Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial.

BACKGROUND: Muscle stretching exercises preserve corporal flexibility and decrease the retraction and shortening of myofascial and articular structures. These exercises are recommended for the treatment of fibromyalgia (FM). The purpose of the study was to verify and compare the effect of muscle stretching exercises on FM patients based on the global posture reeducation method against segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy. METHODS: Forty adults with FM were randomly allocated into two groups: global and segmental. The two kinds of therapies were performed in 10 individual sessions once a week. Two assessments were made: one at baseline and one at the end of therapy. The primary outcome variable was pain intensity (Visual Analog Scale). The secondary outcome variables were multidimensional pain (McGill Pain Questionnaire), the pain threshold at tender points (dolorimetry), attitudes toward chronic pain (Survey of Pain Attitudes-Brief Version), body posture (Postural Assessment Software Protocol), postural control (Modified Clinical Test of Sensory Interaction on Balance), flexibility (sit-and-reach test), the impact of FM on quality of life (Fibromyalgia Impact Questionnaire, FIQ), and self-reported perceptions and body self-care. RESULTS: At the end of treatment, there were no statistically significant differences between the groups in the outcome variables. Furthermore, the groups presented lower pain intensity (baseline vs. final; global group: 6 ± 1.8 vs. 2.2 ± 1.6 cm, p<0.01; segmental group: 6.3 ± 2.1 vs. 2.5 ± 1.7 cm, p<0.01), higher pain threshold (p ≤ 0.01), lower total FIQ score (p < 0.01), and greater postural control (p < 0.01) after treatment. CONCLUSIONS: Muscle stretching exercises based on global posture reeducation and segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy, reduced the pain intensity and impact of FM on quality of life. These exercises also improved FM patients' pain threshold at tender points, attitudes toward chronic pain, and postural control. There were no differences between global posture reeducation and segmental muscle stretching exercises. TRIAL REGISTRATION: ClinicalTrials.gov NCT02384603 . Registered on 10 March 2015.

Effects of a six-week mobile app versus paper book intervention on quality of life, symptoms, and self-care in patients with fibromyalgia: a randomized parallel trial.

BACKGROUND: The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. OBJECTIVE: This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. METHODS: Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale - Revised. RESULTS: No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. CONCLUSIONS: The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia.

Avaliação do agenciamento de autocuidados e sua associação com sintomas e qualidade de vida em indivíduos com fibromialgia / Evaluación del agenciamiento del autocuidado y su asociación con síntomas y calidad de vida de individuos con fibromialgia / Evaluation and association of self-care agency with symptoms and quality of life in patients with fibromyalgia

RESUMO A fibromialgia (FM) é uma condição de alta prevalência e que causa desconforto físico, sofrimento mental e comprometimento nas relações sociais. Assim, o autocuidado pode ser um aspecto determinante para melhorar a qualidade de vida de indivíduos com FM, pois está relacionado ao ato de se investir de poder. Portanto, o objetivo deste estudo foi avaliar o agenciamento do autocuidado de indivíduos com FM e verificar a associação do autocuidado com variáveis sociodemográficas, sintomas e qualidade de vida. Participaram do estudo 40 indivíduos com FM, que preencheram os critérios diagnósticos do Colégio Americano de Reumatologia de 2010. O autocuidado foi avaliado pela Escala de Avaliação de Agenciamento de Autocuidados Revisada (EAAA-R), a intensidade da dor dos pacientes foi verificada pela Escala Visual Analógica (EVA) e pelo Índice de Dor Generalizada (IDG), enquanto a severidade dos sintomas foi avaliado pela Escala de Severidade dos Sintomas (SS) e a qualidade de vida pelo Questionário de Impacto da Fibromialgia Revisado (QIF-R). Utilizamos o coeficiente de correlação de Pearson (dados paramétricos) e coeficiente de correlação de Spearman (dados não paramétricos), com nível de significância α<0,05. Os resultados mostram valores médios para o agenciamento do autocuidado (52,75±10,25), intensidade da dor (5,84±2,16), IDG (13,32±3,78), SS (9,30±1,68), e QIF-R (63,98±17,26). Houve associação do autocuidado com a classe social (r=0,391) e associação com domínios do QIF-R: função (r=-0,338), impacto geral (r=-0,315), sintomas (r=-0,332) e escore total (r=-0,375). O estudo sugere moderado agenciamento de autocuidado e fraca associação do autocuidado com a qualidade de vida e com a classe social em indivíduos com fibromialgia.

