Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction.

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Vincent, Ann; Whipple, Mary O; Low, Phillip A; Joyner, Michael; Hoskin, Tanya L

2016-05-01

Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Cross-sectional, observational, controlled study. Community sample of patients with fibromyalgia and healthy controls. Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Autonomic function, as assessed by self-report, was significantly different between patients and controls (P physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of

Circadian rhythms of women with fibromyalgia

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Klerman, E. B.; Goldenberg, D. L.; Brown, E. N.; Maliszewski, A. M.; Adler, G. K.

2001-01-01

Fibromyalgia syndrome is a chronic and debilitating disorder characterized by widespread nonarticular musculoskeletal pain whose etiology is unknown. Many of the symptoms of this syndrome, including difficulty sleeping, fatigue, malaise, myalgias, gastrointestinal complaints, and decreased cognitive function, are similar to those observed in individuals whose circadian pacemaker is abnormally aligned with their sleep-wake schedule or with local environmental time. Abnormalities in melatonin and cortisol, two hormones whose secretion is strongly influenced by the circadian pacemaker, have been reported in women with fibromyalgia. We studied the circadian rhythms of 10 women with fibromyalgia and 12 control healthy women. The protocol controlled factors known to affect markers of the circadian system, including light levels, posture, sleep-wake state, meals, and activity. The timing of the events in the protocol were calculated relative to the habitual sleep-wake schedule of each individual subject. Under these conditions, we found no significant difference between the women with fibromyalgia and control women in the circadian amplitude or phase of rhythms of melatonin, cortisol, and core body temperature. The average circadian phases expressed in hours posthabitual bedtime for women with and without fibromyalgia were 3:43 +/- 0:19 and 3:46 +/- 0:13, respectively, for melatonin; 10:13 +/- 0:23 and 10:32 +/- 0:20, respectively for cortisol; and 5:19 +/- 0:19 and 4:57 +/- 0:33, respectively, for core body temperature phases. Both groups of women had similar circadian rhythms in self-reported alertness. Although pain and stiffness were significantly increased in women with fibromyalgia compared with healthy women, there were no circadian rhythms in either parameter. We suggest that abnormalities in circadian rhythmicity are not a primary cause of fibromyalgia or its symptoms.

Primary fibromyalgia

DEFF Research Database (Denmark)

Jacobsen, S; Jensen, L T; Foldager, M

1990-01-01

Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

Self-Reported Childhood Maltreatment and Traumatic Events among Israeli Patients Suffering from Fibromyalgia and Rheumatoid Arthritis

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Raneen Hellou

2017-01-01

Full Text Available Objective. The association between Fibromyalgia Syndrome (FMS and childhood maltreatment and adversity has frequently been proposed but limited data exists regarding the transcultural nature of this association. Methods. 75 Israeli FMS patients and 23 Rheumatoid Arthritis (RA patients were compared. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ and potential depressive and anxiety disorders were assessed by the Patient Health Questionnaire-4. FMS severity was assessed by the Widespread Pain Index (WPI, the Symptom Severity Score (SSS, and the FIQ. PTSD was diagnosed according to the DSM IV. RA severity was assessed by the RA Disease Activity Index. Health status was assessed by the SF-36. Results. Similar to reports in other countries, high levels of self-reported childhood adversity were reported by Israeli FMS patients. PTSD was significantly more common among FMS patients compared with RA patients, as well as childhood emotional abuse and physical and emotional neglect. Levels of depression and anxiety were significantly higher among FMS patients. Conclusion. The study demonstrated the cross cultural association between FMS and childhood maltreatment, including neglect, emotional abuse, and PTSD. Significant differences were demonstrated between FMS patients and patients suffering from RA, a model of an inflammatory chronic rheumatic disease.

Clinical features in patients with chronic muscle pain--with special reference to fibromyalgia

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Jacobsen, Søren; Petersen, I S; Danneskiold-Samsøe, B

1993-01-01

was not excessive and seemed appropriate compared to the other patient groups. Effects of various biases and classification criteria on the results of fibromyalgia studies are discussed. The characteristic features of fibromyalgia, its stability when diagnosed and the promotion of research and patient management......Clinical characteristics were studied in patients with chronic muscle pain, divided into three groups according to the characteristics of their pain; "fibromyalgia" (n = 23), "widespread muscle pain" (n = 21), and "regional muscle pain" (n = 28). Typical fibromyalgia features were also seen...... in the other groups of patients, but not to the same extent. In particular, sleep disturbance, subjective swelling, cold and exercise intolerance and low self-reported physical performance were significantly related to fibromyalgia. The major components of fibromyalgia were not wholly different compared...

Correlates of perceived pain-related restrictions among women with fibromyalgia.

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Przekop, Peter; Haviland, Mark G; Morton, Kelly R; Oda, Keiji; Fraser, Gary E

2010-11-01

To identify correlates of perceived pain-related restrictions in a community sample of women with fibromyalgia. The fibromyalgia group was composed of white women with a self-reported, physician-given fibromyalgia diagnosis (N = 238) from the Biopsychosocial Religion and Health Study (BRHS). BRHS respondents had participated in the larger Adventist Health Study-2. To identify associations with pain-related restrictions, we used hierarchical linear regression. The outcome measure was subjects' pain-related restrictions (one SF-12 version 2 item). Predictors included age, education, body mass index (BMI), sleep apnea, and fibromyalgia treatment in the last year, as well as standardized measures for trauma, major life stress, depression, and hostility. To better interpret the findings, pain-related restrictions also were predicted in women with osteoarthritis and no fibromyalgia. Women with fibromyalgia reporting the more severe pain-related restrictions were those who had experienced trauma accompanied by physical pain, were older, less educated, more depressed, more hostile, had high BMI scores, and had been treated for fibromyalgia in the last 12 months (adjusted R(2) = 0.308). Predictors in women with osteoarthritis were age, BMI, treatment in the last 12 months, experience of a major life stressor, and greater depression symptom severity (adjusted R(2) = 0.192). In both groups, age, BMI, treatment in the last 12 months, and depression predicted pain-related restrictions. Experience of a traumatic event with physical pain was the strongest predictor in the fibromyalgia group. These findings may be useful in constructing novel treatments and prevention strategies for pain-related morbidity in fibromyalgia patients. Wiley Periodicals, Inc.

Qigong and Fibromyalgia circa 2017

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Jana Sawynok

2017-06-01

Full Text Available Qigong is an internal art practice with a long history in China. It is currently characterized as meditative movement (or as movement-based embodied contemplative practice, but is also considered as complementary and alternative exercise or mind–body therapy. There are now six controlled trials and nine other reports on the effects of qigong in fibromyalgia. Outcomes are related to amount of practice so it is important to consider this factor in overview analyses. If one considers the 4 trials (201 subjects that involve diligent practice (30–45 min daily, 6–8 weeks, there are consistent benefits in pain, sleep, impact, and physical and mental function following the regimen, with benefits maintained at 4–6 months. Effect sizes are consistently in the large range. There are also reports of even more extensive practice of qigong for 1–3 years, even up to a decade, indicating marked benefits in other health areas beyond core domains for fibromyalgia. While the latter reports involve a limited number of subjects and represent a self-selected population, the marked health benefits that occur are noteworthy. Qigong merits further study as a complementary practice for those with fibromyalgia. Current treatment guidelines do not consider amount of practice, and usually make indeterminate recommendations.

Fibromyalgia and headache: an epidemiological study supporting migraine as part of the fibromyalgia syndrome.

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Marcus, Dawn A; Bernstein, Cheryl; Rudy, Thomas E

2005-11-01

Fibromyalgia is defined by widespread body pain, tenderness to palpation of tender point areas, and constitutional symptoms. The literature reports headache in about half of fibromyalgia patients. The current epidemiological study was designed to determine the prevalence and characteristics of headache in fibromyalgia patients. Treatment-seeking fibromyalgia patients were evaluated with measures for fibromyalgia, chronic headache, quality of life, and psychological distress. Multivariate analysis of variance (MANOVA) and t-tests were used to identify significant differences, as appropriate. A total of 100 fibromyalgia patients were screened (24 fibromyalgia without headache and 76 fibromyalgia with headache). International Headache Society diagnoses included: migraine alone (n = 15 with aura, n = 17 without aura), tension-type alone (n = 18), combined migraine and tension-type (n = 16), post-traumatic (n = 4), and probable analgesic overuse headache (n = 6). Fibromyalgia tender point scores and counts and most measures of pain severity, sleep disruption, or psychological distress were not significantly different between fibromyalgia patients with and without headache. As expected, the fibromyalgia patients with headache scored higher on the Headache Impact Test (HIT-6) (62.1 +/- 0.9 vs 48.3 +/- 1.6, p 60 in 80% of fibromyalgia plus headache patients, representing severe impact from headache, and 56-58 in 4%, representing substantial impact. In summary, chronic headache was endorsed by 76% of treatment-seeking fibromyalgia patients, with 84% reporting substantial or severe impact from their headaches. Migraine was diagnosed in 63% of fibromyalgia plus headache patients, with probable analgesic overuse headache in only 8%. General measures of pain, pain-related disability, sleep quality, and psychological distress were similar in fibromyalgia patients with and without headache. Therefore, fibromyalgia patients with headache do not appear to represent a significantly

Humanistic and economic burden of fibromyalgia in Japan

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Lee, Lulu K; Ebata, Nozomi; Hlavacek, Patrick; DiBonaventura, Marco; Cappelleri, Joseph C; Sadosky, Alesia

2016-01-01

Purpose The aim of this study was to examine the health and economic burden associated with fibromyalgia among adults in Japan. Materials and methods Data from the 2011–2014 Japan National Health and Wellness Survey (n=115,271), a nationally representative survey of adults, were analyzed. The greedy matching algorithm was used to match the respondents who self-reported a diagnosis of fibromyalgia with those not having fibromyalgia (n=256). Generalized linear models, controlling for covariates (eg, age and sex), examined whether the respondents with fibromyalgia differed from matched controls based on health status (health utilities; Mental and Physical Component Summary scores from Medical Outcomes Study: 12-item Version 2 and 36-item Version 2 Short Form Survey), sleep quality (ie, sleep difficulty symptoms), work productivity (Work Productivity and Activity Impairment Questionnaire – General Health Version 2.0), health care resource use, and estimated annual indirect and direct costs (based on published annual wages and resource use events) in Japanese yen (¥). Results After adjustment for covariates, respondents with fibromyalgia relative to matched controls scored significantly lower on health utilities (adjusted means =0.547 vs 0.732), Mental Component Summary score (33.15 vs 45.88), and Physical Component Summary score (39.22 vs 50.81), all with Pfibromyalgia reported significantly poorer sleep quality than those without fibromyalgia. Respondents with fibromyalgia compared with those without fibromyalgia experienced significantly more loss in work productivity and health care resource use, resulting in those with fibromyalgia incurring indirect costs that were more than twice as high (adjusted means =¥2,826,395 vs ¥1,201,547) and direct costs that were nearly six times as high (¥1,941,118 vs ¥335,140), both with Pfibromyalgia experienced significantly poorer health-related quality of life and greater loss in work productivity and health care use than

Fibromyalgia in the adult Danish population

DEFF Research Database (Denmark)

Prescott, E; Jacobsen, S; Kjøller, Mette

1993-01-01

Clinical characteristics of fibromyalgia have so far been based mainly on patients identified in rheumatologic settings. This paper offers the clinical findings in fibromyalgia based on a national health interview survey, in which 123 persons fulfilled preset criteria for widespread pain. Clinical......, headache, difficulty in stair-climbing, and poorer self-evaluated health with more tender points was found. Contrary to that which was expected, fibromyalgia subjects did not suffer from sleep disturbances, irritable bowels or morning stiffness. Our findings indicate that clinical characteristics...... of fibromyalgia in the general population may differ from those found in rheumatological settings....

Altered Functional Performance in Patients with Fibromyalgia.

