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Henley P, Martins T, Zamani R. Assessing Ethnic Minority Representation in Fibromyalgia Clinical Trials: A Systematic Review of Recruitment Demographics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7185. [PMID: 38131736 PMCID: PMC10742509 DOI: 10.3390/ijerph20247185] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The under-representation of non-White participants in Western countries in clinical research has received increased attention, due to recognized physiological differences between ethnic groups, which may affect the efficacy and optimal dosage of some treatments. This review assessed ethnic diversity in pharmaceutical trials for fibromyalgia, a poorly understood chronic pain disorder. We also investigated longitudinal change to non-White participant proportions in trials and non-White participants' likelihood to discontinue with fibromyalgia research between trial stages (retention). First, we identified relevant trials conducted in the United States and Canada between 2000 and 2022, by searching PubMed, Web of Science, Scopus, and the Cochrane Library databases. In trials conducted both across the United States and Canada, and exclusively within the United States, approximately 90% of participants were White. A longitudinal analysis also found no change in the proportion of non-White participants in trials conducted across the United States and Canada between 2000 and 2022. Finally, we found no significant differences in trial retention between White and non-White participants. This review highlights the low numbers of ethnic minorities in fibromyalgia trials conducted in the United States and Canada, with no change to these proportions over the past 22 years. Furthermore, non-White participants were not more likely to discontinue with the fibromyalgia research once they were recruited.
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Affiliation(s)
| | | | - Reza Zamani
- Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK (T.M.)
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Kundakci B, Kaur J, Goh SL, Hall M, Doherty M, Zhang W, Abhishek A. Efficacy of nonpharmacological interventions for individual features of fibromyalgia: a systematic review and meta-analysis of randomised controlled trials. Pain 2022; 163:1432-1445. [PMID: 34813518 DOI: 10.1097/j.pain.0000000000002500] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/15/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Fibromyalgia is a highly heterogeneous condition, but the most common symptoms are widespread pain, fatigue, poor sleep, and low mood. Nonpharmacological interventions are recommended as first-line treatment of fibromyalgia. However which interventions are effective for the different symptoms is not well understood. The objective of this study was to assess the efficacy of nonpharmacological interventions on symptoms and disease-specific quality of life. Seven databases were searched from their inception until June 1, 2020. Randomised controlled trials comparing any nonpharmacological intervention to usual care, waiting list, or placebo in people with fibromyalgia aged >16 years were included without language restriction. Fibromyalgia Impact Questionnaire (FIQ) was the primary outcome measure. Standardised mean difference and 95% confidence interval were calculated using random effects model. The risk of bias was evaluated using the modified Cochrane tool. Of the 16,251 studies identified, 167 randomised controlled trials (n = 11,012) assessing 22 nonpharmacological interventions were included. Exercise, psychological treatments, multidisciplinary modality, balneotherapy, and massage improved FIQ. Subgroup analysis of different exercise interventions found that all forms of exercise improved pain (effect size [ES] -0.72 to -0.96) and depression (ES -0.35 to -1.22) except for flexibility exercise. Mind-body and strengthening exercises improved fatigue (ES -0.77 to -1.00), whereas aerobic and strengthening exercises improved sleep (ES -0.74 to -1.33). Psychological treatments including cognitive behavioural therapy and mindfulness improved FIQ, pain, sleep, and depression (ES -0.35 to -0.55) but not fatigue. The findings of this study suggest that nonpharmacological interventions for fibromyalgia should be individualised according to the predominant symptom.
