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1.
Medicine (Baltimore) ; 99(21): e20257, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481303

RESUMO

BACKGROUND: Fibromyalgia (FM) is a common chronic pain condition that seriously affects the quality of patient lives. Its etiology, pathogenesis, and treatment still remain uncertain. Dietary supplements have been widely trialed for symptom relief for FM. The review aims to synthesize the previous literature publications to assess the impact of herbs and dietary supplements on FM patients. METHODS: We will conduct a literature search in the following databases PubMed, MEDLINE, EMBASE, Cochrane Library, Scopus, and Global Health from database inception to December 2019. Clinical studies published in the English language that used human participants and address the efficacy, safety, and acceptability of herbs and dietary supplements on individuals with FM will be included. The risk of bias and quality assessment of each trial will be evaluated. If trials are enough, a meta-analysis will be conducted using software RevMan5.3, Cochrane Collaboration. RESULT: Our review will be the first attempt to facilitate evidence-based management using herbs and dietary supplements to treat patients with FM. CONCLUSION: The findings may provide a framework for future research and clinic practice in FM management. PROSPERO REGISTRATION NUMBER: CRD42020149941.


Assuntos
Suplementos Nutricionais/efeitos adversos , Fibromialgia/terapia , Plantas Medicinais/efeitos adversos , Doença Crônica , Estudos de Avaliação como Assunto , Feminino , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança
2.
Artigo em Inglês | MEDLINE | ID: mdl-32455853

RESUMO

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.


Assuntos
Catastrofização , Terapia por Exercício/métodos , Exercício Físico , Fibromialgia/psicologia , Fibromialgia/terapia , Qualidade de Vida/psicologia , Treinamento de Resistência/métodos , Ansiedade , Depressão , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Fibromialgia/reabilitação , Humanos , Dor , Estresse Psicológico , Resultado do Tratamento
3.
Artigo em Inglês | MEDLINE | ID: mdl-32357398

RESUMO

Poor sleep quality is a common concern and a troublesome symptom among patients suffering from fibromyalgia. The purpose of this review was to identify and describe the available patient reported outcome measures (PROMs) of sleep quality validated in adult people diagnosed with fibromyalgia. The COSMIN and PRISMA recommendations were followed. An electronic systematized search in the electronic databases PubMed, Scopus, CINAHL Plus, PsycINFO, and ISI Web of Science was carried out. Validation studies of PROMs of sleep quality in fibromyalgia published in English or Spanish were included. The selection of the studies was developed through a peer review process through the online software "COVIDENCE". The quality of the studies was assessed using the COSMIN Risk of Bias checklist. A total of 5 PROMs were found validated in patients with fibromyalgia: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Jenkins Sleep Scale (JSS), (3) Sleep Quality Numeric Rating Scale (SQ-NRS), (4) Medical Outcomes Study-Sleep Scale (MOS-SS), and (5) Fibromyalgia Sleep Diary (FSD). The quality of the evidence was very good and the quality of the results ranged from moderate to high. All the included PROMs, except for the FSD, showed adequate psychometric properties and, therefore, are valid and reliable tools for assessing sleep quality in the context of FM. However, none of the studies analyzed all the psychometric properties of the included PROMs as established in the COSMIN guidelines, highlighting that this is a potential field of research for future investigations.


Assuntos
Transtorno Depressivo Maior , Fibromialgia , Medidas de Resultados Relatados pelo Paciente , Transtornos do Sono-Vigília , Adulto , Feminino , Fibromialgia/complicações , Fibromialgia/terapia , Humanos , Masculino , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Sono , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/terapia , Inquéritos e Questionários
4.
Ann Intern Med ; 172(5): ITC33-ITC48, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32120395

RESUMO

Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.