RESUMEN La fibromialgia (FM) es una enfermedad de alta prevalencia que causa malestar físico, sufrimiento mental y afecta las relaciones sociales. El autocuidado puede ser un aspecto determinante para mejorar la calidad de vida de individuos con FM, pues está relacionado al acto de invertirse de poder. El objetivo de este estudio fue evaluar el agenciamiento del autocuidado de individuos con FM y verificar una asociación del autocuidado con las variables sociodemográficas, síntomas y calidad de vida. En el estudio, participaron 40 personas con FM, que cumplieron con los criterios de diagnóstico del Colegio Americano de Reumatología de 2010. El autocuidado fue puntuado por la Escala de Evaluación de Agencia de Autocuidados Revisados (EAAA-R), la intensidad de dolor fue evaluada por la Escala Visual Analógica (EVA) y por el Índice de dolor generalizado (IDG), mientras que la severidad de los síntomas fue evaluada por la Escala de Severidad de los Síntomas (SS), y la calidad de vida por el Cuestionario de Impacto de la Fibromialgia Revisado (FIQ-R). Se utilizó el Coeficiente de Correlación de Pearson (datos paramétricos) y el Coeficiente de Correlación de Spearman (datos no paramétricos), con un nivel de significancia α<0,05. Los resultados mostraron valores medios para el agenciamiento del autocuidado (52,75±10,25), la intensidad del dolor (5,84±2,16), el IDG (13,32±3,78), la SS (9,30±1,68) y el FIQ-R (63,98±17,26). Hubo una asociación del autocuidado con la clase social (r=0,391) y las asociaciones con los dominios del SIF-R: función (r=−0,338), impacto general (r=−0,315), síntomas (r=0,332) y puntuación total (r=−0,375). El estudio apunta moderado agenciamiento de autocuidado y baja asociación del autocuidado con la calidad de vida y la clase social en el individuo con fibromialgia.

ABSTRACT Fibromyalgia (FM) is a condition of high prevalence, which causes physical discomfort, mental distress and impairment of social relationships. Self-care may be a relevant factor to improve the quality of life in individuals with fibromyalgia, since it is related to the act of empowerment, leading individuals to have control over their own life. The aim of this study was to assess self-care agency of individuals with fibromyalgia and check for associations between self-care and symptoms, quality of life and sociodemographic variables. The study included 40 individuals with FM according to the 2010 American College of Rheumatology criteria. Self-care was measured with the Appraisal Self-Care Agency Scale-Revised (ASAS-R), pain with the Visual Analog Scale (VAS) and the Widespread Pain Index (WPI), severity of symptoms with the Symptom Severity (SS) Scale, and quality of life with the Fibromyalgia Impact Questionnaire - Revised (FIQ-R). In data analysis, the Pearson correlation coefficient was used for parametric data, and the Spearman correlation coefficient was used for non-parametric data. The level of significance adopted was 5%. Moderate values were found for self-care agency (52.75±10.25), VAS pain (5.84±2.16), WPI (13.32±3.78) and SS (9.30±1.68). Severe impact on quality of life was found with the FIQR (63.98±17.26). Additionally, significant correlations were observed of self-care agency with social status (r=0.391), and with the following FIQ-R domains: function (r=−0.338), overall impact (r=-0.315), symptoms (r=−0.332) and total score (r=−0.375). The study suggests that individuals with fibromyalgia have a moderate level of self-care agency, and a weak association of self-care with quality of life and social status.

Prevalence of low back pain in the elderly population: a systematic review.

The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.

Prevalence of low back pain in the elderly population: a systematic review

The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.

