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Al-Rawaf HA, Gabr SA, Iqbal A, Alghadir AH. Circulating microRNAs as potential biomarkers of physical activity in geriatric patients with HCV. BMC Mol Cell Biol 2024; 25:18. [PMID: 39030480 PMCID: PMC11264506 DOI: 10.1186/s12860-024-00514-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Circulating microRNAs have been implicated in a diverse array of biological and pathological phenomena. Their potential utility as noninvasive biomarkers for screening and diagnosing various diseases has been proposed. OBJECTIVE This study aimed to explore the potential role of the miRNAs miR-122 and miR-486 as molecular biomarkers in the pathogenesis of hepatitis C virus (HCV) infection. Thus, miR-122 and miR-486 were detected in the serum of HCV patients and healthy controls. Moreover, the potential correlations of miR-122 and miR-486 with viral complications, such as physical activity, pain, muscle fatigue, and HCV infection, were identified. METHODS A total of 150 subjects aged 30 to 66 years were included in this study. The patients were classified as patients with chronic hepatitis C virus (CHC) (n = 110) or healthy controls (n = 40). Real-time polymerase chain reaction (PCR) analyses were performed to determine miR-122 and miR-486 expression. Physical activity (PA), pain score, HCV genotyping, viral overload, aspartate transaminase (AST), alanine transaminase (ALT), lactic acid dehydrogenase (LDH), creatine kinase (CK), and antioxidant status were also estimated by using prevalidated questionnaires, PCR, and spectrophotometric analyses. RESULTS Compared with those in normal controls, significant increases in the serum levels of miR-122 and miR-486 were reported in patients with CHC. In physically active CHC patients, there was a significant correlation between the expression of miRNAs and increased alanine transaminase (ALT), aspartate transaminase (AST), fibrosis scores, and inflammation activity, but no association was reported for hepatitis C virus (HCV) RNA or viral load. Additionally, significant decreases in LDH, CK, GSSG, and pain scores and increases in TAC, GSH, and the GSH/GSSG ratio were reported. Moreover, the expression of miR-122 and miR-486 was positively correlated with changes in body mass index (BMI) and liver fibrosis stage, as well as negatively correlated with sex, PA, TAC, GSH, GSSG, and the GSH/GSSG ratio. CONCLUSION MiR-122 and miR-486 expression levels were strongly correlated with physical activity, pain perception, and muscle fatigue biomarkers in HCV-infected patients. These miRNA levels were associated with elevated AST, ALT, fibrosis scores, LDH, CK, and antioxidant status, thus suggesting their potential as biomarkers for disease severity and oxidative stress. However, no correlation was observed with viral load or HCV-RNA expression, thus implying that these miRNAs may impact disease progression and symptoms through host factors, rather than directly affecting viral replication. In summary, the results demonstrated that molecular studies of miR-22 and miR-468 and their associations with PA, pain, adiposity, sex differences, and muscle fatigue, as well as routine biomarkers, could be useful as prognostic nanoninvasive biomarkers, thus providing novel therapeutic targets for CHC infection.
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Affiliation(s)
- Hadeel A Al-Rawaf
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
| | - Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
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2
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Galvão-Moreira LV, de Castro LO, Moura ECR, de Oliveira CMB, Nogueira Neto J, Gomes LMRDS, Leal PDC. Pool-based exercise for amelioration of pain in adults with fibromyalgia syndrome: A systematic review and meta-analysis. Mod Rheumatol 2021; 31:904-911. [PMID: 32990113 DOI: 10.1080/14397595.2020.1829339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the effects of pool-based exercises on pain symptomatology among adults with fibromyalgia syndrome. METHODS A systematic review and meta-analysis were carried out using PRISMA guidelines. Database search was conducted by two independent reviewers. For meta-analysis, the visual analogue scale (VAS) score for pain was used as the primary outcome and the Fibromyalgia Impact Questionnaire (FIQ) score was utilized as the secondary outcome. RESULTS A total of 42 out of 292 potentially eligible studies were selected for being read in full by reviewers, 14 of which were included in meta-analysis, being 10 of them used in sensitivity analysis of either the primary or secondary outcome. Data pooled from 10 randomized controlled trials (n = 508) revealed that patients who underwent pool-based exercises exhibited a significantly lower mean in VAS score as compared to controls (SMD = -0.27, 95% CI: -0.45 to -0.09). Regarding FIQ scores, data from 10 randomized controlled trials were pooled (n = 578) and a lower mean score was also shown in the group that underwent a pool-based exercise program (SMD = -0.29, 95% CI: -0.49 to -0.09). Limitations of this study include the small sample size and moderate dropout rates in currently available clinical trials. CONCLUSION Pool-based exercise may provide some additional benefit for pain relief in adults with fibromyalgia as compared to either land-based or no physical exercise. IMPLICATIONS OF KEY FINDINGS Collectively, these findings suggest that pool-based exercise deserves further attention as a potential adjuvant therapeutic option for adults with fibromyalgia. PROSPERO registration number: CRD42019136755.
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Affiliation(s)
| | | | | | | | - João Nogueira Neto
- Department of Medicine I, Federal University of Maranhão, São Luís, Brazil
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3
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Abstract
OBJECTIVES To gain deeper knowledge of factors promoting physical activity in women with fibromyalgia. DESIGN A qualitative study based on semistructured in-depth individual interviews. Analysed using qualitative content analysis. PARTICIPANTS Fourteen women with fibromyalgia, age 38-65, recruited from a previous randomised controlled trial investigating the effects of person-centred progressive resistance exercise compared with relaxation therapy. SETTING Interviews were conducted in a hospital setting. RESULTS The analysis resulted in four categories: a desire to be physically active, finding the proper level and creating proper conditions, managing pain and getting it done. CONCLUSION This study reveals several factors both personal and environmental, which promote the ability to be physically active when living with pain and other symptoms of fibromyalgia. The participants expressed that, although they had a desire to be physically active, they needed support and guidance from a professional with adequate knowledge to help them find the proper level of exercise. They also expressed a need for the professional to understand their preferences, and to use these preferences as a basis for creating the proper conditions, helping them learn to manage pain and supporting them in getting the exercise done.
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Affiliation(s)
- Anette Larsson
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Feldthusen
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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4
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Aquatic exercise and Far Infrared (FIR) modulates pain and blood cytokines in fibromyalgia patients: A double-blind, randomized, placebo-controlled pilot study. J Neuroimmunol 2019; 337:577077. [DOI: 10.1016/j.jneuroim.2019.577077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/27/2019] [Accepted: 09/27/2019] [Indexed: 01/19/2023]
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5
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Abstract
Fibromyalgia is a syndrome characterized by generalized chronic musculoskeletal pain, hyperalgesia in specific points, and psychosomatic symptoms, such as fatigue, sleep disturbances (waking unrefreshed), anxiety, depression, cognitive dysfunction, headache, and gastrointestinal disorders. Investigations with non-pharmacological therapies, focused on physical therapy, have increased in recent years as alternative therapies for the treatment of fibromyalgia. The purpose of this review is to summarize the main physical therapy modalities used to treat fibromyalgia.
