The routines of women with fibromyalgia and an interdisciplinary challenge to promote self-care. / O cotidiano de mulheres com fibromialgia e o desafio interdisciplinar de empoderamento para o autocuidado.

OBJECTIVE: To describe the daily lives of women living with fibromyalgia through the implementation of an interdisciplinary group intervention and verify its benefits to the participants' health. METHOD: This descriptive, exploratory, qualitative study was conducted with 12 women who participanted in an interdisciplinary health education group at the State University of Rio de Janeiro. Data were collected in 2016 through semi-structured interviews, which were organized and analyzed according to Bardin's content analysis. This study was approved by the Institutional Review Board (CAAE 16413013013100005259), in accordance with the legal and ethical guidelines estabished by Resolution 466/2012. RESULTS: Two categories emerged from the analytical corpus, namely: Expression of everyday life and Repercussions of the interdisciplinary group. CONCLUSION: The actions implemented by the interdisciplinary group resulted in numerous physical, psychological and social benefits for the women.

O cotidiano de mulheres com fibromialgia e o desafio interdisciplinar de empoderamento para o autocuidado / El cotidiano de mujeres con fibromialgia y el desafío interdisciplinar de empoderamiento para el autocuidado / The routines of women with fibromyalgia and an interdisciplinary challenge to promote self-care

Resumo OBJETIVOS Descrever o cotidiano das mulheres que vivem com fibromialgia durante a intervenção do grupo interdisciplinar e analisar seus benefícios à saúde das mulheres após a intervenção. MÉTODO Trata-se de um estudo descritivo exploratório, de abordagem qualitativa, desenvolvido com 12 mulheres participantes do grupo interdisciplinar de educação em saúde, em uma Universidade Estadual do Rio de Janeiro. Os dados foram coletados em 2016 por meio de entrevista semiestruturada e, em seguida, organizados e submetidos à análise de conteúdo segundo Bardin. O presente estudo foi aprovado pelo comitê de ética recebendo o número do CAAE 16413013013100005259, em consonância aos aspectos éticos legais da resolução 466/2012. RESULTADOS Do corpus analítico, emergiram duas categorias intituladas: A expressão do cotidiano e Repercussões do grupo interdisciplinar. CONCLUSÃO As ações do grupo interdisciplinar proporcionaram inúmeros benefícios tanto físicos, quanto psicológicos e sociais para cada mulher.

Resumen OBJETIVOS Describir el cotidiano de las mujeres que viven con fibromialgia durante la intervención del grupo interdisciplinario y analizar sus beneficios a la salud de las mujeres después de la intervención. MÉTODO Se trata de un estudio descriptivo exploratorio, de abordaje cualitativo, desarrollado con 12 mujeres participantes del grupo interdisciplinario de educación en salud, en una Universidad Estadual del Río de Janeiro. Los datos fueron recolectados en 2016 por medio de entrevistas semiestructuradas y luego organizados y sometidos al análisis de contenido según Bardin. El presente estudio fue aprobado en el comité de ética recibiendo la numeración del CAAE 16413013013100005259, en consonancia a los aspectos éticos legales de la resolución 466/2012. RESULTADOS Del corpus analítico, emergieron dos categorías tituladas: La expresión del cotidiano y Repercusiones del grupo interdisciplinario. CONCLUSIÓN Las acciones del grupo interdisciplinario proporcionaron innumerables beneficios tanto físicos, como psicológicos y sociales para cada mujer.

Abstract OBJECTIVE To describe the daily lives of women living with fibromyalgia through the implementation of an interdisciplinary group intervention and verify its benefits to the participants' health. METHOD This descriptive, exploratory, qualitative study was conducted with 12 women who participanted in an interdisciplinary health education group at the State University of Rio de Janeiro. Data were collected in 2016 through semi-structured interviews, which were organized and analyzed according to Bardin's content analysis. This study was approved by the Institutional Review Board (CAAE 16413013013100005259), in accordance with the legal and ethical guidelines estabished by Resolution 466/2012. RESULTS Two categories emerged from the analytical corpus, namely: Expression of everyday life and Repercussions of the interdisciplinary group. CONCLUSION The actions implemented by the interdisciplinary group resulted in numerous physical, psychological and social benefits for the women.

