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Matei D, Trăistaru R, Pădureanu V, Avramescu TE, Neagoe D, Genunche A, Amzolini A. The Efficiency of Kinesiotherapy versus Physical Modalities on Pain and Other Common Complaints in Fibromyalgia. Life (Basel) 2024; 14:604. [PMID: 38792625 PMCID: PMC11122147 DOI: 10.3390/life14050604] [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: 03/29/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Due to its variety of signs and symptoms, there have been numerous attempts to treat fibromyalgia (FM), but a cure has yet to be established. The aim of this study was to evaluate the effects of a complex kinetic therapy program and a combined physical modality program on pain and other common symptoms of FM. Patients and methods: A total of 78 female patients were included in this study; 39 subjects underwent a kinesiotherapy (KT) intervention (combining aerobic and Pilates exercises), and 39 participated in a physical modality (PM) program (including electrotherapy (TENS and low-laser therapy) and thermotherapy). Results: Regarding the parameter of pain assessment, kinesiotherapy demonstrated its superiority both during the treatment period and in the evaluation 3 months after therapy cessation. Both in terms of patient-reported pain (inter-group comparisons: p = 0.000 at T3) and the examination of tender points (inter-group comparisons: p = 0.000 at T3), as well as the algometric assessment, pain was alleviated by the two forms of applied kinetic therapy. The observed functional impairment was statistically significantly influenced (p = 0.001) at the end of the kinetic program application, while for the perceived functional impairment, neither therapy proved superiority over the other at any point of evaluation (inter-group comparisons: p = 0.715 at T3). Regarding the influence of the emotional consequences implied by fibromyalgia, neither the forms of kinesiotherapy nor the chosen physical modalities proved superiority at any point of evaluation (HAQ anxiety inter-group comparisons: p = 0.000 at T3). In conclusion, even though kinesiotherapy had superior influences on fibromyalgia pain in the studied group, the current research lends credence to the significance of non-pharmacological therapy in managing fibromyalgia. Participants demonstrated positive advancements in subjective and objective pain assessments, as well as improvements in functional and emotional well-being.
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Affiliation(s)
- Daniela Matei
- Department of Medical Rehabilitation, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.M.); (R.T.)
| | - Rodica Trăistaru
- Department of Medical Rehabilitation, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.M.); (R.T.)
| | - Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | | | - Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | - Amelia Genunche
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
| | - Anca Amzolini
- Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (D.N.); (A.A.)
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Umeda M, Kim Y, Jaén CR, Okifuji A, Corbin LW, Maluf KS. Mediating role of physical activity in the relationship between exercise-induced muscle pain and symptom severity in women with fibromyalgia. Physiother Theory Pract 2024; 40:338-346. [PMID: 35968757 DOI: 10.1080/09593985.2022.2111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Individuals with fibromyalgia (FM) exhibit generalized hyperalgesia to pain stimuli, and physical activity (PA) is critical to manage FM symptoms. PURPOSE This study examined the relationship between exercise-induced muscle pain, symptom severity, and PA in 28 women with FM. METHODS Muscle pain rating (MPR) was assessed during 3 minutes of submaximal isometric handgrip exercise, whereas PA and symptom severity were evaluated via self-report questionnaires. The analysis examined the relationship between the variables, with the specific interest in the mediating role of PA in the relationship between exercise-induced muscle pain and symptom severity. RESULTS MPR was positively associated with symptom severity (b = 1.89; 95% CI = 0.01, 3.76; P = .048) and inversely associated with PA levels (b = -0.16; 95% CI = -0.30, -0.03; P = .021). PA levels were inversely associated with symptom severity (b = -7.94; 95% CI = -12.46, -3.42; P = .001). After statistically controlling for PA levels, the relationship between MPR and symptom severity was no longer significant (b = 0.60; Wald 95% CI = -1.05, 2.25; P = .474). CONCLUSION Results show the link between the variables, and specifically demonstrate that PA mediates the relationship between exercise-induced muscle pain and symptom severity.
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Affiliation(s)
- Masataka Umeda
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Carlos R Jaén
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Akiko Okifuji
- Division of Pain Medicine, Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
| | - Lisa W Corbin
- Department of Medicine, University of Colorado Hospital, Aurora, CO, USA
| | - Katrina S Maluf
- School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, USA
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Gavilán-Carrera B, Borges-Cosic M, Álvarez-Gallardo IC, Soriano-Maldonado A, Acosta-Manzano P, Camiletti-Moirón D, Carbonell-Baeza A, Casimiro AJ, Girela-Rejón MJ, Walitt B, Estévez-López F. Effectiveness of Land- and Water-based Exercise on Fatigue and Sleep Quality in Women With Fibromyalgia: The al-Ándalus Quasi-Experimental Study. Arch Phys Med Rehabil 2023; 104:1775-1784. [PMID: 37245691 DOI: 10.1016/j.apmr.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/26/2023] [Accepted: 04/25/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To assess the effectiveness of 24 weeks of land- and water-based exercise on fatigue and sleep quality in women with fibromyalgia, and the persistence of changes 12 weeks after exercise cessation. DESIGN Quasi-experimental study. SETTING University facilities and fibromyalgia associations. PARTICIPANTS Women with fibromyalgia (N=250; 50.8±7.6 years old). INTERVENTIONS Participants were assigned to land-based exercise (n=83), water-based exercise (n=85), or no exercise control (n=82) groups. The intervention groups engaged in a similar multicomponent exercise program for 24 weeks. MAIN OUTCOME MEASURES The Multidimensional Fatigue Inventory and Pittsburgh Sleep Quality Index were used. RESULTS Intention-to-treat analyses revealed that, compared with the control group, at week 24: (i) the land-based exercise group improved physical fatigue (mean difference -0.9 units; 95% confidence interval -1.7 to -0.1; Cohen's d=0.4) and (ii) the water-based exercise group improved general fatigue (-0.8; -1.4 to -0.1, d=0.4), and global sleep quality (-1.6; -2.7 to -0.6, d=0.6). Additionally, compared with the land-based exercise group, the water-based exercise group improved global sleep quality (-1.2; -2.2 to -0.1, d=0.4). Changes were generally not sustained at week 36. CONCLUSION Land-based multicomponent exercise improved physical fatigue, whereas water-based exercise improved general fatigue and sleep quality. The magnitude of the changes was small-to-medium, and no benefits were maintained after exercise cessation.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
| | - Inmaculada C Álvarez-Gallardo
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, 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
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain; Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Daniel Camiletti-Moirón
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Ana Carbonell-Baeza
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain; MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
| | - Antonio J Casimiro
- 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
| | - María José Girela-Rejón
- PA-HELP "Physical Activity for HEaLth Promotion" Research Group, University of Granada, Granada, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; Department of Didactic of Corporal Expression, Faculty of Education Sciences, University of Granada, Granada, Spain
| | - Brian Walitt
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA.
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Effectiveness of aquatic therapy on sleep in persons with fibromyalgia. A meta-analysis. Sleep Med 2023; 102:76-83. [PMID: 36603514 DOI: 10.1016/j.sleep.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
CONTEXT Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by persistent, widespread pain, myofascial tenderness, negative affect, fatigue, memory problems and sleep disturbances. OBJECTIVE To summarize the evidence of the effects of aquatic therapy on sleep quality in patients with FMS. METHODS This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2020 (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), whit the registration number CRD42021249982. Cochrane library, Medline (PubMed), Science Direct Web of Science (WOS), Scopus, and PEDro were searched from inception until September 2021. The search included only randomized clinical trials. RESULTS Of the 7711 studies identified in the initial search, a total of 7 trials (361 participants) satisfied the eligibility criteria. Finally, a meta-analysis was conducted with 6 studies (311 participants). The overall pooled effect favored aquatic therapy interventions in improving sleep quality in patients with FMS (pooled MD, -2.05; 95% CI, -4.35 to 0.25). CONCLUSIONS The results of this systematic review and meta-analysis provide evidence that aquatic therapy improved sleep quality in patients with FMS. This study highlights the importance of aquatic therapy for sleep. Nonetheless, although an aquatic therapy intervention may represent a good option to improve sleep, given the low number of studies the evidence should be taken with caution.
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Paraskevopoulos E, Koumantakis GA, Papandreou M. A Systematic Review of the Aerobic Exercise Program Variables for Patients with Non-Specific Neck Pain: Effectiveness and Clinical Applications. Healthcare (Basel) 2023; 11:healthcare11030339. [PMID: 36766914 PMCID: PMC9914281 DOI: 10.3390/healthcare11030339] [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: 11/22/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
Studies have shown that aerobic exercise (AE) may improve symptoms related to non-specific neck pain (NNP); however, the variables of the exercise programs and the overall effectiveness of AE have not been evaluated in a systematic review. Therefore, this review aimed to describe and discuss the variables of the AE programs used in clinical trials for patients with NNP. Included studies were analyzed for the selected AE variables such as intensity, frequency, duration, delivery, supervision, and adherence. The PEDro scale was used to assess the methodological quality of the studies. From the literature search, six studies met the inclusion criteria and were evaluated. After reviewing all the included studies, it was found that a range of AE interventions were used such as cycling, brisk walking, aerobics, stationary bike, treadmill running, circuit training, and swimming. Further, the duration was between 30 and 45 min for each session, with or without progressive increases from week to week. The intervention periods ranged from 1 month to 6 months in duration. Most studies used AE three times per week. Furthermore, exercise intensity was measured with either subjective (BORG) or objective measures (heartrate reserve). Justification for the specified intensity and reporting of adverse events was reported only in two studies and differed between studies. Exercise interventions were poorly reported. This review showed that moderate-intensity AE undertaken three times per week, in patients with NNP, may be beneficial for pain and function; however, the development of reporting standards is essential for the successful replication of studies.