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Affiliation(s)
- Fernanda Mendonça Araújo
- Graduate Program in Physiological Science, Federal University of Sergipe, Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil
| | - Josimari Melo DeSantana
- Graduate Program in Physiological Science, Federal University of Sergipe, Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil.,Department of Physical Therapy, Federal University of Sergipe, Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil
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Pastor-Mira MA, López-Roig S, Peñacoba C, Sanz-Baños Y, Lledó A, Velasco L. Predicting walking as exercise in women with fibromyalgia from the perspective of the theory of planned behavior. Women Health 2019; 60:412-425. [DOI: 10.1080/03630242.2019.1662869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Sofía López-Roig
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Cecilia Peñacoba
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Medical Microbiology and Immunology, Faculty of Health Sciences, King Juan Carlos University, Alcorcón, Madrid, Spain
| | - Yolanda Sanz-Baños
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Ana Lledó
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Lilian Velasco
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Medical Microbiology and Immunology, Faculty of Health Sciences, King Juan Carlos University, Alcorcón, Madrid, Spain
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Abstract
The primary aim of this study was to evaluate activity rhythms in fibromyalgia syndrome (FMS) and their association with FMS-related symptoms. We hypothesized that stronger and more consistent activity rhythms would be associated with reduced symptom severity and presentation in FMS. Two hundred ninety-two patients with FMS (mean age = 45.1 ± 11.1; 272 women) provided a 7-day actigraphy recording and responses to questionnaires addressing degree of pain, fatigue, mood, and physical impairment. Using a simple cosine model, we extracted Amplitude (activity range), Phi (time at maximum), Mesor (mean activity), and their variabilities (across days) from each participant's actigraphy. The clinical and actigraphic measures were operationally independent. There was a significant canonical relationship between activity rhythm parameters and clinical FMS measures (r = 0.376, R = 0.14, P < 0.001). The set of Mesor, Amplitude, and Phi activity parameters remained associated with clinical measures when controlled statistically for both demographics and activity variability (P < 0.001). Each activity parameter provided unique discrimination of the clinical set by multivariate test (P = 0.003, 0.018, and 0.007 for Amplitude, Phi, and Mesor, respectively). These results revealed that better pain, fatigue, mood, physical impairment, and sleep outcomes were associated with higher activity range and more rhythmicity (Amplitude), increased mean activity (Mesor), and with earlier timing of peak activity (Phi). Exploratory analyses revealed significantly worse sleep for individuals with low Amplitude and more delayed Phi.
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8
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Plasma Cytokine Levels in Fibromyalgia and Their Response to 15 Weeks of Progressive Resistance Exercise or Relaxation Therapy. Mediators Inflamm 2018; 2018:3985154. [PMID: 29849487 PMCID: PMC5932448 DOI: 10.1155/2018/3985154] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/27/2018] [Accepted: 02/13/2018] [Indexed: 01/12/2023] Open
Abstract
The aims of this study were to compare circulating cytokines between FM and healthy controls and to investigate the effect on cytokine levels by 15 weeks of progressive resistance exercise or relaxation therapy in FM. Baseline plasma cytokine levels and clinical data were analyzed in 125 women with FM and 130 age-matched healthy women. The FM women were then randomized to progressive resistance exercise (n = 49) or relaxation (n = 43). Baseline IL-2, IL-6, TNF-α, IP-10, and eotaxin were higher in FM than in healthy controls (P < 0.041), whereas IL-1β was lower (P < 0.001). There were weak correlations between cytokine levels and clinical variables. After both interventions, IL-1ra had increased (P = 0.004), while IL-1β had increased in the relaxation group (P = 0.002). Changes of IFN-γ, IL-2, IL-4, IL-6, IL-8, and IL-17A were weakly correlated with changes of PPT, but there were no significant correlations between changes of cytokine and changes in other clinical variables. The elevated plasma levels of several cytokines supports the hypothesis that chronic systemic inflammation may underlie the pathophysiology of FM even if the relation to clinical variables was weak. However, 15 weeks of resistance exercise, as performed in this study, did not show any anti-inflammatory effect on neither FM symptoms nor clinical and functional variables. This trial is registered with ClinicalTrials.govNCT01226784, registered October 21, 2010. The first patient was recruited October 28, 2010.
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9
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Fritz TH, Bowling DL, Contier O, Grant J, Schneider L, Lederer A, Höer F, Busch E, Villringer A. Musical Agency during Physical Exercise Decreases Pain. Front Psychol 2018; 8:2312. [PMID: 29387030 PMCID: PMC5776142 DOI: 10.3389/fpsyg.2017.02312] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/20/2017] [Indexed: 01/19/2023] Open
Abstract
Objectives: When physical exercise is systematically coupled to music production, exercisers experience improvements in mood, reductions in perceived effort, and enhanced muscular efficiency. The physiology underlying these positive effects remains unknown. Here we approached the investigation of how such musical agency may stimulate the release of endogenous opioids indirectly with a pain threshold paradigm. Design: In a cross-over design we tested the opioid-hypothesis with an indirect measure, comparing the pain tolerance of 22 participants following exercise with or without musical agency. Method: Physical exercise was coupled to music by integrating weight-training machines with sensors that control music-synthesis in real time. Pain tolerance was measured as withdrawal time in a cold pressor test. Results: On average, participants tolerated cold pain for ~5 s longer following exercise sessions with musical agency. Musical agency explained 25% of the variance in cold pressor test withdrawal times after factoring out individual differences in general pain sensitivity. Conclusions: This result demonstrates a substantial pain reducing effect of musical agency in combination with physical exercise, probably due to stimulation of endogenous opioid mechanisms. This has implications for exercise endurance, both in sports and a multitude of rehabilitative therapies in which physical exercise is effective but painful.
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Affiliation(s)
- Thomas H. Fritz
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
- Institute for Psychoacoustics and Electronic Music, University of Ghent, Ghent, Belgium
| | - Daniel L. Bowling
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
| | - Oliver Contier
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Joshua Grant
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lydia Schneider
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Annette Lederer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Felicia Höer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Eric Busch
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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10
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Exercise Perception and Behaviors in Individuals Living with Primary Immunodeficiency Disease. J Clin Immunol 2018; 38:174-184. [PMID: 29307028 DOI: 10.1007/s10875-017-0472-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/20/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Routine exercise has been established as an effective way to improve overall health. The value of exercise has been established in many diseases, however, there are no studies investigating the impact of exercise for individuals with primary immunodeficiency disease (PID). The purpose of this study was to investigate exercise perceptions and behaviors in individuals diagnosed with PID. METHODS An online survey was distributed over a four-week period. RESULTS Of the 264 responses collected, most were females, 45-54 years old. Respondents reported a measurable loss of function impairing their daily activities due to loss of mobility/physical activity (41.32%), or loss of lung/pulmonary function (40.08%,). They felt exercise decreased stress level and improved their mental well-being (46.25%). Some indicated they participate in exercise (33.20%), while 36.84% had not participated in exercise for at least 1 year. Exercise was limited primarily due to fatigue (86.97%). CONCLUSION Exercise is important for those with chronic medical conditions. Most individuals living with PID can participate in low/moderate physical activity, but struggle with vigorous physical activity, since fatigue is the greatest barrier. Respondents view exercise as beneficial, and would like to increase participation in an exercise program.
