Do fibromyalgia patients feel older than they really are? An observational study.

OBJECTIVES: This study aimed to test the hypothesis that fibromyalgia patients feel older than their actual age and to investigate the associations between their subjective age and clinical parameters such as cognition, depression, anxiety, widespread pain, sleep, and fatigue. METHODS: This observational cross-sectional study enrolled 176 patients with newly diagnosed fibromyalgia and 89 controls. Subjective age was determined by asking the question "how old do you feel?", and the difference between the physiological and subjective ages was calculated. Depression, anxiety, fatigue, sleep cognition, and widespread pain levels in the subjects were evaluated, and multivariate stepwise regression analysis was used to determine the factors explaining the variation in the difference between actual and subjective age. RESULTS: Of the fibromyalgia patients, 75% felt older than their actual age, whereas 45% of the controls felt younger. Regression analysis revealed that depression, widespread pain, and fatigue explained nearly half of the variation in the subjective age and the difference between actual and subjective age. CONCLUSIONS: Fibromyalgia patients feel older than their actual age, and this subjective age is associated with depression, widespread pain, and fatigue. Further studies should investigate usage of subjective age perception in differential diagnosis of fibromyalgia.

Ultrasonography-guided botulinum toxin injection for lumbrical muscle spasticity in a hemiplegic patient.

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Validity and reliability of the Turkish version of the neurogenic bladder symptom score.

PURPOSE: The neurogenic bladder symptom score (NBSS) represents the effect of disease-specific symptoms on the quality of life in patients with neurogenic bladder (NB). The purpose of this study was to assess the psychometric properties of the Turkish version of the NBSS in spinal cord injury (SCI) and multiple sclerosis (MS) patients. METHODS: The cross cultural adaptation was achieved through forward and back translation of the items of the original version by an expert committee. Face and content validity were evaluated in a prepatient group. Internal consistency and test-retest reliability were used for reliability assessment in 102 patients. Validity was examined using Short Form-12 and King's Health Questionnaire. RESULTS: Eighty-four patients with SCI and 18 with MS were included in the study. Cronbach's alpha values for the total score and the incontinence, storage/voiding, and consequences domains were 0.90, 0.91, 0.81, and 0.63, respectively. The intraclass correlation coefficients were >0.80 for all subdomains and the overall score. The correlation analyses indicated that the Turkish version has good construct validity. CONCLUSIONS: Our results showed that the Turkish version of the NBSS has good reliability and validity in patients with SCI and MS and can be used to evaluate NB symptoms. CLINICAL TRIAL NUMBER: NCT03964077.Implications for rehabilitationThe Turkish version of the neurogenic bladder symptom score (NBSS) is a valid and reliable instrument to measure symptom specific quality of life (QOL) in both patients with spinal cord injury and multiple sclerosis.The Turkish version of the NBSS can be used in the Turkish population to measure neurogenic bladder related QOL for clinical and research purposes.

Development and validation of a tool for evaluating YouTube-based medical videos.

BACKGROUND/AIMS: Today, one of the ways to access medical information is the internet. Our objective was to develop a measurement tool to assess the quality of online medical videos. METHODS: Online videos covering a variety of subjects (COVID-19, low back pain, weight loss, hypertension, cancer, chest pain, vaccination, asthma, allergy, and cataracts) were evaluated using our Medical Quality Video Evaluation Tool (MQ-VET) by 25 medical and 25 non-medical professionals. Exploratory factor analysis, Cronbach's alpha, and correlation coefficients were used to assess the validity and reliability of the MQ-VET. RESULTS: The final MQ-VET consisted of 15 items and four sections. The Cronbach's alpha reliability coefficient for the full MQ-VET was 0.72, and the internal consistency for all factors was good (between 0.73 and 0.81). The correlation between the DISCERN questionnaire scores and MQ-VET scores was significant. CONCLUSION: Collectively, our findings indicated that the MQ-VET is a valid and reliable tool that will help to standardize future evaluations of online medical videos.

Caregiver burden in stroke inpatients: a randomized study comparing robot-assisted gait training and conventional therapy.

The effects of caregiver burden during the inpatient rehabilitation period have not yet been investigated. The purpose of this study was to evaluate the burden on stroke survivors' caregivers during the inpatient rehabilitation period, and to compare the associations of robot-assisted gait training and conventional therapy with caregiver burden. Our randomized, crossover, prospective study included 63 stroke survivors and their caregivers, who were randomly assigned to one of two groups. The patients in group I received robot-assisted gait training for 2 weeks, followed by conventional therapy for a further 2 weeks. The patients in group II received conventional therapy for 2 weeks followed by robot-assisted gait training for a further 2 weeks. The caregiver burden inventory, beck depression index, and beck hopelessness scale were administered to the caregivers at day 0, on the "switch day" (day 15), and day 30. Before inpatient rehabilitation, 18 (35%) of the caregivers had somewhat elevated scores on the caregiver burden inventory; however, at the end of rehabilitation, 42 (66.6%) of the caregivers were in a high-burden state. The caregiver burden inventory scores differed significantly between baseline and the end of rehabilitation in both groups. Caregiver depression scores also increased significantly in both groups (p < 0.0001), while hopelessness scores increased only in group II (p = 0.027). Caregiver burden increased during the inpatient stroke rehabilitation period. During inpatient rehabilitation, both robot-assisted gait training and conventional therapy increased caregiver burden.ClinicalTrials.gov Number NCT03535467, First Posted: 24 May 2018.