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Costa, Isis da Silva; Gamundí, Antoni; Miranda, José G Vivas; França, Lucas G Souza; De Santana, Charles Novaes; Montoya, Pedro

2017-01-01

Fibromyalgia is a common chronic pain condition that exerts a considerable impact on patients' daily activities and quality of life. Objectives: The main objective of the present study was to evaluate kinematic parameters of gait, functional performance, and balance in women with fibromyalgia syndrome. Methods: The study included 26 female patients with fibromyalgia (49.2 ± 8.0 years) according to the criteria of the American College of Rheumatology, as well as 16 pain-free women (43.5 ± 8.5 years). Gait and balance parameters were extracted from video recordings of participants performing several motor tasks. Non-linear dynamic of body sway time series was also analyzed by computing the Hurst exponent. In addition, functional performance and clinical pain were obtained by using standardized motor tests (Berg's balance scale, 6-min walking test, timed up and go task, Romberg's balance test) and self-report questionnaires (Fibromyalgia Impact Questionnaire). Results: Walking speed was significantly diminished ( p fibromyalgia and pain-free controls on body sway in the medial-lateral and anterior-posterior axes (all ps gait and balance were significantly associated with high levels of pain, depression, stiffness, anxiety, and fatigue in fibromyalgia. Conclusion: Our data revealed that both gait and balance were severely impaired in FM, and that subjective complaints associated with FM could contribute to functional disability in these patients. These findings suggest that optimal rehabilitation and fall prevention in fibromyalgia require a comprehensive assessment of both psychological responses to pain and physical impairments during postural control and gait.

Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001-2013: a Clinical Practice Research Datalink study.

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Collin, Simon M; Bakken, Inger J; Nazareth, Irwin; Crawley, Esther; White, Peter D

2017-06-01

Objective Trends in recorded diagnoses of chronic fatigue syndrome (CFS, also known as 'myalgic encephalomyelitis' (ME)) and fibromyalgia (FM) in the UK were last reported more than ten years ago, for the period 1990-2001. Our aim was to analyse trends in incident diagnoses of CFS/ME and FM for the period 2001-2013, and to investigate whether incidence might vary by index of multiple deprivation (IMD) score. Design Electronic health records cohort study. Setting NHS primary care practices in the UK. Participants Participants: Patients registered with general practices linked to the Clinical Practice Research Datalink (CPRD) primary care database from January 2001 to December 2013. Main outcome measure Incidence of CFS/ME, FM, post-viral fatigue syndrome (PVFS), and asthenia/debility. Results The overall annual incidence of recorded cases of CFS/ME was 14.8 (95% CI 14.5, 15.1) per 100,000 people. Overall annual incidence per 100,000 people for FM was 33.3 (32.8-33.8), for PVFS 12.2 (11.9, 12.5), and for asthenia/debility 7.0 (6.8, 7.2). Annual incidence rates for CFS/ME diagnoses decreased from 17.5 (16.1, 18.9) in 2001 to 12.6 (11.5, 13.8) in 2013 (annual percent change -2.8% (-3.6%, -2.0%)). Annual incidence rates for FM diagnoses decreased from 32.3 (30.4, 34.3) to 27.1 (25.5, 28.6) in 2007, then increased to 38.2 (36.3, 40.1) per 100,000 people in 2013. Overall annual incidence of recorded fatigue symptoms was 2246 (2242, 2250) per 100,000 people. Compared with the least deprived IMD quintile, incidence of CFS/ME in the most deprived quintile was 39% lower (incidence rate ratio (IRR) 0.61 (0.50, 0.75)), whereas rates of FM were 40% higher (IRR 1.40 (0.95, 2.06)). Conclusion These analyses suggest a gradual decline in recorded diagnoses of CFS/ME since 2001, and an increase in diagnoses of fibromyalgia, with opposing socioeconomic patterns of lower rates of CFS/ME diagnoses in the poorest areas compared with higher rates of FM diagnoses.

Early Experience with a Brief, Multimodal, Multidisciplinary Treatment Program for Fibromyalgia

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Vincent, Ann; Whipple, Mary O.; Oh, Terry H.; Guderian, Janet A.; Barton, Debra L.; Luedtke, Connie A.

2014-01-01

Fibromyalgia is a complex, heterogeneous disorder for which a multidisciplinary individualized approach is currently advocated. We executed a 1 week multidisciplinary fibromyalgia clinical program with 7 patients, based on our previous experience with our existing 1.5 day multidisciplinary fibromyalgia program that has demonstrated both short- and long-term benefits. The current expanded program was not designed as a clinical study, but rather as a clinical feasibility assessment and was multidisciplinary in nature, with cognitive behavioral therapy, activity pacing and graded exercise therapy as major components. We assessed changes in individual patients at 1 week and 3 months following the program utilizing validated self-report measures of pain, fatigue, and self-efficacy. All patients indicated at least small improvements in pain and physical symptoms both at 1 week and 3 months and all but one patient showed improvement in self-efficacy at 1 week and 3 months. Similar trends were observed for fatigue. Based on our early clinical experience, we conclude that the 1 week multidisciplinary fibromyalgia program is logistically feasible and has potential for clinical efficacy. Further research is needed and is planned to test the clinical efficacy of this program and compare it with other interventions. PMID:24315246

A self-report critical incident assessment tool for army night vision goggle helicopter operations.

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Renshaw, Peter F; Wiggins, Mark W

2007-04-01

The present study sought to examine the utility of a self-report tool that was designed as a partial substitute for a face-to-face cognitive interview for critical incidents involving night vision goggles (NVGs). The use of NVGs remains problematic within the military environment, as these devices have been identified as a factor in a significant proportion of aircraft accidents and incidents. The self-report tool was structured to identify some of the cognitive features of human performance that were associated with critical incidents involving NVGs. The tool incorporated a number of different levels of analysis, ranging from specific behavioral responses to broader cognitive constructs. Reports were received from 30 active pilots within the Australian Army using the NVG Critical Incident Assessment Tool (NVGCIAT). The results revealed a correspondence between specific types of NVG-related errors and elements of the Human Factors Analysis and Classification System (HFACS). In addition, uncertainty emerged as a significant factor associated with the critical incidents that were recalled by operators. These results were broadly consistent with previous research and provide some support for the utility of subjective assessment tools as a means of extracting critical incident-related data when face-to-face cognitive interviews are not possible. In some circumstances, the NVGCIAT might be regarded as a substitute cognitive interview protocol with some level of diagnosticity.

Fibromyalgia Flares: A Qualitative Analysis.

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Vincent, Ann; Whipple, Mary O; Rhudy, Lori M

2016-03-01

Patients with fibromyalgia report periods of symptom exacerbation, colloquially referred to as "flares" and despite clinical observation of flares, no research has purposefully evaluated the presence and characteristics of flares in fibromyalgia. The purpose of this qualitative study was to describe fibromyalgia flares in a sample of patients with fibromyalgia. Using seven open-ended questions, patients were asked to describe how they perceived fibromyalgia flares and triggers and alleviating factors associated with flares. Patients were also asked to describe how a flare differs from their typical fibromyalgia symptoms and how they cope with fibromyalgia flares. Content analysis was used to analyze the text. A total of 44 participants completed the survey. Responses to the seven open-ended questions revealed three main content areas: causes of flares, flare symptoms, and dealing with a flare. Participants identified stress, overdoing it, poor sleep, and weather changes as primary causes of flares. Symptoms characteristic of flares included flu-like body aches/exhaustion, pain, fatigue, and variety of other symptoms. Participants reported using medical treatments, rest, activity and stress avoidance, and waiting it out to cope with flares. Our results demonstrate that periods of symptom exacerbation (i.e., flares) are commonly experienced by patients with fibromyalgia and symptoms of flares can be differentiated from every day or typical symptoms of fibromyalgia. Our study is the first of its kind to qualitatively explore characteristics, causes, and management strategies of fibromyalgia flares. Future studies are needed to quantitatively characterize fibromyalgia flares and evaluate mechanisms of flares. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Social security work disability and its predictors in patients with fibromyalgia.

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Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-09-01

To determine prevalence and incidence of US Social Security Disability and Supplemental Security Income (SSD) in patients with fibromyalgia and to investigate prediction of SSD. Over a mean of 4 years (range 1-13 years), we studied 2,321 patients with physician-diagnosed fibromyalgia (prevalent cases) and applied modified American College of Rheumatology (ACR) 2010 research criteria to identify criteria-positive patients. During the study, 34.8% (95% confidence interval [95% CI] 32.9-36.8%) of fibromyalgia patients received SSD. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (95% CI 3.0-3.9%), and 25% were estimated to be work disabled at 9.0 years of followup. By comparison, the prevalence of SSD in rheumatoid arthritis (RA) patients with concomitant fibromyalgia was 55.6% (95% CI 54.3-57.0%) and was 42.4% in osteoarthritis (OA). By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by sociodemographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability index [HAQ DI]). In multivariable models, the HAQ DI and the Short Form 36-item health survey physical and mental component summary scores, but no other variables, predicted SSD. Fibromyalgia criteria-positive patients had more SSD, but the continuous scale, polysymptomatic distress index derived from the ACR criteria was a substantially better predictor of SSD than a criteria-positive diagnosis. The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables. Copyright © 2014 by the American College of Rheumatology.

A Comprehensive Evaluation of Standardized Assessment Tools in the Diagnosis of Fibromyalgia and in the Assessment of Fibromyalgia Severity

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Chad S. Boomershine

2012-01-01

Full Text Available Standard assessments for fibromyalgia (FM diagnosis and core FM symptom domains are needed for biomarker development and treatment trials. Diagnostic and symptom assessments are reviewed and recommendations are made for standards. Recommendations for existing assessments include the American College of Rheumatology FM classification criteria using the manual tender point Survey for diagnosis, the brief pain inventory average pain visual analogue scale for pain intensity, the function subscale of the revised fibromyalgia impact questionnaire (FIQR for physical function, the patient global impression of change and FIQR for overall/global improvement, the hospital anxiety and depression scale depression subscale for depression, the multiple ability self-report questionnaire for cognitive dysfunction, the fatigue severity scale for fatigue, the FIQR for multidimensional function/health-related quality of life, the jenkins sleep scale for sleep disturbance, and the fibromyalgia intensity score for tenderness. Forthcoming assessments including the FIQR for diagnosis, NIH PROMIS, and FIBRO Change scales are discussed.

Nocturnal motor activity in fibromyalgia patients with poor sleep quality.

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Hyyppä, M T; Kronholm, E

1995-01-01

Nocturnal motor activity was examined in long-term rehabilitation patients complaining of poor sleep and having fibromyalgia syndrome (N = 24) or other musculoskeletal disorders (N = 60) and compared with that in 91 healthy controls drawn from a random community sample. Self-reports on sleep complaints and habits were collected. The frequency of nocturnal body movements, the "apnoea" index and ratio of "quiet sleep" to total time in bed were measured using the Static Charge Sensitive Bed (SCSB) (BioMatt). As a group, patients with fibromyalgia syndrome did not differ from patients with other musculoskeletal disorders or from healthy controls in their nocturnal motor activity. The "apnoea" index was a little higher in the fibromyalgia group than in the healthy control group but did not differ from that of the group of other musculoskeletal patients. Further multivariate analyses adjusted for age, BMI, medication and "apnoea" index did not support the assumption that an increased nocturnal motor activity characterizes patients with fibromyalgia syndrome.

Ankle dorsiflexion may play an important role in falls in women with fibromyalgia.

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Góes, Suelen M; Leite, Neiva; Stefanello, Joice M F; Homann, Diogo; Lynn, Scott K; Rodacki, André L F

2015-07-01

Fibromyalgia is a chronic pain condition, which involves reduced range of motion. This leads to gait changes and high incidence of falls. The understanding of the gait patterns in subjects with fibromyalgia and their relationship with falls may be useful when designing intervention programs. The purpose of this study was to evaluate the range of motion of the hip and ankle joints during gait in women with and without fibromyalgia. Further, we determined the relationship between joint range of motion and falls in this population. Middle-aged women (16 with fibromyalgia and 16 as control group) were recruited. Pain intensity, physical activity level, and fall prevalence were assessed. Three dimensional gait analysis provided temporal and joint kinematic variables. In general, hip and ankle range of motion were similar between groups, except that fibromyalgia group showed higher plantar flexion during toe-off (Pfibromyalgia group the higher number of falls was correlated to reduced dorsiflexion during stance phase. This limitation in dorsiflexion was related to longer length of time with fibromyalgia symptoms. Women with fibromyalgia showed a higher number of falls, reduced dorsiflexion during stance phase, and increased plantar flexion during toe-off. Also, the higher number of falls reported in the fibromyalgia group was related to reduced dorsiflexion during stance phase, which was correlated to a longer length of time living with fibromyalgia symptoms. These data suggest that improving ankle kinematics in patients with fibromyalgia may help prevent falls and improve mobility. Copyright © 2015 Elsevier Ltd. All rights reserved.