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | - George A. Koumantakis
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
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Chen X, You J, Ma H, Zhou M, Huang C. Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis. BMJ Open 2023; 13:e062322. [PMID: 36690401 PMCID: PMC9872467 DOI: 10.1136/bmjopen-2022-062322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for fibromyalgia (FM). DESIGN A systematic review and meta-analysis. DATA SOURCES PubMed, EMBASE, Cochrane Library, Web of Science, VIP (China Science and Technology Journal Database), CNKI (China National Knowledge Infrastructure) and WanFang database were searched from from inception to 22 October 2022. ELIGIBILITY CRITERIA We included clinical trials (randomised controlled and non-randomised controlled trials) of HBOT for FM. DATA EXTRACTION AND SYNTHESIS Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Collaboration checklists and the Methodological Index for Non-randomised Studies were used to assess the risk of bias. Meta-analysis was performed by RevMan V.5.4.1 software. Random effect models were used for meta-analysis. RESULTS Nine studies were included in this review, with a total of 288 patients. For pain assessment, we combined the results of the Visual Analogue Scale and Widespread Pain Index. The results showed that HBOT could relieve the pain of FM patients compared with the control intervention (standardised mean difference=-1.56, 95% CI (-2.18 to -0.93), p<0.001, I 2=51%). Most included studies reported that HBOT ameliorated tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM. Adverse events occurred in 44 of 185 patients (23.8%). Twelve patients (6.5%) withdrew because of adverse reactions. No serious adverse events or complications were observed. CONCLUSIONS HBOT might have a positive effect in improving pain, tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM, with reversible side effects. Low pressure (less than 2.0 atmospheric absolute) may be beneficial to reduce adverse events in FM. Further studies should be carried out to evaluate the optimal protocol of HBOT in FM. PROSPERO REGISTRATION NUMBER CRD42021282920.
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Affiliation(s)
- Xinxin Chen
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jiuhong You
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Hui Ma
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Mei Zhou
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Cheng Huang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Abdeen HAA, Rodriguez-Sanz D, Ewidea M, Al-Hamaky DMA, Mohamed MAER, Elerian AE. Efficacy of Vitamin D Supplementation in Addition to Aerobic Exercise Training in Obese Women with Perceived Myalgia: A Single-Blinded Randomized Controlled Clinical Trial. Nutrients 2021; 13:1819. [PMID: 34071781 PMCID: PMC8227578 DOI: 10.3390/nu13061819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/29/2021] [Accepted: 05/15/2021] [Indexed: 01/04/2023] Open
Abstract
Obese women were more susceptible to myalgia because of their significantly lower vitamin D concentrations; the present study investigated the efficacy of vitamin D in addition to an aerobic interval training in the management of obese women with myalgia. Forty-five obese women with vitamin D deficiency and myalgia (30 to 40 years old) were assigned randomly into three equal groups. Group A received an aerobic interval training with vitamin D supplementation, Group B received vitamin D supplementation only, and Group C received aerobic interval training only; participants in all groups were on calorie deficient diets. The study outcomes were the Visual Analog Scale (VAS) for Pain Evaluation, serum vitamin D level, and Cooper 12-Minute Walk Test for Functional Capacity Evaluation, while the Short-Form Health Survey (SF) was used for assessment of quality of life. We detected a significant improvement in pain intensity level, serum vitamin D level, and quality of life in all groups with significant difference between Group A and groups B and C. We also detected a significant improvement in functional capacity in groups A and C, with no significant change in Group B. Aerobic interval training with vitamin D supplementation was more effective for the management of obese women with perceived myalgia.
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Affiliation(s)
- Heba Ahmed Ali Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Mahmoud Ewidea
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Kafr Elshiekh University, Kafr Elsheikh Government 33511, Egypt;
| | - Dina Mohamed Ali Al-Hamaky
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt;
| | - Marwa Abd El-Rahman Mohamed
- Department of Physical Therapy for Women Health, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt;
| | - Ahmed Ebrahim Elerian
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt
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Ferrarini EG, Gonçalves ECD, Ferrareis Menegasso J, Rabelo BD, Felipetti FA, Dutra RC. Exercise Reduces Pain and Deleterious Histological Effects in Fibromyalgia-like Model. Neuroscience 2021; 465:46-59. [PMID: 33945796 DOI: 10.1016/j.neuroscience.2021.04.017] [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] [Received: 12/02/2020] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Fibromyalgia (FM) is characterized by chronic pain and associated comorbidities such as fatigue, anxiety, depression, and sleep disorders. There is a large amount of evidence regarding the benefits of physical exercise in controlling chronic pain. However, there is no consensus on which exercise modality is most suitable and the real benefits of this intervention to treat FM symptoms. The present study investigated the analgesic and antidepressant effects and morphophysiological responses induced by different physical exercise (aerobic and strength protocols) during the experimental model of FM. Spontaneous pain, mechanical hyperalgesia, thermal allodynia, depression-related behavior, and locomotor activity were evaluated weekly, as well as the morphological evaluation of the spinal cord and dorsal root ganglion. Aerobic and strength training protocols consistently abolished nociceptive behaviors, reducing spontaneous pain scores, cold allodynia, and frequency of response to mechanical hyperalgesia. The strength exercise modulated the depressive-like behavior. Finally, our data demonstrated that physical exercise performed for two weeks increased the number of glial cells in the dorsal root horn. However, it was not sufficient to control the other deleterious effects of the reserpine model on the spinal cord and the dorsal root. Together, these results demonstrated that different physical exercise modalities, when performed regularly in mice, proved to be effective and safe non-pharmacological alternatives for the treatment of FM. However, some gaps have yet to be studied regarding the neuroadaptive effects of physical exercise.
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Affiliation(s)
- Eduarda Gomes Ferrarini
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil; Post-Graduate Program of Neuroscience, Center of Biological Science, Campus Florianópolis, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, Brazil
| | - Elaine Cristina Dalazen Gonçalves
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil; Post-Graduate Program of Neuroscience, Center of Biological Science, Campus Florianópolis, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, Brazil
| | - Jaíne Ferrareis Menegasso
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil
| | - Bruna Daniel Rabelo
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil
| | - Francielly Andressa Felipetti
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil
| | - Rafael Cypriano Dutra
- Laboratory of Autoimmunity and Immunopharmacology (LAIF), Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, 88906-072 Araranguá, Brazil; Post-Graduate Program of Neuroscience, Center of Biological Science, Campus Florianópolis, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, Brazil.
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Dantas LO, Carvalho C, Prando BC, McAlindon TE, da Silva Serrão PRM. Mobile health technologies for the management of rheumatic diseases: a systematic review of online stores in Brazil. Clin Rheumatol 2021; 40:2601-2609. [PMID: 33389312 DOI: 10.1007/s10067-020-05561-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/29/2020] [Accepted: 12/21/2020] [Indexed: 01/17/2023]
Abstract
Rheumatic diseases are serious conditions with a low uptake of conservative treatments. Mobile health (mHealth) applications (apps) offer potential to assist the self-management of rheumatic diseases. Our goal was to perform a systematic review of available mHealth apps for rheumatic diseases in Brazil. We focused on the most prevalent rheumatic diseases: osteoarthritis, rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus, osteoporosis, and axial spondylarthritis. Google Play Store and AppStore in Brazil were queried by two independent reviewers on September 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Of the 3173 mHealth apps found, five were eligible for inclusion. Two for fibromyalgia and two for axial spondylarthritis offered exercise, educational content, and tools to track patient-reported symptoms; and one for osteoporosis offered educational content and tracking tools only. The included apps scored moderately on the MARS quality scale, with a mean score (SD) of 3.1 (0.7) on a 0-5 scale. Most apps scored poorly based on credibility, user interface and experience, and engagement. There is growing interest in the development of mHealth technologies to support rheumatic diseases patients. Although the majority of the included apps came from non-profit organizations, they are still of poor quality and limited functionality. This study is a call for to the development of new user-centered mHealth apps that can empower rheumatic diseases patients in Brazil, especially in the area of osteoarthritis, rheumatoid arthritis, and lupus, since no apps were found.
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Affiliation(s)
- Lucas Ogura Dantas
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
| | - Cristiano Carvalho
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
| | - Beatriz Cardinal Prando
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
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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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11
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Running wheel exercise induces therapeutic and preventive effects on inflammatory stimulus-induced persistent hyperalgesia in mice. PLoS One 2020; 15:e0240115. [PMID: 33048957 PMCID: PMC7553300 DOI: 10.1371/journal.pone.0240115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 09/19/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic pain affects significant portion of the world's population and physical exercise has been extensively indicated as non-pharmacological clinical intervention to relieve symptoms in chronic pain conditions. In general, studies on pain chronification and physical exercise intervention have focused on neuropathic pain, although chronic pain commonly results from an original inflammatory episode. Based on this, the objective of the present study was to investigate the therapeutic and preventive effect of the running wheel exercise on the persistent hyperalgesia induced by repetitive inflammatory stimulus, a rodent model that simulates clinical conditions of chronic pain that persist even with no more inflammatory stimulus present. To evaluate the therapeutic effect of physical exercise, we first induced persistent hyperalgesia through 14 days of PGE2 hind paw injections and, after that, mice have access to the regular voluntary running wheel. To evaluate the preventive effect of physical exercise, we first left the mice with access to the regular voluntary running wheel and, after that, we performed 14 days of PGE2 hind paw injection. Our results showed that voluntary running wheel exercise reduced persistent mechanical and chemical hyperalgesia intensity induced by repetitive inflammatory stimulus. In addition, we showed that this therapeutic effect is long-lasting and is observed even if started belatedly, i.e. two weeks after the development of hyperalgesia. Also, our results showed that voluntary running wheel exercise absolutely prevented persistent mechanical and chemical hyperalgesia induction. We can conclude that physical exercise has therapeutic and preventive effect on inflammatory stimulus-induced persistent hyperalgesia. Our data from animal experiments bypass placebo effects bias of the human studies and reinforce physical exercise clinical recommendations to treat and prevent chronic pain.
