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Bayram R, Budak S, YIldIz H. The effect of non-compliance with diet and liquid restriction on fatigue in dialysis patients. Rev Esc Enferm USP 2024; 58:20230251. [PMID: 38808906 PMCID: PMC11135046 DOI: 10.1590/1980-220x-reeusp-2023-0251en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/28/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE This study was conducted to determine the relationship between non-compliance with dietary and fluid restriction, body mass index, and the severity of fatigue in dialysis patients. METHOD A descriptive and cross-sectional study was conducted on 42 dialysis patients. The data were collected employing a "General Information Form", Body Mass Index, "Fatigue Severity Scale", and "Dialysis Diet and Fluid Non-Adherence Questionnaire.". Data were evaluated using percentages, averages, one-way ANOVA, T-tests, and Pearson correlation tests. RESULTS The average number of days when the patients did not comply with their diet was 3.69 ± 4.85, and the average number of days when they did not comply with fluid restriction was 2.71 ± 5.02. The age and marital status of the patients were found to affect the fatigue severity. It was found that the cases were associated with creatinine and calcium values and the number of days they did not comply with fluid restriction. CONCLUSION It was determined that there was no significant relationship between non-compliance with diet and fluid restriction and the severity of fatigue. It was found that the severity of fatigue was lower in patients who complied with diet and fluid restriction, although not significantly lower than in those who did not comply.
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Affiliation(s)
- Ridvan Bayram
- Bursa Uludag University, Faculty of Health Sciences, Department of Medical Nursing, Bursa, Turkey
| | - Serkan Budak
- Kütahya Health Sciences University, Simav Vocational School of Health Services, Department of Medical Services and Techniques, Kütahya, Turkey
| | - Hicran YIldIz
- Bursa Uludag University, Faculty of Health Sciences, Department of Medical Nursing, Bursa, Turkey
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Song J, Yang X, Wu J, Wu Z, Zhuo L, Hong J, Su L, Lyu W, Ye J, Fang Y, Zhan Z, Zhang H, Li X. Could nutrition status predict fatigue one week before in patients with nasopharynx cancer undergoing radiotherapy? Cancer Med 2024; 13:e7191. [PMID: 38659395 PMCID: PMC11043677 DOI: 10.1002/cam4.7191] [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: 11/28/2023] [Revised: 03/15/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy experience significant fatigue, which is frequently underestimated due to the lack of objective indicators for its evaluation. This study aimed to explore the longitudinal association between fatigue and nutrition status 1 week in advance. METHODS From January 2021 to June 2022, a total of 105 NPC patients who received intensity-modulated radiation therapy were enrolled in the observational longitudinal study. The significant outcomes, including the Piper Fatigue Scale-12 (PFS-12), the Scored Patient-Generated Subjective Global Assessment (PG-SGA), four body composition indices, and the Hospital Anxiety and Depression Scale (HADS), were assessed weekly from pre-treatment until the completion of radiotherapy (T0-T7) to explore their relationship. RESULTS The trajectories of PFS-12 and all dimensions for 105 participants reached a peak during the fifth week. Sensory fatigue consistently received the highest scores (T0 = 1.60 ± 2.20, T5 = 6.15 ± 1.57), whereas behavior fatigue exhibited the fastest increase over time (T0 = 1.11 ± 1.86, T5 = 5.47 ± 1.70). Higher PG-SGA scores were found to be weakly explainable for aggravating fatigue (β = 0.02 ~ 0.04). Unlike generalized additive mixed models, marginal structural models (MSM) produced larger effect values (β = 0.12 ~ 0.21). Additionally, body composition indices showed weakly negative relationships with fatigue in MSMs one week in advance. CONCLUSIONS The PG-SGA may be a more accurate predictor of future-week fatigue than individual body composition indicators, particularly when HADS is controlled for as a time-dependent confounder.
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Affiliation(s)
- Jihong Song
- School of NursingHealth Science Center, Xi'an Jiaotong UniversityXi'anChina
- School of NursingFujian Medical UniversityFuzhouChina
| | - Xinru Yang
- School of NursingFujian Medical UniversityFuzhouChina
| | - Jieling Wu
- School of NursingFujian Medical UniversityFuzhouChina
| | - Zilan Wu
- School of NursingFujian Medical UniversityFuzhouChina
| | - Litao Zhuo
- School of NursingFujian Medical UniversityFuzhouChina
| | - Jinsheng Hong
- Department of RadiotherapyCancer Center, the First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
- Department of RadiotherapyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
| | - Li Su
- Department of RadiotherapyCancer Center, the First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
- Department of RadiotherapyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
| | - Wenlong Lyu
- Department of RadiotherapyCancer Center, the First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
- Department of RadiotherapyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
| | - Jinru Ye
- Department of RadiotherapyCancer Center, the First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
- Department of RadiotherapyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical UniversityFuzhouChina
| | - Yan Fang
- Nursing DepartmentThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zhiying Zhan
- Department of Epidemiology and Health StatisticsFujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical UniversityFuzhouChina
| | - Hairong Zhang
- Fujian Center for Disease Control and PreventionFuzhouChina
| | - Xiaomei Li
- School of NursingHealth Science Center, Xi'an Jiaotong UniversityXi'anChina
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Vicente-Campos D, Sánchez-Jorge S, Martí L, Buffet J, Mendoza-Laiz N, Rodriguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicarro JL, Calvo-Lobo C. Skin Bioimpedance Analysis to Determine Cellular Integrity by Phase Angle in Women with Fibromyalgia: A Cross-Sectional Study. Biomedicines 2023; 11:3321. [PMID: 38137542 PMCID: PMC10741687 DOI: 10.3390/biomedicines11123321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Oxidative stress has been proposed as a significant part of the pathogenesis of fibromyalgia, and the phase angle in bioelectrical impedance analysis has been explored as a potential technique to screen oxidative abnormalities. This study recruited 35 women with fibromyalgia and 35 healthy women, who underwent bioelectrical impedance analysis and maximum isometric handgrip strength tests. Women with fibromyalgia showed lower bilateral handgrip strength (right hand: 16.39 ± 5.87 vs. 27.53 ± 4.09, p < 0.001; left hand: 16.31 ± 5.51 vs. 27.61 ± 4.14, p < 0.001), as well as higher body fat mass (27.14 ± 10.21 vs. 19.94 ± 7.25, p = 0.002), body fat percentage (37.80 ± 8.32 vs. 30.63 ± 7.77, p < 0.001), and visceral fat area (136.76 ± 55.31 vs. 91.65 ± 42.04, p < 0.01) compared with healthy women. There was no statistically significant difference in muscle mass between groups, but women with fibromyalgia showed lower phase angles in all body regions when compared with healthy control women (right arm: 4.42 ± 0.51 vs. 4.97 ± 0.48, p < 0.01; left arm: 4.23 ± 0.48 vs. 4.78 ± 0.50, p < 0.001; trunk: 5.62 ± 0.77 vs. 6.78 ± 0.84, p < 0.001; right leg: 5.28 ± 0.56 vs. 5.81 ± 0.60, p < 0.001; left leg: 5.07 ± 0.51 vs. 5.69 ± 0.58, p < 0.001; whole body: 4.81 ± 0.47 vs. 5.39 ± 0.49, p < 0.001). Moreover, whole-body phase-angle reduction was only predicted by the presence of fibromyalgia (R2 = 0.264; β = 0.639; F(1,68) = 24.411; p < 0.001). Our study revealed significantly lower phase angle values, lower handgrip strength, and higher fat levels in women with fibromyalgia compared to healthy controls, which are data of clinical relevance when dealing with such patients.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Sandra Sánchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Luis Martí
