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Avichal Ughreja R, Venkatesan P, Balebail Gopalakrishna D, Preet Singh Y, Vani Lakshmi R. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: A randomized controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2024:S2095-4964(24)00339-X. [PMID: 38955652 DOI: 10.1016/j.joim.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 04/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Sleep disturbance is commonly seen in fibromyalgia syndrome (FMS); however, high quality studies involving manual therapies that target FMS-linked poor sleep quality are lacking for the Indian population. OBJECTIVE Craniosacral therapy (CST), Bowen therapy and exercises have been found to influence the autonomic nervous system, which plays a crucial role in sleep physiology. Given the paucity of evidence concerning these effects in individuals with FMS, our study tests the effectiveness of CST, Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION A placebo-controlled randomized trial was conducted on 132 FMS participants with poor sleep at a hospital in Bangalore. The participants were randomly allocated to one of the four study groups, including CST, Bowen therapy, standard exercise program, and a manual placebo control group that received static touch. CST, Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks; the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks. After 12 weeks, all study participants performed the standard exercises at home for another 12 weeks. MAIN OUTCOME MEASURES Sleep quality, pressure pain threshold (PPT), quality of life and fibromyalgia impact, physical function, fatigue, pain catastrophizing, kinesiophobia, and positive-negative affect were recorded at baseline, and at weeks 12 and 24 of the intervention. RESULTS At the end of 12 weeks, the sleep quality improved significantly in the CST group (P = 0.037) and Bowen therapy group (P = 0.023), and the PPT improved significantly in the Bowen therapy group (P = 0.002) and the standard exercise group (P < 0.001), compared to the static touch group. These improvements were maintained at 24 weeks. No between-group differences were observed for other secondary outcomes. CONCLUSION CST and Bowen therapy improved sleep quality, and Bowen therapy and standard exercises improved pain threshold in the short term. These improvements were retained within the groups in the long term by adding exercises. CST and Bowen therapy are treatment options to improve sleep and reduce pain in FMS. TRIAL REGISTRATION NUMBER Registered at Clinical Trials Registry of India with the number of CTRI/2020/04/024551. Please cite this article as: Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, Lakshmi VR. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: a randomized controlled trial. J Integr Med. 2024; Epub ahead of print.
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Affiliation(s)
- Reepa Avichal Ughreja
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Prem Venkatesan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
| | | | - Yogesh Preet Singh
- Department of Clinical Immunology and Rheumatology, All India Institute of Medical Sciences, Bilaspur 174001, Himachal Pradesh, India
| | - R Vani Lakshmi
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Boylan KA, Dworetzky BA, Baslet G, Polich G, Angela O’Neal M, Reinsberger C. Functional neurological disorder, physical activity and exercise: What we know and what we can learn from comorbid disorders. Epilepsy Behav Rep 2024; 27:100682. [PMID: 38953100 PMCID: PMC11215960 DOI: 10.1016/j.ebr.2024.100682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 07/03/2024] Open
Abstract
Functional neurological disorder (FND) is a common neurologic disorder associated with many comorbid symptoms including fatigue, pain, headache, and orthostasis. These concurrent symptoms lead patients to accumulate multiple diagnoses comorbid with FND, including fibromyalgia, chronic fatigue syndrome, postural orthostatic tachycardia syndrome, persistent post-concussive symptoms, and chronic pain. The role of physical activity and exercise has not been evaluated in FND populations, though has been studied in certain comorbid conditions. In this traditional narrative literature review, we highlight some existing literature on physical activity in FND, then look to comorbid disorders to highlight the therapeutic potential of physical activity. We then consider abnormalities in the autonomic nervous system (ANS) as a potential pathophysiological explanation for symptoms in FND and comorbid disorders and postulate how physical activity and exercise may provide benefit via autonomic regulation.