Assuntos
Fibromialgia , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Prognóstico , Encaminhamento e Consulta , Fatores de Risco
5.
Clin Exp Rheumatol ; 38 Suppl 123(1): 94-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116209

RESUMO

OBJECTIVES: This paper briefly describes the therapeutic mechanisms underlying hyperbaric oxygen therapy (HBOT), and reviews data concerning its effects and efficacy in Parkinson's disease (PD) and fibromyalgia (FM). METHODS: The studies included in this review all evaluated the effect of HBOT in patients with diseases involving CNS. The PubMed databases were searched from 1980 to September 2019 using the keywords: 'hyperbaric oxygen therapy', 'fibromyalgia' and 'Parkinson's disease'. RESULTS: HBOT is already indicated in various diseases and is the subject of continuous research and development. Data from models of PD show that it may play a neuroprotective role because of its ability to reduce oxidative stress and neurodegeneration, and protect against neuronal apoptosis. It is effective in improving the symptoms and quality of life of fibromyalgia patients, and rectifies abnormal brain activity in pain-related areas. Evidence from animal studies supports its use as an alternative treatment for other rheumatic diseases as it alleviates pain and reduces inflammation. CONCLUSIONS: Data mainly from animal studies support the use of HBOT in the treatment of PD and rheumatic diseases, but further work is necessary to clarify its therapeutic role in patients with these chronic disorders.


Assuntos
Doenças do Sistema Nervoso Central/terapia , Fibromialgia/terapia , Oxigenação Hiperbárica , Animais , Humanos , Qualidade de Vida , Doenças Reumáticas
6.
Clin Exp Rheumatol ; 38 Suppl 123(1): 72-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116211

RESUMO

OBJECTIVES: To evaluate the patterns of treatment among patients with fibromyalgia (FM) in Spain and to assess patient satisfaction and perceived tolerability of the treatment received. METHODS: An observational, cross-sectional study was conducted in Spain via internet from September 2015 to March 2017. We recorded sociodemographic and clinical information, including treatment satisfaction evaluated using a 10-point numerical rating scale (NRS) and adverse events. RESULTS: Evaluable subjects (n=915) were predominantly middle-aged, married women who presented with moderate to severe pain, sleep disturbance and affected quality-of-life. The most frequent non-pharmacologic treatments were physical exercise (85%), diet (47%), supplements such as magnesium and vitamins (47%), and psychotherapy (31%). The most frequently prescribed drugs were tramadol (40%), benzodiazepines (30%), duloxetine (22%), pregabalin (19%), amitriptyline (17%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 16%); 7.5% of patients received stronger opioids. After excluding benzodiazepines, NSAIDs, and paracetamol, 46% of patients received ≥2 drugs. Satisfaction with treatment (NRS mean score) was generally poor for pharmacologic treatment (4.1), exercise (4.7), psychotherapy (5.2), diet (5.0), physiotherapy (6.2) and acupuncture (6.3). The increase in the number of drugs prescribed was not associated with an increase in satisfaction, but rather with an increase in adverse events. CONCLUSIONS: Patients with FM in Spain are overtreated with a combination of non-pharmacologic and pharmacologic therapies. Several of these therapies lack adequate support from randomised clinical trials and/or clinical practice guidelines. This overtreatment is not associated with relevant clinical benefits or patient satisfaction and, in the case of pharmacologic treatments, poses tolerability and safety issues.


Assuntos
Fibromialgia/tratamento farmacológico , Fibromialgia/terapia , Satisfação do Paciente , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários
7.
Clin Exp Rheumatol ; 38 Suppl 123(1): 86-93, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116212