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Jorge Buffet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Nuria Mendoza-Laiz
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - J. L. Chicarro
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
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Neelapala YVR, Mercuri D, Macedo L, Hanna S, Kobsar D, Carlesso L. Mechanisms hypothesized for pain-relieving effects of exercise in fibromyalgia: a scoping review. Ther Adv Musculoskelet Dis 2023; 15:1759720X231182894. [PMID: 37484924 PMCID: PMC10356998 DOI: 10.1177/1759720x231182894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/31/2023] [Indexed: 07/25/2023] Open
Abstract
Background Exercise is one of the most recommended management strategies by treatment guidelines for fibromyalgia (FM); however, the mechanism through which exercise improves pain in FM is still unknown. Objective We aimed to summarize the hypothesized theoretical mechanisms for the pain-relieving effects of exercise in people with FM. Eligibility Criteria Randomized controlled trials (RCTs) in English reporting mechanisms for pain-relieving effects of exercise in the 'Introduction' and 'Discussion' sections and significant within- group or between-group effects of exercise interventions were included. Sources of Evidence We searched the databases Ovid MEDLINE(R), EMBASE, CINAHL, COCHRANE, Sports Discuss, and AMED with the keywords: exercise and fibromyalgia until December 2021. Charting Methods Two authors independently performed title/abstract, full-text review, and data abstraction using a data abstraction form. The hypothesized mechanisms from individual studies were grouped into three categories. Results The literature search resulted in 2147 studies, out of which 220 studies were considered for full-text review. A total of 50 RCTs proposing 29 unique mechanisms for the pain-relieving effects of exercise were included. These mechanisms were divided into three categories: physical, neuro-physiological, and psychological. The neuro-physiological category was further subdivided into exercise-induced hypoalgesia (EIH), pain sensitization, the autonomic system, the immune system, the endocrine system, and miscellaneous categories. The most frequently hypothesized mechanisms were EIH (n = 15), autonomic modulation (n = 7), improved sleep (n = 6), muscle oxygenation (n = 6), self-efficacy (n = 5), mental health (n = 4), and benefits of the aquatic environment (n = 12). While all exercise interventions involved FM patients, most of the supporting evidence for these mechanisms was cited from previous studies conducted on healthy samples. No studies performed analyses to demonstrate causal associations between the mechanisms and outcomes. Conclusion Multiple mechanisms were hypothesized for the positive influence of exercise in people with FM. Future studies using causal analyses, such as mediation analysis, are recommended to validate these mechanisms.
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Affiliation(s)
| | - Domenico Mercuri
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Luciana Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Steven Hanna
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Dylan Kobsar
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Ghamri KA, Alsulami SS, Alotaibi LA, Salem IW, Tash RF, Yousof SM. Determinants of insulin therapy among women with gestational diabetes mellitus: A cross-sectional study. Niger J Clin Pract 2023; 26:417-423. [PMID: 37203105 DOI: 10.4103/njcp.njcp_447_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Gestational diabetes mellitus (GDM) is a common complication in pregnancy that occurs during the second half of pregnancy. In the majority of patients, medical nutritional therapy (MNT) alone is sufficient to achieve the glycemic goal. Aim To evaluate the clinical and biochemical factors that predict the need for insulin therapy in women with GDM. Materials and Methods Between March 2020 and November 2021, an analytic cross-sectional study was conducted on 127 women diagnosed with GDM at their final antenatal visit. Multivariate logistic regression was used to determine the variables associated with the likelihood of insulin requirement in patients with GDM. Results To achieve glycemic control, 56.7% of the study population required insulin treatment. Fasting glucose, pre-conceptional body mass index (BMI), parity, and third-trimester glycated hemoglobin levels were all higher in the insulin-treated group (P = 0.00, 0.01, 0.01, and 0.02), respectively. Fasting glucose level is the main determinant of insulin use in patients with GDM (odds ratio [OR]: 1.110; 95% confidence interval [CI]: 1.001-1.191; P = 0.004). Conclusions Fasting glucose level is the most important predictor of the need for insulin therapy.
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Affiliation(s)
- K A Ghamri
- Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S S Alsulami
- Department of Internal Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - L A Alotaibi
- Internal Medicine Department, King Abdulaziz Hospital, Endocrine and Diabetic Center, Jeddah, Saudi Arabia
| | - I W Salem
- Community Medicine Department, King Abdulaziz University, Rabigh, Saudi Arabia; Community Medicine Department, Al Azhar University, Cairo, Egypt
| | - R F Tash
- Anatomy and Embryology Department, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia; Anatomy and Embryology Department, Faculty of Medicine, Ain Shams University, Abassia, Cairo, Egypt
| | - S M Yousof
- Physiology Department, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia; Physiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Cigdem Karacay B, Sahbaz T, Medin Ceylan C. The vicious cycle of physical inactivity, fatigue and kinesiophobia in patients with fibromyalgia syndrome. Reumatismo 2023; 74. [PMID: 36942983 DOI: 10.4081/reumatismo.2022.1502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/09/2023] [Indexed: 03/23/2023] Open
Abstract
This study aims to determine the association between fatigue, kinesiophobia, disease severity, and physical inactivity by comparing fibromyalgia syndrome (FMS) patients with healthy controls. Pain and fatigue are significant barriers to the participation in functional activities. Inactivity is a result of fatigue, but exercise is the foundation of FMS treatment. This case-control study included a total of 203 participants (107 patients with FMS and 96 healthy volunteers). The fibromyalgia impact questionnaire, the fatigue severity scale, the international physical activity questionnaire, and the Tampa scale for kinesiophobia were assessed. The FMS group scored significantly higher on the fatigue severity scale and kinesiophobia than the control group (p<0.001). Significantly lower metabolic task equivalent (MET) scale values were observed in the FMS group compared to the control group (p<0.001). The severity of fatigue and kinesiophobia correlated positively with the FMS impact questionnaire (p=0.001, r=0.621) and negatively with the MET scale (p=0.009, r= -0.287). Patients with FMS experience greater fatigue, kinesiophobia, and inactivity. As the severity of FMS worsens, so do disability, kinesiophobia, and fatigue. This study highlights the importance of breaking the cycle of fatigue and inactivity in the treatment of FMS.
