Effects of a low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia: A randomized clinical trial.

BACKGROUND AND OBJECTIVES: Self-reported psychological variables related to pain have been posited as the major contributors to the quality of life of fibromyalgia (FM) women and should be considered when implementing therapeutic strategies among this population. The aim of this study was to explore the effect of low-pressure hyperbaric oxygen therapy (HBOT) on psychological constructs related to pain (i.e., pain catastrophism, pain acceptance, pain inflexibility, mental defeat) and quality of life in women with FM. METHODS: This was a randomized controlled trial. Thirty-three women with FM were randomly allocated to a low-pressure hyperbaric oxygen therapy group (HBOTG) (n=17), who received an 8-week intervention (5 sessions per week), and a control group (CG) (n=16). All women were assessed at baseline (T0) and upon completion of the study (T1) for self-perceived pain intensity, pain catastrophism, pain acceptance, pain inflexibility, mental defeat and quality of life. RESULTS: At T1, the HBOTG improved across all variables related to pain (i.e. self-perceived pain intensity, pain catastrophism, pain acceptance, pain flexibility, mental defeat) (p<0.05) and quality of life (p<0.05). In contrast, the CG showed no improvements in any variable. Furthermore, significant differences between the groups were found in quality of life (p<0.05) after the intervention. CONCLUSIONS: HBOT is effective at improving the psychological constructs related to pain (i.e. pain catastrophism, pain acceptance, pain flexibility, mental defeat) and quality of life among women with FM. Clinical Trial Link Clinical Trials gov identifier (NCT03801109).

Fibromyalgia syndrome is associated with sexual dysfunction regardless of physical activity status: a cross-sectional study.

BACKGROUND: Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. AIM: The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. METHODS: The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. OUTCOMES: The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. RESULTS: There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). CLINICAL IMPLICATIONS: Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. STRENGTHS AND LIMITATIONS: The main limitation is that the outcome measures were self-reported. CONCLUSION: We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.

Effectiveness of High-Frequency Transcranial Magnetic Stimulation and Physical Exercise in Women With Fibromyalgia: A Randomized Controlled Trial.

OBJECTIVE: Fibromyalgia (FM) is characterized by chronic widespread pain and both physical and emotional alterations, which in turn may affect the individual's quality of life. Thus, interventions aimed at treating such symptoms, without increasing fatigue, are needed. The aim of this study was to explore the effect of high-frequency transcranial magnetic stimulation (HF-TMS) and physical exercise (PE) on pain, impact of FM, physical conditioning, and emotional status in women with FM. METHODS: Forty-nine women with FM were randomly allocated to: (1) a PE group (PEG, n = 16), who underwent an 8-week (two 60-minute sessions/wk) low-intensity PE program; (2) a TMS group (TMSG, n = 17) receiving a 2-week (five 20-minute sessions/wk) HF-TMS intervention; and (3) a control group (CG, n = 16). Pain (ie, perceived pain and average pressure pain threshold), perceived impact of FM (ie, overall impact, symptoms, and perceived physical function), physical conditioning (ie, endurance and functional capacity, fatigue, gait velocity, and power), and emotional status (ie, anxiety, depression, stress, and satisfaction) were assessed at baseline (T0) and after the intervention (T1, at 2 weeks for TMSG and at 8 weeks for PEG and CG). RESULTS: The TMSG showed significant improvement in all studied variables after the intervention except for satisfaction, whereas the PEG showed improved average pressure pain threshold, perceived overall impact of FM and total score, endurance and functional capacity, velocity and power, anxiety, depression, and stress. In contrast, the CG showed no improvements in any variable. CONCLUSION: Both PE and HF-TMS are effective in improving pain, impact of FM, physical conditioning, and emotional status in people with FM; HF-TMS achieved larger improvements in emotional status than PE. IMPACT: TMS and PE have similar benefits for physical status, whereas TMS has greater benefits than PE for emotional status in women with FM.

Thermal imaging ruled out as a supplementary assessment in patients with fibromyalgia: A cross-sectional study.