RESUMO

OBJECTIVES: The aim of this study was to investigate the effectiveness of a web-based exercise intervention in improving the severity of symptoms in different health domains in patients with fibromyalgia (FM). METHODS: Consecutive FM patients insufficiently responding to drug treatment (defined as a score of >4 on a numerical rating scale of pain) were enrolled in a web-based intervention group (Fibro-Web) and underwent a 24-week daily home exercise programme. They were evaluated through the revised Fibromyalgia Impact Questionnaire (FIQR) and the Modified Fibromyalgia Assessment Status questionnaire (Mod FAS) at baseline, and then every two weeks until the end of the programme. The outcomes were compared with those of patients receiving usual care. RESULTS: The final analysis was based on 140 patients: 68 in the Fibro-Web group and 72 in the usual care group. At the end of the 24-week study period, the patients in the Fibro-Web group showed a significant improvement in overall and sub-scale scores of the FIQR (p=0.0279) and Mod FAS (p=0.0057), expressed as time-integrated values. This improvement started in the 16th week. CONCLUSIONS: The use of a web-based daily exercise programme in FM patients significantly improves disease severity indices.


Assuntos
Terapia por Exercício , Fibromialgia/terapia , Intervenção Baseada em Internet , Humanos , Medição da Dor , Qualidade de Vida , Inquéritos e Questionários
8.
Clin Exp Rheumatol ; 38 Suppl 123(1): 3-8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116216

RESUMO

Fibromyalgia (FM) is a frequently encountered syndrome that is characterised by chronic widespread pain, fatigue, sleep disturbances, and many other symptoms that impair the quality of life. Its aetiopathogenesis is still unclear but, although there is no specific therapy, a number of pharmacological and non-pharmacological therapies are available. The aim of this review is to describe the most recent findings concerning the diagnosis, aetiopathogenesis and treatment of FM published between January 2019 and January 2020. They include the new concept of nociplastic pain, some neuroendocrine and metabolic alterations found in FM patients, and investigations concerning not only novel applications of old drugs, but also, and in particular, complementary therapies, such as the hyperbaric oxygen chamber, ozone therapy and mindfulness-based interventions.


Assuntos
Fibromialgia/diagnóstico , Fibromialgia/terapia , Dor Crônica , Terapias Complementares , Fadiga , Humanos , Qualidade de Vida
9.
Psicosom. psiquiatr ; (12): 35-45, ene.-mar. 2020.
Artigo em Inglês | IBECS | ID: ibc-193132

RESUMO

INTRODUCTION: Fibromyalgia (FM) is a clinical condition characterized by chronic widespread pain, fatigue, non refreshing sleep, mood disturbance and cognitive impairment with accompanying functional disability. It's etiology and even it's existence as a clinical entity have been discussed over the last decades. The lack of understanding of it's physiopathology and the fact that, to this date, there is no strong effective treatment for it makes this discussion even more relevant for clinicians. We here try to revise some of the clinical relevant data available to this day.METHODS: This paper is a narrative revision which gathers information based on a PubMed database search from the last 6 years (2012-2018), in Portuguese or English, for clinical trials or reviews, on the term "Fibromyalgia treatment".Results and discussion: Although there isn't a single strong intervention for FM patients, there is enough evidence suggesting that patient education on the symptoms, on the disease itself and on the realistic treatment goals can benefit these patients. Exercise is also evidence based and should be appropriately suggested. Classical and new Cognitive Behavioural Therapy (CBT) interventions should be seen as the corner stone of treatment in these patients, specially if having co-morbid affective disorders. Many drugs have been studied in the hopes of helping FM patients but few have evidence to support its recommendation


INTRODUCCIÓN: La fibromialgia (FM) es una condición clínica caracterizada por dolor crónico generalizado, fatiga, sueño no reparador, alteraciones del estado de ánimo y deterioro cognitivo con discapacidad asiciada, en casis extremis. Su etiología, e incluso su existencia como entidad clínica, se han debatido en las últimas décadas. La falta de comprensión de su fisiopatología y el hecho de que, hasta la fecha, no exista un tratamiento suficientmente efectivo, convierte el debate en muy relevante para los clínicos. METODOLOGÍA: Este documento revisa información basada en una búsqueda en la base de datos de PubMed de los últimos 6 años (2012-2018), en portugués o inglés, para ensayos clínicos o revisiones, en los términos " Fybromialgia Treatment". Resultados y DISCUSIÓN: Aunque no existe una sola intervención suficientemente sólida para pacientes con FM, gozamos de evidencias suficientes que sugieren que la educación del paciente sobre los síntomas, la enfermedad misma y los objetivos del tratamiento realistas pueden beneficiarlos El ejercicio también se basa en la evidencia debe sugerirse de manera apropiada. Las intervenciones clásicas y de segunda y tercera generación de la Terapia Cognitivo Conductual (TCC) , deben considerarse la piedra angular del tratamiento en estos pacientes, especialmente si se asocian trastornos afectivos comorbidos. Muchos fármacos se han estudiado con la esperanza de ayudar a los pacientes con FM, pero pocos tienen evidencia para sostener su recomendación