Self-Reported Minimalist Running Injury Incidence and Severity: A Pilot Study.

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Ostermann, Katrina; Ridpath, Lance; Hanna, Jandy B

2016-08-01

Minimalist running entails using shoes with a flexible thin sole and is popular in the United States. Existing literature disagrees over whether minimalist running shoes (MRS) improve perceived severity of injuries associated with running in traditional running shoes (TRS). Additionally, the perceived injury patterns associated with MRS are relatively unknown. To examine whether injury incidence and severity (ie, degree of pain) by body region change after switching to MRS, and to determine if transition times affect injury incidences or severity with MRS. Runners who were either current or previous users of MRS were recruited to complete an Internet-based survey regarding self-reported injury before switching to MRS and whether self-reported pain from that injury decreased after switching. Questions regarding whether new injuries developed in respondents after switching to MRS were also included. Analyses were calculated using t tests, Wilcoxon signed rank tests, and Fischer exact tests. Forty-seven runners completed the survey, and 16 respondents reported injuries before switching to MRS. Among these respondents, pain resulting from injuries of the feet (P=.03) and knees (P=.01) decreased. Eighteen respondents (38.3%) indicated they sustained new injuries after switching to MRS, but the severity of these did not differ significantly from no injury. Neither time allowed for transition to MRS nor use or disuse of a stretching routine during this period was correlated with an increase in the incidence or severity of injuries. After switching to MRS, respondents perceived an improvement in foot and knee injuries. Additionally, respondents using MRS reported an injury rate of 38.3%, compared with the approximately 64% that the literature reports among TRS users. Future studies should be expanded to determine the full extent of the differences in injury patterns between MRS and TRS.

Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia.

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Kim, Chul H; Vincent, Ann; Clauw, Daniel J; Luedtke, Connie A; Thompson, Jeffrey M; Schneekloth, Terry D; Oh, Terry H

2013-03-15

Although alcohol consumption is a common lifestyle behavior with previous studies reporting positive effects of alcohol on chronic pain and rheumatoid arthritis, no studies to this date have examined alcohol consumption in patients with fibromyalgia. We examined the association between alcohol consumption and symptom severity and quality of life (QOL) in patients with fibromyalgia. Data on self-reported alcohol consumption from 946 patients were analyzed. Subjects were grouped by level of alcohol consumption (number of drinks/week): none, low (≤ 3), moderate (>3 to 7), and heavy (>7). Five hundred and forty-six subjects (58%) did not consume alcohol. Low, moderate, and heavy levels of alcohol consumption were reported for 338 (36%), 31 (3%), and 31 patients (3%), respectively. Employment status (P fibromyalgia symptoms and better physical QOL than nondrinkers. Our study demonstrates that low and moderate alcohol consumption was associated with lower fibromyalgia symptoms and better QOL compared to no alcohol consumption. The reasons for these results are unclear. Since recent studies have demonstrated that γ-Aminobutyric Acid (GABA) levels are low in fibromyalgia, and alcohol is known to be a GABA-agonist, future studies should examine whether alcohol could have a salutary effect on pain and other symptoms in fibromyalgia.

Association of abuse history with symptom severity and quality of life in patients with fibromyalgia.

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Jiao, Juan; Vincent, Ann; Cha, Stephen S; Luedtke, Connie A; Oh, Terry H

2015-03-01

A high prevalence of abuse has been reported in patients with fibromyalgia. We aimed to examine the association between self-reported abuse history and symptom severity and quality of life (QOL) in 962 patients with fibromyalgia. All patients completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form 36 health survey (SF-36). Multivariate regression analyses were performed. In total, 289 patients (30%) reported a history of abuse. Of those who specified abuse types, 161 patients (59%) reported more than 1 type of abuse (36% emotional, 32% physical, 25% sexual, and 7% verbal). Patients in the abuse group were younger and more likely to be female, unemployed, unmarried, and current smokers compared with patients who reported no abuse. After adjusting for these differences, abuse history was associated with worse symptoms, as indicated by a higher FIQ total score (P history was associated with worse QOL, with lower SF-36 scores in all domains except the physical component summary. In conclusion, abuse history in patients with fibromyalgia was associated with worse symptoms and QOL compared with those patients without abuse history. Future studies are needed to assess whether additional tailored interventions as part of fibromyalgia treatment are helpful for patients with a history of abuse.

Self-Regulatory Fatigue: A Missing Link in Understanding Fibromyalgia and Other Chronic MultiSymptom Illnesses.

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Nes, Lise Solberg; Ehlers, Shawna L; Whipple, Mary O; Vincent, Ann

2017-04-01

Patients with chronic multisymptom illnesses such as fibromyalgia syndrome (FMS) are experiencing a multitude of physical and mental challenges. Facing such challenges may drain capacity to self-regulate, and research suggests patients with these illnesses may experience self-regulatory fatigue (SRF). This study sought to examine whether SRF can be associated with quality of life (QoL) in patients with FMS. Patients (N = 258) diagnosed with FMS completed self-report measures related to demographics, SRF (Self-Regulatory Fatigue 18 [SRF-18]), anxiety (Generalized Anxiety Disorder questionnaire [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), physical fatigue (Multidimensional Fatigue Inventory [MFI]), symptoms related to FMS (Fibromyalgia Impact Questionnaire [FIQ]), and QoL (36-Item Short-Form Health Survey [SF-36]). Hierarchical regressions showed higher SRF to be associated with lower QoL in terms of lower overall physical QoL, with subscales related to physical functioning, role limitations-physical, bodily pain, and general health (all P's > 0.001), as well as lower overall mental QoL, with subscales related to vitality, social functioning, role limitations-emotional, and mental health (all P's > 0.001). Including traditional predictors such as anxiety, depression, physical fatigue, and FMS-related symptoms as covariates in the analyses reduced the link between SRF and QoL somewhat, but the associations remained generally strong, particularly for SRF and mental QoL. This is the first study to show higher SRF relating to lower QoL for patients with FMS. Results suggest that SRF is distinct from anxiety, depression, and fatigue, and predicts QoL above and beyond these traditional factors in the area of chronic multisymptom illnesses such as FMS. SRF may be a "missing link" in understanding the complex nature of chronic multisymptom illnesses. © 2016 World Institute of Pain.

Effects of a one week multidisciplinary inpatient self-management programme for patients with fibromyalgia: a randomised controlled trial

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Hamnes Bente

2012-09-01

Full Text Available Abstract Background Self-management programmes (SMP are recommended for patients with fibromyalgia. The purpose of this study was to evaluate effects of a one week multidisciplinary inpatient self-management programme on psychological distress, skills as a consumer of health services, self-efficacy, and functional and symptomatic consequences of fibromyalgia (FM. Methods A randomised controlled two-armed, assessor-blinded trial with three-week follow-up to evaluate SMP. Primary outcomes were the General Health Questionnaire (GHQ-20 and the Effective Musculoskeletal Consumer Scale (EC-17, while secondary outcomes included the Fibromyalgia Impact Questionnaire (FIQ and Self-efficacy scales for pain, function and symptoms (ASES. Results 150 patients with FM were randomised to one week one SMP (n = 75 or to a waiting list control group (n = 75. Of these, 58 participants in the treatment group and 60 in the control group completed the study. At three weeks’ follow up there was a significant difference in EC-17 (0-100 in favour of the treatment group (mean difference 4.26, 95 CI 0.8 to 7.7, p = 0.02. There were no differences between the groups for any of the other outcomes. Conclusion This study shows that in patients with FM the SMP had no effect on psychological distress, functional and symptomatic consequences and self-efficacy, except for a small short-term effect on skills and behaviour that are important for managing and participating in health care (EC-17. Clinical Trials.gov Id: NCT01035125. Trial registration Clinical Trials.gov Id: NCT01035125

How can group-based multidisciplinary rehabilitation for patients with fibromyalgia influence patients' self-efficacy and ability to cope with their illness: a grounded theory approach

DEFF Research Database (Denmark)

Uggen Rasmussen, Marianne; Amris, K; Rydahl-Hansen, Susan

2017-01-01

Aims and objectives: To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness. Background: Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self...... coding. Results: Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness...

Review of overlap between thermoregulation and pain modulation in fibromyalgia

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Larson, Alice A.; Pardo, José V.; Pasley, Jeffrey D.

2013-01-01

Fibromyalgia syndrome is characterized by widespread pain that is exacerbated by cold and stress but relieved by warmth. We review the points along thermal and pain pathways where temperature may influence pain. We also present evidence addressing the possibility that brown adipose tissue activity is linked to the pain of fibromyalgia given that cold initiates thermogenesis in brown adipose tissue via adrenergic activity, while warmth suspends thermogenesis. Although females have a higher incidence of fibromyalgia as well as more resting thermogenesis, they are less able to recruit brown adipose tissue in response to chronic stress than males. In addition, conditions that are frequently comorbid with fibromyalgia compromise brown adipose activity making it less responsive to sympathetic stimulation. This results in lower body temperatures, lower metabolic rates, and lower circulating cortisol/corticosterone in response to stress - characteristics of fibromyalgia. In the periphery, sympathetic nerves to brown adipose also project to surrounding tissues, including tender points characterizing fibromyalgia. As a result, the musculoskeletal hyperalgesia associated with conditions like fibromyalgia may result from referred pain in the adjacent muscle and skin. PMID:23887348

Mitochondrial myopathy presenting as fibromyalgia: a case report

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Abdullah Mishal

2012-02-01

Full Text Available Abstract Introduction To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy. Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia. Case presentation Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points. Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms. A six-minute walk study demonstrated an elevated lactic acid level (5 mmol/L; normal Conclusions This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy. This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.

Validation of a Spanish language version of the pain self-perception scale in patients with fibromyalgia

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Alda M

2010-11-01

Full Text Available Abstract Background The Pain Self-Perception Scale (PSPS is a 24-item questionnaire used to assess mental defeat in chronic pain patients. The aim of this study was to develop a Spanish language version of the PSPS (PSPS-Spanish, to assess the instrument's psychometric properties in a sample of patients with fibromyalgia and to confirm a possible overlapping between mental defeat and pain catastrophizing. Methods The PSPS was translated into Spanish by three bilingual content and linguistic experts, and then back-translated into English to assess for equivalence. The final Spanish version was administered, along with the Hospital Anxiety Depression Scale (HADS, Pain Visual Analogue Scale (PVAS, Pain Catastrophizing Scale (PCS and Fibromyalgia Impact Questionnaire (FIQ, to 250 Spanish patients with fibromyalgia. Results PSPS-Spanish was found to have high internal consistency (Cronbach's α = 0.90 and the item-total r correlation coefficients ranged between 0.68 and 0.86. Principal components analysis revealed a one-factor structure which explained 61.4% of the variance. The test-retest correlation assessed with the intraclass correlation coefficient, over a 1-2 weeks interval, was 0.78. The total PSPS score was significantly correlated with all the questionnaires assessed (HADS, PVAS, PCS, and FIQ. Conclusions The Spanish version of the PSPS appears to be a valid tool in assessing mental defeat in patients with fibromyalgia. In patients with fibromyalgia and Post-Traumatic Stress Disorder (PTSD, PSPS-Spanish correlates more intensely with FIQ than in patients without PTSD. Mental defeat seems to be a psychological construct different to pain catastrophizing.

Fibromyalgia

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Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points ... when pressure is put on them. People with fibromyalgia may also have other symptoms, such as Trouble ...

OMERACT-based fibromyalgia symptom subgroups: an exploratory cluster analysis.