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Affiliation(s)
- B Cigdem Karacay
- Kirsehir Ahi Evran University Faculty od Medicine, Clinic of Physical Medicine and Rehabilitation, Kirsehir.
| | - T Sahbaz
- Health Sciences University, Kanuni Sultan Suleyman Research Hospital Department of Physical Medicine and Rehabilitation, Istanbul.
| | - C Medin Ceylan
- Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Clinic of Physical Medicine and Rehabilitation Istanbul.
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Whole-Body Vibration Training on Oxidative Stress Markers, Irisin Levels, and Body Composition in Women with Fibromyalgia: A Randomized Controlled Trial. Bioengineering (Basel) 2023; 10:bioengineering10020260. [PMID: 36829754 PMCID: PMC9952264 DOI: 10.3390/bioengineering10020260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
(1) Background: Mitochondrial dysfunction and redox imbalance seem to be involved in fibromyalgia (FM) pathogenesis. The results of our previous studies suggest that whole-body vibration training (WBVT) would improve redox status markers, increase blood irisin levels, and ameliorate the body composition of women with FM. (2) Objective: The current study aimed to investigate WBVT on oxidative stress markers, plasma irisin levels, and body composition in women with FM. (3) Methods: Forty women with FM were randomized into WBVT or untrained (UN) groups. Before and after 6 weeks of WBVT, body composition was assessed by dual-energy radiological absorptiometry (DXA), and inflammatory marker activities were measured by enzymatic assay. (4) Results: Body composition, blood irisin levels, and oxidative stress markers were similar between UN and WBVT groups before the intervention. After 6 weeks of intervention, the WBVT group presented higher irisin levels (WBVT: 316.98 ± 109.24 mg·dL³, WBVT: 477.61 ± 267.92 mg·dL³, p = 0.01) and lower TBARS levels (UN: 0.39 ± 0.02 nmol MDA/mg protein, WBVT: 0.24 ± 0.06 nmol MDA/mg protein, p = 0.001) and visceral adipose tissue mass (UN: 1.37 ± 0.49 kg, WBVT: 0.69 ± 0.54 kg, p = 0.001) compared to the UN group. (5) Conclusions: Six weeks of WBVT improves blood redox status markers, increases irisin levels, and reduces visceral adipose tissue mass, favoring less cell damage and more outstanding oxidative balance in women with FM.
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Majdoub F, Ben Nessib D, Ferjani HL, Kaffel D, Triki W, Maatallah K, Hamdi W. Non-pharmacological therapies in Fibromyalgia: New horizons for physicians, new hopes for patients. Musculoskeletal Care 2023; 21:603-610. [PMID: 36757930 DOI: 10.1002/msc.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Fibromyalgia (FM) is a chronic musculoskeletal condition characterised by reduced quality of life and severe limitations in daily living activities. Considering the wide spectrum of symptoms and the ineffectiveness of a single pharmacological approach, the latest clinical guidelines recommend non-pharmacological therapies as both an alternative and a better-tolerated approach. Several studies have been conducted to determine the effectiveness of non-pharmacological therapies in the management of FM. AIMS Through a literature review, this paper aims to describe the different complementary therapies and investigate their potential sustainability and effectiveness on FM symptoms in the short and/or long term. METHODS We searched the PubMed and Google Scholar databases using broad search terms up to June 2022, to identify all types of study designs restricted to human subjects on non-pharmacological therapies in FM. RESULTS Recent evidence demonstrated that physical activity is the mainstay of therapeutic management, highlighting the relevance of walking as the best method of exercise in FM patients. Nevertheless, adherence to physical activity remains fraught with obstacles that could be overcome with a multimodal and multidisciplinary approach involving a wide range of passive therapies. The effectiveness of passive non-pharmacological therapies remains however unproven in the long term. They can be therefore suggested as 'adjunct' or 'bridge' therapy to improve adherence to physical activity. CONCLUSION To conclude, FM management requires a multimodal and symptom-based approach, guided by the predominant bothersome symptom on the one hand, and the preferences of each patient on the other hand.
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Affiliation(s)
- Fatma Majdoub
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Dorra Ben Nessib
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Hanene Lassoued Ferjani
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Dhia Kaffel
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Wafa Triki
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Kaouther Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
| | - Wafa Hamdi
- Rheumatology Department, Kassab Orthopedics Institute, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
- Research Unit UR17SP04, Tunis, Tunisia
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Jiao J, Cheng ZY, Xiao YY, Wang H, Zhang YF, Zhao YY, Jia Y. Validation of the 2011 and 2016 American college of rheumatology diagnostic criteria for fibromyalgia in a Chinese population. Ann Med 2023; 55:2249921. [PMID: 37634058 PMCID: PMC10461495 DOI: 10.1080/07853890.2023.2249921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE To provide a foundation for clinical diagnosis, epidemiological investigation and intervention trials, we examined the reliability and validity of the American College of Rheumatology (ACR) 2011 and 2016 survey diagnostic criteria among Chinese patients based on the fibromyalgia severity (FS) scale. METHODS In this study, 200 fibromyalgia patients diagnosed according to the 1990 criteria (1990c) were matched with rheumatoid arthritis (RA) patients based on age and gender. The FS scale score and its subscales were examined to determine their correlations with the revised fibromyalgia impact questionnaire (FIQR). Receiver operator characteristic (ROC) analysis was performed, and test-retest reliability, internal consistency, and construct validity were examined. RESULTS The area under the curve (AUC) for the ACR 2011c and 2016c was 0.870 and 0.845, respectively, and the sensitivity and specificity were 78.0% and 96.0% for the 2011c and 70.5% and 98.5% for the 2016c, respectively. The FS scale and its subscales were confirmed to exhibit good internal consistency, and they were significantly correlated with the FIQR, thereby indicating adequate construct validity. Using a lower cutoff value 11 points for the FS scale score based on the generalized pain requirement might be a more effective approach in the Chinese population; this approach yielded an AUC of 0.923 and a sensitivity of 87.0% and specificity of 97.5%. CONCLUSION The 2011c and 2016c are reliable instruments for diagnosing fibromyalgia patients in China. The FS scale could be a valid tool to assist in fibromyalgia diagnosis, and a cutoff value 11 points is more suitable in Chinese patients. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03381131.