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Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain. Pain Rep 2020; 5:e823. [PMID: 33062901 PMCID: PMC7523781 DOI: 10.1097/pr9.0000000000000823] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/02/2020] [Accepted: 04/21/2020] [Indexed: 01/07/2023] Open
Abstract
This review describes methodology used in the assessment of the manifestations of exercise-induced hypoalgesia in humans and previous findings in individuals with and without pain. Possible mechanisms and future directions are discussed. Exercise and physical activity is recommended treatment for a wide range of chronic pain conditions. In addition to several well-documented effects on physical and mental health, 8 to 12 weeks of exercise therapy can induce clinically relevant reductions in pain. However, exercise can also induce hypoalgesia after as little as 1 session, which is commonly referred to as exercise-induced hypoalgesia (EIH). In this review, we give a brief introduction to the methodology used in the assessment of EIH in humans followed by an overview of the findings from previous experimental studies investigating the pain response after acute and regular exercise in pain-free individuals and in individuals with different chronic pain conditions. Finally, we discuss potential mechanisms underlying the change in pain after exercise in pain-free individuals and in individuals with different chronic pain conditions, and how this may have implications for clinical exercise prescription as well as for future studies on EIH.
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Britto A, Rodrigues V, Dos Santos AM, Rizzini M, Britto P, Britto L, Garcia JBS. Effects of water- and land-based exercises on quality of life and physical aspects in women with fibromyalgia: A randomized clinical trial. Musculoskeletal Care 2020; 18:459-466. [PMID: 32573912 DOI: 10.1002/msc.1481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Fibromyalgia (FM) is consistently associated with fatigue, sleep disturbances, morning stiffness, and anxiety and depression, affecting physical capacities and skills and thereby reducing quality of life. The aim of this study was to compare the effects of water-based and land-based therapies as an adjuvant treatment for women with FM in relation to quality of life and physical aspects. METHODS FM women were randomized into a water-based exercise group (WG) and land-based exercise group (LG). The interventions were conducted for 8 weeks, three times a week, and each therapy session had a 60-min duration. Evaluations were performed before and after intervention using the Fibromyalgia Impact Questionnaire, the Visual Analogue Scale, the number of tender points (TPs), and the Wells bench sit and reach test score. RESULTS Both interventions produced significantly positive clinical effects in most aspects evaluated. However, only WG obtained significant improvements for the variables functional capacity, number of TPs, and flexibility. CONCLUSIONS The findings suggest that water-based exercise is effective as an adjuvant FM treatment, including FM-related physical and psychological health aspects.
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Affiliation(s)
- André Britto
- School of Medicine, Federal University of Maranhão, Pinheiro, Brazil
| | | | - Alcione M Dos Santos
- Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
| | - Marta Rizzini
- Collective Health Graduate Program, Federal University of Maranhão, São Luís, Brazil
| | - Paula Britto
- Physiotherapy Service, Club Sante, São Luís, Brazil
| | - Lucio Britto
- Physiotherapy Service, Club Sante, São Luís, Brazil
| | - João B S Garcia
- Health Science Graduate Program, Federal University of Maranhão, São Luís, Brazil
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Sauch Valmaña G, Vidal-Alaball J, Poch PR, Peña JM, Panadés Zafra R, Cantero Gómez FX, Ruíz Comellas A, Barranco Reixachs D. Effects of a Physical Exercise Program on Patients Affected with Fibromyalgia. J Prim Care Community Health 2020; 11:2150132720965071. [PMID: 33084477 PMCID: PMC7786411 DOI: 10.1177/2150132720965071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND physical activity has been used for a number of years in the treatment of fibromyalgia (FM). The main objective of this study is to compare the effects of physical activity on 2 groups of women diagnosed with FM in terms of pain, quality of life and the impact of the condition on their daily lives. METHODS this was a randomized clinical trial to assess the effects of physical activity performed by subjects assigned to one of 2 groups on the scores of 3 questionnaires, the pain Visual Analog Scale (EVA), the Fibromyalgia Impact Questionnaire (FIQ) and the SF-36 health questionnaire administered before and after the intervention. RESULTS A total of 24 subjects were randomly assigned to each of the 2 study groups. No significant differences were found after the program of 3 months of physical activity ended. CONCLUSIONS Our study shows that a physical activity program with duration of less than 3 months does not significantly improve any of the factors studied.
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Affiliation(s)
- Glòria Sauch Valmaña
- Unitat de Suport a la Recerca Catalunya Central, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, (IDIAPJGol), Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages (Barcelona), Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca Catalunya Central, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, (IDIAPJGol), Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages (Barcelona), Spain
| | | | - Jacobo Mendiroz Peña
- Unitat de Suport a la Recerca Catalunya Central, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, (IDIAPJGol), Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages (Barcelona), Spain
| | - Robert Panadés Zafra
- Centre d’Atenció Primària Anoia Rural. Institut Català de la Salut, Catalunya Central, Igualada, (Barcelona), Spain
| | - Francesc Xavier Cantero Gómez
- Centre d’Atenció Primària Igualada Urbà. Institut Català de la Salut, Catalunya Central, Igualada (Barcelona), Spain
| | - Anna Ruíz Comellas
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages (Barcelona), Spain
- Centre d’Atenció Primària Sant Joan de Vilatorrada. Institut Català de Salut, Catalunya Central (Barcelona), Spain
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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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16
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Hyperbaric oxygen and aerobic exercise in the long-term treatment of fibromyalgia: A narrative review. Biomed Pharmacother 2018; 109:629-638. [PMID: 30399600 DOI: 10.1016/j.biopha.2018.10.157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/13/2018] [Accepted: 10/25/2018] [Indexed: 12/20/2022] Open
Abstract
Chronic pain is one of the most common clinical presentations in the primary care settings. In the US, Fibromyalgia (FM) affects about 1-3% of adults and commonly occurs in adults between the ages of 40-50 years. FM causes widespread muscular pain and tenderness with hyperalgesia and allodynia and may be associated with other somatic complaints. Hyperbaric oxygen therapy (HBOT) has been utilized and has recently shown promising effects in the management of FM and other chronic pain disorders. In HBOT, the intermittent breathing of 100% oxygen in a pressurized chamber where the pressure is higher than 1 atmosphere absolute (ATA) has been utilized. HBOT exhibits a significant anti-inflammatory effect through reducing production of glial cells and inflammatory mediators which results in pain alleviation in different chronic pain conditions. HBOT can also influence neuroplasticity and affects the mitochondrial mechanisms resulting in functional brain changes. In addition to that, HBOT stimulates nitric oxide (NO) synthesis which helps in alleviating hyperalgesia and NO-dependent release of endogenous opioids which seemed to be the primary HBOT mechanism of antinociception. Moreover, aerobic exercise and meditative movement therapies (MMT) have gained attention for their role in pain alleviation through different anti-inflammatory and antioxidant mechanisms. In this review, we aim to elucidate the different mechanisms of HBOT and aerobic exercise in attenuating pain as adjuvant therapy in the multidisciplinary treatment strategy of chronic pain, and more particularly fibromyalgia.
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Andrade A, de Azevedo Klumb Steffens R, Sieczkowska SM, Peyré Tartaruga LA, Torres Vilarino G. A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations. Adv Rheumatol 2018; 58:36. [PMID: 30657077 DOI: 10.1186/s42358-018-0033-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/28/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by chronic and generalized musculoskeletal pain. There is currently no cure for FM, but palliative treatments are available. One type of treatment is strength training (ST). However, there is a need for more information on optimal training protocols, intensity, and volume needed to improve symptoms. The aim of this study was to analyze the effects of ST in the treatment of FM through a systematic review of experimental research. METHODS Medical Subject Headings search terms and electronic databases including Scientific Electronic Library Online, PubMed, Science Direct, Web of Science, and Physiotherapy Evidence Database were used to identify studies. RESULTS The inclusion criteria were met by 22 eligible studies. Most of the studies were conducted in the United States (36%), Finland (23%), Brazil (18%), and Sweden (18%). The studies showed that ST reduces the number of tender points, fatigue, depression, and anxiety, and improves sleep quality and quality of life in patients with FM. The intervention period ranged from 3 to 21 weeks, with sessions performed 2 times a week in 81.81% of the studies, at initial intensities of 40% of 1-repetition maximum. The repetitions ranged from 4 to 20, with no specific protocol defined for ST in FM. CONCLUSION The main results included reduction in pain, fatigue, number of tender points, depression, and anxiety, with increased functional capacity and quality of life. Current evidence demonstrates that ST is beneficial and can be used to treat FM. TRIAL REGISTRATION CRD42016048480.
