher method. Functional interpretation of the most associated signals was based on functional genomic annotations, gene ontology, and pathway analyses. Of 723,029 signals identified as lsBINs, 26,399 lsBINs demonstrated the same direction of association in both discovery and replication datasets at nominal significance (P ≤ 0.05). In the combined analysis across 1708 individuals, whereas no lsBINs showed genome-wide significance (P < 10-8), 24 signals reached p≤9E-5, and these included association signals mapping in or near to IL17A, ADIPOR2, and TNFRSF13B. Bioinformatics analyses of the associated methylation bins showed enrichment for neurological pathways in CWP. We estimate that the variance explained by epigenetic factors in CWP is 6%. This, the largest study to date of DNA methylation in CWP, points towards epigenetic modification of neurological pathways in CWP and provides proof of principle of this method in teasing apart the complex risk factors for CWP.
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Welsch P, Üçeyler N, Klose P, Walitt B, Häuser W. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia. Cochrane Database Syst Rev 2018; 2:CD010292. [PMID: 29489029 PMCID: PMC5846183 DOI: 10.1002/14651858.cd010292.pub2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Fibromyalgia is a clinically defined chronic condition of unknown etiology characterized by chronic widespread pain that often co-exists with sleep disturbances, cognitive dysfunction and fatigue. People with fibromyalgia often report high disability levels and poor quality of life. Drug therapy, for example, with serotonin and noradrenaline reuptake inhibitors (SNRIs), focuses on reducing key symptoms and improving quality of life. This review updates and extends the 2013 version of this systematic review. OBJECTIVES To assess the efficacy, tolerability and safety of serotonin and noradrenaline reuptake inhibitors (SNRIs) compared with placebo or other active drug(s) in the treatment of fibromyalgia in adults. SEARCH METHODS For this update we searched CENTRAL, MEDLINE, Embase, the US National Institutes of Health and the World Health Organization (WHO) International Clinical Trials Registry Platform for published and ongoing trials and examined the reference lists of reviewed articles, to 8 August 2017. SELECTION CRITERIA We selected randomized, controlled trials of any formulation of SNRIs against placebo or any other active treatment of fibromyalgia in adults. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data, examined study quality, and assessed risk of bias. For efficacy, we calculated the number needed to treat for an additional beneficial outcome (NNTB) for pain relief of 50% or greater and of 30% or greater, patient's global impression to be much or very much improved, dropout rates due to lack of efficacy, and the standardized mean differences (SMD) for fatigue, sleep problems, health-related quality of life, mean pain intensity, depression, anxiety, disability, sexual function, cognitive disturbances and tenderness. For tolerability we calculated number needed to treat for an additional harmful outcome (NNTH) for withdrawals due to adverse events and for nausea, insomnia and somnolence as specific adverse events. For safety we calculated NNTH for serious adverse events. We undertook meta-analysis using a random-effects model. We assessed the evidence using GRADE and created a 'Summary of findings' table. MAIN RESULTS We added eight new studies with 1979 participants for a total of 18 included studies with 7903 participants. Seven studies investigated duloxetine and nine studies investigated milnacipran against placebo. One study compared desvenlafaxine with placebo and pregabalin. One study compared duloxetine with L-carnitine. The majority of studies were at unclear or high risk of bias in three to five domains.The quality of evidence of all comparisons of desvenlafaxine, duloxetine and milnacipran versus placebo in studies with a parallel design was low due to concerns about publication bias and indirectness, and very low for serious adverse events due to concerns about publication bias, imprecision and indirectness. The quality of evidence of all comparisons of duloxetine and desvenlafaxine with other active drugs was very low due to concerns about publication bias, imprecision and indirectness.Duloxetine and milnacipran had no clinically relevant benefit over placebo for pain relief of 50% or greater: 1274 of 4104 (31%) on duloxetine and milnacipran reported pain relief of 50% or greater compared to 591 of 2814 (21%) participants on placebo (risk difference (RD) 0.09, 95% confidence interval (CI) 0.07 to 0.11; NNTB 11, 95% CI 9 to 14). Duloxetine and milnacipran had a clinically relevant benefit over placebo in patient's global impression to be much or very much improved: 888 of 1710 (52%) on duloxetine and milnacipran (RD 0.19, 95% CI 0.12 to 0.26; NNTB 5, 95% CI 4 to 8) reported to be much or very much improved compared to 354 of 1208 (29%) of participants on placebo. Duloxetine and milnacipran had a clinically relevant benefit compared to placebo for pain relief of 30% or greater. RD was 0.10; 95% CI 0.08 to 0.12; NNTB 10, 95% CI 