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Affiliation(s)
- Juan Jiao
- Rheumatology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zeng-yu Cheng
- Rheumatology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu-ya Xiao
- Rheumatology Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Hui Wang
- Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yong-feng Zhang
- Department of Rheumatology and Clinical Immunology, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Ya-yun Zhao
- Rheumatology Department, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
| | - Yuan Jia
- Department of Rheumatology and Immunology, Peking University People’s Hospital & Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis, Beijing, China
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Álvarez-Nemegyei J, Pacheco-Pantoja EL, Olán-Centeno LJ, Angulo-Ramírez A, Rodríguez-Magaña FE, Aranda-Muiña JF. Association between fibromyalgia syndrome clinical severity and body composition. A principal component analysis. REUMATOLOGIA CLINICA 2022; 18:538-545. [PMID: 36309410 DOI: 10.1016/j.reumae.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/08/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The type of body composition modulates the severity of some musculoskeletal conditions, in fibromyalgia syndrome (FMS), this type of association remains relatively unexplored. OBJECTIVE To analyze the association between the type of body composition and FMS using Principal Component Analysis (PCA). The FMS clinical outcome measures were: Symptom Severity Scale (SSS), Widespread Pain Index (WPI; and Fibromyalgia Impact Questionnaire (FIQ). METHODS Forty-three women with FMS (ACR 2010 criteria) were clinically and anthropometrically evaluated. The anthropometric data were integrated into two indicators using a PCA methodology (PCA-Fat and PCA-muscle). Additionally, the patients were classified into high and low categories for each clinical indicator, which were used as dependent variables in binomial logistic regression (BLR) models. RESULTS We found a positive correlation between PCA-Fat with WPI (r=0.326, P=.043) and FIQ (r=0.325, P=.044), and negative correlation (r=-0.384, P=.013) between PCA-muscle and SSS. In the BLR analysis, PCA-Fat was a significant predictor for high WPI (OR=2.477, P=.038); while for high SSS, PCA-muscle (OR=0.303, P=.009) was an inversely significant predictor. CONCLUSIONS The results suggest that the volume of fat mass can negatively modulate the severity of FMS. We propose that the evaluation of body composition should be a basic element for the clinical approach of patients with FMS.
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Affiliation(s)
| | - Elda Leonor Pacheco-Pantoja
- Chronic-Degenerative Disorders Group, School of Medicine, Universidad Anáhuac Mayab, Km. 15.5 Carr, Mérida-Progreso, Desv. Int. Km. 2, Carr. Chablekal, CP 97310 Mérida, Yucatán, Mexico.
| | | | - Angélica Angulo-Ramírez
- Hospital Regional de Alta Especialidad de la Península de Yucatán (HRAEPY), Rheumatology Staff, Mexico
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Fibromyalgia in women: association of inflammatory plasma proteins, muscle blood flow, and metabolism with body mass index and pain characteristics. Pain Rep 2022; 7:e1042. [PMID: 36213597 PMCID: PMC9534367 DOI: 10.1097/pr9.0000000000001042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Metabolism and inflammation interact in fibromyalgia with obesity that can lead to chronic low-grade inflammation. Introduction: Obesity is a common comorbidity in fibromyalgia (FM). Both FM and obesity have been connected to low-grade inflammation, although it is possible that previously reported inflammatory alterations in FM primarily may be linked to increased body mass index (BMI). Objective: This study aimed to investigate whether the inflammatory plasma protein profile, muscle blood flow, and metabolism and pain characteristics (clinical parameters and patient-reported outcome measurements) differed between female patients with FM with and without obesity. Methods: Patients with FM underwent clinical examinations, physical tests, and answered questionnaires. They were dichotomized according to BMI (<30 kg/m2 [n = 14]; ≥30 kg/m2 [n = 13]). Blood samples were collected and analyzed using a panel of 71 inflammatory plasma proteins. Results: There were significant (P < 0.05) differences in blood pressure, pulse, max VO2, pain intensity, physical capacity, and Fibromyalgia Impact Questionnaire between the groups; the obese group had higher blood pressure, pulse, pain intensity, and Fibromyalgia Impact Questionnaire. There were 14 proteins that contributed to the group belonging. The 4 most important proteins for the group discrimination were MIP1β, MCP4, IL1RA, and IL6, which showed higher concentrations in obese patients with FM. Significantly decreased blood flow and increased concentration of pyruvate were detected in obese patients compared with nonobese patients. There was significant correlation between inflammatory proteins and sedentary behavior and health status in obese patients with FM. Conclusions: These findings suggest that metabolism and inflammation interact in female patients with FM with obesity and might cause chronic low-grade inflammation. Screening for obesity and monitoring of BMI changes should be considered in the treatment of patients with FM.
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Elma Ö, Brain K, Dong HJ. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. J Clin Med 2022; 11:jcm11195950. [PMID: 36233817 PMCID: PMC9571356 DOI: 10.3390/jcm11195950] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Correspondence:
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Gerdle B, Dahlqvist Leinhard O, Lund E, Bengtsson A, Lundberg P, Ghafouri B, Forsgren MF. Fibromyalgia: Associations Between Fat Infiltration, Physical Capacity, and Clinical Variables. J Pain Res 2022; 15:2517-2535. [PMID: 36061487 PMCID: PMC9434492 DOI: 10.2147/jpr.s376590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Obesity is a risk factor for the development of fibromyalgia (FM) and generally most studies report increased Body Mass Index (BMI) in FM. Obesity in FM is associated with a worse clinical presentation. FM patients have low physical conditioning and obesity further exacerbates these aspects. Hitherto studies of FM have focused upon a surrogate for overall measure of fat content, ie, BMI. This study is motivated by that ectopic fat and adipose tissues are rarely investigated in FM including their relationships to physical capacity variables. Moreover, their relationships to clinical variables including are not known. Aims were to 1) compare body composition between FM and healthy controls and 2) investigate if significant associations exist between body composition and physical capacity aspects and important clinical variables. Methods FM patients (n = 32) and healthy controls (CON; n = 30) underwent a clinical examination that included pressure pain thresholds and physical tests. They completed a health questionnaire and participated in whole-body magnetic resonance imaging (MRI) to determine body composition aspects. Results Abdominal adipose tissues, muscle fat, and BMI were significantly higher in FM, whereas muscle volumes of quadriceps were smaller. Physical capacity variables correlated negatively with body composition variables in FM. Both body composition and physical capacity variables were significant regressors of group belonging; the physical capacity variables alone showed stronger relationships with group membership. A mix of body composition variables and physical capacity variables were significant regressors of pain intensity and impact in FM. Body composition variables were the strongest regressors of blood pressures, which were increased in FM. Conclusion Obesity has a negative influence on FM symptomatology and increases the risk for other serious conditions. Hence, obesity, dietary habits, and physical activity should be considered when developing clinical management plans for patients with FM.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Correspondence: Björn Gerdle, Tel +46763927191, Email
| | - Olof Dahlqvist Leinhard
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- AMRA Medical AB, Linköping, Sweden
| | - Eva Lund
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Ann Bengtsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Peter Lundberg
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
| | - Mikael Fredrik Forsgren
- Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden
- AMRA Medical AB, Linköping, Sweden
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Kolak E, Ardıç F, Fındıkoğlu G. Effects of different types of exercises on pain, quality of life, depression, and body composition in women with fibromyalgia: A three-arm, parallel-group, randomized trial. Arch Rheumatol 2022; 37:444-455. [PMID: 36589612 PMCID: PMC9791552 DOI: 10.46497/archrheumatol.2022.9190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/20/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives This study aims to compare the efficacy of three different exercise types on pain, health-related quality of life (HRQoL), depression, and body composition in women with fibromyalgia (FM). Patients and methods Between June 2019 and December 2019, a total of 41 women with FM (mean age: 46.7+9.4 years; range, 24 to 62 years) were randomly allocated into Group 1 (n=13, supervised aerobic plus stretching), Group 2 (n=13, supervised resistance plus stretching), and Group 3 (n=15, home-based stretching). All exercises were performed three times per week for 12 weeks and were individualized by measuring the maximal oxygen consumption (VO2max) for aerobic exercise and one-repetition maximum (1-RM) test for resistance exercise. The main measures were pain intensity assessed by the Visual Analog Scale (VAS), severity by the Fibromyalgia Impact Questionnaire (FIQ), symptoms of depression by the Beck Depression Inventory, HRQoL by the Short-Form Health Questionnaire (SF-36), and body composition by bioelectrical impedance analysis. Results The mean VAS difference (95% confidence interval [CI]): -2.61 (-1.94, -3.29); -2.61 (-1.82, -3.42); -1.07 (-0.49, -1.64) for Group 1, Group 2, and Group 3, respectively (p<0.001); however, there was no significant difference between the combined exercise groups. The FIQ scores decreased significantly in all exercise groups after training (p<0.05). At 12 weeks, 21 (80.8%) patients from combined groups and six (40%) patients from the stretching alone group achieved a minimal clinically significant difference defined as a 14% change in baseline FIQ scores (p=0.008). Other outcome parameters did not differ significantly among the groups. Conclusion Supervised aerobics/muscle strengthening combined with stretching exercises reduced pain, and FM severity more than a home stretching exercise alone.