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Affiliation(s)
- Kelly A. Boylan
- Division of Epilepsy and Neurology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Barbara A. Dworetzky
- Division of Epilepsy and Neurology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Gaston Baslet
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Ginger Polich
- Department of Physical Medicine and Rehabilitation, Mass General Brigham, Boston, MA, United States
| | - M. Angela O’Neal
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Claus Reinsberger
- Division of Sports Neurology and Neurosciences, Mass General Brigham Boston, MA, United States
- Institute of Sports Medicine, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
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Dudarev V, Barral O, Radaeva M, Davis G, Enns JT. Night time heart rate predicts next-day pain in fibromyalgia and primary back pain. Pain Rep 2024; 9:e1119. [PMID: 38322354 PMCID: PMC10843528 DOI: 10.1097/pr9.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain. Objectives Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia. Methods Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports. Results The results showed a predictive relationship between sleep heart rate and next-day pain intensity (P < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain. Conclusions These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, precedes increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.
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Affiliation(s)
- Veronica Dudarev
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- HealthQb Technologies, Vancouver, BC, Canada
| | | | - Mariia Radaeva
- HealthQb Technologies, Vancouver, BC, Canada
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Guy Davis
- HealthQb Technologies, Vancouver, BC, Canada
| | - James T. Enns
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Neelapala YVR, Mercuri D, Macedo L, Hanna S, Kobsar D, Carlesso L. Mechanisms hypothesized for pain-relieving effects of exercise in fibromyalgia: a scoping review. Ther Adv Musculoskelet Dis 2023; 15:1759720X231182894. [PMID: 37484924 PMCID: PMC10356998 DOI: 10.1177/1759720x231182894] [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: 02/07/2023] [Accepted: 05/31/2023] [Indexed: 07/25/2023] Open
Abstract
Background Exercise is one of the most recommended management strategies by treatment guidelines for fibromyalgia (FM); however, the mechanism through which exercise improves pain in FM is still unknown. Objective We aimed to summarize the hypothesized theoretical mechanisms for the pain-relieving effects of exercise in people with FM. Eligibility Criteria Randomized controlled trials (RCTs) in English reporting mechanisms for pain-relieving effects of exercise in the 'Introduction' and 'Discussion' sections and significant within- group or between-group effects of exercise interventions were included. Sources of Evidence We searched the databases Ovid MEDLINE(R), EMBASE, CINAHL, COCHRANE, Sports Discuss, and AMED with the keywords: exercise and fibromyalgia until December 2021. Charting Methods Two authors independently performed title/abstract, full-text review, and data abstraction using a data abstraction form. The hypothesized mechanisms from individual studies were grouped into three categories. Results The literature search resulted in 2147 studies, out of which 220 studies were considered for full-text review. A total of 50 RCTs proposing 29 unique mechanisms for the pain-relieving effects of exercise were included. These mechanisms were divided into three categories: physical, neuro-physiological, and psychological. The neuro-physiological category was further subdivided into exercise-induced hypoalgesia (EIH), pain sensitization, the autonomic system, the immune system, the endocrine system, and miscellaneous categories. The most frequently hypothesized mechanisms were EIH (n = 15), autonomic modulation (n = 7), improved sleep (n = 6), muscle oxygenation (n = 6), self-efficacy (n = 5), mental health (n = 4), and benefits of the aquatic environment (n = 12). While all exercise interventions involved FM patients, most of the supporting evidence for these mechanisms was cited from previous studies conducted on healthy samples. No studies performed analyses to demonstrate causal associations between the mechanisms and outcomes. Conclusion Multiple mechanisms were hypothesized for the positive influence of exercise in people with FM. Future studies using causal analyses, such as mediation analysis, are recommended to validate these mechanisms.