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Vincent, Ann; Hoskin, Tanya L; Whipple, Mary O; Clauw, Daniel J; Barton, Debra L; Benzo, Roberto P; Williams, David A

2014-10-16

The aim of this study was to identify subsets of patients with fibromyalgia with similar symptom profiles using the Outcome Measures in Rheumatology (OMERACT) core symptom domains. Female patients with a diagnosis of fibromyalgia and currently meeting fibromyalgia research survey criteria completed the Brief Pain Inventory, the 30-item Profile of Mood States, the Medical Outcomes Sleep Scale, the Multidimensional Fatigue Inventory, the Multiple Ability Self-Report Questionnaire, the Fibromyalgia Impact Questionnaire-Revised (FIQ-R) and the Short Form-36 between 1 June 2011 and 31 October 2011. Hierarchical agglomerative clustering was used to identify subgroups of patients with similar symptom profiles. To validate the results from this sample, hierarchical agglomerative clustering was repeated in an external sample of female patients with fibromyalgia with similar inclusion criteria. A total of 581 females with a mean age of 55.1 (range, 20.1 to 90.2) years were included. A four-cluster solution best fit the data, and each clustering variable differed significantly (P FIQ-R total scores (P = 0.0004)). In our study, we incorporated core OMERACT symptom domains, which allowed for clustering based on a comprehensive symptom profile. Although our exploratory cluster solution needs confirmation in a longitudinal study, this approach could provide a rationale to support the study of individualized clinical evaluation and intervention.

Kinematics gait disorder in men with fibromyalgia.

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Heredia-Jimenez, Jose M; Soto-Hermoso, Victor M

2014-01-01

The aim of this study was to assess the kinematics disorder of gait in men with fibromyalgia. We studied 12 male with fibromyalgia and 14 healthy men. Each participant of the study walked five trials along a 18.6-m walkway. Fibromyalgia patients completed a Spanish version of Fibromyalgia Impact Questionnaire. Significant differences between fibromyalgia and control groups were found in velocity, stride length, and cadence. Gait parameters of men affected by fibromyalgia were impaired when compared to those of healthy group due to bradykinesia. According to previous studies to assess gait variables in female patients, the male with fibromyalgia also showed lower values of velocity, cadence, and stride length than healthy group but not reported significant differences in swing, stance, single, or double support phase.

Self-Reported Sleep Duration, Napping, and Incident Heart Failure: Prospective Associations in the British Regional Heart Study.

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Wannamethee, S Goya; Papacosta, Olia; Lennon, Lucy; Whincup, Peter H

2016-09-01

To examine the associations between self-reported nighttime sleep duration and daytime sleep and incident heart failure (HF) in men with and without preexisting cardiovascular disease (CVD). Population-based prospective study. General practices in 24 British towns. Men aged 60-79 without prevalent HF followed for 9 years (N = 3,723). Information on incident HF cases was obtained from primary care records. Assessment of sleep was based on self-reported sleep duration at night and daytime napping. Self-reported short nighttime sleep duration and daytime sleep of longer than 1 hour were associated with preexisting CVD, breathlessness, depression, poor health, physical inactivity, and manual social class. In all men, self-reported daytime sleep of longer than 1 hour duration was associated with significantly greater risk of HF after adjustment for potential confounders (adjusted hazard ratio (aHR) = 1.69, 95% CI = 1.06-2.71) than in those who reported no daytime napping. Self-reported nighttime sleep duration was not associated with HF risk except in men with preexisting CVD (napping of longer than 1 hour is associated with greater risk of HF in older men. Self-reported short sleep (<6 hours) in men with CVD is associated with particularly high risk of developing HF. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Development and initial validation of a brief self-report measure of cognitive dysfunction in fibromyalgia.

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Kratz, Anna L; Schilling, Stephen G; Goesling, Jenna; Williams, David A

2015-06-01

Pain is often the focus of research and clinical care in fibromyalgia (FM); however, cognitive dysfunction is also a common, distressing, and disabling symptom in FM. Current efforts to address this problem are limited by the lack of a comprehensive, valid measure of subjective cognitive dysfunction in FM that is easily interpretable, accessible, and brief. The purpose of this study was to leverage cognitive functioning item banks that were developed as part of the Patient Reported Outcomes Measurement Information System (PROMIS) to devise a 10-item short form measure of cognitive functioning for use in FM. In study 1, a nationwide (U.S.) sample of 1,035 adults with FM (age range = 18-82, 95.2% female) completed 2 cognitive item pools. Factor analyses and item response theory analyses were used to identify dimensionality and optimally performing items. A recommended 10-item measure, called the Multidimensional Inventory of Subjective Cognitive Impairment (MISCI) was created. In study 2, 232 adults with FM completed the MISCI and a legacy measure of cognitive functioning that is used in FM clinical trials, the Multiple Ability Self-Report Questionnaire (MASQ). The MISCI showed excellent internal reliability, low ceiling/floor effects, and good convergent validity with the MASQ (r = -.82). This paper presents the MISCI, a 10-item measure of cognitive dysfunction in FM, developed through classical test theory and item response theory. This brief but comprehensive measure shows evidence of excellent construct validity through large correlations with a lengthy legacy measure of cognitive functioning. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Stair negotiation in women with fibromyalgia

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Collado-Mateo, Daniel; Domínguez-Muñoz, Francisco J.; Olivares, Pedro R.; Adsuar, José C.; Gusi, Narcis

2017-01-01

Abstract Walking up and down stairs is a common and important activity of daily living. Women with fibromyalgia often show a reduced ability to perform this task. The objective of this study was to evaluate the test–retest reliability of stair negotiation tasks and to assess the impact of fibromyalgia symptoms on the ability to negotiate stairs. Forty-two women with fibromyalgia participated in this descriptive correlational study. The relevance of the stair negotiation (both walking up and down) was evaluated by assessing its association with the revised version of the fibromyalgia impact questionnaire (FIQ-R) and other health-related variables. Test–retest reliability was also analyzed. The main outcome measures were time spent walking up and down stairs and impact of fibromyalgia, quality of life, number of falls, weight, and lower limb strength and endurance. The intraclass correlation coefficient (ICC) for stair descent was 0.929 whereas that for ascent was 0.972. The score in these tests correlated significantly with the total score for the FIQ-R and the score for many of dimensions and symptoms: that is, physical function, overall impact of fibromyalgia, pain, energy, stiffness, restorative sleep, tenderness, self-perceived balance problems, and sensitivity. Given the importance of the stair negotiation as activity of daily living and the high reliability, both stair ascent and descent tasks may be useful as outcome measures in studies on patients with fibromyalgia. PMID:29069023

Exteroceptive and Interoceptive Body-Self Awareness in Fibromyalgia Patients

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Valenzuela-Moguillansky, Camila; Reyes-Reyes, Alejandro; Gaete, María I.

2017-01-01

Fibromyalgia is a widespread chronic pain disease characterized by generalized musculoskeletal pain and fatigue. It substantially affects patients' relationship with their bodies and quality of life, but few studies have investigated the relationship between pain and body awareness in fibromyalgia. We examined exteroceptive and interoceptive aspects of body awareness in 30 women with fibromyalgia and 29 control participants. Exteroceptive body awareness was assessed by a body-scaled action-anticipation task in which participants estimated whether they could pass through apertures of different widths. Interoceptive sensitivity (IS) was assessed by a heartbeat detection task where participants counted their heartbeats during different time intervals. Interoceptive awareness was assessed by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The “passability ratio” (the aperture size for a 50% positive response rate, divided by shoulder width), assessed by the body-scaled action-anticipation task, was higher for fibromyalgia participants, indicating disrupted exteroceptive awareness. Overestimating body size correlated positively with pain and its impact on functionality, but not with pain intensity. There was no difference in IS between groups. Fibromyalgia patients exhibited a higher tendency to note bodily sensations and decreased body confidence. In addition, the passability ratio and IS score correlated negatively across the whole sample, suggesting an inverse relationship between exteroceptive and interoceptive body awareness. There was a lower tendency to actively listen to the body for insight, with higher passability ratios across the whole sample. Based on our results and building on the fear-avoidance model, we outline a proposal that highlights possible interactions between exteroceptive and interoceptive body awareness and pain. Movement based contemplative practices that target sensory-motor integration and foster non

Agreement between touch-screen and paper-based patient-reported outcomes for patients with fibromyalgia

DEFF Research Database (Denmark)

Wæhrens, Eva Elisabet Ejlersen; Amris, Kirstine; Bartels, Else Marie

2015-01-01

OBJECTIVES: To compare data based on computerized and paper versions of health status questionnaires (HSQs) for sampling patient-reported outcomes (PROs) in patients with fibromyalgia (FM). In addition, to examine associations between patient characteristics (age, education, computer experience......) and differences between versions. Finally, to evaluate the acceptability of computer-based questionnaires among patients with FM. METHOD: The study population comprised female patients diagnosed with FM. All patients completed six HSQs: the Fibromyalgia Impact Questionnaire (FIQ), the Major Depression Inventory...

Experience-Sampling Methodology with a Mobile Device in Fibromyalgia

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Castilla Diana

2012-01-01

Full Text Available This work describes the usability studies conducted in the development of an experience-sampling methodology (ESM system running in a mobile device. The goal of the system is to improve the accuracy and ecology in gathering daily self-report data in individuals suffering a chronic pain condition, fibromyalgia. The usability studies showed that the developed software to conduct ESM with mobile devices (smartphones, cell phones can be successfully used by individuals with fibromyalgia of different ages and with low level of expertise in the use of information and communication technologies. 100% of users completed the tasks successfully, although some have completely illiterate. Also there seems to be a clear difference in the way of interaction obtained in the two studies carried out.

Ineffective ADL skills in women with fibromyalgia

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Von Bülow, Cecilie; Amris, Kirstine; la Cour, Karen

2016-01-01

BACKGROUND: Subgroups of women with fibromyalgia likely show different activity of daily living (ADL) skill deficits. Identifying ineffective ADL skills of significance in the 'typical' woman with fibromyalgia will promote the planning of targeted occupational therapy interventions aiming...... at improving ADL ability. OBJECTIVE: To identify frequently reported ADL skill deficits of significance in subgroups of women with fibromyalgia who have decreased ADL motor ability in combination with decreased or competent ADL process ability. METHOD: Women with fibromyalgia were evaluated with the Assessment...... of Motor and Process Skills (AMPS). If they demonstrated decreased ADL motor ability, the calibrated AMPS raters identified and reported ineffective ADL skills of significance. Descriptive comparisons were made between subgroups displaying either decreased or competent ADL process ability. RESULTS: Moves...

Does fibromyalgia influence symptom bother from pelvic organ prolapse?

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Adams, Kerrie; Osmundsen, Blake; Gregory, W Thomas

2014-05-01

Determine if women with fibromyalgia report increased bother from pelvic organ prolapse compared with women without fibromyalgia. We performed a cross-sectional study of women with symptomatic prolapse on consultation with a private urogynecology practice within a 46-month period. After matching for age, women with a diagnosis of fibromyalgia were compared with a reference group of women without fibromyalgia. Demographic, POPQ examination, medical history, and pelvic floor symptom data (PFDI, PFIQ, and PISQ-12) were collected. Our primary outcome was to compare the mean Pelvic Floor Distress Inventory (PFDI) scores of women with and without fibromyalgia. The prevalence of fibromyalgia in women evaluated for initial urogynecology consultation during the study period was 114 out of 1,113 (7%). Women with fibromyalgia reported significantly higher symptom bother scores related to pelvic organ prolapse, defecatory dysfunction, urinary symptoms, and sexual function: PFDI (p = 0.005), PFIQ (p=0.010), and PISQ (p=0.018). Women with fibromyalgia were found to have a higher BMI (p=0.008) and were more likely to report a history of sexual abuse, OR 3.1 (95 % CI 1.3, 7.9), and have levator myalgia on examination, OR 3.8 (95% CI 1.5, 9.1). In a linear regression analysis, levator myalgia was found to be the significant factor associated with pelvic floor symptom bother. In women with symptomatic prolapse, fibromyalgia is associated with an increased risk of levator myalgia and 50% more symptom bother from pelvic floor disorders.

Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia

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2013-01-01

Introduction Although alcohol consumption is a common lifestyle behavior with previous studies reporting positive effects of alcohol on chronic pain and rheumatoid arthritis, no studies to this date have examined alcohol consumption in patients with fibromyalgia. We examined the association between alcohol consumption and symptom severity and quality of life (QOL) in patients with fibromyalgia. Methods Data on self-reported alcohol consumption from 946 patients were analyzed. Subjects were grouped by level of alcohol consumption (number of drinks/week): none, low (≤3), moderate (>3 to 7), and heavy (>7). Univariate analyses were used to find potential confounders, and analysis of covariance was used to adjust for these confounders. Tukey HSD pairwise comparisons were used to determine differences between alcohol groups. Results Five hundred and forty-six subjects (58%) did not consume alcohol. Low, moderate, and heavy levels of alcohol consumption were reported for 338 (36%), 31 (3%), and 31 patients (3%), respectively. Employment status (P FIQ total score (P = 0.01), physical function (P fibromyalgia symptoms and better physical QOL than nondrinkers. Conclusions Our study demonstrates that low and moderate alcohol consumption was associated with lower fibromyalgia symptoms and better QOL compared to no alcohol consumption. The reasons for these results are unclear. Since recent studies have demonstrated that γ-Aminobutyric Acid (GABA) levels are low in fibromyalgia, and alcohol is known to be a GABA-agonist, future studies should examine whether alcohol could have a salutary effect on pain and other symptoms in fibromyalgia. PMID:23497427

Fibromyalgia

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Marek Grabski

2015-01-01

Full Text Available Fibromyalgia is classified as a disease of the connective tissue. There are many hypotheses about the causes of fibromyalgia, but none of them is finally confirmed. Due to unexplained etiopathogenesis of the illness, its treatment is difficult. People with fibromyalgia who suffer from generalised pains and chronic fatigue give up sport and increased physical activity in fear of escalation of ailments, limiting themselves to pharmacological therapy or psychotherapy. Meanwhile, properly selected kinesitherapeutic training can significantly improve the quality of life of people with fibromyalgia. The article discusses the current diagnostic criteria, clinical picture of the disease, and methods of treatment, with particular emphasis on therapeutic exercises.

Effect of music as nursing intervention for people diagnosed with fibromyalgia.

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Onieva-Zafra, María Dolores; Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Moreno-Lorenzo, Carmen

2013-06-01

Primary fibromyalgia, a poorly understood chronic pain syndrome, is a disorder of uncertain etiology. The ultimate goal of fibromyalgia treatment is to develop a multimodal therapy. In recent years, the use of music as an intervention for the pain management and other symptoms has increased. The purpose of this study was to investigate the effects of music on pain and depression for people diagnosed with fibromyalgia using Rogers' theory of the unitary human being as the theoretical framework. An experimental 4-week longitudinal trial design was undertaken. Sixty patients diagnosed with fibromyalgia were randomly assigned to either a music intervention group or a control group. Music interventions consisted of listening to music once a day for 4 consecutive weeks using two types of CDs. Pain was measured with the McGill Pain Questionnaire Long Form and depression with the Beck inventory; a 100-mm visual analog scale was used to measure pain and depression. The treatment group reported a significant reduction in pain and depression at week 4 compared with the control group. Members of the control group reported no differences in pain. The findings of this pilot study suggest the importance of music therapy as a nursing intervention and justify further investigation into music as a self-management intervention to reduce pain and depression. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Resistance exercise training for fibromyalgia.

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Busch, Angela J; Webber, Sandra C; Richards, Rachel S; Bidonde, Julia; Schachter, Candice L; Schafer, Laurel A; Danyliw, Adrienne; Sawant, Anuradha; Dal Bello-Haas, Vanina; Rader, Tamara; Overend, Tom J

2013-12-20

Fibromyalgia is characterized by chronic widespread pain that leads to reduced physical function. Exercise training is commonly recommended as a treatment for management of symptoms. We examined the literature on resistance training for individuals with fibromyalgia. Resistance training is exercise performed against a progressive resistance with the intention of improving muscle strength, muscle endurance, muscle power, or a combination of these. To evaluate the benefits and harms of resistance exercise training in adults with fibromyalgia. We compared resistance training versus control and versus other types of exercise training. We searched nine electronic databases (The Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, Current Controlled Trials, World Health Organization (WHO) International Clinical Trials Registry Platform, AMED) and other sources for published full-text articles. The date of the last search was 5 March 2013. Two review authors independently screened 1856 citations, 766 abstracts and 156 full-text articles. We included five studies that met our inclusion criteria. Selection criteria included: a) randomized clinical trial, b) diagnosis of fibromyalgia based on published criteria, c) adult sample, d) full-text publication, and e) inclusion of between-group data comparing resistance training versus a control or other physical activity intervention. Pairs of review authors independently assessed risk of bias and extracted intervention and outcome data. We resolved disagreements between the two review authors and questions regarding interpretation of study methods by discussion within the pairs or when necessary the issue was taken to the full team of 11 members. We extracted 21 outcomes of which seven were designated as major outcomes: multidimensional function, self reported physical function, pain, tenderness, muscle strength, attrition rates, and adverse effects. We evaluated benefits and harms of the interventions using

A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia

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Pridgen WL

2017-02-01

Full Text Available William L Pridgen,1 Carol Duffy,2 Judy F Gendreau,3 R Michael Gendreau3 1Innovative Med Concepts, LLC, 2Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, 3Gendreau Consulting, LLC, Poway, CA, USA Objective: Infections and other stressors have been implicated in the development of fibromyalgia. We hypothesized that these stressors could result in recurrent reactivations of latent herpes virus infections, which could lead to the development of fibromyalgia. This study evaluated a famciclovir + celecoxib drug combination (IMC-1, active against suspected herpes virus reactivation and infection, for the treatment of fibromyalgia.Methods: A total of 143 fibromyalgia patients were enrolled at 12 sites in a 16-week, double-blinded, placebo-controlled proof-of-concept trial. Randomized patients received either IMC-1 or placebo in a 1:1 ratio. Outcome measures included a 24-hour recall pain Numerical Rating Scale, the Revised Fibromyalgia Impact Questionnaire (FIQ-R, the Patient’s Global Impression of Change (PGIC questionnaire, the Multidimensional Fatigue Inventory, the NIH Patient-Reported Outcomes Measurement Information System (PROMIS, and the Beck Depression Inventory-II conducted at baseline and weeks 6, 12, and 16 of the study.Results: A significant decrease in fibromyalgia-related pain was observed for patients on IMC-1 treatment versus placebo. PGIC response rates were significantly improved with IMC-1 treatment. Overall, patient self-reported functioning, as measured by the FIQ-R, was significantly improved. Fatigue was also significantly improved as measured by the PROMIS fatigue inventory. The safety profile was encouraging. Despite the celecoxib component of IMC-1, gastrointestinal and nervous system treatment emergent adverse events were reported less frequently in the IMC-1 group, and study completion rates favored IMC-1 treatment.Conclusion: IMC-1 was efficacious and safe in treating symptoms of fibromyalgia

Effects of naltrexone on pain sensitivity and mood in fibromyalgia: no evidence for endogenous opioid pathophysiology.

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Jarred W Younger

Full Text Available The pathophysiological mechanisms underlying fibromyalgia are still unknown, although some evidence points to endogenous opioid dysfunction. We examined how endogenous opioid antagonism affects pain and mood for women with and without fibromyalgia. Ten women with fibromyalgia and ten age- and gender-matched, healthy controls each attended two laboratory sessions. Each participant received naltrexone (50mg at one session, and placebo at the other session, in a randomized and double-blind fashion. Participants were tested for changes in sensitivity to heat, cold, and mechanical pain. Additionally, we collected measures of mood and opioid withdrawal symptoms during the laboratory sessions and at home the night following each session. At baseline, the fibromyalgia group exhibited more somatic complaints, greater sensory sensitivity, more opioid withdrawal somatic symptoms, and lower mechanical and cold pain-tolerance than did the healthy control group. Neither group experienced changes in pain sensitivity due to naltrexone administration. Naltrexone did not differentially affect self-reported withdrawal symptoms, or mood, in the fibromyalgia and control groups. Consistent with prior research, there was no evidence found for abnormal endogenous opioid activity in women with fibromyalgia.

Fibromyalgia

OpenAIRE

Marek Grabski; Tomasz Wójcik; Iwona Napora

2015-01-01

Fibromyalgia is classified as a disease of the connective tissue. There are many hypotheses about the causes of fibromyalgia, but none of them is finally confirmed. Due to unexplained etiopathogenesis of the illness, its treatment is difficult. People with fibromyalgia who suffer from generalised pains and chronic fatigue give up sport and increased physical activity in fear of escalation of ailments, limiting themselves to pharmacological therapy or psychotherapy. Meanwhile, properly selecte...

Major depression, fibromyalgia and labour force participation: A population-based cross-sectional study

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Patten Scott B

2006-01-01

Full Text Available Abstract Background Previous studies have documented an elevated frequency of depressive symptoms and disorders in fibromyalgia, but have not examined the association between this comorbidity and occupational status. The purpose of this study was to describe these epidemiological associations using a national probability sample. Methods Data from iteration 1.1 of the Canadian Community Health Survey (CCHS were used. The CCHS 1.1 was a large-scale national general health survey. The prevalence of major depression in subjects reporting that they had been diagnosed with fibromyalgia by a health professional was estimated, and then stratified by demographic variables. Logistic regression models predicting labour force participation were also examined. Results The annual prevalence of major depression was three times higher in subjects with fibromyalgia: 22.2% (95% CI 19.4 – 24.9, than in those without this condition: 7.2% (95% CI 7.0 – 7.4. The association persisted despite stratification for demographic variables. Logistic regression models predicting labour force participation indicated that both conditions had an independent (negative effect on labour force participation. Conclusion Fibromyalgia and major depression commonly co-occur and may be related to each other at a pathophysiological level. However, each syndrome is independently and negatively associated with labour force participation. A strength of this study is that it was conducted in a large probability sample from the general population. The main limitations are its cross-sectional nature, and its reliance on self-reported diagnoses of fibromyalgia.

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance.

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Collado-Mateo, D; Gallego-Diaz, J M; Adsuar, J C; Domínguez-Muñoz, F J; Olivares, P R; Gusi, N

2015-01-01

To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.

Pediatric fibromyalgia.

Science.gov (United States)

Buskila, Dan

2009-05-01

Fibromyalgia is an idiopathic chronic pain syndrome defined by widespread nonarticular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, nonrefreshing sleep, irritable bowel, and more. Central nervous system sensitization is a major pathophysiologic aspect of fibromyalgia; in addition, various external stimuli such as trauma and stress may contribute to development of the syndrome. Fibromyalgia is most common in midlife, but may be seen at any age. This article reviews the epidemiology, clinical characteristics, etiology, management, and outcome of pediatric fibromyalgia.

Fibromyalgia in the adult Danish population: II. A study of clinical features

DEFF Research Database (Denmark)

Prescott, E; Jacobsen, S; Kjøller, M

1993-01-01

Clinical characteristics of fibromyalgia have so far been based mainly on patients identified in rheumatologic settings. This paper offers the clinical findings in fibromyalgia based on a national health interview survey, in which 123 persons fulfilled preset criteria for widespread pain. Clinical......, headache, difficulty in stair-climbing, and poorer self-evaluated health with more tender points was found. Contrary to that which was expected, fibromyalgia subjects did not suffer from sleep disturbances, irritable bowels or morning stiffness. Our findings indicate that clinical characteristics...... of fibromyalgia in the general population may differ from those found in rheumatological settings....

Fibromyalgia

Science.gov (United States)

... eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274. Mbuyi N. Fibromyalgia. In: ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2017:491-492. Selfridge NJ. Fibromyalgia. In: Rakel ...

Fibromyalgia and seizures.

Science.gov (United States)

Tatum, William O; Langston, Michael E; Acton, Emily K

2016-06-01

The purpose of this case-matched study was to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders and explore the utility of fibromyalgia as a predictor for the diagnosis of psychogenic non-epileptic seizures. The billing diagnosis codes of 1,730 new, non-selected patient encounters were reviewed over a three-year period for an epileptologist in a neurology clinic to identify all patients with historical diagnoses of fibromyalgia. The frequency with which epileptic seizures, psychogenic non-epileptic seizures, and physiological non-epileptic events were comorbid with fibromyalgia was assessed. Age and gender case-matched controls were used for a between-group comparison. Wilcoxon tests were used to analyse interval data, and Chi-square was used to analyse categorical data (pFibromyalgia was retrospectively identified in 95/1,730 (5.5%) patients in this cohort. Females represented 95% of the fibromyalgia sample (age: 53 years; 95% CI: 57, 51). Forty-three percent of those with fibromyalgia had a non-paroxysmal, neurological primary clinical diagnosis, most commonly chronic pain. Paroxysmal events were present in 57% of fibromyalgia patients and 54% of case-matched controls. Among patients with fibromyalgia and paroxysmal disorders, 11% had epileptic seizures, 74% had psychogenic non-epileptic seizures, and 15% had physiological non-epileptic events, compared to case-matched controls with 37% epileptic seizures, 51% psychogenic non-epileptic events, and 12% physiological non-epileptic events (p = 0.009). Fibromyalgia was shown to be a predictor for the diagnosis of psychogenic non-epileptic seizures in patients with undifferentiated paroxysmal spells. However, our results suggest that the specificity and sensitivity of fibromyalgia as a marker for psychogenic non-epileptic seizures in a mixed general neurological population of patients is less than previously described.