Assuntos
Humanos , Fibromialgia/terapia , Prática Clínica Baseada em Evidências/métodos , Dor Crônica/terapia , Transtornos Psicofisiológicos/terapia , Terapia Cognitivo-Comportamental , Educação de Pacientes como Assunto , Exercício Físico , Psicoterapia
10.
J Med Internet Res ; 22(4): e15819, 2020 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-32131045

RESUMO

BACKGROUND: Personal health informatics have the potential to help patients discover personalized health management strategies that influence outcomes. Fibromyalgia (FM) is a complex chronic illness requiring individualized strategies that may be informed by analysis of personal health informatics data. An online health diary program with dynamic feedback was developed to assist patients with FM in identifying symptom management strategies that predict their personal outcomes, and found reduced symptom levels associated with program use. OBJECTIVE: The aim of this study was to determine longitudinal associations between program use and functional impact of FM as measured by scores on a standardized assessment instrument, the Fibromyalgia Impact Questionnaire (FIQ). METHODS: Participants were self-identified as diagnosed with FM and recruited via online FM advocacy websites. Participants used an online health diary program ("SMARTLog") to report symptom ratings, behaviors, and management strategies used. Based on single-subject analysis of the accumulated data over time, individualized recommendations ("SMARTProfile") were then provided by the automated feedback program. Indices of program use comprised of cumulative numbers of SMARTLogs completed and SMARTProfiles received. Participants included in this analysis met a priori criteria of sufficient program use to generate SMARTProfiles (ie, ≥22 SMARTLogs completed). Users completed the FIQ at baseline and again each subsequent month of program use as follow-up data for analysis. Kendall tau-b, a nonparametric statistic that measures both the strength and direction of an ordinal association between two repeated measured variables, was computed between all included FIQ scores and both indices of program use for each subject at the time of each completed FIQ. RESULTS: A total of 76 users met the a priori use criteria. The mean baseline FIQ score was 61.6 (SD 14.7). There were 342 FIQ scores generated for longitudinal analysis via Kendall tau-b. Statistically significant inverse associations were found over time between FIQ scores and (1) the cumulative number of SMARTLogs completed (tau-b=-0.135, P<.001); and (2) the cumulative number of SMARTProfiles received (tau-b=-0.133, P<.001). Users who completed 61 or more SMARTLogs had mean follow-up scores of 49.9 (n=25, 33% of the sample), an 18.9% drop in FM impact. Users who generated 11 or more new SMARTProfiles had mean follow-up scores of 51.8 (n=23, 30% of the sample), a 15.9% drop. CONCLUSIONS: Significant inverse associations were found between FIQ scores and both indices of program use, with FIQ scores declining as use increased. Based on established criteria for rating FM severity, the top one-third of users in terms of use had clinically significant reductions from "severe" to "moderate" FM impact. These findings underscore the value of self-management interventions with low burden, high usability, and high perceived relevance to the user. TRIAL REGISTRATION: ClinicalTrials.gov NCT02515552; https://clinicaltrials.gov/ct2/show/NCT02515552.