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Affiliation(s)
- Erkan Kolak
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Füsun Ardıç
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Gülin Fındıkoğlu
- Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
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15
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Therapeutic Patient Education for Fibromyalgia during Spa Therapy: The FiETT Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084613. [PMID: 35457480 PMCID: PMC9030628 DOI: 10.3390/ijerph19084613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 01/13/2023]
Abstract
Spa therapy is known to improve quality of life and diminish pain. We assessed the efficacy (Fibromyalgia Impact Questionnaire-FIQ) and safety at 6 months of a fibromyalgia-specific therapeutic patient education (TPE) program added to fibromyalgia-specific standardized spa therapy (SST), compared to SST alone, in a controlled randomized trial. We enrolled 157 patients, mostly women, attending spa centers in Southwest France in 2015–2016, and randomized them to SST + TPE (79) or SST (78). The intention-to-treat with “missing as failure” analysis showed a tendency toward a higher, though non-significant, benefit with TPE than without for FIQ (−9 vs. −3; p = 0.053) or pain intensity (−0.9 vs. −1.1; p = 0.58). In addition, pain relief (+3.2 vs. +4.3; p = 0.03) and fatigue (−1.6 vs. −3.7; p = 0.02) were significantly improved, and 87% patients in the SST + TPE arm still regularly practiced the physical exercises taught to them at 6 months. We suspect significant and lasting improvement from spa therapy, as well as our already well-informed and well-managed participants, to have prevented the demonstration of a significant benefit of TPE on FIQ.
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Body Image, Medication Use, and Mental Health among Women with Fibromyalgia in Flanders, Belgium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031418. [PMID: 35162441 PMCID: PMC8835128 DOI: 10.3390/ijerph19031418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
Fibromyalgia (FM) is a chronic illness that does not have clear physical consequences, yet research shows that FM patients often have a low body image. An online cross-sectional study was conducted in Flanders, Belgium, among FM women who are connected to the Flemish League for fibromyalgia patients. An adjusted Body Image Scale (BIS) was used to assess body image, the General Health Questionnaire-12 (GHQ-12) was used for mental health, and the Visual Analogue Scale Fibromyalgia Impact Questionnaire (VASFIQ) was used for FM symptoms. Medication use was assessed by using a 4-point Likert scale. Time since diagnosis and age was assessed. A total of 103 women with FM responded. Linear regression showed that BIS was best predicted in a model by using VASFIQ, GHQ-12, time since diagnosis, and sleep medication, wherein only the GHQ-12 was significant as a variable (B = 0.292; p = 0.009). This model explained 19.3% of the variance. The role of sleep medication use disappeared when controlling for mental health. Mental health was more clearly associated with body image than medication use, or even fibromyalgia symptoms. Thus, having negative mental health is associated with a negative body image. In order to improve the body image of FM patients, symptom control alone is not enough; improving mental health is equally important.
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17
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Zhou WBS, Meng J, Zhang J. Does Low Grade Systemic Inflammation Have a Role in Chronic Pain? Front Mol Neurosci 2021; 14:785214. [PMID: 34858140 PMCID: PMC8631544 DOI: 10.3389/fnmol.2021.785214] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
One of the major clinical manifestations of peripheral neuropathy, either resulting from trauma or diseases, is chronic pain. While it significantly impacts patients’ quality of life, the underlying mechanisms remain elusive, and treatment is not satisfactory. Systemic chronic inflammation (SCI) that we are referring to in this perspective is a state of low-grade, persistent, non-infective inflammation, being found in many physiological and pathological conditions. Distinct from acute inflammation, which is a protective process fighting against intruders, SCI might have harmful effects. It has been associated with many chronic non-communicable diseases. We hypothesize that SCI could be a predisposing and/or precipitating factor in the development of chronic pain, as well as associated comorbidities. We reviewed evidence from human clinical studies indicating the coexistence of SCI with various types of chronic pain. We also collated existing data about the sources of SCI and who could have it, showing that those individuals or patients having SCI usually have higher prevalence of chronic pain and psychological comorbidities. We thus elaborate on the need for further research in the connection between SCI and chronic pain. Several hypotheses have been proposed to explain these complex interactions.
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Affiliation(s)
- Wen Bo Sam Zhou
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - JingWen Meng
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Ji Zhang
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Neurology and Neurosurgery, Faculty of Medicine McGill University, Montreal, QC, Canada
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Kauffman BY, Manning K, Rogers AH, Matoska CT, Zvolensky MJ. Anxiety Sensitivity and Fatigue Severity Among Adults with Chronic Low Back Pain. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2021; 9:227-235. [PMID: 35707566 PMCID: PMC9197086 DOI: 10.1080/21641846.2021.2009684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/18/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The combined impact of chronic low back pain (CLBP) and fatigue severity is associated with increased burden and worsened symptoms. Understanding factors that may contribute to and maintain fatigue severity among individuals with CLBP is needed to isolate intervention modalities. METHODS The current study sought to investigate the role of anxiety sensitivity (AS) in terms of fatigue severity among 1,663 adults (70.0% female, M age = 44.5 years, SD = 11.87) with current mild to severe CLBP as well as a subset of the sample with clinically significant fatigue (n = 778). RESULTS Results indicated AS was a positively and statistically significant predictor of fatigue severity among the entire sample and the subset of the sample with clinically significant fatigue. CONCLUSIONS These cross-sectional data highlight the potential promise of AS as an underrecognized cognitive vulnerability for greater fatigue severity among those with CLBP.