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

Science.gov (United States)

Marcus, Dawn A; Bernstein, Cheryl D; Haq, Adeel; Breuer, Paula

2014-06-01

Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact. The aim of the present study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme. Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities. Numerical rating scores for pain decreased by 10-13% (p Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p fibromyalgia treatment effectiveness. © 2013 John Wiley & Sons, Ltd.

Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications

Science.gov (United States)

Ross, Ruth E.; Shade-Zeldow, Yvonne; Kostas, Konstantinos; Morrissey, Mary; Elias, Dean A.; Shepard, Alan

2007-01-01

Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients’ quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screening test for somatization, HADS, MMPI-2 scale 1 (Hypochondriasis), and self reported severity of symptoms 1 year after treatment. There was no significant difference in initial clinical presentation or demographic characteristics between the patients treated by surgical decompression and those treated by non-surgical means. There was a striking and statistically significant improvement in all symptoms attributed to the fibromyalgia syndrome in the surgical patients but not in the non-surgical patients at 1 year following the treatment of cervical myelopathy (P ≤ 0.018–0.001, Chi-square or Fisher’s exact test). At the 1 year follow-up, there was a statistically significant improvement in both physical and mental quality of life as measured by the SF-36 score for the surgical group as compared to the non-surgical group (Repeated Measures ANOVA P somatization disorder, and the anxiety and depression scores exclusively in the surgical patients (Wilcoxon signed rank, P < 0.001). The surgical treatment of cervical myelopathy due to spinal cord or caudal brainstem compression in patients carrying the diagnosis of fibromyalgia can result in a significant improvement in a wide array of symptoms usually attributed to fibromyalgia with attendant measurable improvements in the quality of life. We recommend detailed neurological and neuroradiological evaluation of patients with fibromyalgia in order to exclude compressive cervical myelopathy, a potentially treatable

Reiki for the treatment of fibromyalgia: a randomized controlled trial.

Science.gov (United States)

Assefi, Nassim; Bogart, Andy; Goldberg, Jack; Buchwald, Dedra

2008-11-01

Fibromyalgia is a common, chronic pain condition for which patients frequently use complementary and alternative medicine, including Reiki. Our objective was to determine whether Reiki is beneficial as an adjunctive fibromyalgia treatment. This was a factorial designed, randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group. The study setting was private medical offices in the Seattle, Washington metropolitan area. The subjects were comprised 100 adults with fibromyalgia. Four (4) groups received twice-weekly treatment for 8 weeks by either a Reiki master or actor randomized to use direct touch or no touch (distant therapy). The primary outcome was subjective pain as measured by visual analog scale at weeks 4, 8, and 20 (3 months following end of treatment). Secondary outcomes were physical and mental functioning, medication use, and health provider visits. Participant blinding and adverse effects were ascertained by self-report. Improvement between groups was examined in an intention-to-treat analysis. Neither Reiki nor touch had any effect on pain or any of the secondary outcomes. All outcome measures were nearly identical among the 4 treatment groups during the course of the trial. Neither Reiki nor touch improved the symptoms of fibromyalgia. Energy medicine modalities such as Reiki should be rigorously studied before being recommended to patients with chronic pain symptoms.

Multidisciplinary and biodanza intervention for the management of fibromyalgia.

Science.gov (United States)

Carbonell-Baeza, Ana; Ruiz, Jonatan R; Aparicio, Virginia A; Martins-Pereira, Clelia M; Gatto-Cardia, M Claudia; Martinez, Jose M; Ortega, Francisco B; Delgado-Fernandez, Manuel

2012-01-01

To evaluate and compare the effectiveness of a 16-week multidisciplinary (exercise plus psychological therapy) and biodanza intervention in women with fibromyalgia. Thirty-eight women with fibromyalgia were distributed to a 16-week multidisciplinary (3-times/week) intervention (n=21) or Biodanza (1-time/week) intervention (n=17). We assessed tender point, body composition, physical fitness and psychological outcomes (Fibromyalgia Impact Questionnaire, the Short-Form Health Survey 36 questionnaire (SF-36), the Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory (VPMI), Rosenberg Self-Esteem Scale and General Self-Efficacy Scale). We observed a significant group*time interaction effect for the scales of SF-36 physical role (P=0.038) and social functioning (P=0.030) and for the passive coping scale in VPMI (P=0.043). Post hoc analysis revealed a significant improvement on social functioning (P=0.030) in the multidisciplinary group whereas it did not change in the Biodanza group. Post hoc analysis revealed a reduction in the use of passive coping (positive) (P less than 0.001) in the multidisciplinary group. There was no significant interaction or time effect in body composition and physical fitness. 16 weeks of multidisciplinary intervention induced greater benefits than a Biodanza intervention for social functioning and the use of passive coping strategies in women with fibromyalgia.

Disability and quality of life in patients with fibromyalgia

Directory of Open Access Journals (Sweden)

Verbunt Jeanine A

2008-01-01

Full Text Available Abstract Background Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia. The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of life. Methods In this cross sectional study, explaining factors for disability were studied based on a regression analysis with gender, mental health, physical and social functioning as independent variables. For the assessment of disability in fibromyalgia the FIQ was used. The levels of psychological distress in patients with fibromyalgia, Complex Regional Pain Syndrome (CRPS and chronic low back pain (CLBP were compared based on scores on the Symptom Checklist (SCL90. Quality of life of patients with fibromyalgia was compared with scores (SF36 of both patients with fibromyalgia and other health conditions as derived from the literature. Results Disability in fibromyalgia seemed best explained by a patients mental health condition (β = -0.360 p = 0.02. The level of psychological distress was higher in patients with fibromyalgia as compared to patients with CRPS or CLBP (p Conclusion Patients with fibromyalgia report a considerable impact on their quality of life and their perceived disability level seems influenced by their mental health condition. In comparison with patients with other pain conditions psychological distress is higher.

Self-efficacy expectations and emotional adjustment on coping with fibromyalgia - Las expectativas de autoeficacia y el ajuste emocional en el afrontamiento de la fibromialgia

Directory of Open Access Journals (Sweden)

Miguel Ángel Vallejo Pareja

2009-04-01

Full Text Available The objective was to evaluate the relationship between of self-efficacy expectations, psychological distress and coping strategies among subjects with fibromyalgia, given the physical and psychosocial components of pain, and specially the need to clarify the relationship between them in order to improve the adjustment to any chronic pain condition. One-hundred women diagnosed of fibromyalgia from the rehabilitation center at the Hospital Universitario Gregorio Marañón de Madrid completed the following set of questionnaires, the Hospital Anxiety and Depression Scale (HADS, the Chronic Pain Coping Inventory (CPCI and the Chronic Pain Self-efficacy Scale (CPSS. The results showed that self-efficacy was inversely correlated with psychological distress (anxiety and depression. Respect to coping strategies, task persistence was significantly related to expectations of self-efficacy, while this variable was inversely correlated with depression. A negative relation was found between guarding, resting and self-efficacy. These findings suggest that expectations of self-efficacy may have greater explanatory power over the use of positive coping strategies and correct emotional functioning in FMS patients.

Prevalence and predictors of unsupervised walking and physical activity in a community population of women with fibromyalgia.

Science.gov (United States)

López-Roig, Sofía; Pastor, María-Ángeles; Peñacoba, Cecilia; Lledó, Ana; Sanz, Yolanda; Velasco, Lilian

2016-08-01

Physical exercise is recognized as a component of the evidence-based guidelines for treatment of fibromyalgia. Walking is a low-moderate intensity exercise easily adaptable to a fibromyalgia patient's situation. The present study aims to estimate the prevalence of unsupervised walking for exercise in women with fibromyalgia, to describe their level of physical activity and to identify their predictors among socio-demographic, symptom perception and medical advice to walk. A cross-sectional survey with 920 women (all members of fibromyalgia associations) completed the International Physical Activity Questionnaire-Short Form and self-reported scales to assess symptom perception, walking, medical advice to walk and physical comorbidity. The prevalence of reported walking regularly as physical exercise was 30.8 % and it was predicted by medical advice (odds ratio, OR 1.876), age (OR 1.021) and fatigue intensity (OR 0.912). The prevalence of physical activity was 16 % for high-intensity activity, 40 % for moderate activity and 44 % for low activity. Predictors of low versus moderate and high physical activity were pain intensity (OR 1.171) and fatigue impact perception (OR 1.076). Evidence shows a low percentage of women with fibromyalgia walking regularly for physical exercise. Most reported low or moderate physical activity. The results indicate the importance of doctors' advice in promoting walking. Symptom perception and socio-demographic characteristics were weak predictors. Further work is required to examine other determinants of these low levels.

Disability and quality of life in patients with fibromyalgia

Science.gov (United States)

Verbunt, Jeanine A; Pernot, Dia HFM; Smeets, Rob JEM

2008-01-01

Background Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia. The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of life. Methods In this cross sectional study, explaining factors for disability were studied based on a regression analysis with gender, mental health, physical and social functioning as independent variables. For the assessment of disability in fibromyalgia the FIQ was used. The levels of psychological distress in patients with fibromyalgia, Complex Regional Pain Syndrome (CRPS) and chronic low back pain (CLBP) were compared based on scores on the Symptom Checklist (SCL90). Quality of life of patients with fibromyalgia was compared with scores (SF36) of both patients with fibromyalgia and other health conditions as derived from the literature. Results Disability in fibromyalgia seemed best explained by a patients mental health condition (β = -0.360 p = 0.02). The level of psychological distress was higher in patients with fibromyalgia as compared to patients with CRPS or CLBP (p fibromyalgia on quality of life appeared to be high as compared to the impact of other health conditions. Conclusion Patients with fibromyalgia report a considerable impact on their quality of life and their perceived disability level seems influenced by their mental health condition. In comparison with patients with other pain conditions psychological distress is higher. PMID:18211701

Fibromyalgia and neuropathic pain - differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia

Science.gov (United States)

2011-01-01

Background Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities. Methods The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, PainDETECT). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts. Results Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%). Conclusions DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance

Directory of Open Access Journals (Sweden)

D. Collado-Mateo

2015-01-01

Full Text Available Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Results. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. Conclusion. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.

The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia.

NARCIS (Netherlands)

Middendorp, H. van; Lumley, M.A.; Jacobs, J.W.G.; Bijlsma, J.W.J.; Geenen, R.

2010-01-01

OBJECTIVE: Negative emotions are commonly experienced in fibromyalgia and may affect pain. This study examined the effects of anger and sadness on clinical pain reports and on pain threshold and tolerance in response to electrical stimulation in women with and without fibromyalgia. METHODS: In an

Physical fitness reference standards in fibromyalgia : The al-Ándalus project

NARCIS (Netherlands)

Álvarez-Gallardo, Inmaculada C; Carbonell-Baeza, A; Segura-Jiménez, V.; Soriano-Maldonado, Alberto; Intemann, T; Aparicio, Virgina A; Estévez-López, F|info:eu-repo/dai/nl/412501031; Camiletti-Moirón, Daniel; Herrador-Colmenero, Manuel; Ruiz, Jonatan R; Delgado-Fernández, M.; Ortega, Francisco B

2017-01-01

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with

Stair negotiation in women with fibromyalgia: A descriptive correlational study.