Development of ProFibro - a mobile application to promote self-care in patients with fibromyalgia.

Fibromyalgia is a rheumatic syndrome characterised by chronic widespread pain, often associated with fatigue, unrefreshed sleep and cognitive problems. Effective management of fibromyalgia requires a proactive approach in which the patient takes responsibility for self-care. The purpose of this research was to develop an application (app) for promoting self-care as a complementary Mobile Health resource to physical therapy in the management of fibromyalgia. The app was developed in five stages, according to the prototyping paradigm. In Stage 1, an expert panel of five physical therapists, five patients with fibromyalgia, a digital interface designer and a programmer analysed the requirements and content, and set the software objectives. In Stage 2, the designer created the screen layouts. In Stage 3, the programmer developed the prototype for the Android operating system (Google Inc., Mountain View, CA, USA). In Stage 4, the prototype was pilot tested regarding its quality of use by 10 patients with fibromyalgia. Finally, in Stage 5, the designer improved the interface and the programmer built the final product. This article describes the development of ProFibro, the first free mobile app in Brazilian Portuguese for fibromyalgia. Its functions are patient education through animation, self-monitoring, sleep strategies, scheduling, graded exercise programme, practice of gratitude, family adjustments and hints through notifications.

Prevalence of fibromyalgia: literature review update / A prevalência de fibromialgia: atualização da revisão de literatura

ABSTRACT The present study aimed to update the literature review on the prevalence of fibromyalgia published in 2006. A bibliographical survey was carried out from 2005 to 2014 in the MEDLINE, Web of Science, Embase, LILACS and SciELO databases and 3274 records were identified. Five researchers selected the studies, following the inclusion criteria: studies that obtained the prevalence of fibromyalgia. Fibromyalgia studies in associated diseases were excluded. When screening by title and abstract, 2073 irrelevant articles were excluded. The full texts of 210 articles were evaluated for eligibility and this review included 39 studies, described in 41 articles. The selected studies were grouped into four categories: (A) prevalence of fibromyalgia in the general population; (B) prevalence of fibromyalgia in women; (C) prevalence of fibromyalgia in rural and urban areas; (D) prevalence of fibromyalgia in special populations. The literature shows values of fibromyalgia prevalence in the general population between 0.2 and 6.6%, in women between 2.4 and 6.8%, in urban areas between 0.7 and 11.4%, in rural areas between 0.1 and 5.2%, and in special populations values between 0.6 and 15%. This literature review update shows a significant increase in fibromyalgia prevalence studies in the world. The new 2010 American College of Rheumatology criteria have not been widely used yet and the COPCORD (Community-oriented program for control of Rheumatic Diseases) methodology has increased the quality of studies on the prevalence of rheumatic diseases in general.

RESUMO O presente estudo teve como objetivo atualizar a revisão de literatura sobre a prevalência da fibromialgia (FM) publicada em 2006. Foi feito levantamento bibliográfico do período de 2005 a 2014 nas bases de dados Medline, Web of Science, Embase, Lilacs e SciELO e identificaram-se 3.274 registros. Cinco pesquisadores selecionaram os estudos, de acordo com os critérios de inclusão: estudos que obtiveram a prevalência da FM. Foram excluídos estudos da FM em doenças. Na triagem pelo título e resumo, foram excluídos 2.073 artigos irrelevantes. Foram avaliados quanto à elegibilidade os textos completos de 210 artigos, incluíram-se nesta revisão 39 estudos, descritos em 41 artigos. Os estudos selecionados foram agrupados em quatro categorias: a) prevalência da FM na população em geral; b) prevalência da FM em mulheres; c) prevalência da FM em áreas rurais e urbanas; d) prevalência da FM em populações especiais. A literatura aponta valores de prevalência da FM na população em geral entre 0,2 e 6,6%, em mulheres entre 2,4 e 6,8%, nas áreas urbanas entre 0,7 e 11,4%, nas rurais entre 0,1 e 5,2% e em populações especiais entre 0,6 e 15%. Esta atualização de revisão de literatura mostra um aumento expressivo de estudos de prevalência da FM ao redor do mundo. Os novos critérios do Colégio Americano de Reumatologia de 2010 foram ainda pouco usados e a metodologia Copcord (Programa Orientado para a Comunidade para Controle de Doenças Reumáticas) aumentou a qualidade dos estudos de prevalência de doenças reumáticas em geral.