Assuntos
Fibromialgia/terapia , Informática Médica/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Telemedicina
11.
Clin Plast Surg ; 47(2): 203-213, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32115047

RESUMO

Fibromyalgia is characterized by generalized pain, specific sites of musculoskeletal tenderness, fatigue, sleep disturbance, headaches, and many other visceral and cognitive maladies. The epidemiology is not well-elucidated and the diagnoses and management can be difficult. Surgery may not be the most appropriate management of some of these pain conditions like fibromyalgia. It may even be more difficult to discern some surgical conditions from points of heightened sensitivity in the fibromyalgia patient. Close attention to the current and past medical history in such patients should aid the surgeon in his attempt to rid the patient of painful conditions through surgery.


Assuntos
Fibromialgia/diagnóstico , Manejo da Dor/métodos , Medição da Dor/métodos , Diagnóstico Diferencial , Fibromialgia/terapia , Humanos
12.
Complement Ther Clin Pract ; 38: 101076, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32056812

RESUMO

PURPOSE: To compare the effects of spinal stabilization exercise (SSE) plus kinesio taping (KT) and SSE alone on pain and well-being in women with fibromyalgia (FM). MATERIAL AND METHODS: Patients with FM were randomly allocated into SSE (n:19) and SSE + KT (n:17) groups. Pain and fatigue with Visual Analog Scale, health status with Fibromyalgia Impact Questionnaire, quality of life (QoL) with Nottingham Health Profile, depression with Beck Depression Inventory, sleep quality with Jenkins Sleep Scale were assessed. SSE and KT with fascial correction technique were carried out 2 days a week for 6 weeks. RESULTS: SSE + KT was more effective in decreasing pain and fatigue, and improving some parameters related to health status and the QoL compared to SSE alone (p < 0.05). After treatment, pain, depression, health status, QoL, and sleep quality improved in both groups (p < 0.05). CONCLUSIONS: SSE with KT was superior for improving pain and general well-being compared to SSE alone.


Assuntos
Fita Atlética , Terapia por Exercício/métodos , Fibromialgia/terapia , Qualidade de Vida , Adolescente , Adulto , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Inquéritos e Questionários , Escala Visual Analógica , Adulto Jovem
13.
Scand J Med Sci Sports ; 30(5): 904-913, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32077144

RESUMO

There are evidences that physical exercise is an effective instrument for improving physical fitness, health, and quality of life and causes beneficial effects on the symptoms of patients with fibromyalgia. The purpose of this study was to analyze effects of a functional training program on pain, fitness, and quality of life in patients with fibromyalgia in a 9-year prospective longitudinal cohort study. Forty women with fibromyalgia participated in this study; 24 received an exercise program and were called the active group; and 16 were the control group. Tender points, visual analogical scale (VAS) of pain, physical fitness, Fibromyalgia Impact Questionnaire (FIQ), and Short-Form Health Survey 36 (SF-36) were analyzed. The active group experienced significant improvements in FIQ, TP, and VAS (P < .001), whereas the control group showed significant worsening in the FIQ scale (P = .004). Moreover, the active group experienced significant improvements in leg strength (P < .001), balance (P = .033), cardiorespiratory fitness (P < .001), emotional role (P = .024), and mental health (P = .025); whereas the control group significantly worsened on handgrip strength (P = .017), balance (P = .043), cardiorespiratory fitness (P = .020), and in general health (P < .001). A Pearson correlation analysis revealed a significant relationship between the improvement in physical fitness variables and the improvements in FIQ, TP, and VAS. In conclusion, a regular practice of moderate-intensity physical activity shows a positive effect long-term on fitness, pain, the impact of the disease, and the quality of life in women with fibromyalgia.