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Affiliation(s)
- Alexandro Andrade
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil. .,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil.
| | - Ricardo de Azevedo Klumb Steffens
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil.,Regional University of Blumenau - FURB, Blumenau, SC, Brazil
| | - Sofia Mendes Sieczkowska
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil
| | - Leonardo Alexandre Peyré Tartaruga
- Human Movement Sciences and Pneumological Sciences, UFRGS- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Research Laboratory of Exercise - LAPEX, Porto Alegre, RS, Brazil
| | - Guilherme Torres Vilarino
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil
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18
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Chen LJ, Fox KR, Ku PW, Chang YW. Effects of Aquatic Exercise on Sleep in Older Adults with Mild Sleep Impairment: a Randomized Controlled Trial. Int J Behav Med 2017; 23:501-6. [PMID: 26025630 DOI: 10.1007/s12529-015-9492-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Exercise has been found to be associated with improved sleep quality. However, most of the evidence is based on resistance exercise, walking, or gym-based aerobic activity. PURPOSE This study aimed to examine the effects of an 8-week aquatic exercise program on objectively measured sleep parameters among older adults with mild sleep impairment. METHODS A total of 67 eligible older adults with sleep impairment were selected and randomized to exercise and control groups, and 63 participants completed the study. The program involved 2 × 60-min sessions of aquatic exercise for 8 weeks. Participants wore wrist actigraphs to assess seven parameters of sleep for 1 week before and after the intervention. Mixed-design analysis of variance (ANOVA) was used to assess the differences between groups in each of the sleep parameters. RESULTS No significant group differences on demographic variables, life satisfaction, percentage of body fat, fitness, seated blood pressure, and any parameter of sleep were found at baseline. Significant group × time interaction effects were found in sleep onset latency, F(1,58) = 6.921, p = .011, partial eta squared = .011, and in sleep efficiency, F(1, 61) = 16.909, p < 0.001, partial eta squared = .217. The exercise group reported significantly less time on sleep onset latency (mean difference = 7.9 min) and greater sleep efficiency (mean difference = 5.9 %) than the control group at posttest. There was no significant difference between groups in change of total sleep time, wake after sleep onset, activity counts, or number and length of awakenings. CONCLUSIONS An 8-week aquatic exercise has significant benefits on some sleep parameters, including less time for sleep onset latency and better sleep efficiency in older adults with mild sleep impairment.
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Affiliation(s)
- Li-Jung Chen
- National Taiwan University of Sport, Taichung, Taiwan
| | | | - Po-Wen Ku
- National Changhua University of Education, Changhua, Taiwan.
| | - Yi-Wen Chang
- National Taiwan University of Sport, Taichung, Taiwan
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19
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Microvascular functions in patients with fibromyalgia syndrome: effects of physical exercise. Turk J Phys Med Rehabil 2017; 63:215-223. [PMID: 31453457 DOI: 10.5606/tftrd.2017.351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/01/2016] [Indexed: 12/31/2022] Open
Abstract
Objectives This study aims to evaluate the current state of microvascular function and to investigate the effect of supervised aerobic exercise on microvascular control mechanisms and health outcomes in women with fibromyalgia syndrome (FMS). Patients and methods Forty female patients (mean age 51±11 years) with a diagnosis of FMS according to the American College of Rheumatology criteria and 20 healthy female controls (mean age 52±9 years) were included in the study. Microvascular blood flow was measured using a laser Doppler flowmeter (LDF) at the volar skin site of the forearm. Pain severity and FMS were assessed using the visual analog scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ), respectively, both at the beginnig and at the end of the study. Fibromyalgia was evaluated and a spectral analysis of LDF signals was carried out to assess the relative contribution of each control mechanisms. The local thermal hyperemia was used to test the microvascular functions. Moderate-intensity aerobic activity (energy expenditure 3.0 to 6.0 metabolic equivalent) was performed by treadmill walking for 30 min for five days each week for a month. Results The patients with FMS had lower VAS and FIQ scores at the end of the exercise period. There was a positive correlation between improved myogenic and neurogenic mechanisms and reduced FIQ scores. Cardiac signals were positively correlated with the FIQ scores at the end of the exercise period. Endothelial function was under the influence of pain, and baseline nitric oxide activity was found to be positively correlated with VAS. Conclusion Our study results suggest that microvascular functions are impaired in FMS patients and moderate exercise training is effective to improve the FIQ/VAS scores and enhance vascular functions.
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20
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Sanz-Baños Y, Pastor-Mira MÁ, Lledó A, López-Roig S, Peñacoba C, Sánchez-Meca J. Do women with fibromyalgia adhere to walking for exercise programs to improve their health? Systematic review and meta-analysis. Disabil Rehabil 2017; 40:2475-2487. [DOI: 10.1080/09638288.2017.1347722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yolanda Sanz-Baños
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | | | - Ana Lledó
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Sofía López-Roig
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Cecilia Peñacoba
- Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Rey Juan Carlos University, Madrid, Spain
| | - Julio Sánchez-Meca
- Department of of Basic Psychology and Methodology, Murcia University, Murcia, Spain
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21
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Bidonde J, Busch AJ, Schachter CL, Overend TJ, Kim SY, Góes SM, Boden C, Foulds HJA. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev 2017; 6:CD012700. [PMID: 28636204 PMCID: PMC6481524 DOI: 10.1002/14651858.cd012700] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with fibromyalgia that will replace the "Exercise for treating fibromyalgia syndrome" review first published in 2002. OBJECTIVES • To evaluate the benefits and harms of aerobic exercise training for adults with fibromyalgia• To assess the following specific comparisons ० Aerobic versus control conditions (eg, treatment as usual, wait list control, physical activity as usual) ० Aerobic versus aerobic interventions (eg, running vs brisk walking) ० Aerobic versus non-exercise interventions (eg, medications, education) We did not assess specific comparisons involving aerobic exercise versus other exercise interventions (eg, resistance exercise, aquatic exercise, flexibility exercise, mixed exercise). Other systematic reviews have examined or will examine these comparisons (Bidonde 2014; Busch 2013). SEARCH METHODS We searched the Cochrane Library, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), Thesis and Dissertation Abstracts, the Allied and Complementary Medicine Database (AMED), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and the ClinicalTrials.gov registry up to June 2016, unrestricted by language, and we reviewed the reference lists of retrieved trials to identify potentially relevant trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) in adults with a diagnosis of fibromyalgia that compared aerobic training interventions (dynamic physical activity that increases breathing and heart rate to submaximal levels for a prolonged period) versus no exercise or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted data, performed a risk of bias assessment, and assessed the quality of the body of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences between groups. MAIN RESULTS We included 13 RCTs (839 people). Studies were at risk of selection, performance, and detection bias (owing to lack of blinding for self-reported outcomes) and had low risk of attrition and reporting bias. We prioritized the findings when aerobic exercise was compared with no exercise control and present them fully here.Eight trials (with 456 participants) provided low-quality evidence for pain intensity, fatigue, stiffness, and physical function; and moderate-quality evidence for withdrawals and HRQL at completion of the intervention (6 to 24 weeks). With the exception of withdrawals and adverse events, major outcome measures were self-reported and were expressed on a 0 to 100 scale (lower values are best, negative mean differences (MDs)/standardized mean differences (SMDs) indicate improvement). Effects for aerobic exercise versus control were as follows: HRQL: mean 56.08; five studies; N = 372; MD -7.89, 95% CI -13.23 to -2.55; absolute improvement of 8% (3% to 13%) and relative improvement of 15% (5% to 24%); pain intensity: mean 65.31; six studies; N = 351; MD -11.06, 95% CI -18.34 to -3.77; absolute improvement of 11% (95% CI 4% to 18%) and relative improvement of 18% (7% to 30%); stiffness: mean 69; one study; N = 143; MD -7.96, 95% CI -14.95 to -0.97; absolute difference in improvement of 8% (1% to 15%) and relative change in improvement of 11.4% (21.4% to 1.4%); physical function: mean 38.32; three studies; N = 246; MD -10.16, 95% CI -15.39 to -4.94; absolute change in improvement of 10% (15% to 5%) and relative change in improvement of 21.9% (33% to 11%); and fatigue: mean 68; three studies; N = 286; MD -6.48, 95% CI -14.33 to 1.38; absolute change in improvement of 6% (12% improvement to 0.3% worse) and relative change in improvement of 8% (16% improvement to 0.4% worse). Pooled analysis resulted in a risk ratio (RR) of moderate quality for withdrawals (17 per 100 and 20 per 100 in control and intervention groups, respectively; eight studies; N = 456; RR 1.25, 95%CI 0.89 to 1.77; absolute change of 5% more withdrawals with exercise (3% fewer to 12% more).Three trials provided low-quality evidence on long-term effects (24 to 208 weeks post intervention) and reported that benefits for pain and function persisted but did not for HRQL or fatigue. Withdrawals were similar, and investigators did not assess stiffness and adverse events.We are uncertain about the effects of one aerobic intervention versus another, as the evidence was of low to very low quality and was derived from single trials only, precluding meta-analyses. Similarly, we are uncertain of the effects of aerobic exercise over active controls (ie, education, three studies; stress management training, one study; medication, one study) owing to evidence of low to very low quality provided by single trials. Most studies did not measure adverse events; thus we are uncertain about the risk of adverse events associated with aerobic exercise. AUTHORS' CONCLUSIONS When compared with control, moderate-quality evidence indicates that aerobic exercise probably improves HRQL and all-cause withdrawal, and low-quality evidence suggests that aerobic exercise may slightly decrease pain intensity, may slightly improve physical function, and may lead to little difference in fatigue and stiffness. Three of the reported outcomes reached clinical significance (HRQL, physical function, and pain). Long-term effects of aerobic exercise may include little or no difference in pain, physical function, and all-cause withdrawal, and we are uncertain about long-term effects on remaining outcomes. We downgraded the evidence owing to the small number of included trials and participants across trials, and because of issues related to unclear and high risks of bias (performance, selection, and detection biases). Aerobic exercise appears to be well tolerated (similar withdrawal rates across groups), although evidence on adverse events is scarce, so we are uncertain about its safety.