BACKGROUND: The diagnosis of fibromyalgia syndrome (FMS) syndrome is often complicated and relies on diagnostic criteria based mostly on the symptoms reported by patients. Implementing objective complementary tests would be desirable to better characterize this population. OBJECTIVE: The purpose of this cross-sectional study was to compare the skin temperature at rest using thermography in women with FMS and healthy women. METHODS: Eighty-six women with FMS and 92 healthy controls volunteered to participate. The temperature of all participants was measured by infra-red thermography, registering the skin surface temperature (minimum, maximum and average) at rest in different areas: neck, upper and lower back, chest, knees and elbows. In order to analyze the differences in the skin temperature between groups, inferential analyses of the data were performed using Mann-Whitney U test. RESULTS: The results showed no significant difference in skin temperature between groups in the neck, upper back, chest and elbows (p>0.05). The lower back and knees areas showed significant differences between groups (p<0.05), although these differences did not reach a minimum of clinically detectable change. CONCLUSIONS: Women with fibromyalgia presented no clinically meaningful reduction or difference in skin temperature at rest when compared with a group of healthy women. The infra-red thermography is not an effective supplementary assessment tool in women with fibromyalgia.

Comparative study of the effectiveness of a low-pressure hyperbaric oxygen treatment and physical exercise in women with fibromyalgia: randomized clinical trial.

BACKGROUND: Fibromyalgia (FM) is characterized by chronic pain and fatigue, among other manifestations, thus advising interventions that do not aggravate these symptoms. The main purpose of this study is to analyse the effect of low-pressure hyperbaric oxygen therapy (HBOT) on induced fatigue, pain, endurance and functional capacity, physical performance and cortical excitability when compared with a physical exercise program in women with FM. METHODS: A total of 49 women with FM took part in this randomized controlled trial. They were randomly allocated to three groups: physical exercise group (PEG, n = 16), low-pressure hyperbaric oxygen therapy group (HBG, n = 17) and control group (CG, n = 16). Induced fatigue, perceived pain, pressure pain threshold, endurance and functional capacity, physical performance and cortical excitability were assessed. To analyse the effect of the interventions, two assessments, that is, pre and post intervention, were carried out. Analyses of the data were performed using two-way mixed multivariate analysis of variance. RESULTS: The perceived pain and induced fatigue significantly improved only in the HBG (p < 0.05) as opposed to PEG and CG. Pressure pain threshold, endurance and functional capacity, and physical performance significantly improved for both interventions (p < 0.05). The cortical excitability (measured with the resting motor threshold) did not improve in any of the treatments (p > 0.05). CONCLUSIONS: Low-pressure HBOT and physical exercise improve pressure pain threshold, endurance and functional capacity, as well as physical performance. Induced fatigue and perceived pain at rest significantly improved only with low-pressure HBOT. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03801109.

Importancia de la música para y en la formación del fisioterapeuta / Importance of music for and in the training of the physiotherapist / Importância da música para e no treinamento do fisioterapeuta

Resumen Introducción: son muchos los especialistas de Ciencias de la Salud que han demostrado lo interesante y significativo de utilizar la Música en sus tratamientos terapéuticos. No obstante, en España, solo una universidad pública cuenta con formación musical para capacitarlos en su utilización. Objetivo: esta investigación intentó demostrar la necesidad de formación musical desde el Grado de Fisioterapia, a través de propuestas de Movimiento con Música desde la perspectiva dalcroziana. Materiales y métodos: se realizaron una serie de prácticas de concienciación corporal con Música, atendiendo al trabajo de distintos elementos musicales y partiendo de las propuestas de Jaques-Dalcroze; que terminaron concretándose después en role-playing extrapolables a sus sesiones de prácticas fisioterapéuticas. Se distribuyeron a lo largo de cuatro semanas de trabajo, a razón de tres horas semanales de trabajo, que finalizaban con el feedback aportado por las propuestas prácticas adaptadas a sus futuras sesiones de Fisioterapia. Resultados: los datos mostraron la importancia que el fisioterapeuta concede al estímulo auditivo musical como motivador y no solo como relajante. Los resultados centrados en la interiorización-corporización, por parte del fisioterapeuta, fueron significativos porque se produjo un aumento de la concienciación acerca del propio movimiento corporal; hecho que, posibilitó una incorporación de sus propias propuestas durante el período de Prácticum. Conclusiones: Se pudo comprobar cómo la implementación de una materia musical en el Grado de Fisioterapia podrá contribuir al desarrollo de las competencias genéricas, específicas y transversales vinculadas a dicha titulación. La Universidad de Valencia se convirtió, así, en pionera al ofertar Musicoterapia a sus estudiantes.