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Affiliation(s)
- Burak Kundakci
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- cCentre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Jaspreet Kaur
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Siew Li Goh
- Sports Medicine Unit, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Hall
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Division of Physiotherapy and Rehabilitation Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Michael Doherty
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Weiya Zhang
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Abhishek Abhishek
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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Development of ketorolac tromethamine loaded microemulsion for topical delivery using D-optimal experimental approach: Characterization and evaluation of analgesic and anti-inflammatory efficacy. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Essential oil therapy in rheumatic diseases: A systematic review. Complement Ther Clin Pract 2021; 43:101391. [PMID: 33865080 DOI: 10.1016/j.ctcp.2021.101391] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/04/2021] [Accepted: 04/04/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This paper aims to review articles that have evaluated the role of essential oil therapy in patients with rheumatic diseases. METHODOLOGY Systematic review. No study design or language limitation was applied. RESULTS We have identified 13 articles, most of them were used in osteoarthritis (n = 4), rheumatoid arthritis (n = 3) and fibromyalgia (n = 3). Two studies included patients with RA and OA (n = 2). The number of people involved in the study varied from 9 to 162, where female sex was observed in 60-100%. The age of the patients ranged from 36 to 78.3 years old and disease duration 1-11.67 years. The lavender essential oil was the most used, and then Ginger oil, Rosemary oil, and Rosmarinus officinalis. Time of oil use varied from 2 to 12 weeks. Importantly, all studies but one (91.6%) have demonstrated the efficacy of aromatherapy. CONCLUSION There are few reports on essential oils in rheumatic disease, mainly osteoarthritis, rheumatoid arthritis, and fibromyalgia. All but one study have showed the efficacy of this complementary therapy.
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Perry R, Leach V, Davies P, Penfold C, Ness A, Churchill R. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Syst Rev 2017; 6:97. [PMID: 28506257 PMCID: PMC5433031 DOI: 10.1186/s13643-017-0487-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/25/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process. METHODS Five databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events. RESULTS We identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited. CONCLUSIONS Overall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical Capsicum, but further research is required. There is some evidence to support the effectiveness of acupuncture for FM, but further high-quality trials are needed to investigate its benefits, harms and mechanisms of action, compared with no or standard treatment. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016035846 .
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Affiliation(s)
| | | | | | | | - Andy Ness
- University of Bristol, Bristol, England
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Chen HY, Wang MF, Lin JY, Tsai YC, Cheng FC. Inhalation of Shin-I essential oil enhances lactate clearance in treadmill exercise. Asian Pac J Trop Biomed 2014; 4:158-63. [PMID: 25182288 DOI: 10.1016/s2221-1691(14)60225-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 01/22/2014] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To evaluate the effect of Shin-I essential oil inhalation on blood lactate changes in rats subjected to treadmill exercise. METHODS : Adult male Sprague Dawley rats (n=12) were randomly divided into the control or the Shin-I group. Rats were subjected to a treadmill exercise program (15 m/min for 30 min). After exercise, rats were exposed to 200 µL of water or Shin-I essential oil, respectively, using a nebulizer for 180 min during the recovery period. Blood samples were collected every 15 min. Blood glucose and lactate concentrations were determined in a CMA 600 analyzer. RESULTS : The basal glucose and lactate levels were no significantly different between two groups. After exercise, glucose levels were slightly increased to about 110%-120% of the basal level in both groups. Lactate levels of both groups reached to 110%-140% of basal levels during exercise. In the recovery period, lactate levels further increased to 180% of the basal level and were maintained at a plateau in the control group. However, lactate levels gradually decreased to 60%-65% of the basal level in the Shin-I group. Lactate clearance was significantly enhanced after Shin-I essential oil inhalation. CONCLUSIONS : Our results provide evidence that Shin-I essential oil inhalation may accelerate recovery after exercise in rats.
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Affiliation(s)
- Hsuan-Ying Chen
- Stem Cell Center, Department of Medical Research, Taichung Veterans General Hospital, 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan ; Department of Food and Nutrition, Providence University, 200, Sec. 7, Taiwan Boulevard, Shalu Dist., Taichung, 43301, Taiwan
| | - Ming-Fu Wang
- Department of Food and Nutrition, Providence University, 200, Sec. 7, Taiwan Boulevard, Shalu Dist., Taichung, 43301, Taiwan
| | - Jun-Ying Lin
- Yangsen Biotechnology Co., Ltd. 3F, 5, Sec.1, Bei-tou.Rd., Bei-tou, Taipei, 11245, Taiwan
| | - Ying-Chieh Tsai
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, 155, Sec.2, Li-nong Street, Taipei, 11221, Taiwan
| | - Fu-Chou Cheng
- Stem Cell Center, Department of Medical Research, Taichung Veterans General Hospital, 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan
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Tang SK, Tse MYM. Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons? BIOMED RESEARCH INTERNATIONAL 2014; 2014:430195. [PMID: 25114901 PMCID: PMC4119713 DOI: 10.1155/2014/430195] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 05/10/2014] [Indexed: 12/21/2022]
Abstract
To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.