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Affiliation(s)
- Julia Bidonde
- Norwegian Institute of Public HealthPO Box 4404 NydalenOsloNorway0403
| | - Angela J Busch
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonSKCanadaS7N 2Z4
| | | | - Tom J Overend
- University of Western OntarioSchool of Physical TherapyElborn College, Room 1588,School of Physical Therapy, University of Western OntarioLondonONCanadaN6G 1H1
| | - Soo Y Kim
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonSKCanadaS7N 2Z4
| | - Suelen M. Góes
- University of SaskatchewanSchool of Physical Therapy, College of MedicineRoom 3400, E‐wing Health Science Building 104 Clinic PlaceSaskatoonSaskatchewanCanadaS7N 2Z4
| | - Catherine Boden
- University of SaskatchewanLeslie and Irene Dube Health Sciences Library, University LibraryRm 1400 Health Sciences Building 104 Clinic PlaceSaskatoonSKCanadaS7N 5E5
| | - Heather JA Foulds
- University of SaskatchewanCollege of Kinesiology87 Campus RoadSaskatoonSKCanadaS7N 5B2
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Trevisan DC, Avila MA, Driusso P, Gramani-Say K, Araujo-Moreira FM, Parizotto NA. Effects of Hydrotherapy on Postural Control of Women with Fibromyalgia Syndrome: A Single Arm Study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/24708593.2017.1300205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Deborah Colucci Trevisan
- Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil,
- Biotechnology Post-Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil,
| | - Mariana Arias Avila
- Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil,
- Physical Therapy Department, Centro Universitario Central Paulista, Sao Carlos, Brazil,
| | - Patricia Driusso
- Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil,
| | - Karina Gramani-Say
- Gerontology Department, Federal University of Sao Carlos, Sao Carlos, Brazil, and
| | - Fernando M. Araujo-Moreira
- Biotechnology Post-Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil,
- Physics Department, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Nivaldo Antonio Parizotto
- Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil,
- Biotechnology Post-Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil,
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Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2016; 76:318-328. [PMID: 27377815 DOI: 10.1136/annrheumdis-2016-209724] [Citation(s) in RCA: 702] [Impact Index Per Article: 87.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. METHODS A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/non-pharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations. RESULTS 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on meta-analyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on non-pharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability). CONCLUSIONS These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome.
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Affiliation(s)
- G J Macfarlane
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - C Kronisch
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.,Department of Rheumatology, Cantonal Hospital, Fribourg, Switzerland
| | - L E Dean
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - F Atzeni
- ICRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - W Häuser
- Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany.,Department of Psychosomatic Medicine, Technische Universität München, München, Germany
| | - E Fluß
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - E Choy
- Section of Rheumatology, Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - E Kosek
- Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Spine Centre, Stockholm, Sweden
| | - K Amris
- Department of Rheumatology, Bispebjerg and Frederiksberg, The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - J Branco
- Rheumatology Department, CEDOC-NOVA Medical School, UNL, CHLO, Hospital Egas Moniz, Lisbon, Portugal
| | - F Dincer
- Hacettepe University Division of Internal Medicine, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - P Leino-Arjas
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - G M McCarthy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Makri
- Patient Representative, Limassol, Cyprus
| | - S Perrot
- Centre de la Douleur, Hôpital Cochin-Hôtel Dieu, Université Paris Descartes, Paris, France
| | - P Sarzi-Puttini
- Rheumatology Unit, L. Sacco University Hospital, Milan, Italy
| | - A Taylor
- Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - G T Jones
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Semiz EA, Hizmetli S, Semiz M, Karadağ A, Adalı M, Tuncay MS, Alim B, Hayta E, Uslu AU. Serum cortisol and dehydroepiandrosterone-sulfate levels after balneotherapy and physical therapy in patients with fibromyalgia. Saudi Med J 2016; 37:544-50. [PMID: 27146618 PMCID: PMC4880655 DOI: 10.15537/smj.2016.5.15032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objectives: To investigated serum cortisol and serum dehydroepiandrosterone-sulphate (DHEA-S) levels between fibromyalgia (FMS) patients and a control group, and the effect of balneotherapy (BT) on these hormones. Methods: Seventy-two patients with FMS and 39 healthy volunteers were included in the study. This prospective and cross-sectional study was carried out in the Medical Faculty, Physical Medicine and Rehabilitation Clinic, Cumhuriyet University, Cumhuriyet, Turkey between June 2012 and June 2013. Patients were divided into 2 groups. There were 40 patients in the first group, consisting of BT and physical therapy (PT) administered patients. There were 32 FMS patients in the second group who were only administered PT. Thirty-nine healthy volunteers were enrolled as a control group. Result: Cortisol was observed to be lower in FMS patients compared with the controls (10.10±4.08 μg/dL and 11.78±3.6 μg/dL; p=0.033). Serum DHEA-S level was observed to be lower in FMS patients compared with the controls (89.93±53.96 μg/dL and 143.15±107.92 μg/dL; p=0.015). Average serum cortisol levels of patients receiving BT were determined to be 9.95±3.20 μg/dL before treatment and 9.06±3.77μg/dL after treatment; while average serum DHEA-S levels were 77.60±48.05 μg/dL before treatment, and 76.84±48.71 μg/dL after treatment. No significant changes were determined in serum cortisol and DHEA-S levels when measured again after BT and PT. Conclusion: Low levels of serum cortisol and DHEA-S were suggested to be associated with the physiopathology of FMS.
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Affiliation(s)
- Esra A Semiz
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University School of Medicine, Eskisehir, Turkey. E-mail.
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Umeda M, Kempka L, Weatherby A, Greenlee B, Mansion K. Effects of caffeinated chewing gum on muscle pain during submaximal isometric exercise in individuals with fibromyalgia. Physiol Behav 2016; 157:139-45. [DOI: 10.1016/j.physbeh.2016.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 12/14/2022]
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Morris LD, Louw QA, Grimmer KA, Meintjes E. Targeting pain catastrophization in patients with fibromyalgia using virtual reality exposure therapy: a proof-of-concept study. J Phys Ther Sci 2015; 27:3461-7. [PMID: 26696719 PMCID: PMC4681926 DOI: 10.1589/jpts.27.3461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/19/2015] [Indexed: 12/02/2022] Open
Abstract
[Purpose] Pain catastrophizing is a key predictor of poor compliance to exercises among
patients with fibromyalgia syndrome. Alteration of pain catastrophizing in this group is
thus warranted. This study aimed to provide proof-of-concept of a novel virtual reality
exposure therapy program as treatment for exercise-related pain catastrophizing in
patients with fibromyalgia syndrome. [Subjects and Methods] An exploratory,
case-controlled study was conducted (fibromyalgia syndrome group and matched control
group). Functional magnetic resonance imaging was used to acquire neural correlates. The
functional magnetic resonance imaging task consisted of two stimuli: active (exercise
activity visuals) and passive (relaxing visuals). Structural images and
blood-oxygenation-level-dependent contrasts were acquired for the conditions and compared
within subjects/groups and between groups. Statistic images were thresholded using
corrected clusters (determined by Z>2.3; level of significance: 0.05). [Results]
Thirteen fibromyalgia syndrome subjects and nine healthy matched controls were included.
The right inferior frontal gyrus, right middle frontal gyrus, right posterior cerebellum,
left thalamus, and left supramarginal gyrus were activated in the fibromyalgia syndrome
subjects. [Conclusion] The study results provide preliminary proof indicating that
exposing patients with fibromyalgia syndrome to visuals of exercises elicits
neurophysiological changes in functional brain areas associated with pain
catastrophization and add to the current body of knowledge regarding the possibility of
objectively identifying cognitive behavioral strategies like pain catastrophization.