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11
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Physical and occupational therapy outcomes: Adolescents' change in functional abilities using objective measures and self-report. Scand J Pain 2017; 14:60-66. [PMID: 28850431 DOI: 10.1016/j.sjpain.2016.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE This study evaluates the clinical usefulness of patient-rated and objective measures to identify physically-oriented functional changes after an intensive chronic pain program in a pediatric setting. Past studies have demonstrated the importance of adolescents' perception of their abilities and measurement tools used for rehabilitation outcomes within physical and occupational therapy; however, these tools used are not often easily utilized or have not been examined with a pediatric chronic pain population. In chronic pain rehabilitation, it is important to have a primary focus on functional improvement not on pain reduction as a leading outcome. This study examines how both self-report and objective physical activity measures can be meaningful constructs and can be used as reliable outcome measures. It was hypothesized that adolescents completing an interdisciplinary pain rehabilitation program would report functional gains from admission to discharge, and that perceived gains in physical ability would be associated with objective physical activities. Further, it was hypothesized that gains in functioning would be associated with mild pain reduction. METHODS Data from 78 children and adolescents with chronic pain that participated in an intensive multidisciplinary treatment program completed self-report measures including the Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI). In addition, adolescents were objectively monitored for repetitions of selected physical activities for 1min intervals. RESULTS Data demonstrated significant gains in all measures of functioning during the program. Correlations between self-report and objective outcomes suggest they are measuring similar yet distinct factors. CONCLUSIONS The LEFS, UEFI, and objective exercises provide a meaningful way to track progress in pediatric chronic pain rehabilitation. Despite similarities, they appear to track separate but related aspects of rehabilitation and capture important short-term response to rehabilitation. Both measures appear distinct from pain as an outcome. These findings increase our understanding of rehabilitation practices provide opportunities to promote clinical improvement in pediatric pain. IMPLICATIONS The use of self-report measures along with objective measures can help therapists gain understanding in regards to a patient's insight and how that may impact their overall outcome compared to the use of a single outcome measure. Viewing these rated measures at any point in the rehabilitation process can be useful to facilitate discussion about challenges they can identify and how therapies can facilitate improvement and functional gains.
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Abstract
Systemic lupus erythematosus (SLE) is a rheumatic disease characterized by a variety of symptoms, especially fatigue, pain and reduced quality of life. Physical exercise is a useful tool for improving cardiovascular fitness, reducing metabolic abnormalities and fatigue and improving quality of life. However, very few studies have focused on the relationship between SLE and physical exercise. This paper reviews the main SLE symptoms that can be alleviated by exercising, as well as the results of studies seeking to analyse the exercise capacity and physical training possibilities of SLE patients. Considerations for future research are also discussed.
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Affiliation(s)
- C Ayán
- Department of Physiology, National Institute of Physical Activity and Sport Science, University of León, Spain.
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13
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Ericsson A, Mannerkorpi K. How to manage fatigue in fibromyalgia: nonpharmacological options. Pain Manag 2016; 6:331-8. [PMID: 27297077 DOI: 10.2217/pmt-2016-0015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this article is to suggest recommendations for the management of fatigue in fibromyalgia (FM) by reviewing and compiling findings of nonpharmacological treatment for fatigue in patients with FM. The management of fatigue in FM should incorporate regular physical exercise maintained for a longer period of time, which contributes to improved general health and facilitates coping with fatigue and other symptoms. The evidence is still low and the effect of exercise on fatigue in FM needs to be further studied. Patients with FM appear to benefit from general sleep hygiene advice and also need to develop individual strategies to manage the complex factors in everyday life that may be related to fatigue.
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Affiliation(s)
- Anna Ericsson
- University of Gothenburg, Sahlgrenska Academy, Institution of Neuroscience & Physiology - Section of Health & Rehabilitation, Physiotherapy, Göteborg, Sweden.,Närhälsan Research & Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Kaisa Mannerkorpi
- University of Gothenburg, Sahlgrenska Academy, Institution of Neuroscience & Physiology - Section of Health & Rehabilitation, Physiotherapy, Göteborg, Sweden
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14
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Ernberg M, Christidis N, Ghafouri B, Bileviciute-Ljungar I, Löfgren M, Larsson A, Palstam A, Bjersing J, Mannerkorpi K, Kosek E, Gerdle B. Effects of 15 weeks of resistance exercise on pro-inflammatory cytokine levels in the vastus lateralis muscle of patients with fibromyalgia. Arthritis Res Ther 2016; 18:137. [PMID: 27296860 PMCID: PMC4906587 DOI: 10.1186/s13075-016-1041-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed at investigating the effect of a resistance exercise intervention on the interstitial muscle levels of pro-inflammatory cytokines in fibromyalgia (FMS) and healthy controls (CON). Methods Twenty-four female patients with FMS (54 ± 8 years) and 27 female CON (54 ± 9 years) were subjected to intramuscular microdialysis of the most painful vastus lateralis muscle before and after 15 weeks of progressive resistance exercise twice per week. Baseline dialysates were sampled in the resting muscle 140 min after insertion of the microdialysis catheter. The participants then performed repetitive dynamic contractions (knee extension) for 20 min, followed by 60 min rest. Pain intensity was assessed with a 0–100 mm visual analogue scale (VAS), and fatigue was assessed with Borg’s RPE throughout microdialysis. Dialysates were sampled every 20 min and analyzed with Luminex for interleukin (IL)-1β, tumor necrosis factor (TNF) alpha, IL-6, and IL-8. Results At both sessions and for both groups the dynamic contractions increased pain (P < 0.012) and fatigue (P < 0.001). The levels of TNF were lower in the FMS group than the CON group at both sessions (P < 0.05), but none of the other cytokines differed between the groups. IL-6 and IL-8 increased after the dynamic contractions in both groups (P < 0.010), while TNF increased only in CON (P < 0.05) and IL-1β did not change. Overall pain intensity was reduced after the 15 weeks of resistance exercise in FMS (P < 0.05), but there was no changes in fatigue or cytokine levels. Conclusion Progressive resistance exercise for 15 weeks did not affect the interstitial levels of IL-1β, TNF, IL-6, and IL-8 in the vastus lateralis muscle of FMS patients or CON. Trial registration Clinicaltrials.gov NCT01226784, registered 21 October 2010.