Prevalence of fibromyalgia: literature review update.

The present study aimed to update the literature review on the prevalence of fibromyalgia published in 2006. A bibliographical survey was carried out from 2005 to 2014 in the MEDLINE, Web of Science, Embase, LILACS and SciELO databases and 3274 records were identified. Five researchers selected the studies, following the inclusion criteria: studies that obtained the prevalence of fibromyalgia. Fibromyalgia studies in associated diseases were excluded. When screening by title and abstract, 2073 irrelevant articles were excluded. The full texts of 210 articles were evaluated for eligibility and this review included 39 studies, described in 41 articles. The selected studies were grouped into four categories: (A) prevalence of fibromyalgia in the general population; (B) prevalence of fibromyalgia in women; (C) prevalence of fibromyalgia in rural and urban areas; (D) prevalence of fibromyalgia in special populations. The literature shows values of fibromyalgia prevalence in the general population between 0.2 and 6.6%, in women between 2.4 and 6.8%, in urban areas between 0.7 and 11.4%, in rural areas between 0.1 and 5.2%, and in special populations values between 0.6 and 15%. This literature review update shows a significant increase in fibromyalgia prevalence studies in the world. The new 2010 American College of Rheumatology criteria have not been widely used yet and the COPCORD (Community-oriented program for control of Rheumatic Diseases) methodology has increased the quality of studies on the prevalence of rheumatic diseases in general.

Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis.

The systematic review aimed to evaluate the effectiveness of massage in fibromyalgia. An electronic search was conducted at MEDLINE, SCiELO, EMBASE, ISI, PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (Jan 1990-May 2013). Ten randomized and non-randomized controlled trials investigating the effects of massage alone on symptoms and health-related quality of life of adult patients with fibromyalgia were included. Two reviewers independently screened records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Meta-analysis (pooled from 145 participants) shows that myofascial release had large, positive effects on pain and medium effects on anxiety and depression at the end of treatment, in contrast with placebo; effects on pain and depression were maintained in the medium and short term, respectively. Narrative analysis suggests that: myofascial release also improves fatigue, stiffness and quality of life; connective tissue massage improves depression and quality of life; manual lymphatic drainage is superior to connective tissue massage regarding stiffness, depression and quality of life; Shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life; and Swedish massage does not improve outcomes. There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and Shiatsu. Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.

Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial.

BACKGROUND: Low back pain is a relevant public health problem, being an important cause of work absenteeism worldwide, as well as affecting the quality of life of sufferers and their individual functional performances. Supervised active physical routines and of cognitive-behavioral therapies are recommended for the treatment of chronic Low back pain, although evidence to support the effectiveness of different techniques is missing. Accordingly, the aim of this study is to contrast the effectiveness of two types of exercises, graded activity or supervised, in decreasing symptoms of chronic low back pain. METHODS/DESIGN: Sample will consist of 66 patients, blindly allocated into one of two groups: 1) Graded activity which, based on an operant approach, will use time-contingent methods aiming to increase participants' activity levels; 2) Supervised exercise, where participants will be trained for strengthening, stretching, and motor control targeting different muscle groups. Interventions will last one hour, and will happen twice a week for 6 weeks. Outcomes (pain, disability, quality of life, global perceived effect, return to work, physical activity, physical capacity, and kinesiophobia) will be assessed at baseline, at treatment end, and three and six months after treatment end. Data collection will be conducted by an investigator blinded to treatment allocation. DISCUSSION: This project describes the randomisation method that will be used to compare the effectiveness of two different treatments for chronic low back pain: graded activity and supervised exercises. Since optimal approach for patients with chronic back pain have yet not been defined based on evidence, good quality studies on the subject are necessary. TRIAL REGISTRATION: NCT01719276.