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Affiliation(s)
- Linzette Deidrè Morris
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Quinette Abegail Louw
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Karen Anne Grimmer
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa ; International Centre for Allied Health Evidence (iCAHE), University of South Australia, Australia
| | - Ernesta Meintjes
- MRC/UCT Medical Imaging Research Unit, Faculty of Health Sciences, University of Cape Town, South Africa
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27
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Cerrillo-Urbina AJ, García-Hermoso A, Sánchez-López M, Martínez-Vizcaíno V. Effect of Exercise Programs on Symptoms of Fibromyalgia in Peri-Menopausal Age Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. ACTA ACUST UNITED AC 2015. [DOI: 10.3109/10582452.2015.1083640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Mairena Sánchez-López
- Social and Health Care Research Centre, University of Castilla-La Mancha, Cuenca, Spain,
- School of Education, University of Castilla-La Mancha, Ciudad Real, Spain
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Genc A, Tur BS, Aytur YK, Oztuna D, Erdogan MF. Does aerobic exercise affect the hypothalamic-pituitary-adrenal hormonal response in patients with fibromyalgia syndrome? J Phys Ther Sci 2015; 27:2225-31. [PMID: 26311959 PMCID: PMC4540854 DOI: 10.1589/jpts.27.2225] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/13/2015] [Indexed: 01/22/2023] Open
Abstract
[Purpose] The hypothalamic-pituitary-adrenal (HPA) axis in the etiopathogenesis of fibromyalgia is not clear. This study aimed to analyze the effects of a 6-week aerobic exercise program on the HPA axis in patients with fibromyalgia and to investigate the effects of this program on the disease symptoms, patients' fitness, disability, and quality of life. [Subjects and Methods] Fifty fibromyalgia patients were randomized to Group 1 (stretching and flexibility exercises at home for 6 weeks) and Group 2 (aerobic exercise three times a week and the same at-home exercises as Group 1 for 6 weeks). Serum levels of cortisol, adrenocorticotropic hormone, insulin-like growth factor-1, and growth hormone were analyzed at baseline and at the end of, and 1 hr after an exercise stress test. [Results] Group 2 showed better improvement in morning stiffness duration and pain. Growth hormone levels significantly increased after intervention and cortisol levels significantly decreased at time-time interaction in both groups. No significant differences in adrenocorticotropic hormone and insulin-like growth factor-1 were found. [Conclusion] The results of this study seem to support the hypothesis that there is a dysregulation of the HPA axis in patients with FM, and that a six-week exercise program can influence symptoms and affect the HPA axis hormones.
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Affiliation(s)
- Aysun Genc
- Physiotherapy Programme, Ankara University Vocational School of Haymana, Turkey
| | - Birkan Sonel Tur
- Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Turkey
| | - Yesim Kurtais Aytur
- Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Turkey
| | - Derya Oztuna
- Department of Biostatistics, Ankara University Faculty of Medicine, Turkey
| | - Murat Faik Erdogan
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Turkey
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29
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Kaleth AS, Slaven JE, Ang DC. Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia? Arthritis Care Res (Hoboken) 2015; 66:1887-94. [PMID: 25049001 DOI: 10.1002/acr.22398] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/01/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To examine the concurrent and predictive associations between the number of steps taken per day and clinical outcomes in patients with fibromyalgia (FM). METHODS A total of 199 adults with FM (mean age 46.1 years, 95% women) who were enrolled in a randomized clinical trial wore a hip-mounted accelerometer for 1 week and completed self-report measures of physical function (Fibromyalgia Impact Questionnaire-Physical Impairment [FIQ-PI], Short Form 36 [SF-36] health survey physical component score [PCS], pain intensity and interference (Brief Pain Inventory [BPI]), and depressive symptoms (Patient Health Questionnaire-8 [PHQ-8]) as part of their baseline and followup assessments. Associations of steps per day with self-report clinical measures were evaluated from baseline to week 12 using multivariate regression models adjusted for demographic and baseline covariates. RESULTS Study participants were primarily sedentary, averaging 4,019 ± 1,530 steps per day. Our findings demonstrate a linear relationship between the change in steps per day and improvement in health outcomes for FM. Incremental increases on the order of 1,000 steps per day were significantly associated with (and predictive of) improvements in FIQ-PI, SF-36 PCS, BPI pain interference, and PHQ-8 (all P < 0.05). Although higher step counts were associated with lower FIQ and BPI pain intensity scores, these were not statistically significant. CONCLUSION Step count is an easily obtained and understood objective measure of daily physical activity. An exercise prescription that includes recommendations to gradually accumulate at least 5,000 additional steps per day may result in clinically significant improvements in outcomes relevant to patients with FM. Future studies are needed to elucidate the dose-response relationship between steps per day and patient outcomes in FM.
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Knijnik LM, Dussán-Sarria JA, Rozisky JR, Torres ILS, Brunoni AR, Fregni F, Caumo W. Repetitive Transcranial Magnetic Stimulation for Fibromyalgia: Systematic Review and Meta-Analysis. Pain Pract 2015; 16:294-304. [DOI: 10.1111/papr.12276] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/17/2014] [Accepted: 11/02/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Leonardo M. Knijnik
- Laboratory of Pain and Neuromodulation; Hospital de Clínicas de Porto Alegre (HCPA); Porto Alegre Brazil
- School of Medicine; Rio Grande do Sul Federal University (UFRGS); Porto Alegre Brazil
| | - Jairo A. Dussán-Sarria
- Laboratory of Pain and Neuromodulation; Hospital de Clínicas de Porto Alegre (HCPA); Porto Alegre Brazil
- Post-Graduate Program in Medical Sciences; School of Medicine; UFRGS; Porto Alegre Brazil
- Pain and Palliative Care Service at HCPA; UFRGS; Porto Alegre Brazil
| | - Joanna R. Rozisky
- Laboratory of Pain and Neuromodulation; Hospital de Clínicas de Porto Alegre (HCPA); Porto Alegre Brazil
| | - Iraci L. S. Torres
- Post-Graduate Program in Medical Sciences; School of Medicine; UFRGS; Porto Alegre Brazil
- Pharmacology Department; Institute of Basic Health Sciences; UFRGS; Porto Alegre Brazil
| | - Andre R. Brunoni
- Service of Interdisciplinary Neuromodulation; Department and Institute of Psychiatry; University of São Paulo; São Paulo Brazil
| | - Felipe Fregni
- Spaulding Center of Neuromodulation; Department of Physical Medicine and Rehabilitation; Harvard Medical School; Boston Massachusetts U.S.A
| | - Wolnei Caumo
- Laboratory of Pain and Neuromodulation; Hospital de Clínicas de Porto Alegre (HCPA); Porto Alegre Brazil
- Pain and Palliative Care Service at HCPA; UFRGS; Porto Alegre Brazil
- Department of Surgery; HCPA; UFRGS; Porto Alegre Brazil
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Umeda M, Corbin LW, Maluf KS. Examination of contraction-induced muscle pain as a behavioral correlate of physical activity in women with and without fibromyalgia. Disabil Rehabil 2014; 37:1864-9. [DOI: 10.3109/09638288.2014.984878] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Derman EW, Whitesman S, Dreyer M, Patel DN, Nossel C, Schwellnus MP. Healthy lifestyle interventions in general practice: Part 16: Lifestyle and fibromyalgia. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2011.10874144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- EW Derman
- UCT/MRC Research Unit for Sports Science and Sports Medicine; International Olympic Committee (IOC) Research Center for Injury Prevention and Protection of Health of the Athlete, University of Cape Town
| | | | | | | | | | - MP Schwellnus
- UCT/MRC Research Unit for Sports Science and Sports Medicine; International Olympic Committee (IOC) Research Center for Injury Prevention and Protection of Health of the Athlete, University of Cape Town
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Naumann J, Sadaghiani C. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther 2014; 16:R141. [PMID: 25000940 PMCID: PMC4227103 DOI: 10.1186/ar4603] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 07/01/2014] [Indexed: 12/12/2022] Open
Abstract
Introduction In the present systematic review and meta-analysis, we assessed the effectiveness of different forms of balneotherapy (BT) and hydrotherapy (HT) in the management of fibromyalgia syndrome (FMS). Methods A systematic literature search was conducted through April 2013 (Medline via Pubmed, Cochrane Central Register of Controlled Trials, EMBASE, and CAMBASE). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Results Meta-analysis showed moderate-to-strong evidence for a small reduction in pain (SMD −0.42; 95% CI [−0.61, −0.24]; P < 0.00001; I2 = 0%) with regard to HT (8 studies, 462 participants; 3 low-risk studies, 223 participants), and moderate-to-strong evidence for a small improvement in health-related quality of life (HRQOL; 7 studies, 398 participants; 3 low-risk studies, 223 participants) at the end of treatment (SMD −0.40; 95% CI [−0.62, −0.18]; P = 0.0004; I2 = 15%). No effect was seen at the end of treatment for depressive symptoms and tender point count (TPC). BT in mineral/thermal water (5 studies, 177 participants; 3 high-risk and 2 unclear risk studies) showed moderate evidence for a medium-to-large size reduction in pain and TPC at the end of treatment: SMD −0.84; 95% CI [−1.36, −0.31]; P = 0.002; I2 = 63% and SMD −0.83; 95% CI [−1.42, −0.24]; P = 0.006; I2 = 71%. After sensitivity analysis, and excluding one study, the effect size for pain decreased: SMD −0.58; 95% CI [−0.91, −0.26], P = 0.0004; I2 = 0. Moderate evidence is given for a medium improvement of HRQOL (SMD −0.78; 95% CI [−1.13, −0.43]; P < 0.0001; I2 = 0%). A significant effect on depressive symptoms was not found. The improvements for pain could be maintained at follow-up with smaller effects. Conclusions High-quality studies with larger sample sizes are needed to confirm the therapeutic benefit of BT and HT, with focus on long-term results and maintenance of the beneficial effects.