Abstract Introduction: there are many specialists in Health Sciences who have shown how interesting and meaningful to use music in their therapeutic treatments. However, in Spain, only one public university has musical training to train the in its use. Objective: this research attempted to demonstrate the need for musical training from the Degree of Physiotherapy, through proposals of Movement with Music from the Jaques-Dalcrozian perspective. Materials and methods: a series of body awareness practices with Music was carried out, based on the works of different musical elements and based on Dalcroze's proposals; that ended up being concreted later in role-playing extrapolables to their sessions of physiotherapeutic practices. They were di stributed over four weeks of work, at the rate of three hours per week of work, which ended with the feedback provided by the practical proposals adapted to their future physiotherapy sessions. Results: the data showed the importance that the physiotherapist gives to the musical auditory stimulus as motivator and not only as relaxing. The results focused on the internationalization-embodiment by the physiotherapist, were significant because there was an increase in awareness about one's body movement; fact that, it made possible an incorporation of its own proposals during the Practicum period. Conclusions. It was possible to verify how the implementation of a musical subject in the Degree of Physiotherapy can contribute to the development of the generic, specific and transversal competences linked to said degree. The University of Valencia thus became a pioneer in offering Music Therapy to its students.

Resumo Introdução: muitos especialistas em ciências da saúde mostraram como é interessante e significativo usar a música em seus tratamentos terapêuticos. No entanto, na Espanha, apenas uma universidade pública possui treinamento musical para treiná-las em seu uso. Objetivo: esta pesquisa procurou demonstrar a necessidade de treinamento musical a partir do Grau de Fisioterapia, através de propostas de Movimento com Música na perspectiva dalroziana. Materiais e métodos: realizou-se uma série de práticas de consciência corporal com a música, atendendo ao trabalho de diferentes elementos musicais e com base nas propostas de Jaques-Dalcroze; que acabaram-se concretizando na encenação extrapolada para as sessões de prática fisioterapêutica. Eles foram distribuídos ao longo de quatro semanas de trabalho, na proporção de três horas por semana de trabalho, terminando com o feedback fornecido pelas propostas práticas adaptadas às suas futuras sessões de Fisioterapia. Resultados: os dados mostraram a importância que o fisioterapeuta atribui ao estímulo auditivo musical como motivador e não apenas como relaxante. Os resultados focados na incorporação-incorporação, pelo fisioterapeuta, foram significativos porque houve um aumento na consciência do próprio movimento corporal; fato que possibilitou a incorporação de suas próprias propostas durante o período de estágio. Conclusões: foi possível verificar como a implementação de uma disciplina musical no Grau de Fisioterapia poderia contribuir para o desenvolvimento de competências genéricas, específicas e transversais vinculadas a esse diploma. A Universidade de Valência tornou-se assim pioneira em oferecer Musicoterapia aos seus alunos.

Low-Intensity Physical Exercise Improves Pain Catastrophizing and Other Psychological and Physical Aspects in Women with Fibromyalgia: A Randomized Controlled Trial.

Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain and other physical and psychological features. In this study, we aimed to analyze the effect of a low-intensity physical exercise (PE) program, combining endurance training and coordination, on psychological aspects (i.e., pain catastrophizing, anxiety, depression, stress), pain perception (i.e., pain acceptance, pressure pain threshold (PPT), and quality of life and physical conditioning (i.e., self-perceived functional capacity, endurance and functional capacity, power and velocity) in women with FM. For this purpose, a randomized controlled trial was carried out. Thirty-two women with FM were randomly allocated to a PE group (PEG, n = 16), performing an eight-week low-intensity PE program and a control group (CG, n = 16). Pain catastrophizing, anxiety, depression, stress, pain acceptance, PPT, quality of life, self-perceived functional capacity, endurance and functional capacity, power, and velocity were assessed before and after the intervention. We observed a significant improvement in all studied variables in the PEG after the intervention (p < 0.05). In contrast, the CG showed no improvements in any variable, which further displayed poorer values for PPT (p < 0.05). In conclusion, a low-intensity combined PE program, including endurance training and coordination, improves psychological variables, pain perception, quality of life, and physical conditioning in women with FM.