Eficácia do Shiatsu na dor, sono, ansiedade, nível de confiança no equilibrio e qualidade de vida de indivíduos com fibromialgia: um ensaio clínico controlado / Efficacy of Shiatsu on pain, sleep, anxiety, balance confidence level and quality of life in individuals with fibromyalgia: a controlled clinical trial

Introdução: A fibromialgia é uma desordem reumatológica comum que compromete significativamente a qualidade de vida. Caracteriza-se por dor crônica generalizada e limiar de dor diminuído, associados normalmente a sintomas e comorbidades, como sono não reparador, distúrbios de equilíbrio e ansiedade. Dentre as modalidades de tratamento, vem crescendo o uso das terapias alternativas e complementares, porém mais evidências são necessárias. O objetivo principal deste estudo foi avaliar o efeito do Shiatsu na dor, qualidade de sono, ansiedade, nível de confiança no equilíbrio e qualidade de vida relacionada à saúde de indivíduos com fibromialgia. Método: participaram do estudo 34 sujeitos na faixa etária de 33 a 62 anos, divididos em: Grupo Shiatsu (GS; n=17), que realizou 16 sessões de Shiatsu corporal com duração de 50 minutos, duas vezes por semana, e Grupo Controle (GC; n=17), que recebeu orientações educativas através de uma cartilha. Os grupos foram avaliados na linha de base, após 4 e 8 semanas, quanto a: intensidade da dor pela Escala Visual Analógica (EVA), limiar de dor pela dolorimetria, qualidade de sono pelo Índice de Qualidade de Sono de Pittsburgh (IQSP), ansiedade pelo Inventário de Ansiedade Traço-Estado, confiança no equilíbrio pela Escala de Confiança no Equilíbrio em Atividades Específicas (Escala ABC) e qualidade de vida pelo Questionário de Impacto da Fibromialgia (QIF). Resultados: por regressão logística, verificou-se que o tratamento de oito semanas com Shiatsu está associado à melhora na EVA (p=0,043), limiar de dor (p=0,014), IQSP (p=0,006), Escala ABC (p=0,026) e QIF (p=0,016). Todas essas variáveis também apresentaram ganho percentual relativo clinicamente importante (EVA: 40,6%; limiar de dor: 76,4%; IQSP: 34,4%; Escala ABC: 44,2%; QIF: 22,3%). Não foram observadas melhoras estatisticamente significantes ou clinicamente relevantes para a ansiedade. Conclusão: o Shiatsu foi eficaz para melhorar a dor, qualidade de sono, confiança no equilíbrio e qualidade de vida de sujeitos com fibromialgia.(AU)

Introduction: Fibromyalgia is a common rheumatological disorder that greatly impairs quality of life. It is characterized by chronic widespread pain and decreased pain threshold, normally associated with symptoms and comorbidities, such as non-restorative sleep, balance disorders and anxiety. Among treatment modalities, the use of complementary and alternative therapies is increasing, but more evidence is needed. The main objective of this study was to evaluate the effect of Shiatsu in pain, sleep quality, anxiety, balance confidence level and health-related quality of life of individuals with fibromyalgia. Methods: 34 subjects aged 33 to 62 years participated in this study and were divided into: Shiatsu Group (SG; n=17), which received 16 sessions of full-body Shiatsu lasting 50 minutes, twice a week, and Control Group (CG; n=17), which received educational guidance through a booklet. Groups were assessed at baseline, after 4 and 8 weeks, regarding: pain intensity by Visual Analogue Scale (VAS), pain threshold by dolorimetry, sleep quality by Pittsburgh Sleep Quality Index (PSQI), anxiety by State-Trait Anxiety Inventory, balance confidence level by Activities-specific Balance Confidence Scale (ABC Scale) and quality of life by the Fibromyalgia Impact Questionnaire (FIQ). Results: by logistic regression, it was found that the eight-week treatment with Shiatsu was associated with improvements in VAS (p=0.043), pain threshold (p=0.014), PSQI (p=0.006), ABC Scale (p=0.026) and FIQ (p=0.016). All these variables also presented clinically important relative percentage changes (VAS: 40.6%; pain threshold: 76.4%; PSQI: 34.4%; ABC Scale: 44.2%; FIQ: 22.3%). There were no statistically significant or clinically relevant improvements for anxiety. Conclusion: Shiatsu was effective for improving pain, sleep quality, balance confidence and quality of life of subjects with fibromyalgia.(AU)