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Pastor MÁ, López-Roig S, Lledó A, Peñacoba C, Velasco L, Schweiger-Gallo I, Cigarán M, Ecija C, Limón R, Sanz Y. Combining motivational and volitional strategies to promote unsupervised walking in patients with fibromyalgia: study protocol for a randomized controlled trial. Trials 2014; 15:120. [PMID: 24721143 PMCID: PMC4026054 DOI: 10.1186/1745-6215-15-120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 03/21/2014] [Indexed: 11/13/2022] Open
Abstract
Background Fibromyalgia patients are often advised to engage in regular low- to moderate-intensity physical exercise. The need of fibromyalgia patients to walk has been stressed in previous research. Behavioral self-regulation theories suggest that a combination of motivational aspects (to develop or strengthen a behavioral intention: Theory of Planned Behavior) and volitional aspects (engagement of intention in behavior: implementation intentions) is more effective than a single intervention. In this paper, we describe a protocol for identifying the motivational processes (using the Theory of Planned Behavior) involved in the practice of walking (phase I) and for studying the efficacy of an intervention that combines motivational and volitional contents to enhance the acquisition and continuation of this exercise behavior (phase II). The paper also shows the characteristics of eligible individuals (women who do not walk) and ineligible populations (women who walk or do not walk because of comorbidity without medical recommendation to walk). Both groups consist of members of any of four patients’ associations in Spain who are between 18 and 70 years of age and meet the London Fibromyalgia Epidemiology Study Screening Questionnaire criteria for fibromyalgia. Furthermore, using this study protocol, we will explore the characteristics of participants (eligible women who agreed to participate in the study) and nonparticipants (eligible women who refused to participate). Methods/design Two studies will be conducted: Phase I will be a cross-sectional study, and phase II will be a triple-blind, randomized longitudinal study with two treatment groups and one active control group. The questionnaires were sent to a total of 2,227 members of four patients’ associations in Spain. A total of 920 participants with fibromyalgia returned the questionnaires, and 582 were ultimately selected to participate. Discussion The first data gathered have allowed us to identify the characteristics of the study population and they support the appropriateness of the inclusion criteria.. When the study is complete, the results will enable us to establish whether this kind of intervention can be used as a self-regulation tool for increasing and maintaining walking as unsupervised physical exercise of low to moderate intensity in fibromyalgia patients. Trial registration Trial registration number:
ISRCTN68584893
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Affiliation(s)
- María-Ángeles Pastor
- Department of Health Psychology, Universidad Miguel Hernández, Crta, Nacional 332, s/n, Sant Joan D'Alacant 03550, Spain.
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Kaleth AS, Saha CK, Jensen MP, Slaven JE, Ang DC. Effect of moderate to vigorous physical activity on long-term clinical outcomes and pain severity in fibromyalgia. Arthritis Care Res (Hoboken) 2013; 65:1211-8. [PMID: 23401486 DOI: 10.1002/acr.21980] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 01/26/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the relationship between long-term maintenance of moderate to vigorous physical activity (MVPA) and clinical outcomes in fibromyalgia (FM). METHODS Patients with FM (n = 170) received individualized exercise prescriptions and completed baseline and followup physical activity assessments using the Community Health Activities Model Program for Seniors questionnaire at weeks 12, 24, and 36. The primary outcome was the change in the Fibromyalgia Impact Questionnaire-Physical Impairment (FIQ-PI) score. The secondary outcomes included improvements in overall well-being (FIQ total score), pain severity ratings, and depression. RESULTS Using a threshold increase in MVPA of ≥10 metabolic equivalent hours/week above usual activities, 27 subjects (15.9%) increased and sustained (SUS-PA), 68 (40%) increased but then declined (UNSUS-PA), and 75 (44.1%) did not achieve (LO-PA) this benchmark. Compared to LO-PA subjects, both SUS-PA and UNSUS-PA subjects reported greater improvement in FIQ-PI (P < 0.01) and FIQ total score (P < 0.05). Additionally, the SUS-PA group reported greater improvement in pain severity compared to the LO-PA group (P < 0.05). However, there were no significant group differences between SUS-PA and UNSUS-PA for any primary or secondary outcome measure. CONCLUSION Increased participation in MVPA for at least 12 weeks improved physical function and overall well-being in patients with FM. Although sustained physical activity was not associated with greater clinical benefit compared with unsustained physical activity, these findings also suggest that performing greater volumes of physical activity is not associated with worsening pain in FM. Future research is needed to determine the relationship between sustained MVPA participation and subsequent improvement in patient outcomes.
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Affiliation(s)
- Anthony S Kaleth
- Department of Kinesiology, Indiana University-Purdue University Indianapolis, 901 West New York Street, Indianapolis, IN 46202-5193, USA.
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Umeda M, Corbin LW, Maluf KS. Pain mediates the association between physical activity and the impact of fibromyalgia on daily function. Clin Rheumatol 2013; 34:143-9. [PMID: 24030630 DOI: 10.1007/s10067-013-2386-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/12/2013] [Accepted: 09/01/2013] [Indexed: 11/29/2022]
Abstract
This study quantified the association between recreational physical activity and daily function in women with fibromyalgia, and determined if this association is mediated by symptoms of pain, depression, or body mass. Twenty-three women diagnosed with fibromyalgia participated in an observational survey study. Recreational physical activity and the impact of fibromyalgia on daily function were assessed using the sport and leisure time physical activity subscales of the Baecke Physical Activity Questionnaire (BPAQ) and the Fibromyalgia Impact Questionnaire (FIQ), respectively. Potential mediators of the association between physical activity and daily function were assessed using the Visual Analogue Scale for pain intensity (VAS-Pain), the Beck Depression Inventory (BDI), and body mass index (BMI). BPAQ was inversely associated with FIQ (R (2) = 0.20) and VAS-Pain (R (2) = 0.39). VAS-Pain was positively associated with FIQ (R (2) = 0.23). The inverse association between BPAQ and FIQ was no longer significant after controlling for VAS-Pain. BDI was positively associated with FIQ (R (2) = 0.37), whereas BMI was not. BPAQ was not significantly associated with either BDI or BMI. These results indicate that the intensity of musculoskeletal pain, rather than depressive symptoms or body mass, mediates the association between physical activity and daily function among women with fibromyalgia.
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Affiliation(s)
- Masataka Umeda
- Department of Health, Exercise, and Sport Sciences, Texas Tech University, Lubbock, TX, USA
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37
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Cheatham SW. Fibromyalgia. Strength Cond J 2013. [DOI: 10.1519/ssc.0b013e3182977938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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38
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Ruiz JR, Segura-Jiménez V, Ortega FB, Álvarez-Gallardo IC, Camiletti-Moirón D, Aparicio VA, Carbonell-Baeza A, Femia P, Munguía-Izquierdo D, Delgado-Fernández M. Objectively measured sedentary time and physical activity in women with fibromyalgia: a cross-sectional study. BMJ Open 2013; 3:bmjopen-2013-002722. [PMID: 23794573 PMCID: PMC3686217 DOI: 10.1136/bmjopen-2013-002722] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To characterise levels of objectively measured sedentary time and physical activity in women with fibromyalgia. DESIGN Cross-sectional study. SETTING Local Association of Fibromyalgia (Granada, Spain). PARTICIPANTS The study comprised 94 women with diagnosed fibromyalgia who did not have other severe somatic or psychiatric disorders, or other diseases that prevent physical loading, able to ambulate and to communicate and capable and willing to provide informed consent. PRIMARY OUTCOME MEASURES Sedentary time and physical activity were measured by accelerometry and expressed as time spent in sedentary behaviours, average physical activity intensity (counts/minute) and amount of time (minutes/day) spent in moderate intensity and in moderate-to-vigorous-intensity physical activity (MVPA). RESULTS The proportion of women meeting the physical activity recommendations of 30 min/day of MVPA on 5 or more days a week was 60.6%. Women spent, on average, 71% of their waking time (approximately 10 h/day) in sedentary behaviours. Both sedentary behaviour and physical activity levels were similar across age groups, waist circumference and percentage body fat categories, years since clinical diagnosis, marital status, educational level and occupational status, regardless of the severity of the disease (all p>0.1). Time spent on moderate-intensity physical activity and MVPA was, however, lower in those with greater body mass index (BMI) (-6.6 min and -7 min, respectively, per BMI category increase, <25, 25-30, >30 kg/m(2); p values for trend were 0.056 and 0.051, respectively). Women spent, on average, 10 min less on MVPA (p<0.001) and 22 min less on sedentary behaviours during weekends compared with weekdays (p=0.051). CONCLUSIONS These data provide an objective measure of the amount of time spent on sedentary activities and on physical activity in women with fibromyalgia.