Representações da relação entre exercício físico e saúde por pacientes fibromiálgicos / Representations of the relationship between physical exercise and health for patients with fibromyalgia

Fibromialgia (FM) é uma síndrome caracterizada por dor músculo esquelética crônica generalizada, fadiga, distúrbio do sono e sintomas associados. Preocupação com o controle da síndrome justifica-se por sua crescente prevalência e pelo impacto negativo na qualidade de vida dos afetados. Das opções de tratamento não-medicamentoso, o exercício físico (EF) é elemento terapêutico relevante. Há preocupação como o impacto da síndrome e sua terapêutica sobre a saúde, aqui entendida como um conjunto de dimensões - física, emocional, social, espiritual, intelectual e profissional - de uma pessoa. O objetivo do estudo foi identificar a percepção de pacientes com FM sobre a relação entre EF e saúde. Utilizou-se o referencial teórico-metodológico das Representações Sociais numa amostra de 22 mulheres de um projeto multidisciplinar: Educação Física, Nutrição, Medicina e Psicologia. A análise dos dados foi realizada a partir do conteúdo transcrito das gravações de entrevista semiestruturada e interpretação de ilustrações feitas pelas pacientes. Houve melhora na dimensão física, demonstrada pelo alívio da dor nas falas; houve também melhora na dimensão emocional, evidenciada pela melhora da autoestima indicada nas ilustrações. Com base na teoria utilizada, as pacientes reconhecem a relação positiva entre EF e saúde.

The fibromyalgia syndrome (FMS) is characterized by widespread chronic musculoskeletal pain, fatigue, disturbed sleep and associated symptoms. Its increasing prevalence and life quality impairment of patients justify researches for its control. Physical exercise (PE) is a relevant therapeutic tool among nonpharmachologic treatments options. It is important to mind the impact of FMS and different therapeutics on health, here understood as a set of dimensions: physical, emotional, social, spiritual, intellectual and professional. This study aimed to identify FMS patients' perception of relationship between PE and health. It used the theoretical methodological reference of Social Representation to study 22 women of a multidisciplinary project: Physical Education, Nutrition, Medicine and Psychology. Data analysis considered transcription of recorded semi-structured interview, and interpretation of patients' illustrations. There were improvements in physical dimension evidenced by pain relief. Positive effects were also observed in emotional dimension, evidenced by self-esteem improvement, which appeared in the pictures. Based on the theory adopted, it was possible to identify that patients recognize a positive relationship between PE and health.

A randomized clinical trial of home-based exercise combined with a slight caloric restriction on obesity prevention among women.

OBJECTIVE: The study investigated the effectiveness of home-based exercise combined with a slight caloric restriction on weight change during 12 months in non-obese women. METHODS: A randomized clinical trial with a factorial design was conducted from 2003 to 2005. Two hundred three middle-aged women (Rio de Janeiro/Brazil), 25-45 years, were randomly assigned to one of two groups: control (CG) and home-based exercise (HB). The HB group received a booklet on aerobic exercise that could be practiced at home (3 times/week-40 min/session), in low-moderate intensity, during 12 months. Both groups received dietary counseling aimed at a slight energy restriction of 100-300 calories per day. RESULTS: The HB experienced a greater weight loss in the first 6 months (-1.4 vs. -0.8 kg; p=0.04), but after 12 months there was no differences between groups (-1.1 vs. -1.0; p=0.20). Of the serum biochemical markers, HDL cholesterol showed major change, with an increase at month 12 of 18.3mg/dl in the HB compared to 9.5 in the CG (p<0.01). CONCLUSION: Home-based exercise promoted greater weight reduction during the first 6 months after which no further benefits are observed. Continuous favorable changes in HDL cholesterol after 1 year suggest that home-based exercise promote health benefits.

Evasão de um programa de tratamento multidisciplinar para mulheres com fibromialgia / Dropout of a multidisciplinary treatment program for women with fibromyalgia

Objetivo: Avaliar a evasão de um programa de tratamento multidisciplinar da fibromialgia (FM). Métodos: Estudo observacional realizado durante o período de abril de 2000 adezembro de 2005, incluindo 133 mulheres com FM, participantes de um programa de tratamento multidisciplinar. As que se afastaram do tratamento por período de duas semanas ou mais foram classificadas como inativas e contatadas por telefone para registro dos motivos de sua evasão, sendo estes divididos em quatro grupos: 1) Familiares; 2) Ocupações;3) Médicos; 4) Outros Motivos. Resultados: No momento da coleta de dados, 92 (69,4%) mulheres foram consideradas como inativas. Não houve diferença significativa entre a evasão de antes e de após seis meses de tratamento. Do total de mulheres inativas, 54 (40,8%) participantes evadiram por motivos médicos, 30 (22,6%) por outros motivos, 26 (19,4%) por motivos familiares e 23 (17,2%) por ocupação. Não foi observada diferença estatística entre os motivos de evasão de acordo com o tempo de permanência no programa (p > 0,05). Conclusão: Conclui-se que o programa multidisciplinar para mulheres com FM apresentou níveis elevados de evasão, sendo que metade destes ocorreu nos seis primeiros meses. Dentre os principais motivos relatados para o abandono, os motivos médicos foram mais observados.