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Affiliation(s)
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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Elkfury JL, Antunes LC, Dal Moro Angoleri L, Sipmann RB, de Souza A, da Silva Torres IL, Caumo W. Dysfunctional eating behavior in fibromyalgia and its association with serum biomarkers of brain plasticity (BDNF and S100B): an exploratory study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:713-722. [PMID: 34591410 PMCID: PMC10065384 DOI: 10.20945/2359-3997000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess disordered eating, hunger and satiety perceptions in women with fibromyalgia (FM) compared to healthy controls (HC) and their association with biomarkers of brain plasticity (brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100B)). METHODS Cross-sectional exploratory study. The sample included FM (n = 20) and HC (n = 19), matched to age and waist perimeter. Dysfunctional eating was assessed through the Three Factor Eating Questionnaire and Eating Disorders Examination with a questionnaire. Hunger and satiety levels were rated by a Numerical Scale. Serum leptin, S100B and BDNF were analyzed. RESULTS The MANCOVA analysis showed that the mean of Emotional Eating rates was 30.65% higher in FM compared to HC (p = 0.015). Eating, shape and weight concerns were 77.77%, 57.14% and 52.22% higher in FM (p = <0.001) compared to HC, respectively. Moreover, the FM group reported higher scores for feeling of hunger "[5.2 (±2.9) vs. 4.8 (±2.0); p = 0.042] and lower scores for satiety [7.0 (±1.7) vs. 8.3 (±1.0); p = 0.038]. In the FM group, serum BDNF was negatively associated with hunger (r = - 0.52; p = 0.02), while S100B was positively associated with hunger scores (r = 0.463; p = 0.004). CONCLUSION The present findings support the hypothesis that the association between FM and obesity can be mediated by a hedonistic pathway. Further research is needed.
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Affiliation(s)
- Jéssica Lorenzzi Elkfury
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Luciana C Antunes
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Centro de Ciências da Saúde, Divisão de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Letícia Dal Moro Angoleri
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Raquel Busanello Sipmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andressa de Souza
- Programa de Pós-graduação em Saúde e Desenvolvimento Humano, LaSalle, Canoas, RS, Brasil
- Programa de Pós-graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Iraci Lucena da Silva Torres
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Wolnei Caumo
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Gu M, Xiao L, Wang J, Cai Q, Liu Y, Xu P, Liu Y, Huang X, Hu W, Sun W. Obesity and Poststroke Fatigue: A 2-Year Longitudinal Study. Neurol Ther 2021; 10:955-969. [PMID: 34436757 PMCID: PMC8571443 DOI: 10.1007/s40120-021-00276-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Obesity is associated with fatigue in many diseases, but the correlation between obesity and poststroke fatigue (PSF) is unclear. The study aimed to investigate the relationship between body mass index (BMI) and the occurrence of and recovery from PSF. Methods Within 3 days of the onset of ischemic stroke, patients were consecutively recruited. We assessed PSF at admission and at 6, 12, and 24 months with the Fatigue Severity Scale (FSS). Multivariable logistic regression and restricted cubic spline function were used to explore the relationships between baseline BMI and the risk of PSF at different time points. The correlation between baseline BMI and the dynamic changes in the natural logarithm transformation of the FSS (lnFSS) score during the follow-up period was analyzed by the piecewise linear mixed-effects model. Results A total of 1026 stroke patients were included. Multivariable analyses indicated that obesity was associated with a decreased risk of early PSF (fatigue diagnosed at baseline) [odds ratio (OR) 0.61, 95% confidence interval (CI) 0.41–0.93] but an increased risk of late PSF (fatigue diagnosed 6 months after the index stroke) (OR 1.63, 95% CI 1.06–2.50 for 6 months; OR 1.87, 95% CI 1.18–2.96 for 12 months; OR 2.11, 95% CI 1.28–3.49 for 24 months). Longitudinal analyses indicated that in the late stage of fatigue, the higher the BMI category, the slower the rate of decrease was for the FSS score. Conclusion Obese patients are less likely to develop fatigue in the acute stage of ischemic stroke. However, they are more prone to late fatigue and exhibit a slower decline in the FSS score in the long term. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00276-x.
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Affiliation(s)
- Mengmeng Gu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lulu Xiao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiankun Cai
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yujing Liu
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Pengfei Xu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yuanlu Liu
- Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China
| | - Xianjun Huang
- Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui Province, China
| | - Wei Hu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Wen Sun
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
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Chiu HH, Tsao LI, Liu CY, Lu YY, Shih WM, Wang PH. Using a short questionnaire of the perimenopausal fatigue scale to evaluate perimenopausal women prone to fatigue syndrome. Taiwan J Obstet Gynecol 2021; 60:734-738. [PMID: 34247816 DOI: 10.1016/j.tjog.2021.05.026] [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] [Accepted: 04/09/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Fatigue, a painful and unpleasant subjective experience, is common in perimenopausal women. Therefore, an effective tool to evaluate the fatigue-precipitating factor is important for perimenopausal women prone to fatigue syndrome. MATERIALS AND METHODS This study was surveyed by short-term perimenopausal fatigue scale. The enrollment period was from November 2019 to January 2020. The subjects were perimenopausal women prone to perimenopausal fatigue. The differences between the fatigue-precipitating factors and the degrees of fatigue and disturbance were determined by one-way ANOVA and t test. RESULTS A total of 220 perimenopausal women with mean age of 51.3 years were included. Among these, 64.1% did not have a habit of regular exercise and 55.5% had chronic diseases. Fatigue syndrome was found in 64.1% of subjects, who were mainly presented by shoulder and neck pain and sleep problems. There were significant differences between "perimenopausal fatigue" and "duration" (p < 0.001); "with and without regular exercise" (p = 0.05); and "with and without chronic diseases" (p = 0.03). CONCLUSIONS Our study showed the perimenopausal fatigue syndrome is more frequently found in perimenopausal women who have a co-morbidity (chronic illness) and do not have a habit of regular exercise. An early identification and prompt intervention may help perimenopausal women to deal with their fatigue syndrome. The short questionnaire perimenopausal fatigue scale seems to be useful for screening perimenopausal women prone to fatigue syndrome.
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Affiliation(s)
- Hsiao-Hui Chiu
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112, Taiwan; Graduate Institute of Gerontology and Heath Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Lee-Ing Tsao
- Graduate Institute of Gerontology and Heath Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Chieh-Yu Liu
- Graduate Institute of Gerontology and Heath Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Yu-Ying Lu
- Graduate Institute of Gerontology and Heath Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Whei-Mei Shih
- Graduate Institute of Gerontology and Heath Care Management, Chang Gung University of Science and Technology, Taoyuan City 333, Taiwan
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan; Female Cancer Foundation, Taipei 112, Taiwan.