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Affiliation(s)
- Jonatan R Ruiz
- PROFITH “PROmoting FITness and Health through physical activity” Research Group, Faculty of Sport Sciences, Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Francisco B Ortega
- PROFITH “PROmoting FITness and Health through physical activity” Research Group, Faculty of Sport Sciences, Department of Physical Education and Sports, University of Granada, Granada, Spain
| | | | - Daniel Camiletti-Moirón
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Physiology, School of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Physiology, School of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Ana Carbonell-Baeza
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Physical Education, School of Education, University of Cadiz, Cadiz, Spain
| | - Pedro Femia
- Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain
| | - Diego Munguía-Izquierdo
- Deparment of Sports and Informatics, Section of Physical Education and Sports, Faculty of Sport, University Pablo de Olavide, Seville, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Breda CA, Félix Rodacki AL, Leite N, Homann D, Goes SM, Facco Stefanello JM. Nível de atividade física e desempenho físico no teste de caminhada de 6 minutos em mulheres com fibromialgia. REVISTA BRASILEIRA DE REUMATOLOGIA 2013. [DOI: 10.1590/s0482-50042013000300005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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A Mechanism-Based Approach to Prevention of and Therapy for Fibromyalgia. PAIN RESEARCH AND TREATMENT 2012; 2012:951354. [PMID: 22110947 PMCID: PMC3200141 DOI: 10.1155/2012/951354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 07/06/2011] [Indexed: 11/17/2022]
Abstract
Fibromyalgia syndrome (FMS) is characterized by pain referred to deep tissues. Diagnosis and treatment of FMS are complicated by a variable coexistence with regional pain, fatigue, sleep disruption, difficulty with mentation, and depression. The widespread, deep pain of FMS can be a consequence of chronic psychological stress with autonomic dysregulation. Stress acts centrally to facilitate pain and acts peripherally, via sympathetic vasoconstriction, to establish painful muscular ischemia. FMS pain, with or without a coexistent regional pain condition, is stressful, setting up a vicious circle of reciprocal interaction. Also, stress interacts reciprocally with systems of control over depression, mentation, and sleep, establishing FMS as a multiple-system disorder. Thus, stress and the ischemic pain it generates are fundamental to the multiple disorders of FMS, and a therapeutic procedure that attenuates stress and peripheral vasoconstriction should be highly beneficial for FMS. Physical exercise has been shown to counteract peripheral vasoconstriction and to attenuate stress, depression, and fatigue and improve mentation and sleep quality. Thus, exercise can interrupt the reciprocal interactions between psychological stress and each of the multiple-system disorders of FMS. The large literature supporting these conclusions indicates that exercise should be considered strongly as a first-line approach to FMS therapy.
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Chan CLW, Wang CW, Ho RTH, Ng SM, Ziea ETC, Wong VT. Qigong Exercise for the Treatment of Fibromyalgia: A Systematic Review of Randomized Controlled Trials. J Altern Complement Med 2012; 18:641-6. [DOI: 10.1089/acm.2011.0347] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cecilia L. W. Chan
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Chong-Wen Wang
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Rainbow T. H. Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Siu-Man Ng
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Eric T. C. Ziea
- Chinese Medicine Department, Hospital Authority, Hong Kong, China
| | - Vivian Taam Wong
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Mutlu B, Paker N, Bugdayci D, Tekdos D, Kesiktas N. Efficacy of supervised exercise combined with transcutaneous electrical nerve stimulation in women with fibromyalgia: a prospective controlled study. Rheumatol Int 2012; 33:649-55. [PMID: 22527135 DOI: 10.1007/s00296-012-2390-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/11/2012] [Indexed: 10/28/2022]
Abstract
The aim of this study was to investigate the results of a supervised exercise with transcutaneous electrical nerve stimulation (TENS) in an exercise controlled study in women with fibromyalgia. Sixty-six women with fibromyalgia who admitted to the outpatient clinic of our hospital were randomized into two treatment groups. The patients in both groups participated in a supervised combined exercise program for 12 weeks. The women in first group had additional TENS in the first 3 weeks of the study. All subjects were analyzed at the baseline, at the end of the 3rd and 12th weeks. Outcome measures were tender point count (TPC), myalgic pain score (MPS), Fibromyalgia Impact Questionnaire (FIQ) and Short Form-36 (SF-36) Health Survey. Sixty women with fibromyalgia completed the study. The patients in both groups showed improvement in terms of TPC, MPS, FIQ, physical and mental summary scores and total scores of SF-36 at the end of the 3rd and 12th weeks. The improvement in MPS at the third week was higher in the first group (p = 0.01). But there was no difference in terms of the improvement in MPS between the groups at the end of the 12th week control (p = 0.87). There was no significant difference between the improvement in the other outcome parameters of the two groups. As a result, supervised exercise program was successful to improve the myalgic pain, functional status and quality of life in women with fibromyalgia. Exercises combined with TENS might be useful due to quick myalgic pain relief in the treatment of fibromyalgia in everyday practice.
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Affiliation(s)
- B Mutlu
- Istanbul Physical Medicine and Rehabilitation Training Hospital, Bahçelievler, Istanbul, Turkey.
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Wilson B, Spencer H, Kortebein P. Exercise Recommendations in Patients With Newly Diagnosed Fibromyalgia. PM R 2012; 4:252-5. [DOI: 10.1016/j.pmrj.2011.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/23/2011] [Accepted: 11/25/2011] [Indexed: 01/24/2023]
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Carbonell-Baeza A, Ruiz JR, Aparicio VA, Ortega FB, Munguía-Izquierdo D, Alvarez-Gallardo IC, Segura-Jiménez V, Camiletti-Moirón D, Romero A, Estévez-López F, Samos B, Casimiro AJ, Sierra Á, Latorre PA, Pulido-Martos M, Femia P, Pérez-López IJ, Chillón P, Girela-Rejón MJ, Tercedor P, Lucía A, Delgado-Fernández M. Land- and water-based exercise intervention in women with fibromyalgia: the al-Andalus physical activity randomised controlled trial. BMC Musculoskelet Disord 2012; 13:18. [PMID: 22336292 PMCID: PMC3350451 DOI: 10.1186/1471-2474-13-18] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 02/15/2012] [Indexed: 01/03/2023] Open
Abstract
Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia. Trial registration ClinicalTrials.gov ID: NCT01490281
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Affiliation(s)
- Ana Carbonell-Baeza
- Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain.
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45
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Selfridge NJ, Muller D. Fibromyalgia. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Busch AJ, Webber SC, Brachaniec M, Bidonde J, Bello-Haas VD, Danyliw AD, Overend TJ, Richards RS, Sawant A, Schachter CL. Exercise therapy for fibromyalgia. Curr Pain Headache Rep 2011; 15:358-67. [PMID: 21725900 PMCID: PMC3165132 DOI: 10.1007/s11916-011-0214-2] [Citation(s) in RCA: 191] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being.
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Affiliation(s)
- Angela J Busch
- School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, Saskatchewan S7N 0W3, Canada.
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Dal U, Cimen OB, Incel NA, Adim M, Dag F, Erdogan AT, Beydagi H. Fibromyalgia Syndrome Patients Optimize the Oxygen Cost of Walking by Preferring a Lower Walking Speed. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/10582452.2011.609639] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Smith HS, Bracken D, Smith JM. Pharmacotherapy for fibromyalgia. Front Pharmacol 2011; 2:17. [PMID: 21772818 PMCID: PMC3131797 DOI: 10.3389/fphar.2011.00017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 03/09/2011] [Indexed: 12/27/2022] Open
Abstract
Fibromyalgia (FM) is a chronic disorder characterized by multifocal pain and other associated somatic symptoms including fatigue, insomnia, cognitive/memory problems, and even psychological distress. It appears that 2–4% of the general population suffers from FM. FM negatively impacts the physical functioning of its patients, as evidenced by difficulties with multiple daily activities, as well as affecting emotional health, social functioning, and health related quality of life. This review will discuss the potential theories that possibly contribute to the pathogenesis of FM, although the precise mechanism is unknown. The evolution of the assessment of FM will also be examined, with the waning use of tender point examinations and the appearance of new simple, practical diagnostic criteria. Although non-pharmacologic therapeutic options (exercise, education, cognitive–behavioral therapy) have been shown to be extremely effective in FM, the focus of this article will be on pharmacologic strategies. Non-Food and Drug Administration (FDA) approved as well as FDA approved agents will be presented. Each agent's therapeutic “niche” in FM management will be discussed based on its pharmacologic profile, patient responsiveness, and tolerability. Finally a clinical algorithm will be presented for the step-wise management of pain and other associated symptoms of FM.
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Affiliation(s)
- Howard S Smith
- Department of Anesthesiology, Albany Medical College Albany, NY, USA
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Effects of an exercise programme on self-esteem, self-concept and quality of life in women with fibromyalgia: a randomized controlled trial. Rheumatol Int 2011; 32:1869-76. [DOI: 10.1007/s00296-011-1892-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 03/13/2011] [Indexed: 01/07/2023]
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50
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Smith HS, Bracken D, Smith JM. Duloxetine: a review of its safety and efficacy in the management of fibromyalgia syndrome. J Cent Nerv Syst Dis 2010; 2:57-72. [PMID: 23861632 PMCID: PMC3661232 DOI: 10.4137/jcnsd.s4127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Fibromyalgia (FM) is a chronic disorder characterized by widespread pain and other associated symptoms including fatigue, insomnia, cognitive/memory problems, and even psychological distress. Duloxetine is one of three FDA approved medications (the other two being milnacipran and pregabalin) for the treatment of FM. It has been demonstrated that FM patients possess low central nervous system levels of serotonin and norepinephrine. Duloxetine, which is classified pharmacologically as a serotonin-norepinephrine reuptake inhibitor (SNRI), may be beneficial for FM patients by increasing these levels. This review will touch briefly upon the pathophysiology of FM, diagnostic tools, currently available therapeutic options (both pharmacologic and non-pharmacologic), as well as the pharmacokinetic/pharmacodynamic properties of duloxetine. In addition, the efficacy and safety/tolerability of duloxetine exclusively in FM will be assessed through examination of 5 randomized controlled trials, as well as pooled analyses of current data. Suggestions for a therapeutic niche for duloxetine in FM are discussed based on a presentation of the characteristics of duloxetine.
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Affiliation(s)
- Howard S Smith
- Albany Medical College, Department of Anesthesiology, Albany, New York 12208, USA
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