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Affiliation(s)
| | - Domenico Mercuri
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Luciana Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Steven Hanna
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Dylan Kobsar
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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de Orleans Casagrande P, Coimbra DR, de Souza LC, Andrade A. Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: Systematic review and meta-analysis. PM R 2023; 15:899-915. [PMID: 35726183 DOI: 10.1002/pmrj.12867] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/29/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effects of yoga on depressive symptoms, anxiety, sleep quality, and mood of patients with rheumatic diseases through a systematic literature review with meta-analysis. LITERATURE SURVEY This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and the Cochrane recommendations and risk of bias tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Studies were selected using the PICOS (participants, intervention, comparison, outcome, and study) strategy. Searches were carried out until March 2022 and performed in Web of Science, PubMed, SportDiscus, Scopus, Cochrane, and EBSCO databases. METHODOLOGY Data were extracted to identify the differences between yoga and control and exercise groups and effect sizes. SYNTHESIS In total, 27 studies were included for qualitative analysis and 18 for meta-analysis. The studies found investigated yoga in patients with osteoarthritis, fibromyalgia, rheumatoid arthritis, and chronic fatigue syndrome. Regarding the risk of bias, the majority of studies showed a high risk or uncertain risk of bias in several criteria. Regarding the meta-analysis, yoga was favored to decrease depressive symptoms (standard mean difference [SMD]:-0.88; 95% confidence interval [CI]:-1.42; -0.34), anxiety (SMD: -0.51; 95% CI = -0.81 to -0.20), and improve sleep quality SMD = -0.96; 95% CI = -1.36 to -0.56). No differences were found between yoga and other exercise modalities in depression (p < .01). CONCLUSIONS Yoga is effective in improving depression, anxiety, and sleep quality of patients with rheumatic diseases. However, research in this field still needs further studies, because of methodological issues in the studies and a reduced number of studies conducted on each rheumatic disease and on the effects of yoga on each variable.
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Affiliation(s)
- Pedro de Orleans Casagrande
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
| | - Danilo Reis Coimbra
- Federal University of Juiz de Fora (UFJF), Life Sciences Institute, ICV, Faculty of Physical Education and Sport, Physical Education Department, Governador Valadares, Brazil
| | - Loiane Cristina de Souza
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
| | - Alexandro Andrade
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
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Bigelow H, Fenesi B. Pre-Service Teachers' Perceptions of and Experiences with Classroom Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1049. [PMID: 36673808 PMCID: PMC9858912 DOI: 10.3390/ijerph20021049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Physical inactivity is one of the most modifiable factors linked to childhood obesity. Several Canadian provinces adopted daily physical activity (DPA) policies to promote physical activity during the school day. In Ontario, only 23% of in-service teachers meet DPA mandates. Promoting DPA implementation must occur at the pre-service level to foster self-efficacy and create long-term teaching habits. This study surveyed 155 pre-service teachers from an Ontario university to determine key perceptions and practices that should be targeted during their educational training to improve DPA fidelity. Findings revealed that over 96% of pre-service teachers viewed physical activity as beneficial for their own and their students mental and physical health, and as much as 33% received no education or training related to DPA. Pre-service teachers valued DPA more if they had opportunities to learn about and observe DPA during school placements. Pre-service teachers were more confident implementing DPA if they were more physically active, viewed themselves as more athletic, and had more positive physical education experiences. This work brings to the forefront important factors that could contribute to DPA implementation among in-service teachers and highlights target areas at the pre-service level for improved fidelity.
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Effects of resistance training on the physical symptoms and functional capacity of patients with fibromyalgia: a systematic review and meta-analysis of randomized clinical trials. Ir J Med Sci 2022:10.1007/s11845-022-03205-5. [PMID: 36326999 DOI: 10.1007/s11845-022-03205-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Resistance training (RT) has become an important topic for the treatment of fibromyalgia (FM); however, there are still controversies regarding its ability to significantly improve physical symptoms and a lack of adequate recommendations for evidence-based practice. AIM The aim of this study is to analyze the effects of RT on the physical symptoms of patients with FM through a systematic review with meta-analysis. METHODS We conducted a systematic review of randomized controlled trials in June 2022, according to PRISMA recommendations. The searches were carried out on the databases PubMed, Embase, Science Direct, Web of Science, PEDro, CINAHL, SciELO, and Google Scholar for gray literature, and the protocol was recorded in PROSPERO. Studies that evaluated patients with FM undergoing an RT program lasting more than 2 weeks and that analyzed physical health were selected. To carry out the meta-analysis, the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were followed. RESULTS In total, 13 studies were included for qualitative analysis and nine for meta-analysis. Regarding meta-analysis, a favorable improvement was found for pain ([MD = - 10.22 (95% CI: - 18.86 to - 1.58; I2: 64%; P for heterogeneity: 0.003)]; very low quality of evidence {QoE}), fatigue ([SMD = - 0.39 (95% CI: - 0.61 to - 0.17; I2: 0%; P = 0.91)]; moderate QoE), and muscle strength ([SMD = 0.94 (95% CI: 0.02 to 1.85; I2: 93%; for heterogeneity: < 0.0001)]; very low QoE) and improvement in functional capacity ([MD = 18.75 (95% CI: 4.27 to 33.22; I2: 39%; P = 0.19)]; low QoE), in the general comparison. CONCLUSION RT was effective in reducing pain and fatigue and increasing strength and functional capacity; however, due to the quality of the evidence, more studies are needed.