Assuntos
Terapia por Exercício/métodos , Exercício Físico , Fibromialgia/fisiopatologia , Fibromialgia/terapia , Aptidão Física , Idoso , Aptidão Cardiorrespiratória , Avaliação da Deficiência , Feminino , Força da Mão , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Qualidade de Vida
14.
Medicine (Baltimore) ; 99(4): e18833, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977878

RESUMO

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain and multiple symptoms. It is a common clinical condition whose etiology is unclear. Currently, there is no gold standard treatment for FM. Management of this condition is therefore aimed at reducing symptoms and maintaining the individual's ability to function optimally. Based on the principal symptoms and characteristics of individuals with FM, we hypothesized that the implementation of a multicomponent treatment (with physical exercise, cognitive behavioral therapy adding to a graded motor imagery program, and therapeutic neuroscience education) would be more effective than conventional treatment in women with FM. This paper describes the rationale and methods of study intended to test the effectiveness of multicomponent treatment versus conventional treatment in patients with FM. METHOD/DESIGN: Fifty-six female individuals between 18 and 65 years of age, who were referred to the physical therapy department of the Rehabilitar Center in Chile, will be randomized into two treatment arms. The intervention group will receive a multicomponent treatment program for duration of 12 weeks. The control group will receive a conventional treatment for this condition for 12 weeks. The primary outcome measure will be the pain intensity score, measured by the numeric pain rating scale (NPRS), and the secondary outcomes will be the FM Impact Questionnaire (FIQ), and affective components of pain, such as catastrophizing using the Pain Catastrophizing Scale (PCS), fear of movement using the Tampa Scale Kinesiophobia (TSK), and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). DISCUSSION: This paper reports the design of a randomized clinical trial aimed at assessing the effectiveness of the multicomponent treatment versus conventional treatment in women with FM. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN number U1111-1232-0862. Registered 22 April 2019.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Fibromialgia/terapia , Adulto , Idoso , Catastrofização/prevenção & controle , Catastrofização/psicologia , Feminino , Fibromialgia/psicologia , Humanos , Pessoa de Meia-Idade , Dor/psicologia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-31963773

RESUMO

The study protocol of a prospective and randomized controlled trial for the assessment of the efficacy of nature activity therapy for people with Fibromyalgia (NAT-FM) is described. The primary outcome is the mean change from baseline in the Revised Fibromyalgia Impact Questionnaire (FIQR) score at post-treatment (12 weeks) and at 9 months of follow-up, and secondary outcomes are changes in the positive affect, negative affect, pain, fatigue, self-efficacy, catastrophising, and emotional regulation. A total of 160 patients with fibromyalgia will be divided into two arms: treatment-as-usual (TAU) and NAT-FM+TAU. Pre, during, post, +6, and +9 months assessments will be carried out, as well as an ecological momentary assessment (EMA) of intrasession and intersessions. Results will be subjected to a mixed group (NAT-FM+TAU vs. TAU) × phase (pre, post, +6 months, +9 months) general linear model. EMA intrasession measurements will be subjected to a 2 (pre vs. post) × 5 (type of activity) mixed-effects ANOVA. EMA between-session measurements obtained from both arms of the study will be analysed on both a time-domain and frequency-domain basis. Effect sizes and number needed to treat (NNT) will be computed. A mediation/moderation analysis will be conducted.


Assuntos
Terapia por Exercício/psicologia , Fibromialgia/terapia , Manejo da Dor/psicologia , Sistemas de Apoio Psicossocial , Terapia de Relaxamento/psicologia , Humanos , Educação de Pacientes como Assunto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Espanha
16.
Rev Esp Salud Publica ; 942020 Jan 10.
Artigo em Espanhol | MEDLINE | ID: mdl-31919340