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Affiliation(s)
- Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), SE-141 04, Huddinge, Sweden.
| | - Nikolaos Christidis
- Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), SE-141 04, Huddinge, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institutet, and Department of Rehabilitation Medicine, Danderyd Hospital, SE-182 88, Stockholm, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, and Department of Rehabilitation Medicine, Danderyd Hospital, SE-182 88, Stockholm, Sweden
| | - Anette Larsson
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Göteborg, Sweden.,University of Gothenburg Centre for Person-centred Care (GPCC), Sahlgrenska Academy, SE-405 30, Göteborg, Sweden
| | - Annie Palstam
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Göteborg, Sweden
| | - Jan Bjersing
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Göteborg, Sweden
| | - Kaisa Mannerkorpi
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Göteborg, Sweden.,University of Gothenburg Centre for Person-centred Care (GPCC), Sahlgrenska Academy, SE-405 30, Göteborg, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Stockholm Spine Center, SE-194 89, Stockholm, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
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15
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López-Roig S, Pastor MÁ, Peñacoba C, Lledó A, Sanz Y, Velasco L. Prevalence and predictors of unsupervised walking and physical activity in a community population of women with fibromyalgia. Rheumatol Int 2016; 36:1127-33. [DOI: 10.1007/s00296-016-3508-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/26/2016] [Indexed: 01/29/2023]
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16
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Ekici G, Unal E, Akbayrak T, Vardar-Yagli N, Yakut Y, Karabulut E. Effects of active/passive interventions on pain, anxiety, and quality of life in women with fibromyalgia: Randomized controlled pilot trial. Women Health 2016; 57:88-107. [DOI: 10.1080/03630242.2016.1153017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Kas T, Colby M, Case M, Vaughn D. The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program. J Bodyw Mov Ther 2016; 20:774-783. [PMID: 27814858 DOI: 10.1016/j.jbmt.2016.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/18/2016] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program. PARTICIPANTS Patients between the ages of 18-65 with the medical diagnosis of FM. METHODS Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises. OUTCOME MEASURES The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL). RESULTS Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant. CONCLUSIONS This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening.
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Affiliation(s)
- Tamara Kas
- Grand Valley State University, HRRC File No. 14-003-H, USA
| | - Megan Colby
- Grand Valley State University, HRRC File No. 14-003-H, USA.
| | - Maureen Case
- Grand Valley State University, HRRC File No. 14-003-H, USA
| | - Dan Vaughn
- Grand Valley State University, Cook-DeVos Center for Health Science, 301 Michigan St. NE, Grand Rapids, MI 49503, USA
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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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Moukaddem A, Chaaya M, Slim ZFN, Jaffa M, Sibai AM, Uthman I. Fibromyalgia: epidemiology and risk factors, a population-based case-control study in Lebanon. Int J Rheum Dis 2015; 20:169-176. [PMID: 26172074 DOI: 10.1111/1756-185x.12701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM To investigate the epidemiology of fibromyalgia (FM) and assess its risk factors. METHODS Using data from the 2009 Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study conducted in Lebanon, a population-based case control study was performed. The sample included 34 FM patients, frequency matched with 136 controls free from any musculoskeletal complaints and randomly sampled from the population. The controls were frequency matched with cases by age and gender. RESULTS The 34 female FM cases were prevalent cases which existed for a long period of time and all those who consulted a doctor were previously misdiagnosed. Family history of joint problems (OR = 4.93, 95% CI: 1.56-15.58) and working status (OR = 2.69, 95% CI: 1.04-6.93) were significant risk factors for FM, after adjusting for body mass index, distress level, smoking status and residence location. CONCLUSION This was the first study to address the epidemiology of FM in Lebanon and the region. The chronic nature of FM that is characterized by frequent bouts of intense disabling pain and symptoms constitutes a significant health and economic burden. Clustering of cases in coastal areas was partially explained by other factors such as body mass index, distress level, smoking and work status. The high burden of FM found in our study calls for further investigation of potential risk factors of this condition.
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Affiliation(s)
- Afaf Moukaddem
- Department of Epidemiology & Population Health, American University of Beirut, Beirut, Lebanon
| | - Monique Chaaya
- Department of Epidemiology & Population Health, American University of Beirut, Beirut, Lebanon
| | - Zeinab F N Slim
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Miran Jaffa
- Department of Epidemiology & Population Health, American University of Beirut, Beirut, Lebanon
| | - Abla Mehio Sibai
- Department of Epidemiology & Population Health, American University of Beirut, Beirut, Lebanon
| | - Imad Uthman
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Sevimli D, Kozanoglu E, Guzel R, Doganay A. The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome. J Phys Ther Sci 2015; 27:1781-6. [PMID: 26180320 PMCID: PMC4499983 DOI: 10.1589/jpts.27.1781] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/26/2015] [Indexed: 01/14/2023] Open
Abstract
[Purpose] There are various treatment modalities for fibromyalgia syndrome (FMS), which
is characterized by widespread pain and fatigue. The aim of this study was to investigate
the effects of aquatic, aerobic and isometric strength-stretching exercises on the
physical and psychological parameters of patients with FMS. [Subjects and Methods] Seventy
five female patients with FMS were randomly selected and divided into three groups.
Patients (18–50 years) were treated for 3 months using one of three methods: a home-based
isometric strength and stretching exercise program (ISSEP), a gym-based aerobic exercise
program (AEP), and a pool-based aquatic aerobic exercise program (AAEP). Items evaluated
were: the number of tender points, Visual Analog Scale (VAS), Fibromyalgia Impact
Questionnaire (FIQ), the Six-Minute Walk Test (6MWT), SF-36 physical and mental health
scores, and the Beck Depression Inventory (BDI). [Results] The results revealed that AAEP
was the most effective treatment of the three. All of the groups showed significant
improvements in all variables between pre-and post-test, except the mean values of VAS and
BDI in ISSEP. [Conclusion] The results suggest that aquatic aerobic exercise program is
more effective than AEP and ISSEP in the treatment of FMS.
