RESUMEN
BACKGROUND: Fibromyalgia (FM) is considered a stress-related disorder characterized mainly by chronic widespread pain. Its pathogenesis is unknown, but cumulative evidence points at dysfunctional transmitter systems and inflammatory biomarkers that may underlie the major symptoms of the condition. This study aimed to evaluate pain scores (primary outcome), quality of life, inflammatory biomarkers and neurotransmitter systems in women with FM (secondary outcomes) subjected to gentle touch therapy (GTT) or placebo. METHODS: A total of 64 female patients with FM were randomly assigned to two groups, namely GTT (n = 32) or Placebo (n = 32). Clinical assessments were conducted at baseline and post-intervention with six-month follow-up. We measured serum catecholamines (dopamine), indolamines and intermediary metabolites (serotonin or 5-hydroxyindolacetic acid (5-HIAA)), as well as tetrahydrobiopterin (BH4), which is a cofactor for the synthesis of neurotransmitters and inflammatory biomarkers in women with FM. A group of healthy individuals with no intervention (control group) was used to compare biochemical measurements. Intervention effects were analyzed using repeated measures (RM) two-way ANOVA followed by Bonferroni post hoc test and mixed ANCOVA model with intention to treat. RESULTS: Compared to placebo, the GTT group presented lower pain scores and brain-derived neurotrophic factor (BDNF) levels without altering the quality of life of women with FM. Changes in BDNF had a mediating role in pain. Higher baseline serum BDNF and 5-HIAA or those with a history of anxiety disorder showed a higher reduction in pain scores across time. However, women with higher serum dopamine levels at baseline showed a lower effect of the intervention across the observation period revealed by an ANCOVA mixed model. CONCLUSIONS: In conclusion, lower pain scores were observed in the GTT group compared to the placebo group without altering the quality of life in women with FM. Reductions in BDNF levels could be a mechanism of FM pain status improvement. In this sense, the present study encourages the use of these GTT techniques as an integrative and complementary treatment of FM.
RESUMEN
Alterações musculares e anatômicas são em sua maioria responsáveis pela síndrome patelofemoral (SDPF). Sabendo que a musculatura do quadríceps é de grande importância na estabilização da patela, questiona-se como o músculo Vasto Medial Oblíquo (VMO) influencia na estabilizaçãopatelar evitando a SDPF. Muitos pesquisadores tem investigado o uso da bandagem funcional como meio de ativação muscular. Objetivo: O presente estudo teve como objetivo analisar o uso da bandagem como meio de ativação do VMO no exercício de agachamento. Método: A atividade dos músculos VMO e Vasto lateral (VL) foi avaliada através de eletromiografia durante o agachamento com adução e o agachamento com o uso de bandagem. A amostra composta por 39 indivíduos foi dividida em quatro grupos: indivíduos do sexo masculino sedentários e atletas, eindivíduos do sexo feminino sedentárias e atletas. Resultados: Embora tenha sido encontrada uma maior ativação do VMO em relação ao VL, com a presente metodologia e variáveis estudadas, não foi possível demonstrar diferença estatística entre os grupos nos agachamentos com e sem o uso da bandagem. No entanto, é importante ressaltar que a ausência de diferença na ativação do VMO durante o agachamento com adução e com bandagem sugerem um efeito positivo e facilitador da bandagem na ativação muscular. Este resultado é muito importante no tratamento de lesões agudas onde o movimento ativo está limitado. Conclusão: Sugere-se a execução de novos estudos aonde outros parâmetros da eletromiografia e estimulação reflexa sejam abordados, a fim de investigar o real papel da bandagem funcional na ativação muscular.
Muscular and anatomical changes are mostly responsible for patella femoral syndrome (PFPS). Knowing that the quadriceps muscles are very important in stabilizing the patella, studies have questioned the influence of the Vastus Medialis Obliquus (VMO) in the patellar stabilization avoiding the PFPS. Many researchers have investigated the use of taping as a means of muscleactivation. Objective: The present study aimed to analyze the use of functional taping to activate the VMO during the squat exercise. Method: The activity of the VMO and Vastus Lateralis (VL) was assessed by electromyography during squats and squats with adduction using functional taping. The sample, composed of 39 individuals, was divided into four groups: males and females, both separated into sedentary and athletic types. Results: Although greater activation of the VMO has been found in comparison with the VL, with the applied methodology and variables, we could not demonstrate a statistical difference between groups in squats with and without the use of functional taping. However, it is important to emphasize that the lack of difference in the activation of VMO during squats with adduction and taping suggests a positive effect of the taping in muscleactivation. This result is very important in the treatment of acute injuries where active movement is limited. Conclusion: Future studies should be done with other electromyography parameters and reflex activation in order to investigate the actual role of functional taping in muscle activation.