Efeito da massoterapia nos sintomas e qualidade de vida de fibromiálgicos: relato de casos / Effect of massage therapy in patients with fibromyalgia: case reports

Introdução: A fibromialgia é uma síndrome caracterizada por dor crônica e generalizada e sensibilidade dolorosa à palpação em tender points. É comum estar associada também a fadiga, rigidez matinal, distúrbios do sono, ansiedade e depressão. Os profissionais da área de saúde têm utilizado as terapias alternativas e complementares em tratamentos multidisciplinares, e a massoterapia vem apresentando evidências de eficácia no tratamento da fibromialgia. Objetivo: Este estudo teve como objetivo verificar o efeito de duas técnicas na dor, ansiedade e qualidade de vida de duas mulheres fibromiálgicas. Método: Ambas foram avaliadas antes e após o tratamento, com relação ao limiar de dor dos tender points com a dolorimetria, intensidade da dor com a Escala Visual Analógica, ansiedade com o Inventário de Ansiedade Traço-Estado e qualidade de vida com o Questionário de Impacto da Fibromialgia. Os sujeitos foram submetidos a oito sessões de massagem, um com a técnica de fricção em oito tender points específicos, e o outro com deslizamento superficial e profundo na região onde esses tender points estão localizados. Resultados: Nos dois casos, houve aumento do limiar de dor nos tender points, inclusive nos que não foram diretamente massageados, redução da intensidade da dor e do impacto da fibromialgia na qualidade de vida. No Sujeito 1, houve redução da ansiedade estado, enquanto a ansiedade-traço permaneceu inalterada, e o Sujeito 2 apresentou redução apenas na ansiedade traço. Conclusão: Ambas as técnicas foram eficazes no tratamento dos sujeitos com fibromialgia, aumentando o limiar de dor nos tender points, diminuindo a intensidade da dor e a ansiedade e melhorando a qualidade de vida, com resultados mais expressivos na massagem de deslizamento superficial e profundo. Devido à ínfima amostra, sugerese a realização de estudos controlados de boa qualidade com número maior de sujeitos.

Introduction: Fibromyalgia is a syndrome characterized by chronic widespread pain and tenderness on palpation in tender points. Commonly it is also associated with fatigue, morning stiffness, sleep disturbances, anxiety and depression. Frequently, health care professionals have been using complementary and alternative therapies, and massage therapy has been showing evidences of efficacy in the treatment of fibromyalgia. Objective: This study has the goal of verifying the effect of two techniques on the pain, anxiety and quality of life of two women with fibromyalgia. Method:80th subjects were evaluated before and after the treatment, regarding the pain threshold of tender points with dolorimetry, pain intensity with the Visual Analogue Scale, anxiety with the State-Trait Anxiety Inventory, and quality of life with the Fibromyalgia Impact Questionnaire. The subjects received eight sessions of massage, one of them with friction technique on eight specific tender points, and the other with superficial and deep sliding in the area where these tender points are located. Results: In these cases, there was an increase of pain threshold of tender points, including those that were not directly massaged, and a decrease of pain intensity and impact of fibromyalgia over quality of life. In Subject 1, there was a reduction of state anxiety, as trait anxiety remained unchanged, and Subject 2 presented reduction only intraitanxiety. Conclusion: 80th techniques were efficient in the treatment of the subjects with fibromyalgia, increasing the pain threshold of tender points, decreasing the pain intensity and anxiety and improving the quality of life. The results were more expressive with the superficial and deep sliding massage. Due to the insufficient sample, it is suggested that well-designed controlled studies with a greater number of subjects should be undertaken.