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Affiliation(s)
- Dilek Sevimli
- Coaching Department, School of Physical Education and Sports, Cukurova University, Turkey
| | - Erkan Kozanoglu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Turkey
| | - Rengin Guzel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Turkey
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Letieri RV, Furtado GE, Letieri M, Góes SM, Pinheiro CJB, Veronez SO, Magri AM, Dantas EM. Pain, quality of life, self perception of health and depression in patients with fibromyalgia, submited to hydrokinesiotherapy. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 53:494-500. [PMID: 24477728 DOI: 10.1016/j.rbr.2013.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 04/07/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to analyze the effects of treatment by hydrotherapy on quality of life, perception of pain and the severity of depression in a group of patients with fibromyalgia. MATERIALS AND METHODS We evaluated 64 females divided into two groups: hydrocinesiotherapy (n = 33, 58.2 ± 10.6 years) and control group (n = 31 with 59.6 ± 9.4 years) with clinical diagnosis of fibromyalgia. Individuals were assessed by Visual Analog Scale of Pain (VAS), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory. Participants underwent a treatment in a hydrotherapy pool heated to 33ºC over a period of 15 weeks, two sessions per week of 45 minutes, a total of 30 sessions. The exercises were underwater: cardiovascular conditioning, strength training, mobility, coordination, balance and still, stretching exercises and muscle relaxation. The ANOVA 2 × 2 and Kruskall-Wallis was used for statistical analysis RESULTS There were statistically significant improvements in the perception of pain intensity (Δ% = -28.2%, p < 0, 01), quality of life (Δ% = -32.4%, p < 0, 05) and depression symptoms (Δ% = -35.4%, p < 0, 05) in favor of the Hydrotherapy group compared to the control group. CONCLUSIONS The study suggests that hydrocinesiotherapy was effective as an alternative therapy for fibromyalgia, however further studies are recommended to test the associations between the variables and intervention programs and using the water activities, and the modifiability of the parameters of physical and mental health when these individuals undergo programs of short, medium and long duration.
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Bote ME, García JJ, Hinchado MD, Ortega E. An exploratory study of the effect of regular aquatic exercise on the function of neutrophils from women with fibromyalgia: role of IL-8 and noradrenaline. Brain Behav Immun 2014; 39:107-12. [PMID: 24257330 DOI: 10.1016/j.bbi.2013.11.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 11/08/2013] [Accepted: 11/08/2013] [Indexed: 02/04/2023] Open
Abstract
Fibromyalgia (FM) syndrome is associated with elevated systemic inflammatory and stress biomarkers, and an elevated innate cellular response mediated by monocytes and neutrophils. Exercise is accepted as a good non-pharmacological therapy for FM. We have previously found that regular aquatic exercise decreases the release of inflammatory cytokines by monocytes from FM patients. However, its effects on the functional capacity of neutrophils have not been studied. The aim of the present exploratory study was to evaluate, in 10 women diagnosed with FM, the effect of an aquatic exercise program (8months, 2sessions/week, 60min/session) on their neutrophils' function (phagocytic process), and on IL-8 and NA as potential inflammatory and stress mediators, respectively. A control group of 10 inactive FM patients was included in the study. After 4months of the exercise program, no significant changes were observed in neutrophil function (chemotaxis, phagocytosis, or fungicidal capacity) or in IL-8 and NA. However, at the end of the exercise program (8months), a neuro-immuno-endocrine adaptation was observed, manifested by a significant decrease to values below those in the basal state in neutrophil chemotaxis, IL-8, and NA. No significant seasonal changes in these parameters were observed during the same period in the group of non-exercised FM patients. After the 8months of the exercise program, the FM patients had lower concentrations of IL-8 and NA together with reduced chemotaxis of neutrophils compared with the values determined in the same month in the control group of non-exercised FM women. These results suggest that "anti-inflammatory" and "anti-stress" adaptations may be contributing to the symptomatic benefits that have been attributed to regular aquatic exercise in FM syndrome, as was corroborated in the present study by the scores on the Fibromyalgia Impact Questionnaire.
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Affiliation(s)
- M E Bote
- Immunophysiology Research Group, Department of Physiology, Science Faculty, University of Extremadura, Spain
| | - J J García
- Immunophysiology Research Group, Department of Physiology, Science Faculty, University of Extremadura, Spain
| | - M D Hinchado
- Immunophysiology Research Group, Department of Physiology, Science Faculty, University of Extremadura, Spain
| | - E Ortega
- Immunophysiology Research Group, Department of Physiology, Science Faculty, University of Extremadura, Spain.
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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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Bozkurt M, Oktayoglu P, Em S, Çaglayan M, Yuksel H, Uçar D, Batmaz İ, Sarıyıldız MA, Karatoprak S, Nas K. Serum Coenzyme Q10 Levels and Oxidative Status in Patients with Fibromyalgia Syndrome. ACTA ACUST UNITED AC 2014. [DOI: 10.3109/10582452.2014.883040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Wright SA, McVeigh JG, Finch MB. Discussion paper - Fibromyalgia syndrome and bone health. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331904225005070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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26
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McKenna O, Blake C. Management of hepatitis C: the potential benefits of exercise. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331907x223065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ghafouri N, Ghafouri B, Larsson B, Stensson N, Fowler CJ, Gerdle B. Palmitoylethanolamide and stearoylethanolamide levels in the interstitium of the trapezius muscle of women with chronic widespread pain and chronic neck-shoulder pain correlate with pain intensity and sensitivity. Pain 2013; 154:1649-1658. [PMID: 23707281 DOI: 10.1016/j.pain.2013.05.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 05/01/2013] [Indexed: 12/25/2022]
Abstract
Chronic widespread pain (CWP) is a complex condition characterized by central hyperexcitability and altered descending control of nociception. However, nociceptive input from deep tissues is suggested to be an important drive. N-Acylethanolamines (NAEs) are endogenous lipid mediators involved in regulation of inflammation and pain. Previously we have reported elevated levels of the 2 NAEs, the peroxisome proliferator-activated receptor type-α ligand N-palmitoylethanolamine (PEA) and N-stearoylethanolamine (SEA) in chronic neck/shoulder pain (CNSP). In the present study, the levels of PEA and SEA in women with CWP (n=18), CNSP (n=34) and healthy controls (CON, n=24) were investigated. All subjects went through clinical examination, pressure pain threshold measurements and induction of experimental pain in the tibialis anterior muscle. Microdialysis dialysate of the trapezius was collected before and after subjects performed a repetitive low-force exercise and analyzed by mass spectrometry. The levels of PEA and SEA in CNSP were significantly higher post exercise compared with CWP, and both pre and post exercise compared with CON. Levels of both NAEs decreased significantly pre to post exercise in CWP. Intercorrelations existed between aspects of pain intensity and sensitivity and the level of the 2 NAEs in CWP and CNSP. This is the first study demonstrating that CNSP and CWP differ in levels of NAEs in response to a low-force exercise which induces pain. Increases in pain intensity as a consequence of low-force exercise were associated with low levels of PEA and SEA in CNSP and CWP. These results indicate that PEA and SEA have antinociceptive roles in humans.