RESUMO

OBJECTIVE: The clinical approach of fibromyalgia is a cause of frustration for some professionals due to the controversy on its diagnosis, etiopathology and clinical management. The aim of this study was to explore the beliefs and knowledge on fibromyalgia among health professionals from different specialties of the public health service from Almería province. METHODS: A descriptive and cross-sectional study was carried out. A questionnaire prepared ex profeso was applied to a sample of 103 clinicians from Primary Care Physicians, Mental Health, Internal Medicine and Rheumatology. The chi-square test was performed to explore the relationships among variables. RESULTS: 59.7% of Primary Care providers and 66.7% of Internal Medicine conceptualized fibromyalgia as a somatization. Likewise, 58.9% of Primary Care indicated that fibromyalgia should be considered in no case as a disabling illness, compared to 16.7% from Rheumatology, as well as for 42.5% of them the fibromyalgia diagnosis is not essential, compared to the amount of other specialties. Mood disorders were mentioned by 53.4% of Primary Care as entities from which fibromyalgia is difficult to discriminate. Sleep or gastrointestinal problems were mentioned by 83.3% and 50% of Rheumatology professionals, respectively. CONCLUSIONS: A high percentage of professionals considered fibromyalgia as a psychogenic entity, especially among Internal Medicine and Primary Care, highlighting in the last one a position against the consideration of disability and its difficult differentiation from mood disorders. These latest findings could be explained by beliefs or attitudes on the amplification of pain behaviors and secondary gains. A deeper knowledge on fibromyalgia symptoms from Rheumatology is highlighted. Methodological limitations and recommendations are discussed.


Assuntos
Atitude do Pessoal de Saúde , Consenso , Dissidências e Disputas , Fibromialgia , Adulto , Estudos Transversais , Feminino , Fibromialgia/diagnóstico , Fibromialgia/etiologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Medicina Interna , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Reumatologia , Espanha , Inquéritos e Questionários
17.
Acupunct Med ; 38(2): 101-108, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31941349

RESUMO

BACKGROUND: Acupuncture has been clinically recommended as a method of pain relief by the World Health Organization and is widely used by medical doctors. Fibromyalgia (FM) pain has a complex physiological and psychological origin and can be pharmacologically treated with duloxetine, milnacipran and pregabalin. However, these drugs produce undesirable side effects, such as headaches, nausea and diarrhoea. Acupuncture may serve as an effective alternative treatment for pain relief with few side effects. AIMS: We hypothesised that acupuncture would reduce FM pain by influencing transient receptor potential cation channel subfamily V member 1 (TRPV1) and the downstream phosphorylated extracellular signal-regulated kinases (pERK), which are located in the central thalamus, amygdala and cortex. METHODS: A FM mouse model was established by injecting two doses of acid saline into 32 female C57/B6 mice. The mice were then assigned to different subgroups (n=8 each) and treated with electroacupuncture (EA) or EA sham control. TRPV1 and pERK expression levels were measured using Western blotting and immunohistochemistry. RESULTS: Our results demonstrated that the expression of TRPV1 and pERK in the thalamus, amygdala and somatosensory cortex was normal in the control mice, but significantly increased in FM mice; these FM-induced changes in expression were attenuated by EA. CONCLUSION: Our data suggest that EA can reverse the central sensitisation of the TRPV1-ERK signalling pathway in the mouse brain. Thus, our findings provide mechanistic evidence supporting the potential therapeutic efficacy of EA for treating FM pain.


Assuntos
Encéfalo/metabolismo , Eletroacupuntura , Fibromialgia/terapia , Manejo da Dor/métodos , Transdução de Sinais , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Canais de Cátion TRPV/metabolismo , eIF-2 Quinase/metabolismo
18.
Int J Biometeorol ; 64(3): 513-520, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31797039

RESUMO

To compare the efficacy of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome (FMS). A parallel 1:1, single-blind, pilot study was performed. Patients were recruited from musculoskeletal disorders outpatient clinic. Eligible participants were patients aged 18-60, diagnosed as FMS according to ACR 2010 criteria. They were randomly assigned to either consecutive or intermittent treatment groups. Both groups received 20 min of full body immersion in a tap water pool at 38-39 °C and 30 min of mud pack application on the back region at 45 °C. Delivery of the treatment was five times weekly during 2 weeks in consecutive group and two times weekly during 5 weeks in intermittent group. The primary outcomes were pain intensity and the number of patients achieving a minimal clinically important difference (MCID) on Fibromyalgia Impact Questionnaire (FIQ) at the 1st month after the completion of the treatment. Statistical analyses were based on intention to treat method. The assessing physician was blinded. Pain intensity significantly decreased in all post-treatment evaluations of both groups (except after treatment in the intermittent group). There was no significant difference between the groups. MCID for FIQ was achieved in 6 (24%) patients in the consecutive group and 12 (48%) in the intermittent group at the 1st month. There was no statistical difference in the secondary judgment criteria. The consecutive and intermittent deliveries of balneological outpatient treatment (hydrotherapy and peloidotherapy) seem to have similar effects on the clinical status of patients with FMS.