8 to 12. Duloxetine and milnacipran had no clinically relevant benefit for fatigue (SMD -0.13, 95% CI -0.18 to -0.08; NNTB 18, 95% CI 12 to 29), compared to placebo. There were no differences between either duloxetine or milnacipran and placebo in reducing sleep problems (SMD -0.07; 95 % CI -0.15 to 0.01). Duloxetine and milnacipran had no clinically relevant benefit compared to placebo in improving health-related quality of life (SMD -0.20, 95% CI -0.25 to -0.15; NNTB 11, 95% CI 8 to 14).There were 794 of 4166 (19%) participants on SNRIs who dropped out due to adverse events compared to 292 of 2863 (10%) of participants on placebo (RD 0.07, 95% CI 0.04 to 0.10; NNTH 14, 95% CI 10 to 25). There was no difference in serious adverse events between either duloxetine, milnacipran or desvenlafaxine and placebo (RD -0.00, 95% CI -0.01 to 0.00).There was no difference between desvenlafaxine and placebo in efficacy, tolerability and safety in one small trial.There was no difference between duloxetine and desvenlafaxine in efficacy, tolerability and safety in two trials with active comparators (L-carnitine, pregabalin). AUTHORS' CONCLUSIONS The update did not change the major findings of the previous review. Based on low- to very low-quality evidence, the SNRIs duloxetine and milnacipran provided no clinically relevant benefit over placebo in the frequency of pain relief of 50% or greater, but for patient's global impression to be much or very much improved and in the frequency of pain relief of 30% or greater there was a clinically relevant benefit. The SNRIs duloxetine and milnacipran provided no clinically relevant benefit over placebo in improving health-related quality of life and in reducing fatigue. Duloxetine and milnacipran did not significantly differ from placebo in reducing sleep problems. The dropout rates due to adverse events were higher for duloxetine and milnacipran than for placebo. On average, the potential benefits of duloxetine and milnacipran in fibromyalgia were outweighed by their potential harms. However, a minority of people with fibromyalgia might experience substantial symptom relief without clinically relevant adverse events with duloxetine or milnacipran.We did not find placebo-controlled studies with other SNRIs than desvenlafaxine, duloxetine and milnacipran.
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Affiliation(s)
- Patrick Welsch
- Health Care Center for Pain Medicine and Mental Health, Saarbrücken, Germany
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Selfridge NJ. Fibromyalgia. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fibromyalgia Syndrome and Vitiligo: A Novel Association. Arch Rheumatol 2017; 33:174-180. [PMID: 30207563 DOI: 10.5606/archrheumatol.2018.6524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/06/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to assess the relationship between fibromyalgia syndrome (FMS) and vitiligo in Iraqi patients and evaluate the predictors of this relationship, if present. Patients and methods The case-control study included 100 Iraqi patients (46 males, 54 females; mean age 30.4±14 years; range 15 to 65 years) with vitiligo and 200 age- and sex-matched healthy controls (74 males, 126 females; mean age 30.3±9.4 years; range 15 to 62 years). Baseline characteristics of patients and controls were recorded. The 2012 Canadian Guidelines criteria were used for the diagnosis of FMS and applied to all patients and controls. Results Prevalence of FMS in vitiligo patients and controls was 12% and 7%, respectively (p=0.15, odds ratio=1.8, 95% confidence interval=0.8-4.08). FMS symptoms in vitiligo patients were fatigue (46%), diffuse body pain (34%), sleep disturbance (33%), cognitive dysfunction (30%), and mood disorders (23%), while visceral involvements were central nervous system (52%), skin (35%), gastrointestinal tract (32%), cardiovascular system- respiratory system (16%), genitourinary tract (8%), and ear nose throat (7%). Of vitiligo patients, FMS was significantly more common among females (22.2%) compared to none among males (0%) (p<0.05). Prevalence of FMS was restricted to female sex only and a significantly higher prevalence rate of FMS was found among female vitiligo patients (22.2%) compared to controls (9.5%). Receiving phototherapy significantly increased the risk of having FMS by 5 times compared to female patients not receiving phototherapy. Use of any steroid reduced the risk of having FMS by 2.5 times (inverse of odds ratio=0.4) among females patients (p>0/05). No significant association was found between FMS in vitiligo patients and age, disease duration, type of vitiligo, use of any immunosuppressant and body mass index (p>0.05). Conclusion Fibromyalgia syndrome was more prevalent in vitiligo patients compared to controls, which was clinically important but statistically not significant. There was a significant association between FMS in vitiligo patients and female sex, severe form of vitiligo, and receiving phototherapy. This may suggest that early diagnosis of FMS in vitiligo patients may help in early treatment and subsequently improve patients' quality of life.
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