Physical Condition Factors that Predict a Better Quality of Life in Women with Fibromyalgia.

What physical qualities can predict the quality of life (QoL) in women with fibromyalgia (FM)? QoL is a very complex outcome affected by multiple comorbidities in people with fibromyalgia. This study aims to determine which physical qualities can predict the quality of life in women with FM. Also, a comparison between the physical qualities of women with FM and healthy counterparts was conducted. In total, 223 women participated in this cross-sectional study, 123 with FM, with ages ranging between 45 and 70 years. The study was conducted at several fibromyalgia associations and specialized medical units. QoL was measured as the main outcome. In addition, functional capacity, muscular strength, maintenance of thoracic posture, postural control, flexibility, pain threshold, and anxiety were measured. Prediction of the QoL was conducted with multiple linear regression analysis and comparison between groups, using the Mann-Whitney U test. There were significant differences between groups in all the variables measured (p < 0.01). The multiple linear regression model showed that factors influencing QoL in women with FM for all the variables measured were functional capacity, handgrip strength and bicep strength, maintenance of thoracic posture, pain threshold, and anxiety (R2 = 0.53, p < 0.05). To conclude, women with FM show a significantly lower QoL than their healthy counterparts, and the factors that predict their perceived QoL are functional capacity, muscular strength, postural maintenance, pain threshold, and anxiety.

Effect of Kinesio taping on clinical symptoms in people with fibromyalgia: A randomized clinical trial.

BACKGROUND: Fibromyalgia syndrome (FMS) is a disorder characterized by chronic widespread pain and muscle soreness. Because of its high prevalence, many therapeutic approaches have been proposed with the aim of improving overall physical function and reducing pain. Since low adherence is one of the major limitations among these patients, treatments that do not interfere with their daily routines, such as KT, would be a feasible option. OBJECTIVE: The main goal of this study was to analyze the effect of Kinesio Tape (KT) on pain, posture, body comfort and quality of life (QoL) in people with FMS. METHODS: Thirty-five women (between 17 and 70 years of age) with FMS were randomly allocated to two treatment groups, depending on the location of the KT: "Upper trunk group" (UTG) (n= 18) and "Global trunk group" (GTG) (n= 17). The intervention period lasted 3 weeks. Pain, comfort, trunk posture and QoL were assessed before and after the intervention. RESULTS: Both KT treatments were effective in reducing pain and improving neck and shoulder comfort (p< 0.05). The GTG achieved a significant improvement in thoracic comfort (p< 0.05), whereas the UTG experienced a significant improvement in non-dominant side trunk posture and showed a significant improvement in the QoL score (p< 0.05). CONCLUSION: GT and UT KT applications have positive effects on patients with FMS and may be considered as a suitable treatment option among this population.

Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial.

PURPOSE: The scars derived from the treatment of breast cancer lead to adverse effects such as fibrosis or retractions of the connective tissue. Myofascial release (MR) seeks to reduce restrictions of the fascial system. Therefore, the aim of this study was to analyze the clinical impact of MR treatment on women survivors of breast cancer. METHODS: We enrolled 24 women with breast cancer, 13 received myofascial release treatment (MR) and 11, a placebo manual lymphatic drainage treatment (PMLD). Both interventions were administered over a period of 4 weeks. The outcomes studied were pain, shoulder range of motion (ROM), functionality, quality of life (QoL), and depression, immediately after treatment and 1 month later. RESULTS: After 4 weeks of treatment, only the participants who received MR experienced a significant decrease in pain intensity in the short and midterm (p < 0.05). This therapy also achieved a general improvement in ROM (p < 0.05), except for internal rotation, that persisted 1 month after treatment. Regarding functionality, both therapies achieved the level of significance (p < 0.05), but only MRG sustained the improvement in the midterm. General QoL, assessed with FACT-B, and its physical well-being dimension were significantly improved after MR implementation (p < 0.05), while the emotional dimension and the breast cancer subscale improved only with PMLD (p < 0.05). CONCLUSIONS: In conclusion, an MR-based treatment shows physical benefits (i.e., overall shoulder movement, functionality, and perceived pain) in women after breast cancer surgery. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov NCT03182881.

Effect of the soft-tissue techniques in the quality of life in patients with Crohn's disease: A randomized controlled trial.