Assuntos
Fibromialgia , Hidroterapia , Adolescente , Adulto , Feminino , Fibromialgia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Projetos Piloto , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-31878319

RESUMO

The aim of this study was to analyze the effects of a 24 week exergame intervention and 24 weeks of detraining on lower-limb strength, agility, and cardiorespiratory fitness in women with fibromyalgia (FM). It was performed as a single-blinded randomized controlled trial of 55 women with FM. University facilities were used. The 24 week exergame intervention was focused on mobility, postural control, upper- and lower-limb coordination, aerobic fitness, and strength. Participants performed 120 min of exergaming per week, which was divided into two sessions. Twenty-four weeks after the end of the intervention, participants were re-evaluated. A chair-stand test, 10 step stair test, and six-minute walk test were conducted to assess lower-body strength, agility, and cardiorespiratory fitness, respectively. The exergame intervention significantly improved lower-limb strength and cardiorespiratory fitness. However, no significant effects on agility were observed. After the detraining period, lower-limb strength and agility returned to their baseline level, but improvements in cardiorespiratory fitness were sustained over time. Exergaming was therefore shown to be beneficial for physical fitness in people with FM. However, exergames had to be played regularly to maintain the benefits. This long-term intervention (24 weeks) may have changed the lifestyle of women with FM, which could explain why cardiorespiratory fitness improvements remained after the detraining period. Future research should focus on lifestyle changes after long-term interventions.


Assuntos
Aptidão Cardiorrespiratória , Exercício Físico/fisiologia , Fibromialgia/terapia , Força Muscular/fisiologia , Aptidão Física/fisiologia , Equilíbrio Postural/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Idoso , Terapia por Exercício , Feminino , Humanos , Pessoa de Meia-Idade , Espanha
20.
Rev Assoc Med Bras (1992) ; 65(10): 1265-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721958

RESUMO

OBJECTIVE: We reported our multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our aim was to verify the effectiveness of a proprioceptive training program as a complementary therapy for a traditional protocol of education, mindfulness, and exercise training for the management of fibromyalgia associated with imbalance. METHODS: Retrospective cohort study on 84 women, with primary fibromyalgia associated to imbalance. A group of patients performed traditional exercise training; in a second group the training was supplemented with proprioception exercises. Each session lasted from 40 to 60 minutes and was performed three times a week for 12 weeks. RESULTS: After three months of training and eight months after the end of the training, the balance evaluation revealed significant differences in the comparison of the Timed Up and Go test, Berg Balance Scale, and Tinetti scale with the baseline, there was a better improvement in the proprioceptive training group (p<0.05). A reduction in pain and improvement in functional and muscular performance and quality of life were observed in both groups (p<0.05), but with no significant differences between them in the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, and Short Form Health Survey (p>0.05). Fifteen months after the end of the program, the effects of training were not maintained. CONCLUSION: The present study revealed that training supplemented with proprioception exercises has beneficial effects on clinical findings and improves balance in patients with fibromyalgia, even if the positive results did not persist after the interruption of the rehabilitative program in the long term.


Assuntos
Terapia por Exercício/métodos , Fibromialgia/terapia , Equilíbrio Postural , Transtornos das Sensações/terapia , Protocolos Clínicos , Feminino , Fibromialgia/complicações , Humanos , Estudos Retrospectivos , Transtornos das Sensações/etiologia , Inquéritos e Questionários
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