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Affiliation(s)
- Shuk Kwan Tang
- Department of Orthopaedics & Traumatology, United Christian Hospital, Kowloon, Hong Kong
| | - M. Y. Mimi Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Efficacy and safety of medicinal plants or related natural products for fibromyalgia: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:149468. [PMID: 23861696 PMCID: PMC3687718 DOI: 10.1155/2013/149468] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 05/14/2013] [Indexed: 11/26/2022]
Abstract
To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients. The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life. Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects.
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Rutledge DN, Martinez A, Traska TK, Rose DJ. Fall experiences of persons with fibromyalgia over 6 months. J Adv Nurs 2012; 69:435-48. [DOI: 10.1111/j.1365-2648.2012.06026.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hongratanaworakit T. Aroma-therapeutic Effects of Massage Blended Essential Oils on Humans. Nat Prod Commun 2011. [DOI: 10.1177/1934578x1100600838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although blended essential oils are increasingly being used for the improvement of the quality of life and for the relief of various symptoms in patients, the scientific evaluation of the aroma-therapeutic effects of blended essential oils in humans is rather scarce. In this study, we hypothesized that applying blended essential oil would provide a synergistic effect that would have a chance for success in treating depression or anxiety. Therefore, the main objective of this study was to investigate the effects of the blended essential oil on autonomic parameters and on emotional responses in humans following transdermal absorption. The blended essential oil consisted of lavender and bergamot oils. Human autonomic parameters, i.e. blood pressure, pulse rate, breathing rate, and skin temperature, were recorded as indicators of the arousal level of the autonomic nervous system. In addition, subjects had to rate their emotional condition in terms of relaxation, vigor, calmness, attentiveness, mood, and alertness in order to assess subjective behavioral arousal. Forty healthy volunteers participated in the experiments. Blended essential oil was applied topically to the skin of the abdomen of each subject. Compared with placebo, blended essential oil caused significant decreases of pulse rate, and systolic and diastolic blood pressure, which indicated a decrease of autonomic arousal. At the emotional level, subjects in the blended essential oil group rated themselves as ‘more calm’ and ‘more relaxed’ than subjects in the control group. This finding suggests a decrease of subjective behavioral arousal. In conclusion, our investigation demonstrates the relaxing effect of a mixture of lavender and bergamot oils. This synergistic blend provides evidence for its use in medicine for treating depression or anxiety in humans.
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Affiliation(s)
- Tapanee Hongratanaworakit
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Srinakharinwirot University, Rangsit-Ongkharak Road, Nakhonnayok 26120, Thailand
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Predictors of Physical Performance and Functional Ability in People 50+ With and Without Fibromyalgia. J Aging Phys Act 2010; 18:353-68. [DOI: 10.1123/japa.18.3.353] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purposes of this study were to determine whether people with and without fibromyalgia (FM) age 50 yr and above showed differences in physical performance and perceived functional ability and to determine whether age, gender, depression, and physical activity level altered the impact of FM status on these factors. Dependent variables included perceived function and 6 performance measures (multidimensional balance, aerobic endurance, overall functional mobility, lower body strength, and gait velocity—normal or fast). Independent (predictor) variables were FM status, age, gender, depression, and physical activity level. Results indicated significant differences between adults with and without FM on all physical-performance measures and perceived function. Linear-regression models showed that the contribution of significant predictors was in expected directions. All regression models were significant, accounting for 16–65% of variance in the dependent variables.
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