Working From Home During a Pandemic: Investigation of the Impact of COVID-19 on Employee Health and Productivity.

OBJECTIVE: To determine ergonomic problems when working from home during the COVID-19 pandemic with regard to musculoskeletal pain, sleep conditions, physical activity, resting, equipment, and productivity. METHODS: In this cross-sectional study, office workers who switched to working from home during the COVID-19 pandemic participated in an online survey (n = 194). The data were interpreted using descriptive and multivariate regression analysis. RESULTS: A significant increase in back pain was revealed (P < 0.001). Significant weight gain was observed (P < 0.001) connected to a decrease in physical activity and an increase in the consumption of junk food. Despite the negative health impact, participants self-reported an increase in productivity. CONCLUSION: The self-reported productivity was higher during the working from home, but a declining trend in employee health can be observed including low back pain and weight gain.

Decreased Chronic Widespread Pain on Nonworking Days Might Help Differentiate Work-Related Musculoskeletal Disorders From Fibromyalgia: A Cross-Sectional Study of Working Females.

OBJECTIVES: This study aims to investigate whether fibromyalgia (FM) and work-related musculoskeletal disorders can be differentiated in working females by comparing their pain on nonworking and working days. PATIENTS AND METHODS: The study included 142 female workers (mean age 30.0±6.5 years; range, 18 to 50 years) from five different work areas: 27 factory workers, 27 janitors, 25 data automation employees, 31 nurses, and 32 physiotherapists. Demographic characteristics were recorded. FM was diagnosed according to 2016 criteria of the American College of Rheumatology. The extended version of the Nordic Musculoskeletal Questionnaire was used to evaluate the participants' musculoskeletal complaints and the severity of their pain. Pain was assessed with visual analog scale (VAS) scores on working and nonworking days. Differences in the participants' VAS-Pain on working and nonworking days were compared. Sensitivity, specificity, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used. RESULTS: Of the 142 working females, 32 (22.5%) were diagnosed with FM. There was a significant difference in nonworking day VAS-Pain scores between the FM patients and the work-related musculoskeletal disorder patients (p<0.001). Analysis of ROC curve for VAS-Pain difference scores yielded AUC of 0.860 (95% confidence interval=0.774-0.945) (p<0.001). ROC analysis identified 1.5 centimeters of VAS-Pain difference score as the cut-point for differentiating work-related musculoskeletal disorders and FM resulting in sensitivity of 97% and specificity of 96%. FM patients had significantly higher rates of positive answers to "visit health professionals," "take medication," and "sick leave" questions compared to patients with work-related musculoskeletal disorders (p<0.001). CONCLUSION: The amount of the decrease in pain on nonworking days may help differentiate work-related musculoskeletal disorders from FM in working females. Therefore, evaluating pain on nonworking days may help clinicians diagnose and treat FM correctly.

The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases.

OBJECTIVE: This study explored the role of central sensitization (CS) pain in patients with various rheumatic diseases using the CS inventory (CSI). METHODS: A total of 193 patients of mean age 50.72 ± 9.65 years were included; they were divided into four different groups in terms of their rheumatic diseases. Patients with rheumatoid arthritis (RA), spondyloarthropathy (SpA), osteoarthritis (OA), and fibromyalgia syndrome (FMS) were evaluated in tertiary care rheumatology/pain medicine settings. Disease duration and activity, the Bath Ankylosing Spondylitis Disease Activity Index, the Disease Activity Score-28, and pain severity (evaluated using a visual analog scale) were assessed, and the Turkish version of the CSI administered. RESULTS: CS syndromes were present in almost half the patients (45% of SpA, 41% of RA, 62% of OA, and 94% of FMS patients). We found no significant relationship between disease activity and the CSI-A scores in SpA or RA patients (p = 0.731 and p = 0.390, respectively). As expected, the CSI-A scores were highest in the FMS group (p = 0.000), but were similar in the other groups (p < 0.05). CS-related syndromes (CSI-B conditions) were present at similar frequencies in the RA, SpA, and OA groups, but were less common in the FMS group (p = 0.000). CONCLUSIONS: The CSI usefully detects CS pain in patients with rheumatic diseases. Treatment of such pain can enhance the quality of daily life in patients with rheumatic diseases.Key Point• Central sensitization pain is common in patients with rheumatic diseases including rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.