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Affiliation(s)
- Nazdar Ghafouri
- Rehabilitation Medicine, Department of Medicine and Health Sciences, Linköping University, SE 581 85 Linköping, Sweden Pain and Rehabilitation Centre, UHL, County Council of Östergötland, SE 581 85 Linköping, Sweden Department of Pharmacology and Clinical Neuroscience, Umeå University, SE 901 87 Umeå, Sweden Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE 581 85 Linköping, Sweden Centre of Occupational and Environmental Medicine, County Council of Östergötland, SE 581 85 Linköping, Sweden
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Panton L, Simonavice E, Williams K, Mojock C, Kim JS, Kingsley JD, McMillan V, Mathis R. Effects of Class IV laser therapy on fibromyalgia impact and function in women with fibromyalgia. J Altern Complement Med 2012; 19:445-52. [PMID: 23176373 DOI: 10.1089/acm.2011.0398] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study evaluated the effects of Class IV laser therapy on pain, Fibromyalgia (FM) impact, and physical function in women diagnosed with FM. DESIGN The study was a double-blind, randomized control trial. SETTING Testing was completed at the university and Rheumatologist office and treatment was completed at a chiropractic clinic. PARTICIPANTS Thirty-eight (38) women (52±11 years; mean±standard deviation) with FM were randomly assigned to one of two treatment groups, laser heat therapy (LHT; n=20) or sham heat therapy (SHT; n=18). INTERVENTION Both groups received treatment twice a week for 4 weeks. Treatment consisted of application of LHT or SHT over seven tender points located across the neck, shoulders, and back. Treatment was blinded to women and was administered by a chiropractic physician for 7 minutes. OUTCOME MEASURES Participants were evaluated before and after treatment for number and sensitivity of tender points, completed the FM Impact Questionnaire (FIQ) and the pain question of the FIQ, and were measured for function using the continuous scale physical functional performance (CS-PFP) test. Data were evaluated using repeated-measures analysis of variance with significance accepted at p≤0.05. RESULTS There were significant interactions for pain measured by the FIQ (LHT: 7.1±2.3 to 6.2±2.1 units; SHT: 5.8±1.3 to 6.1±1.4 units) and for upper body flexibility measured by the CS-PFP (LHT: 71±17 to 78±12 units; SHT: 77±12 to 77±11 units) with the LHT improving significantly compared to SHT. There was a time effect for the measure of FM impact measured by the FIQ, indicating that FM impact significantly improved from pre- to post-treatment in LHT (63±20 to 57±18 units), while no change was observed in the SHT (57±11 to 55±12 units). CONCLUSIONS This study provides evidence that LHT may be a beneficial modality for women with FM in order to improve pain and upper body range of motion, ultimately reducing the impact of FM.
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Affiliation(s)
- Lynn Panton
- Department of Nutrition, Food and Exercise Sciences, The Florida State University, Tallahassee, FL 32306, USA.
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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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Gobbo M, Esteve-Vives J, Rivera J, Vallejo MÁ, Lopez-González R. Fibromyalgia Health Assessment Questionnaire: evaluación de la sensibilidad al cambio. ACTA ACUST UNITED AC 2012; 8:174-8. [DOI: 10.1016/j.reuma.2012.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/09/2012] [Accepted: 01/15/2012] [Indexed: 11/27/2022]
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Ortega E. ¿Por qué el ejercicio físico puede mejorar los síntomas de la fibromialgia? Med Clin (Barc) 2011; 137:405-7. [DOI: 10.1016/j.medcli.2010.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
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Hecker CD, Melo C, Tomazoni SDS, Martins RÁBL, Leal Junior ECP. Análise dos efeitos da cinesioterapia e da hidrocinesioterapia sobre a qualidade de vida de pacientes com fibromialgia: um ensaio clínico randomizado. FISIOTERAPIA EM MOVIMENTO 2011. [DOI: 10.1590/s0103-51502011000100007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Verificar e comparar os efeitos da hidrocinesioterapia e da cinesioterapia na qualidade de vida de pacientes portadoras de fibromialgia. MATERIAIS E MÉTODOS: Foi realizado um ensaio clínico randomizado, cego, para os avaliadores. Para avaliar a qualidade de vida, utilizou-se o questionário genérico SF-36 a fim de analisar os aspectos físicos e psicológicos em 24 pacientes do sexo feminino, portadoras de fibromialgia, com idade de 30 a 55 anos, alocadas aleatoriamente em dois grupos: hidrocinesioterapia e cinesioterapia. Durante um período de 23 semanas, as pacientes foram submetidas a alongamentos e exercícios aeróbios de baixa intensidade com duração de uma hora cada sessão (em ambos os grupos). RESULTADOS: Observou-se melhora estatisticamente significante (p < 0,05) na maior parte dos aspectos abordados pelo SF-36 em ambos os grupos. CONCLUSÃO: A hidrocinesioterapia promoveu um relaxamento muscular favorável para a melhora da qualidade de vida, porém, não foi o fator principal para amenizar os efeitos da patologia, uma vez que a cinesioterapia também proporcionou efeitos benéficos para a promoção do bem-estar dessas pacientes. Portanto, os alongamentos e os exercícios aeróbios de baixa intensidade empregados em ambos os protocolos são os prováveis responsáveis pelos efeitos benéficos observados nas duas modalidades terapêuticas analisadas.
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Sallinen M, Kukkurainen ML, Peltokallio L, Mikkelsson M. “I'm tired of being tired” – Fatigue as experienced by women with fibromyalgia. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/14038196.2010.546880] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The Interface of Pain and Mood Disturbances in the Rheumatic Diseases. Semin Arthritis Rheum 2010; 40:15-31. [DOI: 10.1016/j.semarthrit.2008.11.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 11/11/2008] [Accepted: 11/24/2008] [Indexed: 12/28/2022]
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Sallinen M, Kukkurainen ML, Peltokallio L, Mikkelsson M. Women's narratives on experiences of work ability and functioning in fibromyalgia. Musculoskeletal Care 2010; 8:18-26. [PMID: 19847817 DOI: 10.1002/msc.162] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fibromyalgia is a significant health problem for women of working age. However, little is known about the long-term effects of fibromyalgia in everyday life or on work ability. METHODS A narrative interview study was conducted to explore the experiences of work ability and functioning of patients with a long history of fibromyalgia. Twenty women, aged 34-65 years, were purposively chosen for the interviews, to reach a wide range of patients with different social and professional backgrounds. RESULTS Four types of experience concerning work ability were identified in the narratives: confusion, coping with fluctuating symptoms, being 'in between' and being over the edge of exhaustion. Severe pain and fatigue symptoms, combined with a demanding life situation and ageing, seemed to lead to substantial decrease in work ability and functioning over the long term. In the narratives, vocational rehabilitation or adjustments to work tasks were rarely seen or were started too late to be effective. CONCLUSIONS Exploring the life stories of women with fibromyalgia can reveal the perceived causes and consequences of fibromyalgia related to work ability or disability, which can be utilized in developing client-centred rehabilitation approaches and effective interventions to support work ability and avoid premature retirement in fibromyalgia patients.
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Affiliation(s)
- Merja Sallinen
- Rheumatism Foundation Hospital, Heinola, and Satakunta University of Applied Sciences, Pori, Finland.