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The Link between Fibromyalgia Syndrome and Anger: A Systematic Review Revealing Research Gaps. J Clin Med 2022; 11:jcm11030844. [PMID: 35160295 PMCID: PMC8836473 DOI: 10.3390/jcm11030844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 12/19/2022] Open
Abstract
Anger has been associated with increased pain perception, but its specific connection with Fibromyalgia Syndrome (FMS) has not yet been established in an integrated approach. Therefore, the present systematic review focuses on exploring this connection, and based on this connection, delimiting possible gaps in the research, altogether aimed at improving FMS clinical intervention and guiding future research lines. Anger is considered a basic negative emotion that can be divided into two dimensions: anger-in (the tendency to repress anger when it is experienced) and anger-out (the leaning to express anger through verbal or physical means). The current systematic review was performed based on the guidelines of the PRISMA and Cochrane Collaborations. The Prospective Register of Systematic Reviews (PROSPERO) international database was forehand used to register the review protocol. The quality of chosen articles was assessed and the main limitations and research gaps resulting from each scientific article were discussed. The search included PubMed, Scopus, and Web of Science databases. The literature search identified 13 studies eligible for the systematic review. Levels of anger-in have been shown to be higher in FMS patients compared to healthy participants, as well as patients suffering from other pain conditions (e.g., rheumatoid arthritis). FMS patients had also showed higher levels of state and trait anxiety, worry and angry rumination than other chronic pain patients. Anger seems to amplify pain especially in women regardless FMS condition but with a particularly greater health-related quality of life´s impact in FMS patients. In spite of the relevance of emotions in the treatment of chronic pain, including FMS, only two studies have proposed intervention programs focus on anger treatment. These two studies have observed a positive reduction in anger levels through mindfulness and a strength training program. In conclusion, anger might be a meaningful therapeutic target in the attenuation of pain sensitivity, and the improvement of the general treatment effects and health-related quality of life in FMS patients. More intervention programs directed to reduce anger and contribute to improve well-being in FMS patients are needed.
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Estévez-López F, Guerrero-González JM, Salazar-Tortosa D, Camiletti-Moirón D, Gavilán-Carrera B, Aparicio VA, Acosta-Manzano P, Álvarez-Gallardo IC, Segura-Jiménez V, Soriano-Maldonado A, Geenen R, Delgado-Fernández M, Martínez-González LJ, Ruiz JR, Álvarez-Cubero MJ. Interplay between genetics and lifestyle on pain susceptibility in women with fibromyalgia: The al-Ándalus project. Rheumatology (Oxford) 2021; 61:3180-3191. [PMID: 34875034 PMCID: PMC9348776 DOI: 10.1093/rheumatology/keab911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/29/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives It is widely acknowledged that the experience of pain is promoted by both genetic susceptibility and environmental factors such as engaging in physical activity (PA), and that pain-related cognitions are also important. Thus, the purpose of the present study was to test the association of 64 polymorphisms (34 candidate genes) and the gene–gene, gene–PA and gene–sedentary behaviour interactions with pain and pain-related cognitions in women with FM. Methods Saliva samples from 274 women with FM [mean (s.d.) age 51.7 (7.7) years] were collected for extracting DNA. We measured PA and sedentary behaviour by accelerometers for a week, pain with algometry and questionnaires, and pain-related cognitions with questionnaires. To assess the robustness of the results, a meta-analysis was also performed. Results The rs6311 and rs6313 polymorphisms (5-hydroxytryptamine receptor 2A, HTR2A) were individually related to algometer scores. The interaction of rs4818 (catechol-O-methyltransferase, COMT) and rs1799971 (opioid receptor μ gene, OPRM1) was related to pain catastrophizing. Five gene–behaviour interactions were significant: the interactions of sedentary behaviour with rs1383914 (adrenoceptor alpha 1A, ADRA1A), rs6860 (charged multivesicular body protein 1A, CHMP1A), rs4680 (COMT), rs165599 (COMT) and rs12994338 (SCN9A) on bodily pain subscale of the Short Form 36. Furthermore, the meta-analysis showed an association between rs4680 (COMT) and severity of FM symptoms (codominant model, P-value 0.032). Conclusion The HTR2A gene (individually), COMT and OPRM1 gene–gene interaction, and the interactions of sedentary behaviour with ADRA1A, CHMP1A, COMT and SCN9A genes were associated with pain-related outcomes. Collectively, findings from the present study indicate a modest contribution of genetics and gene–sedentary behaviour interaction to pain and pain catastrophizing in women with FM. Future research should examine whether reducing sedentary behaviour is particularly beneficial for reducing pain in women with genetic susceptibility to pain.
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Affiliation(s)
- Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, The Netherlands, 3015 GD Rotterdam
| | - Juan M Guerrero-González
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - Diego Salazar-Tortosa
- Department of Ecology and Evolutionary Biology, University of Arizona, USA, Tucson, AZ 85719
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain, 18010 Granada
| | | | - Víctor Segura-Jiménez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Spain, Granada.,Hospital Universitario Virgen de las Nieves of Granada, Spain, Granada.,GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain, Cádiz
| | | | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, The Netherlands, 3508 TC Utrecht
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain, 18010 Granada
| | - Luis J Martínez-González
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - Jonatan R Ruiz
- PROFITH-"PROmoting FITness and Health Through Physical Activity"- Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain, 18071 Granada
| | - María J Álvarez-Cubero
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain.,University of Granada, Department of Biochemistry and Molecular Biology III, Faculty of Medicine, Spain, PTS, Granada
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Barhorst EE, Boruch AE, Cook DB, Lindheimer JB. Pain-related post-exertional malaise in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: A systematic review and three-level meta-analysis. PAIN MEDICINE 2021; 23:1144-1157. [PMID: 34668532 DOI: 10.1093/pm/pnab308] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/05/2021] [Accepted: 10/07/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia (FM) are two debilitating, moderately comorbid illnesses in which chronic musculoskeletal pain symptoms are prevalent. These individuals can experience post-exertional malaise (PEM), a phenomenon where symptom severity is worsened 24hr or longer following physical stress, but the pain-related component of PEM is not well characterized. DESIGN Systematic review and meta-analysis. METHODS Case-control studies involving adults with ME/CFS or FM and measuring pain symptoms before and after exposure to a standardized aerobic exercise test were included. Hedges' d effect sizes were aggregated using random effects models and potential moderators were explored with meta-regression analysis. Results were adjusted for nesting effects using three-level modeling. RESULTS Forty-five effects were extracted from 15 studies involving 306 patients and 292 healthy controls. After adjusting for nesting effects, we observed a small-to-moderate effect indicating higher post-exercise pain in patients than controls (Hedges' d=0.42; 95% CI: 0.16, 0.67). The mean effect was significantly moderated by pain measurement timepoint (b = -0.19, z = -2.57, P = 0.01) such that studies measuring pain 8-72hr post-exercise showed larger effects (d = 0.71, 95% CI = 0.28-1.14) than those measuring pain 0-2hr post-exercise (d = 0.32, 95% CI = 0.10-0.53). CONCLUSIONS People with ME/CFS and FM experience small-to-moderate increases in pain severity following exercise which confirms pain as a component of PEM and emphasizes its debilitating impact in ME/CFS and FM. Future directions include determining mechanisms of pain-related PEM and developing exercise prescriptions that minimize symptom exacerbation in these illnesses.