BACKGROUND: Crohn's disease (CD) is a highly prevalent inflammatory bowel disease (IBD), characterized by recurring flares altered by periods of inactive disease and remission, affecting physical and psychological aspects and quality of life (QoL). The aim of this study was to determine the therapeutic benefits of soft non-manipulative osteopathic techniques in patients with CD. METHODS: A single-blind randomized controlled trial was performed. 30 individuals with CD were divided into 2 groups: 16 in the experimental group (EG) and 14 in the control group (CG). The intervention period lasted 30 days (1 session every 10 days). Pain, global quality of life (GQoL) and QoL specific for CD (QoLCD) were assessed before and after the intervention. Anxiety and depression levels were measured at the beginning of the study. RESULTS: We observed a significant effect of the treatment in both the physical and task subscales of the GQoL (P = .01 and P = .04, respectively) and also in the QoLCD (P ≤.0001) but not in pain score (P = .28). When the intensity of pain was taken into consideration in the analysis of the EG, there was a significantly greater increment in the QoLCD after treatment in people without pain than in those with pain (P = .02) The improvements in GQoL were independent from the disease status (P = .16). CONCLUSIONS: Soft, non-manipulative osteopathic treatment is effective in improving overall and physical-related QoL in CD patients, regardless of the phase of the disease. Pain is an important factor that inversely correlates with the improvements in QoL.

Characterization of postural control impairment in women with fibromyalgia.

The main goal of this cross-sectional study was to detect whether women with fibromyalgia syndrome (FMS) have altered postural control and to study the sensory contribution to postural control. We also explored the possibility that self-induced anxiety and lower limb strength may be related to postural control. For this purpose, 129 women within an age range of 40 to 70 years were enrolled. Eighty of the enrolled women had FMS. Postural control variables, such as Ellipse, Root mean square (RMS) and Sample entropy (SampEn), in both directions (i.e. mediolateral and anteroposterior), were calculated under five different conditions. A force plate was used to register the center of pressure shifts. Furthermore, isometric lower limb strength was recorded with a portable dynamometer and normalized by lean body mass. The results showed that women with FMS have impaired postural control compared with healthy people, as they presented a significant increase in Ellipse and RMS values (p<0.05) and a significant decrease in SampEn in both directions (p<0.05). Postural control also worsens with the gradual alteration of sensory inputs in this population (p<0.05). Performing a stressor dual task only impacts Ellipse in women with FMS (p>0.05). There were no significant correlations between postural control and lower limb strength (p>0.05). Therefore, women with FMS have impaired postural control that is worse when sensory inputs are altered but is not correlated with their lower limb strength.

Impaired Trunk Posture in Women With Fibromyalgia.

STUDY DESIGN: A cross-sectional study. OBJECTIVES: The main goal of the study was to analyze posture of Fibromyalgia syndrome (FMS) in women compared with healthy subjects to establish if posture assessment could be useful to characterize the syndrome. Secondarily, we explored the impact of sedentary behavior on trunk posture. SUMMARY OF BACKGROUND DATA: Pain has been associated with poor static postures, however there is little information on the effect of FMS, which is characterized by widespread pain, on trunk posture. METHODS: One hundred eighteen women with FMS and 110 healthy counterparts participated in this study, in which trunk posture was assessed. The thoracic kyphosis, forward head position, and shoulder position (basal and maximum protraction) were measured. Further, maximum shoulder protraction and the ability to maintain the cervical and thoracic angle were assessed. To compare the differences in posture depending on the grouping, an independent Student t test was conducted. To analyze the differences between groups in the ability to maintain the position over a period of time and the differences in posture depending on more or less active lifestyles, two multivariate analysis of variance were performed. RESULTS: The results showed a significantly larger thoracic kyphosis, baseline shoulder protraction and lower craniovertebral angle and maximum protraction in FMG compared with CG (P < 0.05). FMG subjects exhibited an impaired ability to maintain the cervical and thoracic angles, as this varied throughout the test, unlike those of their counterparts. A sedentary lifestyle did not affect trunk posture in the FMS participants. CONCLUSION: FMS female population present an altered trunk posture and an inability to maintain trunk position. Since this does not appear to be influenced by a more or less active lifestyle, specific treatment programs are needed to manage this clinical condition. LEVEL OF EVIDENCE: 2.