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Ortega E, Bote ME, Giraldo E, García JJ. Aquatic exercise improves the monocyte pro- and anti-inflammatory cytokine production balance in fibromyalgia patients. Scand J Med Sci Sports 2010; 22:104-12. [PMID: 20536907 DOI: 10.1111/j.1600-0838.2010.01132.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Current hypotheses of the etiology of fibromyalgia (FM) include inflammatory disorders. We evaluated the effect of a pool-aquatic exercise program (8 months, two weekly 60-min sessions) on the inflammatory cytokine production by isolated monocytes, and on the serum concentration of C-reactive protein (CRP), in a group of female FM patients. Monocytes from FM patients released more IL-1β, TNFα, IL-6, and IL-10 than those from an age-matched control group of healthy women (HW). This inflammatory disorder in FM women was also manifested by high circulating concentrations of CRP. Increased IL-6 with a concomitant decreased TNFα spontaneous release was found after 4 months (midway through) of the exercise program. At the end of the program (8 months), monocytes from FM patients showed diminished spontaneous production of pro-/anti-inflammatory cytokines, with a similar spontaneous release of IL-1β and IL-6 to that of HW, but a lower production of TNFα and higher of IL-10. Lipopolysaccharide-induced production of IL-1β, TNFα, IL-6, and IL-10 also decreased at the end of the exercise program, although IL-10 remained higher than HW. The anti-inflammatory effect of the exercise program was also corroborated by a decrease in the circulating CRP concentration. Exercise also improved the health-related quality of life of FM patients.
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Affiliation(s)
- E Ortega
- Research Group in Immunophysiology: Exercise, Stress and Health, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain.
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Fibromyalgia Syndrome's New Paradigm: Neural Sensitization and Its Implications for Treatment. ACTA ACUST UNITED AC 2010. [DOI: 10.1300/j094v15n02_08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Mannerkorpi K. Physical Activity and Body Functions in Patients with Fibromyalgia Syndrome. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/10582450903088294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zanni GR. Diagnosing and treating fibromyalgia. THE CONSULTANT PHARMACIST : THE JOURNAL OF THE AMERICAN SOCIETY OF CONSULTANT PHARMACISTS 2009; 24:572-589. [PMID: 19689173 DOI: 10.4140/tcp.n.2009.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Characterized by chronic, widespread pain and heightened pain sensitivity, fibromyalgia affects up to 10 million adults. It is physically disabling and often is accompanied by chronic fatigue and psychiatric comorbidities. Individuals frequently see multiple providers before finding an answer about their condition; diagnosis is often a process of elimination. Etiology is unknown, but studies suggest fibromyalgia is a centrally mediated neurosensory disorder. Despite its recognition as an independent condition, debate continues with critics arguing fibromyalgia is a variant of other known disorders. Treatment consists of pharmacotherapy, psychotherapy, and exercise.
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Mannerkorpi K, Rivano-Fischer M, Ericsson A, Nordeman L, Gard G. Experience of physical activity in patients with fibromyalgia and chronic widespread pain. Disabil Rehabil 2009; 30:213-21. [PMID: 17852217 DOI: 10.1080/09638280701254160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Patients with fibromyalgia (FM) and chronic widespread pain (CWP) find physical activity troublesome. The purpose was to develop a questionnaire to investigate the experience of physical activity in FM and CWP populations. METHOD A questionnaire was developed from a qualitative study. After that, a total of 204 patients with FM or CWP completed the questionnaire. A factor analysis was conducted and the internal consistency was investigated. The relationship between the factors and pain, health status (the Fibromyalgia Impact Questionnaire, FIQ), distress (the Hospital Anxiety and Distress scale, HAD) and leisure time physical activity (the Leisure Time Physical Activity Instrument, LTPAI) was investigated. RESULTS Five factors were identified: Physical Relaxation (PR), Well-being (WB), Activity Beliefs (AB), Activity-related Symptoms (AS) and Activity Habits (AH). Cronbach's alpha ranged from 0.57 to 0.86. The PR showed a correlation (rho 0.28, p < 0.01) with the FIQ Pain. The AS showed a correlation (rho 0.25, p < 0.01) with the FIQ total score, while the AH showed a correlation with the HAD Depression (0.26, p < 0.01) and with strenuous physical activity (LTPAI) (-0.32, p < 0.01). CONCLUSION A new instrument was developed to study the experience of physical activity in persons with long-lasting pain. Five factors were identified using factor analysis, and three of them showed fair associations with FM symptoms, distress or physical activity.
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Affiliation(s)
- Kaisa Mannerkorpi
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
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Busch AJ, Overend TJ, Schachter CL. Fibromyalgia treatment: the role of exercise and physical activity. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/ijr.09.23] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Payen JL, Pillard F, Mascarell V, Rivière D, Couzigou P, Kharlov N. Is physical activity possible and beneficial for patients with hepatitis C receiving pegylated interferon and ribavarin therapy? ACTA ACUST UNITED AC 2009; 33:8-14. [DOI: 10.1016/j.gcb.2008.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 08/23/2008] [Accepted: 10/07/2008] [Indexed: 11/29/2022]
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[The fibromyalgia treatment with physical exercise in warm water reduces the impact of the disease on female patients' physical and mental health]. ACTA ACUST UNITED AC 2008; 3:33-7. [PMID: 21794393 DOI: 10.1016/s1699-258x(07)73596-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Accepted: 11/30/2006] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Fibromyalgia (FM) patients present pain, muscle stiffness, reduced physical condition and fatigue that limit their daily life activities. The purpose of this study was to evaluate the effects of the addition of 12 weeks of physical exercise in warm water to usual medical care on the impact of FM on physical and mental health in female patients. PATIENTS, MATERIALS AND METHODS Thirty four physically untrained females with FM were randomly assigned into two groups: an experimental group (n=17), to perform 3 weekly sessions for 60 minutes of physical exercise in warm water; and control group (n=17), who did not receive the additional treatment. The impact of the FM on patients' physical and mental health was assessed using the Fibromyalgia Impact Questionnaire (FIQ). RESULTS After 12 weeks of physical exercise, the experimental group showed improvements compared to the control group in physical function (35%, P=0.016), feel good (34%, P=0.003), job ability (14%, P=0.046), pain (26%, P=0.030), stiffness (33%, P=0.038), anxiety (36%, P=0.044), depression (26%, P=0.046), and FIQ total scores (27%, P=0.004). CONCLUSIONS The addition of the aquatic physical exercise programme to usual care was effective to decrease the impact of the disease on physical and mental health. However, the placebo effect could have contributed to this effectiveness.