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22
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Arakaki JS, Jennings F, Estrela GQ, Cruz Martinelli VDG, Natour J. Strengthening exercises using swiss ball improve pain, health status, quality of life and muscle strength in patients with fibromyalgia: a randomized controlled trial. Reumatismo 2021; 73:15-23. [PMID: 33874643 DOI: 10.4081/reumatismo.2021.1357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/22/2021] [Indexed: 11/23/2022] Open
Abstract
The aim was to evaluate the effectiveness of strengthening exercises using the Swiss ball in patients with fibromyalgia through a randomized controlled trial with intention to treat analyses. A total of 60 patients with fibromyalgia met the inclusion criteria and were randomly allocated to either the Swiss ball exercise group (n=30) or a stretching group (n=30). All patients participated in 40-minute training sessions 3 times per week for 12 weeks. Pain (Visual Analogue Scale 0-100); muscle strength (One Repetition Maximum test); health status (Fibromyalgia Impact Questionnaire Revised); quality of life (Short Form-36 questionnaire) were evaluated at baseline, and after 6 and 12 weeks of training. The Swiss ball group showed a statistically significant improvement in VAS (0-100) (p<0.001), SF-36 (p<0.05) and Fibromyalgia Impact Questionnaire (p<0.001) compared with the stretching group. The results of this study proved that the treatment for fibromyalgia with strengthening exercises and the use of the Swiss ball led to improvement of pain, quality of life, muscle strength and decreased the need for medications for this disease compared to stretching exercises, without negative effects.
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Affiliation(s)
- J S Arakaki
- Universidade Federal de São Paulo - UNIFESP, São Paulo.
| | - F Jennings
- Universidade Federal de São Paulo - UNIFESP, São Paulo.
| | - G Q Estrela
- Universidade Federal de São Paulo - UNIFESP, São Paulo.
| | | | - J Natour
- Universidade Federal de São Paulo - UNIFESP, São Paulo.
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Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51:409-424. [PMID: 33676126 DOI: 10.1016/j.semarthrit.2021.02.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/30/2021] [Accepted: 02/15/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Obesity has been associated with several complications, including musculoskeletal disorders. Aim of the present systematic review was to identify all available evidence on the relationship between fibromyalgia (FM) and obesity, including epidemiological association, impact of obesity on FM severity and effect of weight loss strategies on FM symptoms. METHODS MedLine, Cochrane Central Register of Controlled Trials and Web of Science databases were searched up to September 2020 to identify eligible articles. Data from studies reporting the prevalence of obesity in FM patients were pooled using a random-effects model. RESULTS After removal of duplicate records, 393 studies proceeded to review. A total of 41 articles were deemed eligible for inclusion in final synthesis. Quality assessment revealed that the overall risk of bias was high. The overall prevalence of obesity in FM was 35.7% (95% CI: 31.8 - 39.9%), with higher figures reported for USA. The majority of studies included demonstrated that obesity is associated with different domains of the disorder, including composite measures of activity, pain severity, tender point count, stiffness, fatigue, physical functioning/disability, sleep, cognitive dysfunction, and quality of life; the strength of correlation was weak on average. Inconsistent data were available regarding the correlation with depression and anxiety. Only few studies addressed the effect of therapeutic weight loss in FM, either by bariatric surgery, diet/exercise combination or behavioral weight loss, providing preliminary evidence for a potential benefit of weight loss in ameliorating FM symptoms. CONCLUSIONS Available data support a potential interplay between obesity and FM-related symptoms. Weight management should be encouraged in patients with FM.
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Atzeni F, Alciati A, Salaffi F, Di Carlo M, Bazzichi L, Govoni M, Biasi G, Di Franco M, Mozzani F, Gremese E, Dagna L, Batticciotto A, Fischetti F, Giacomelli R, Guiducci S, Guggino G, Bentivegna M, Gerli R, Salvarani C, Bajocchi G, Ghini M, Iannone F, Giorgi V, Farah S, Bonazza S, Barbagli S, Gioia C, Marino NG, Capacci A, Cavalli G, Cappelli A, Carubbi F, Nacci F, Riccucci I, Cutolo M, Sinigaglia L, Sarzi-Puttini P. The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients. Rheumatol Adv Pract 2021; 5:rkab015. [PMID: 34345760 PMCID: PMC8324026 DOI: 10.1093/rap/rkab015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Various studies have shown that overweight and obesity are central features of FM, but the real impact of a high BMI on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a Web-based registry of patients with FM. Methods Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, in addition to the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status questionnaire (ModFAS) and the Polysymptomatic Distress Scale (PDS). Results A total of 2339 patients were recruited and divided into two weight categories, underweight/normal (U/N, n = 1127, 48.2%) and overweight/obese (O/O, n = 1212, 51.8%). The total and subscales of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all the mean scores of the individual FIQR items (P < 0.001 for all). Conclusion Our findings demonstrate that O/O patients with FM are significantly more impaired than U/N patients in all the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS, thus suggesting that being O/O has an additional effect on symptoms and function.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, Department of Internal Medicine, University of Messina, Messina
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, Humanitas Clinical and Research Center, Como, Milan, Rozzano
| | - Fausto Salaffi
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Marco Di Carlo
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | | | - Marcello Govoni
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Giovanni Biasi
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Manuela Di Franco
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Flavio Mozzani
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Elisa Gremese
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | | | - Fabio Fischetti
- Unit of Rheumatology, Department of Medical, Surgery and Health Sciences, ASUGI and Clinical University, University of Trieste
| | - Roberto Giacomelli
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Serena Guiducci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Giuliana Guggino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo
| | - Mario Bentivegna
- Integrated Reference Center of Rheumatology, Scicli Hospital, Ragusa
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Carlo Salvarani
- University of Modena and Reggio Emilia, Azienda USL-IRCCS di Reggio Emilia
| | - Gianluigi Bajocchi
- Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | | | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, Bari
| | - Valeria Giorgi
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
| | - Sonia Farah
- Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Ancona
| | - Sara Bonazza
- Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara
| | - Stefano Barbagli
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena
| | - Chiara Gioia
- Rheumatology Unit, Department of Internal Medicine, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome
| | - Noemi Giuliana Marino
- Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Annunziata Capacci
- Rheumatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Antonella Cappelli
- Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Varese
| | - Francesco Carubbi
- Clinical Unit of Rheumatology, School of Medicine, University of L'Aquila
| | - Francesca Nacci
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Ilenia Riccucci
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
| | - Maurizio Cutolo
- Research Laboratory and Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino, Genova
| | | | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Milan University School of Medicine, Milan
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Fawole HO, Idowu OA, Abaraogu UO, Dell'Isola A, Riskowski JL, Oke KI, Adeniyi AF, Mbada CE, Steultjens MP, Chastin SFM. Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis. Rheumatol Adv Pract 2021; 5:rkab013. [PMID: 33928211 PMCID: PMC8068317 DOI: 10.1093/rap/rkab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/22/2021] [Indexed: 02/01/2023] Open
Abstract
Objective The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. Methods A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case–control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). Results Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. Conclusion Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations.