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Affiliation(s)
- Ellen E Barhorst
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,School of Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Alex E Boruch
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Dane B Cook
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jacob B Lindheimer
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2021; 30:535-551. [PMID: 34489364 DOI: 10.1123/japa.2021-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.
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Colas C, Goutte J, Creac'h C, Fontana L, Vericel MP, Manzanares J, Peuriere M, Akrour M, Martin C, Presles E, Barth N, Guyot J, Garros M, Trombert B, Massoubre C, Roche F, Féasson L, Marotte H, Cathebras P, Hupin D. Efficiency of an Optimized Care Organization in Fibromyalgia Patients: The From Intent to Move (FIMOUV) Study Protocol of a Randomized Controlled Trial. Front Public Health 2021; 9:554291. [PMID: 34113593 PMCID: PMC8185292 DOI: 10.3389/fpubh.2021.554291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 03/29/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Fibromyalgia (FM) is characterized by multiple symptoms including pain, fatigue, and sleep disorders, altering patient's quality of life. In the absence of effective pharmacological therapy, the last European guidelines recommend a multidisciplinary management based on exercise and education. Thus, our main objective was to measure the effectiveness of a healthcare organization offering a specific program of adapted physical activity combined with a therapeutic education program for FM patients. Methods and Analysis: The From Intent To Move (FIMOUV) study will recruit 330 FM patients randomized into two groups: test and control. The test group will benefit from a 1-month mixed exercise training program supervised at the hospital, followed by 2 months in a community-based relay in a health-sport structure. In addition, each of the two groups will benefit from therapeutic patient education sessions. The main endpoint is the measurement of the level of physical activity by accelerometry at 1 year. The secondary endpoints concern adherence to the practice of physical activity, impact on lifestyle, state of health, and physical capacity, as well as an estimate of the budgetary impact of this management strategy. Discussion: This interventional research will allow us to assess the evolution of behaviors in physical activity after an FM syndrome management based solely on patient education or based on a supervised and adapted practice of physical activity associated with this same therapeutic education program. It seems to be the first study evaluating the impact of its intervention on objective data for measuring physical activity and sedentary behavior via accelerometry among FM patients. Trial registration:ClinicalTrials.gov NCT04107948.
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Affiliation(s)
- Claire Colas
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Julie Goutte
- Department of Internal Medicine, University Hospital Center, Saint-Étienne, France
| | - Christelle Creac'h
- Pain Center, University Hospital Center, Saint-Étienne, France.,University Claude Bernard, Central Integration of Pain (NeuroPain) Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, Bron, France
| | - Luc Fontana
- Department of Occupational and Environmental Medicine, University Hospital Center, Saint-Étienne, France.,University Lyon, University Lyon 1, University St Etienne, University Gustave Eiffel, IFSTTAR, UMRESTTE, UMR_T9405, Saint-Étienne, France
| | - Marie-Pierre Vericel
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | | | - Marie Peuriere
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Madjid Akrour
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Charly Martin
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Emilie Presles
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France.,Department of Clinical Investigation Center, CIC 1408-INSERM, University Hospital Center, Saint-Étienne, France
| | - Nathalie Barth
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Chaire Santé des Ainés, Saint-Étienne, France.,Gerontopole Auvergne-Rhone-Alpes, Saint-Étienne, France
| | - Jessica Guyot
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Chaire Santé des Ainés, Saint-Étienne, France
| | - Maël Garros
- Sport Health House, CDOS 42, Saint-Étienne, France
| | - Béatrice Trombert
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Public Health, University Hospital Center, Saint-Étienne, France
| | | | - Frédéric Roche
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Léonard Féasson
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Interuniversity Laboratory of Human Movement Biology, EA 7424, Saint-Étienne, France
| | - Hubert Marotte
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Rheumatology, University Hospital Center, Saint-Étienne, France
| | - Pascal Cathebras
- Department of Internal Medicine, University Hospital Center, Saint-Étienne, France
| | - David Hupin
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France.,Department of Medicine, K2, Solna Karolinska Institutet, Stockholm, Sweden
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Masquelier E, D'haeyere J. Physical activity in the treatment of fibromyalgia. Joint Bone Spine 2021; 88:105202. [PMID: 33962033 DOI: 10.1016/j.jbspin.2021.105202] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
International treatment recommendations for fibromyalgia (FM) highlight the importance of adapted physical activity (APA) combined with patient education. Cognitive and behavioral therapies as well as an interdisciplinary approach can be proposed for more complex or severe clinical situations, with a biopsychosocial vision of rehabilitation. To personalize the rehabilitation's therapeutic approach, a clinician can use simple and validated instruments for measuring physical performance that will highlight levels of physical conditioning, which range from low to very low in FM patients. Several systematic reviews and meta-analyses have found strong evidence that supervised aerobic and resistance-training programs reduce the pain intensity and significantly improve the quality of life and the physical and psychological functioning of female FM subjects. These therapeutic approaches appear safe and promising in terms of cost-effectiveness and should be the subject of more randomized controlled trials among male FM subjects and adolescents.