Objective: To evaluate the dropout of a multidisciplinary treatment program in fibromyalgia (FM). Methods: An observational study conducted during the period of April 2000 to December 2005, including 133 women with fibromyalgia, participating in a multidisciplinary treatment program. Those who had left the treatment for two weeks or more were classified as inactive and contacted by telephone to record the reasons for their noncompliance, which were divided into four groups: 1) Family; 2) Occupations; 3) Medical; 4) Other Reasons. Results: When collecting data, 92 (69.4%) women were considered inactive. There was no significant difference between noncompliance before and after six months of treatment. Of the total number of inactive women, 54 (40.8%) participants left for medical reasons, 30 (22.6%) for other reasons, 26 (19.4%) for family reasons and 23 (17.2%) due to occupation. There was no statistical difference between the motives of dropout according to the length of stay in the program (p> 0.05). Conclusion: We conclude that the multidisciplinary program for women with fibromyalgia had high levels of noncompliance, half of them occurred in the first six months. Among the main reasons reported for dropout, the medical reasons were more frequent.

[Effects of exercise on insulin sensitivity in obese women submitted to a weight loss program: a clinical trial]. / Efeito do exercício físico na sensibilidade à insulina em mulheres obesas submetidas a programa de perda de peso: um ensaio clínico.

The aim of this study was to evaluate the effects of exercise on insulin sensitivity, lipid metabolism and weight loss in women submitted to a weight reduction program. The study consisted in a clinical trial including 40 obese women (BMI 30.41 to 53.29 kg/m2), 20 in each group. Both groups received nutritional counseling and psychological support. The intervention group participated in supervised exercise three times per week for 20 weeks. For the anthropometric measurements, which were taken at three times, the linear mixed modeling procedure showed a reduction of 2 kg in body mass (p = 0.02) and 0.88 kg/m2 in the Body Mass Index (p = 0.02) in intervention group compared with controls after 20 weeks of treatment. We did not detect significant differences between the two groups for body fat location (waist circumference and waist-to-hip ratio), serum lipoprotein profile, and insulin sensitivity evaluated by HOMA-IR. Serum levels of free fatty acids significantly increased in the intervention group compared with controls (difference between groups = 0,30 mmol/L; p = 0,002). The addition of physical exercise in a weight reduction program promoted greater weight loss, increased free fatty acids, but did not alter insulin sensitivity in obese women.

Efeito do exercício físico na sensibilidade à insulina em mulheres obesas submetidas a programa de perda de peso: um ensaio clínico / Effects of exercise on insulin sensitivity in obese women submitted to a weight loss program: a clinical trial

O objetivo deste estudo foi de avaliar o efeito do exercício sobre a sensibilidade insulínica, metabolismo lipídico e perda de peso em mulheres submetidas a programa de redução ponderal. Realizou-se ensaio clínico com 40 mulheres obesas (IMC de 30,41 a 53,29 kg/m²), incluindo 20 em cada grupo. Ambos os grupos (intervenção e controle) receberam orientação nutricional e apoio psicológico. O grupo de intervenção também realizou três sessões semanais de exercícios físicos durante 20 semanas. As variáveis antropométricas foram medidas em três momentos. A análise através de medidas repetidas (modelo linear misto) mostrou redução de 2 kg peso corporal (p = 0,02) e de 0,88 kg/m² no índice de Massa Corporal (p = 0,02), ao final de 20 semanas, do grupo intervenção comparado ao controle. Não foram encontradas diferenças significativas entre os grupos para variáveis relativas à localização da gordura corporal (circunferência de cintura e relação cintura-quadril), perfil lipídico e sensibilidade insulínica medida pelo HOMA-IR. Os ácidos graxos livres apresentaram elevação no grupo intervenção comparado ao controle (diferença entre os grupos = 0,30 mmol/L; p = 0,002). A inclusão de exercícios no programa de redução do peso promoveu maior redução ponderal, aumentou os AGLs, mas não alterou a sensibilidade insulínica em mulheres obesas.

The aim of this study was to evaluate the effects of exercise on insulin sensitivity, lipid metabolism and weight loss in women submitted to a weight reduction program. The study consisted in a clinical trial including 40 obese women (BMI 30.41 to 53.29 kg/m²), 20 in each group. Both groups received nutritional counseling and psychological support. The intervention group participated in supervised exercise three times per week for 20 weeks. For the anthropometric measurements, which were taken at three times, the linear mixed modeling procedure showed a reduction of 2 kg in body mass (p = 0.02) and 0.88 kg/m² in the Body Mass Index (p = 0.02) in intervention group compared with controls after 20 weeks of treatment. We did not detect significant differences between the two groups for body fat location (waist circumference and waist-to-hip ratio), serum lipoprotein profile, and insulin sensitivity evaluated by HOMA-IR. Serum levels of free fatty acids significantly increased in the intervention group compared with controls (difference between groups = 0,30 mmol/L; p = 0,002). The addition of physical exercise in a weight reduction program promoted greater weight loss, increased free fatty acids, but did not alter insulin sensitivity in obese women.