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Affiliation(s)
- Henrietta O Fawole
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Opeyemi A Idowu
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Ukachukwu O Abaraogu
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Medical Rehabilitation, University of Nigeria, Enugu, Nigeria
| | - Andrea Dell'Isola
- Department of Clinical Sciences, Orthopaedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jody L Riskowski
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Kayode I Oke
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Ade F Adeniyi
- Department of Physiotherapy, University of Ibadan, Oyo State
| | - Chidozie E Mbada
- Department of Medical Rehabilitation, Obafemi Awolowo University, Osun State, Nigeria
| | - Martijn P Steultjens
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sebastien F M Chastin
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Movement and Sports Science, Ghent University, Ghent, Belgium
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Dong HJ, Larsson B, Rivano Fischer M, Gerdle B. Facing obesity in pain rehabilitation clinics: Profiles of physical activity in patients with chronic pain and obesity-A study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). PLoS One 2020; 15:e0239818. [PMID: 32986777 PMCID: PMC7521725 DOI: 10.1371/journal.pone.0239818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/14/2020] [Indexed: 11/19/2022] Open
Abstract
Background The obesity epidemic has influenced pain rehabilitation clinics. To date, little is known about baseline level of physical activity (PA) in patients referred to pain rehabilitation clinics. We aimed to investigate the PA levels of patients referred to pain rehabilitation clinics and to evaluate the effect of excess weight on PA level. Methods and findings Data were obtained from the Swedish Quality Registry for Pain Rehabilitation between 2016 and 2017. These data included PA time (everyday PA and physical exercise per week), Body Mass Index (BMI), sociodemographic factors, chronic pain and psychological aspects (e.g., pain intensity, depressive and anxiety symptoms and insomnia problems). Insufficient PA was defined as less than 150 minutes per week. We performed logistic regressions as well as orthogonal partial least square regression to estimate the effects of excess weight on PA. Over one-fourth of the patients were classified as obese (BMI ≥30 kg/m2, 871/3110, 25.3%) and nearly one-third of these patients were classified as severely obese (BMI ≥35 kg/m2, 242/871, 27.8%). Time estimations for physical exercise varied among the BMI groups, but patients in the higher BMI category were more likely to spend less time on everyday PA. Compared to normal weight, mild obesity [odds ratio (OR) 0.65, 95% confidence interval (CI) 0.53–0.81] and severe obesity (OR 0.56, 95% CI 0.42–0.74) were associated with less PA. Mild obese patients had an elevated risk of 65% and severe obese patients had an elevated risk of 96% for insufficient PA. Increased pain intensity was positively related to insufficient PA (OR 1.17, 95% CI 1.06–1.29) among the obese patients. Conclusion Having low PA is very common for patients referred to pain rehabilitation clinics, especially for those with comorbid obesity. As a first step to increase PA, obese patients need to be encouraged to increase the intensity and amount of less painful daily PA.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- * E-mail:
| | - Britt Larsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Health Sciences, Research Group Rehabilitation Medicine, Lund University, Lund, Sweden
- Department of Neurosurgery and Pain Rehabilitation, Skane University Hospital, Lund, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Atan T, Karavelioğlu Y. Effectiveness of High-Intensity Interval Training vs Moderate-Intensity Continuous Training in Patients With Fibromyalgia: A Pilot Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 101:1865-1876. [PMID: 32585169 DOI: 10.1016/j.apmr.2020.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) combined with strengthening and stretching exercises in patients with fibromyalgia. DESIGN Interventional, single-blind, randomized controlled trial. SETTING Outpatient rehabilitation center. PARTICIPANTS Women with fibromyalgia (N=60) were randomized to HIIT, MICT, and control groups. INTERVENTIONS HIIT included a 5-minute warm-up at 50% of peak heart rate and 4 cycles of 4 minutes at 80%-95% of peak heart rate followed by 3-minute recovery intervals at 70% of peak heart rate. MICT consisted of 45 minutes at 65%-70% of peak heart rate. Each aerobic training session was followed by standardized strengthening and stretching exercises. The programs performed using cycle ergometers for 5 sessions per week for 6 weeks. The control group did not participate in any supervised exercise sessions. MAIN OUTCOME MEASURES The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). The secondary outcome measures were visual analog scale for pain, Short Form-36 Health Survey (SF-36), cardiopulmonary exercise test (CPET), and body composition parameters. RESULTS Fifty-five participants completed the study. There was no significant difference in FIQ between HIIT vs MICT (1.03; 95% CI, -9.67 to 11.75) after treatment. Group-time interactions were significant for the FIQ between interventions and control (HIIT vs control, -16.20; 95% CI, -27.23 to -5.13 and MICT vs control, -17.24; 95% CI, -28.27 to -6.22) (all P<.001). There were significant group-time interactions for the pain, SF-36, and CPET parameters between treatments and control (all P<.05). Body weight, fat percentage, fat mass, and body mass index improved significantly (all P<.05) only in the MICT group after treatment. CONCLUSIONS The HIIT plus strengthening and stretching exercises and MICT plus strengthening and stretching exercises interventions showed significant improvements for the effect of fibromyalgia, pain degree, functional capacity, and quality of life compared with the control group. HIIT was not superior to MICT. Furthermore, body composition parameters were improved significantly only for the MICT group.
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Affiliation(s)
- Tuğba Atan
- Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, Ankara.
| | - Yusuf Karavelioğlu
- Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey
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Impaired Balance in Patients with Fibromyalgia Syndrome: Predictors of the Impact of This Disorder and Balance Confidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093160. [PMID: 32370043 PMCID: PMC7246608 DOI: 10.3390/ijerph17093160] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/05/2022]
Abstract
Patients with fibromyalgia syndrome (FMS) have a nonspecific postural balance disorder and a greater prevalence of falls. Objective: to clarify which aspects of maintaining balance are associated with the impact of the disorder and with balance confidence. Methods: A total of 182 persons with FMS agreed to participate in this study. After re-evaluation, 57 fully met inclusion criteria: age 40–70 years and moderate-severe impact of the illness according to the Fibromyalgia Impact Questionnaire (FIQ). All participants underwent a posture control analysis with a stabilometric platform, an evaluation of the perception of verticality and an exploration of the vestibular system via functional tests. Additionally, they self-completed questionnaires about balance confidence, central sensitization, pain catastrophizing, kinesiophobia, dizziness and days with episodes of instability. Results: The FIQ was associated with central sensitization and dizziness, which explained 56% of its variance (AdjR2 = 0.566), while days with instability, kinesiophobia and dizziness also explained more than half of the variance of the balance confidence scale (AdjR2 = 0.527). A high percentage of positive responses was found for functional tests (>50%) and a high dispersion in the stabilometric parameters. Conclusion: the detection of factors susceptible to intervention, such as disability due to dizziness, takes on special relevance in patients with FMS.
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