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Affiliation(s)
- Etienne Masquelier
- Centre Multidisciplinaire de Douleur Chronique, CHU UCL Namur, site Godinne, Avenue Dr G. Thérasse, 1, 5530 Yvoir, Belgium; Institute of NeuroScience (IoNS), Université catholique de Louvain, Louvain, Belgium.
| | - Jacques D'haeyere
- Centre Multidisciplinaire de Douleur Chronique, CHU UCL Namur, site Godinne, Avenue Dr G. Thérasse, 1, 5530 Yvoir, Belgium
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Andrade A, Dominski FH, Sieczkowska SM. What we already know about the effects of exercise in patients with fibromyalgia: An umbrella review. Semin Arthritis Rheum 2020; 50:1465-1480. [DOI: 10.1016/j.semarthrit.2020.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/15/2020] [Accepted: 02/08/2020] [Indexed: 02/08/2023]
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BARHORST ELLENE, ANDRAE WILLIAME, RAYNE TESSAJ, FALVO MICHAELJ, COOK DANEB, LINDHEIMER JACOBB. Elevated Perceived Exertion in People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: A Meta-analysis. Med Sci Sports Exerc 2020; 52:2615-2627. [DOI: 10.1249/mss.0000000000002421] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zamunér AR, Andrade CP, Arca EA, Avila MA. Impact of water therapy on pain management in patients with fibromyalgia: current perspectives. J Pain Res 2019; 12:1971-2007. [PMID: 31308729 PMCID: PMC6613198 DOI: 10.2147/jpr.s161494] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/20/2019] [Indexed: 11/23/2022] Open
Abstract
Exercise-related interventions have been recommended as one of the main components in the management of fibromyalgia syndrome (FMS). Water therapy, which combines water's physical properties and exercise benefits, has proven effective in improving the clinical symptoms of FMS, especially pain, considered the hallmark of this syndrome. However, to our knowledge, the mechanisms underlying water therapy effects on pain are still scarcely explored in the literature. Therefore, this narrative review aimed to present the current perspectives on water therapy and the physiological basis for the mechanisms supporting its use for pain management in patients with FMS. Furthermore, the effects of water therapy on the musculoskeletal, neuromuscular, cardiovascular, respiratory, and neuroendocrine systems and inflammation are also addressed. Taking into account the aspects reviewed herein, water therapy is recommended as a nonpharmacologic therapeutic approach in the management of FMS patients, improving pain, fatigue, and quality of life. Future studies should focus on clarifying whether mechanisms and long-lasting effects are superior to other types of nonpharmacological interventions, as well as the economic and societal impacts that this intervention may present.
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Affiliation(s)
| | | | - Eduardo Aguilar Arca
- Departamento de Fisioterapia, Universidade do Sagrado Coração, Bauru, São Paulo, Brasil
| | - Mariana Arias Avila
- Departamento de Fisioterapia e Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, São Paulo, Brasil
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