Science.gov (United States)

Collado-Mateo, Daniel; Domínguez-Muñoz, Francisco J; Olivares, Pedro R; Adsuar, José C; Gusi, Narcis

2017-10-01

Walking up and down stairs is a common and important activity of daily living. Women with fibromyalgia often show a reduced ability to perform this task.The objective of this study was to evaluate the test-retest reliability of stair negotiation tasks and to assess the impact of fibromyalgia symptoms on the ability to negotiate stairs.Forty-two women with fibromyalgia participated in this descriptive correlational study. The relevance of the stair negotiation (both walking up and down) was evaluated by assessing its association with the revised version of the fibromyalgia impact questionnaire (FIQ-R) and other health-related variables. Test-retest reliability was also analyzed. The main outcome measures were time spent walking up and down stairs and impact of fibromyalgia, quality of life, number of falls, weight, and lower limb strength and endurance.The intraclass correlation coefficient (ICC) for stair descent was 0.929 whereas that for ascent was 0.972. The score in these tests correlated significantly with the total score for the FIQ-R and the score for many of dimensions and symptoms: that is, physical function, overall impact of fibromyalgia, pain, energy, stiffness, restorative sleep, tenderness, self-perceived balance problems, and sensitivity.Given the importance of the stair negotiation as activity of daily living and the high reliability, both stair ascent and descent tasks may be useful as outcome measures in studies on patients with fibromyalgia.

Cognitive Dysfunction in Fibromyalgia

Directory of Open Access Journals (Sweden)

Tuba Tulay Koca

2015-03-01

Full Text Available The primary symptom of fibromyalgia is widespread pain with muscle tenderness to light palpation. Howeover many patients report a wide range of symptoms including pain, dyscognition, sleep disturbances, fatigue and mood disorders (frequently depression. Such symptoms seem to be related to one another. Besides, a decrease in concentration and memory disorder has recognised as an independent symptom yet; added into literature under the terms and lsquo;dyscognition' and and lsquo;fibrofog'. Recently clinicians interested in investigations about dyscognition in fibromyalgia syndrome. Cognitive symptoms may be exacerbated by the presence of depression, anxiety, sleep dysorders, endocrine disregulations and pain; but the relationship is unclear. Additionally some of recent studies suggest that insulin resistance may represent a risk factor for memory impairment in these patients. There is lack of standardized tests, treatment methods and studies for understanding pathophysiologic pathways of cognitive problems (memory, concentration in fibromyalgia.

Predictors of clinical outcome in fibromyalgia after a brief interdisciplinary fibromyalgia treatment program: single center experience.

Science.gov (United States)

Oh, Terry H; Hoskin, Tanya L; Luedtke, Connie A; Weingarten, Toby N; Vincent, Ann; Kim, Chul H; Thompson, Jeffrey M

2012-04-01

To determine which patient characteristics are closely associated with a positive response to a brief interdisciplinary fibromyalgia treatment program (FTP). A prospective cohort study. FTP at a tertiary medical center. A total of 536 patients with a confirmed diagnosis of fibromyalgia who underwent the FTP and completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6-12 months after treatment. A brief 1.5-day interdisciplinary FTP, which included evaluation with a registered nurse and a physician for a diagnosis or confirmation of fibromyalgia, fibromyalgia education, interactive self management session, and physical and occupational therapy. The responder definition was an improvement of 14% or more in the FIQ total score from their baseline to 6-12 months after treatment. Mean (standard deviation) age of our patients was 50.3 ± 13.0 years; 515 women (96%) and 23 men (4%). Two hundred forty-eight patients (46%) met the responder definition at 6-12 months follow-up. In an univariate analysis, younger age (P = .008), college or higher education (P = .02), fewer tender points (P = .048), and higher FIQ depression subscore (P = .02) significantly predicted positive response. In a multivariate analysis, these factors all remained statistically significant. In addition, a positive abuse history became significant (P = .03). There was no significant association for gender, duration of symptoms, marital status, employment, smoking status, or 3 numeric rating scale pain scores. Patients with younger age, more years of education (with college or graduate degree), higher baseline FIQ depression score, lower tender point count, and absent abuse history experience greater benefit from a brief FTP. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Examination of contraction-induced muscle pain as a behavioral correlate of physical activity in women with and without fibromyalgia.

Science.gov (United States)

Umeda, Masataka; Corbin, Lisa W; Maluf, Katrina S

2015-01-01

This study aimed to compare muscle pain intensity during a sustained isometric contraction in women with and without fibromyalgia (FM), and examine the association between muscle pain and self-reported levels of physical activity. Fourteen women with FM and 14 healthy women completed the study, where muscle pain ratings (MPRs) were obtained every 30 s during a 3 min isometric handgrip task at 25% maximal strength, and self-reported physical activity was quantified using the Baecke Physical Activity Questionnaire. Women with FM were less physically active than healthy controls. During the isometric contraction, MPR progressively increased in both groups at a comparable rate, but women with FM generally reported a greater intensity of muscle pain than healthy controls. Among all women, average MPR scores were inversely associated with self-reported physical activity levels. Women with FM exhibit augmented muscle pain during isometric contractions and reduced physical activity than healthy controls. Furthermore, contraction-induced muscle pain is inversely associated with physical activity levels. These observations suggest that augmented muscle pain may serve as a behavioral correlate of reduced physical activity in women with FM. Implications for Rehabilitation Women with fibromyalgia experience a greater intensity of localized muscle pain in a contracting muscle compared to healthy women. The intensity of pain during muscle contraction is inversely associated with the amount of physical activity in women with and without fibromyalgia. Future studies should determine whether exercise adherence can be improved by considering the relationship between contraction-induced muscle pain and participation in routine physical activity.

The Occupational Profile of Women with Fibromyalgia Syndrome.

Science.gov (United States)

Pérez-de-Heredia-Torres, Marta; Huertas Hoyas, Elisabet; Sánchez-Camarero, Carlos; Pérez-Corrales, Jorge; Fernández de-Las-Peñas, César

2016-06-01

The aims of this study were to assess the functional level of women with fibromyalgia; to investigate the differences in the occupational activities between women with fibromyalgia and healthy women; and to analyse the perceived importance of occupational performance during self-care, productivity and leisure activities. A cross-sectional case control study was performed. Twenty women with fibromyalgia and 20 healthy women completed the Functional Independence Measure (FIM), the Canadian Occupational Performance Measure (COPM), a Numerical Pain Rating Scale, the Fibromyalgia Impact Questionnaire and the SF-36 health survey. The Chi-square test (χ2), the Student's t test and the Spearman's test were used on the data. The FIM revealed significant differences regarding several activities: personal hygiene, bathing and memory (p  0.10). Women with fibromyalgia had higher disability and reduced quality of life and required greater assistance to perform specific activities of daily living, i.e. hygiene, than healthy women. This highlights the specific occupational therapy needs these women have for performing many basic activities and for improving their quality of life. Limitations of the study include the small sample size, the exclusion of male participants and the possible influence of the women's psychological status on the assessments performed. Findings should be generalized with caution. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Investigation of the relationship between anxiety and heart rate variability in fibromyalgia: A new quantitative approach to evaluate anxiety level in fibromyalgia syndrome.

Science.gov (United States)

Bilgin, Suleyman; Arslan, Evren; Elmas, Onur; Yildiz, Sedat; Colak, Omer H; Bilgin, Gurkan; Koyuncuoglu, Hasan Rifat; Akkus, Selami; Comlekci, Selcuk; Koklukaya, Etem

2015-12-01

Fibromyalgia syndrome (FMS) is identified by widespread musculoskeletal pain, sleep disturbance, nonrestorative sleep, fatigue, morning stiffness and anxiety. Anxiety is very common in Fibromyalgia and generally leads to a misdiagnosis. Self-rated Beck Anxiety Inventory (BAI) and doctor-rated Hamilton Anxiety Inventory (HAM-A) are frequently used by specialists to determine anxiety that accompanies fibromyalgia. However, these semi-quantitative anxiety tests are still subjective as the tests are scored using doctor-rated or self-rated scales. In this study, we investigated the relationship between heart rate variability (HRV) frequency subbands and anxiety tests. The study was conducted with 56 FMS patients and 34 healthy controls. BAI and HAM-A test scores were determined for each participant. ECG signals were then recruited and 71 HRV subbands were obtained from these ECG signals using Wavelet Packet Transform (WPT). The subbands and anxiety tests scores were analyzed and compared using multilayer perceptron neural networks (MLPNN). The results show that a HRV high frequency (HF) subband in the range of 0.15235Hz to 0.40235Hz, is correlated with BAI scores and another HRV HF subband, frequency range of 0.15235Hz to 0.28907Hz is correlated with HAM-A scores. The overall accuracy is 91.11% for HAM-A and 90% for BAI with MLPNN analysis. Doctor-rated or self-rated anxiety tests should be supported with quantitative and more objective methods. Our results show that the HRV parameters will be able to support the anxiety tests in the clinical evaluation of fibromyalgia. In other words, HRV parameters can potentially be used as an auxiliary diagnostic method in conjunction with anxiety tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

Validation of the Greek Version of the Fibromyalgia Rapid Screening Tool.

Science.gov (United States)

Zis, Panagiotis; Brozou, Vassiliki; Stavropoulou, Evmorfia; Argyra, Erifilli; Siafaka, Ioanna; Kararizou, Evangelia; Bouhassira, Didier; Perrot, Serge; Zis, Vassileios; Vadalouca, Athina

2017-09-01

The Fibromyalgia Rapid Screening Tool (FiRST) is a brief, simple, and straightforward self-administered questionnaire that was developed by Perrot et al. for the detection of fibromyalgia syndrome in patients with diffuse chronic pain. The aim of our study was to develop and validate the Greek version of FiRST. The study was set up as a prospective observational study. The original French version of FiRST was adapted into Greek using forward and backward translation. Patients with chronic diffuse pain with a clinical diagnosis of fibromyalgia and osteoarthritis based on the criteria of the American College of Rheumatology were invited to participate to the study. Of the 101 patients who met our inclusion criteria, 42 were diagnosed with fibromyalgia and 59 with osteoarthritis. The 2 groups did not differ significantly regarding gender and pain characteristics (duration, intensity). Cronbach's alpha coefficient was 0.79. Receiver operating characteristic analysis showed an area under the curve of 89% (95% confidence interval = 83 to 95%; SE: 0.032, P fibromyalgia in daily practice. © 2016 World Institute of Pain.

Celiac symptoms in patients with fibromyalgia: a cross-sectional study.

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García-Leiva, Juan Miguel; Carrasco, Jorge Luis Ordóñez; Slim, Mahmoud; Calandre, Elena P

2015-03-01

Fibromyalgia is a chronic pain syndrome associated with numerous somatic symptoms including gastrointestinal manifestations of nonspecific nature. Celiac disease and nongluten sensitivity frequently evolve in adults with gastrointestinal and extraintestinal symptoms similar to those found among patients with fibromyalgia. The objective of the present study was to evaluate the presence of celiac-type symptoms among patients with fibromyalgia in comparison with healthy subjects and with those experienced by adult celiac patients and subjects with gluten sensitivity. A list of typical celiac-type symptoms was developed, comparing the frequency of presentation of these symptoms between patients with fibromyalgia (N = 178) and healthy subjects (N = 131), in addition to those of celiac patients and gluten-sensitive patients reported in the literature. The frequency of presentation of every celiac-type symptom, excepting anemia, was significantly higher among patients with fibromyalgia compared to controls (p symptoms and cutaneous lesions predominated among patients with fibromyalgia, whereas the prevalence of gastrointestinal symptoms was higher among patients with fibromyalgia compared to gluten-sensitive patients and was similar among patients with fibromyalgia and celiac disease patient. The symptomatological similarity of both pathologies, especially gastrointestinal symptoms, suggests that at least a subgroup of patients with fibromyalgia could experience subclinical celiac disease or nonceliac gluten intolerance.

Fibromyalgia symptom reduction by online behavioral self-monitoring, longitudinal single subject analysis and automated delivery of individualized guidance

OpenAIRE

William Collinge; Paul Yarnold; Robert Soltysik

2013-01-01

Background: Fibromyalgia (FM) is a complex chronic pain condition that is difficult to treat. The prevailing approach is an integration of pharmacological, psycho-educational, and behavioral strategies. Information technology offers great potential for FM sufferers to systemically monitor symptoms as well as potential impacts of various management strategies. Aims: This study aimed to evaluate effects of a web-based, self-monitoring and symptom management system (SMARTLog) that analyzes perso...

Thermal self-focusing at oblique incidence

International Nuclear Information System (INIS)

Craxton, R.S.; McCrory, R.L.