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Bremander A, Bergman S. Non-pharmacological management of musculoskeletal disease in primary care. Best Pract Res Clin Rheumatol 2008; 22:563-77. [PMID: 18519105 DOI: 10.1016/j.berh.2008.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Musculoskeletal diseases as a group are one of the most common causes of contact in primary care and the most common causes of disability and long-term sick leave in several Western countries. Pain and dysfunction are often present without any specific findings in the musculoskeletal system, and a strictly biomedical approach is often inadequate. Body structure and function interact with personal and environmental factors, affecting the ability to perform activities and participate in society. It is important to meet these needs in primary care, and non-pharmacological principles such as physical activity and patient education with a cognitive approach are cornerstones in a multimodal management model.
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Affiliation(s)
- Ann Bremander
- Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, SE 313 92 Oskarström, Sweden
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The effectiveness of hydrotherapy in the management of fibromyalgia syndrome: a systematic review. Rheumatol Int 2008; 29:119-30. [PMID: 18751709 DOI: 10.1007/s00296-008-0674-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 08/01/2008] [Indexed: 10/21/2022]
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Chronic widespread pain in patients with occupational spinal disorders: prevalence, psychiatric comorbidity, and association with outcomes. Spine (Phila Pa 1976) 2008; 33:1889-97. [PMID: 18670343 DOI: 10.1097/brs.0b013e3181808c4e] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective study assessing chronic widespread pain (CWP) and psychiatric comorbidities in patients with chronic disabling occupational spinal disorders (CDOSDs). OBJECTIVE To assess the prevalence of CWP, demographic characteristics, and associated psychiatric comorbidity among CDOSD patients, as well as determine if CWP is a risk factor for less successful one-year postrehabilitation socioeconomic outcomes. SUMMARY OF BACKGROUND DATA CWP is an essential criterion for diagnosing fibromyalgia. CWP is estimated to affect between 4.1% to 13.5% of the general population and it is associated with higher rates of psychiatric disorders and growing rates of disability. The prevalence of CWP, or its associations as a comorbidity, in patients with CDOSDs are unknown. METHODS The socioeconomic outcomes, demographic characteristics, and psychiatric comorbidity of CDOSD patients with CWP were compared to non-CWP patients within a cohort of consecutive CDOSD patients (n = 2730), treated in an interdisciplinary functional restoration program. CWP was determined according to American College of Rheumatology criteria. Psychiatric comorbidity was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-fourth Edition at the beginning of the rehabilitation program. RESULTS.: In the CDOSD cohort, 32% of the patients (N = 878) met American College of Rheumatology criteria for CWP, relative to 4.1% to 13.5% within the general population. CWP patients (82%) were much more likely than non-CWP patients (16%) to have multisite pain complaints, leading to the finding that CDOSD patients with multisite pain showed a CWP prevalence of 70%. CWP patients were 1.5 times more likely to be female, more likely to have multiple compensable injuries, and had slightly elevated rates of pre- and postinjury Axis I psychopathology. Nevertheless, CWP was not associated with less successful 1-year socioeconomic outcomes. CONCLUSION A surprisingly high frequency of CDOSD patients participating in interdisciplinary rehabilitation met criteria for CWP, though the diagnosis was generally unknown to the patient. In this large workers' compensation cohort, CWP was not associated with longer periods of disability, more prerehabilitation surgery or higher pain self-report. With appropriate rehabilitation, CWP patients can have equally successful work return and health utilization outcomes compared to non-CWP patients, despite having significantly higher rates of certain psychiatric disorders.
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Ottawa Panel evidence-based clinical practice guidelines for strengthening exercises in the management of fibromyalgia: part 2. Phys Ther 2008; 88:873-86. [PMID: 18497302 DOI: 10.2522/ptj.20070115] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE The objective of this study was to create guidelines for the use of strengthening exercises in the management of adult patients (>18 years of age) with fibromyalgia (FM), as defined by the 1990 American College of Rheumatology criteria. METHODS Following Cochrane Collaboration methods, the Ottawa Methods Group found and synthesized evidence from comparative controlled trials and formed the Ottawa Panel, with nominated experts from key stakeholder organizations. The Ottawa Panel then developed criteria for grading the recommendations based on experimental design (I for randomized controlled trials, II for nonrandomized studies) and strength of evidence (A, B, C+, C, D+, D, or D-). From the rigorous literature search, 5 randomized controlled trials were selected. Statistical analysis was based on Cochrane Collaboration methods. Continuous data were calculated with weighted mean differences between the intervention and control groups, and dichotomous data were analyzed with relative risks. Clinical improvement was calculated using absolute benefit and relative difference in change from baseline. Clinical significance was attained when an improvement of 15% relative to a control was found. RESULTS There were 5 positive recommendations: 2 grade A and 3 grade C+. All 5 were of clinical benefit. DISCUSSION AND CONCLUSION The Ottawa Panel recommends strengthening exercises for the management of fibromyalgia as a result of the emerging evidence (grades A, B, and C+, although most trials were rated low quality) shown in the literature.
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Sarzi-Puttini P, Buskila D, Carrabba M, Doria A, Atzeni F. Treatment Strategy in Fibromyalgia Syndrome: Where Are We Now? Semin Arthritis Rheum 2008; 37:353-65. [DOI: 10.1016/j.semarthrit.2007.08.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Revised: 07/29/2007] [Accepted: 08/20/2007] [Indexed: 11/17/2022]
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Changes associated with a quota-based approach on a walking program for individuals with fibromyalgia. J Orthop Sports Phys Ther 2007; 37:717-24. [PMID: 18349477 DOI: 10.2519/jospt.2007.2607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Single-subject, multiple-baseline design across 3 subjects. OBJECTIVE To investigate the use of a quota-based approach to prescribing a walking program for individuals with fibromyalgia (FM). BACKGROUND Exercise has been found to be beneficial for individuals with FM. What has not been determined is the best way to implement an exercise program that does not increase FM symptoms. METHODS AND MEASURES Three women with FM were randomly assigned a baseline period of 5, 6, or 7 weeks, which served as the control phase, followed by an intervention period consisting of an 8-week walking program. The walking program progression was prescribed using a quota-based approach. Weekly outcome measures were the Fibromyalgia Impact Questionnaire (FIQ), Arthritis Self-Efficacy Scale (ASES), and SF-36v2 (acute). A 6-minute walk test was recorded twice: at the start of the baseline phase (after a trial phase) and at the end of the intervention phase. RESULTS Subjects 1 and 3 had a significant decrease in the symptoms associated with FM during the intervention phase (FIQ, P<.05), but no significant increase in self-efficacy (ASES). They increased their walking distances used for exercise by 640 and 480 m, respectively. Subject 2 had no significant improvements in her symptoms of FM. Despite a significant decrease in ASES (P<.05), walking distance used for exercise by subject 2 increased by 2080 m. Six-minute walk test distances increased 76, 32, and 106 m for subjects 1, 2, and 3, respectively. CONCLUSIONS Prescribing a walking program using a quota-based exercise prescription resulted in increasing the distance walked for 3 subjects. It also decreased symptoms associated with FM in 2 of the 3 subjects, but did not increase self-efficacy.
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