1984-03-01

Thermal self-focusing at oblique incidence has been investigated in two-dimensional line-focus geometry using the Eulerian hydrodynamics simulation code SAGE. The laser beam interacts with a long-scale-length preformed plasma with an expontial density profiele. Questions to be addressed include: (1) What happens when a self-focusing channel reaches the turning point of the incident rays, and (2) Does the unabsorbed light return in the specular direction or back along the channel. A comparison is also made between thermal self-focusing at normal incidence in cylindrical and line-focus geometries: in cylindrical geometry the self-focusing mechanism is enhanced by the relative ease with which plasma may be expelled from a small cylindrical channel

Physical fitness reference standards in fibromyalgia: The al-Ándalus project.

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Álvarez-Gallardo, I C; Carbonell-Baeza, A; Segura-Jiménez, V; Soriano-Maldonado, A; Intemann, T; Aparicio, V A; Estévez-López, F; Camiletti-Moirón, D; Herrador-Colmenero, M; Ruiz, J R; Delgado-Fernández, M; Ortega, F B

2017-11-01

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls (P fitness levels among patients with fibromyalgia and controls in a large sample of patients with fibromyalgia from southern of Spain. Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls. This information could be useful to correctly interpret physical fitness assessments and helping health care providers to identify individuals at risk for losing physical independence. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessment of functional capacity in women with fibromyalgia: direct and self-reported methods. DOI: 10.5007/1980-0037.2011v13n4p292

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Diogo Homann

2011-08-01

Full Text Available Fibromyalgia can limit activities of daily living (ADLs performance and has a negative impact on the quality of life of these patients. The objective of this study was to evaluate the association between direct and indirect methods for the assessment of functional capacity and their relationship with some features of fibromyalgia. Thirty-eight women with a diagnosis of fibromyalgia participated in the study. Functional capacity was assessed by the Health Assessment Questionnaire (HAQ, distance in the six-minute walk test (6MWT, and handgrip strength (HGS. Pain was rated on a visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ was applied to assess the impact on quality of life. Body mass index and waist circumference were also evaluated. Pearson’s correlation test was used for parametric data and Spearman’s correlation test for nonparametric data. Multiple regressions were also performed. Pain intensity was high in the patients (median: 9.5. The 6MWT distance was correlated with HAQ score (r=-0.55, p<0.01 and HGS (r=0.34, p<0.01. Pain was correlated with HGS (r=-0.41, p<0.01, HAQ score (r=0.62, p<0.01, and FIQ (r =0.66, p<0.01. Pain intensity explained 40% of the variation in HAQ scores. This variation increased to 60% after inclusion of 6MWT distance. In conclusion, pain seems to compromise HGS, ADLs and quality of life in women with fibromyalgia. The lower performance in the 6MWT might be explained by high body mass index. Taking into account pain, the HAQ seems to be an appropriate tool for the assessment of functional capacity in women with fibromyalgia.

Assessment of functional capacity in women with fibromyalgia: direct and self-reported methods. DOI: 10.5007/1980-0037.2011v13n4p292

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Diogo Homann

2011-06-01

Full Text Available Fibromyalgia can limit activities of daily living (ADLs performance and has a negative impact on the quality of life of these patients. The objective of this study was to evaluate the association between direct and indirect methods for the assessment of functional capacity and their relationship with some features of fibromyalgia. Thirty-eight women with a diagnosis of fibromyalgia participated in the study. Functional capacity was assessed by the Health Assessment Questionnaire (HAQ, distance in the six-minute walk test (6MWT, and handgrip strength (HGS. Pain was rated on a visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ was applied to assess the impact on quality of life. Body mass index and waist circumference were also evaluated. Pearson’s correlation test was used for parametric data and Spearman’s correlation test for nonparametric data. Multiple regressions were also performed. Pain intensity was high in the patients (median: 9.5. The 6MWT distance was correlated with HAQ score (r=-0.55, p<0.01 and HGS (r=0.34, p<0.01. Pain was correlated with HGS (r=-0.41, p<0.01, HAQ score (r=0.62, p<0.01, and FIQ (r =0.66, p<0.01. Pain intensity explained 40% of the variation in HAQ scores. This variation increased to 60% after inclusion of 6MWT distance. In conclusion, pain seems to compromise HGS, ADLs and quality of life in women with fibromyalgia. The lower performance in the 6MWT might be explained by high body mass index. Taking into account pain, the HAQ seems to be an appropriate tool for the assessment of functional capacity in women with fibromyalgia.

How can group-based multidisciplinary rehabilitation for patients with fibromyalgia influence patients' self-efficacy and ability to cope with their illness: a grounded theory approach.

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Rasmussen, Marianne Uggen; Amris, Kirstine; Rydahl-Hansen, Susan

2017-04-01

To describe how group-based multidisciplinary rehabilitation for patients with fibromyalgia can influence patients' self-efficacy and ability to cope with their illness. Multidisciplinary rehabilitation is recommended in the management of fibromyalgia. Self-efficacy is said to influence and predict adaptive coping behaviours and functioning. However, knowledge is lacking on how rehabilitation programmes may influence self-efficacy and ability to cope, from the patients' perspective. Grounded theory study of semi-structured focus group interviews. Participants (n = 17) were included in four focus groups that had completed a two-week multidisciplinary rehabilitation programme together. Interviews were conducted four weeks after each group had completed the programme. The analysis was conducted constant comparatively applying open, axial and selective coding. Categories (in italics) were derived from data in which the explanatory core category was identified: Learning to accept and live with pain as a life condition, and linked to three categories mutually influencing each other: Increased self-acceptance of living with the illness, experiencing acceptance from others and developing new coping strategies. Thus, patients benefitted from multidisciplinary rehabilitation with stronger self-efficacy and expectations to their future coping. However, limitations in the programme were identified, as the programme was short and intensive with no subsequent follow-up, and social welfare was not sufficiently addressed. Participants also found it difficult to maintain knowledge and were lacking individual sessions with the psychologist and had waited long to receive rehabilitation. Multidisciplinary rehabilitation may advantageously be offered to patients with fibromyalgia. However, earlier action with longer programmes, in which patients' social situation is addressed, comprising individual sessions with the psychologist, with multiple repetitions of the content and follow

Self-reported nonrestorative sleep in fibromyalgia – relationship to impairments of body functions, personal function factors, and quality of life

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Liedberg GM

2015-08-01

Full Text Available Gunilla M Liedberg,1 Mathilda Björk,2 Björn Börsbo31Department of Social and Welfare Studies, Linköping University, Norrköping, 2Rehabilitation Centre and Department of Medical and Health Sciences, 3Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH, Linköping University, Linköping, SwedenPurpose: The purpose of this study was: 1 to determine variables that might characterize good or bad sleep; and 2 to describe the relationship between sleep, impairment of body functions, personal function factors, and quality of life based on quality of sleep in women with fibromyalgia (FM. Methods: This cross-sectional descriptive study included 224 consecutive patients diagnosed at a specialist center. These patients were mailed a questionnaire concerning sleep, body functions, personal factors, and health-related quality of life. In total, 145 completed questionnaires were collected. Results: Using sleep variables (sleep quality, waking up unrefreshed, and tiredness when getting up, we identified two subgroups – the good sleep subgroup and the bad sleep subgroup – of women with FM. These subgroups exhibited significantly different characteristics concerning pain intensity, psychological variables (depressed mood, anxiety, catastrophizing, and self-efficacy, impairments of body functions, and generic and health-related quality of life. The good sleep subgroup reported a significantly better situation, including higher employment/study rate. The bad sleep subgroup reported a greater use of sleep medication. Five variables determined inclusion into either a good sleep or a bad sleep subgroup: pain in the evening, self-efficacy, anxiety, and according to the Short Form health survey role emotional and physical functioning. Conclusion: This study found that it was possible to identify two subgroups of women with FM based on quality of sleep variables. The two subgroups differed significantly with respect to pain, psychological

Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.

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Hughes, Linda; Adair, Jean; Feng, Feng; Maciejewski, Stephanie; Sharma, Harsha

2016-01-01

In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia. Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia. The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%). Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.

A pilot study: pain, fatigue and stress in maternal relatives of adolescent female psychiatric inpatients assessed for juvenile primary fibromyalgia syndrome.

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Lommel, Karen; Bamford, Jaime; Jhavari, Malhar; Martin, Catherine; Crofford, Leslie

2011-01-01

This study was designed to assess the presence of pain and impaired functioning in the maternal relatives of adolescent females in an inpatient adolescent psychiatric population. We compared the relatives of adolescents who met the criteria for juvenile primary fibromyalgia syndrome (JPFS) to relatives of adolescents who did not meet the criteria for JPFS. A total of 55 biological maternal relatives of adolescent females admitted to a psychiatric unit were recruited to participate in the study. Participants completed four self-administered questionnaires: Multidimensional Fatigue Inventory, Fibromyalgia Impact Questionnaire, Medical Outcomes Survey (SF36v2), and the EPIFUND Health Survey. The maternal relatives of adolescents who met the criteria for JPFS did not score higher than the maternal relatives of adolescents who did not meet the criteria for JPFS. However, all maternal relatives consistently scored higher on self-reported measures of pain, impaired functioning, fatigue, and fibromyalgia symptoms than the average patient diagnosed with fibromyalgia or a chronic pain syndrome. Mood disorders and pain disorders share genetic risk factors and vulnerability. Future research is needed to further delineate other factors impacting the maternal caregivers' functioning. These could include stress associated with an adolescent child with psychiatric issues severe enough to warrant hospitalization.

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients.

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Corsalini, Massimo; Daniela, Di Venere; Biagio, Rapone; Gianluca, Stefanachi; Alessandra, Laforgia; Francesco, Pettini

2017-01-01

The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia. The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari. 24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients). Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.

The association of major depressive episode and personality traits in patients with fibromyalgia

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Danyella de Melo Santos

2011-01-01

Full Text Available INTRODUCTION: Personality traits have been associated with primary depression. However, it is not known whether this association takes place in the case of depression comorbid with fibromyalgia. OBJECTIVE: The authors investigated the association between a current major depressive episode and temperament traits (e.g., harm avoidance. METHOD: A sample of 69 adult female patients with fibromyalgia was assessed with the Temperament and Character Inventory. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview severity of depressive symptomatology with the Beck Depression Inventory, and anxiety symptomatology with the IDATE-state and pain intensity with a visual analog scale. RESULTS: A current major depressive episode was diagnosed in 28 (40.5% of the patients. They presented higher levels of harm avoidance and lower levels of cooperativeness and self-directedness compared with non-depressed patients, which is consistent with the Temperament and Character Inventory profile of subjects with primary depression. However, in contrast to previous results in primary depression, no association between a major depressive episode and self-transcendence was found. CONCLUSIONS: The results highlight specific features of depression in fibromyalgia subjects and may prove important for enhancing the diagnosis and prognosis of depression in fibromyalgia patients.

Cannabinoids for fibromyalgia.

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Walitt, Brian; Klose, Petra; Fitzcharles, Mary-Ann; Phillips, Tudor; Häuser, Winfried

2016-07-18

This review is one of a series on drugs used to treat fibromyalgia. Fibromyalgia is a clinically well-defined chronic condition of unknown aetiology characterised by chronic widespread pain that often co-exists with sleep problems and fatigue affecting approximately 2% of the general population. People often report high disability levels and poor health-related quality of life (HRQoL). Drug therapy focuses on reducing key symptoms and disability, and improving HRQoL. Cannabis has been used for millennia to reduce pain and other somatic and psychological symptoms. To assess the efficacy, tolerability and safety of cannabinoids for fibromyalgia symptoms in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE to April 2016, together with reference lists of retrieved papers and reviews, three clinical trial registries, and contact with trial authors. We selected randomised controlled trials of at least four weeks' duration of any formulation of cannabis products used for the treatment of adults with fibromyalgia. Two review authors independently extracted the data of all included studies and assessed risk of bias. We resolved discrepancies by discussion. We performed analysis using three tiers of evidence. First tier evidence was derived from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for drop-outs; at least 200 participants in the comparison, eight to 12 weeks' duration, parallel design), second tier evidence from data that did not meet one or more of these criteria and were considered at some risk of bias but with adequate numbers (i.e. data from at least 200 participants) in the comparison, and third tier evidence from data involving small numbers of participants that were considered very likely to be biased or used outcomes of limited clinical utility, or both. We assessed the

Self-Reported Periodontitis and Incident Type 2 Diabetes among Male Workers from a 5-Year Follow-Up to MY Health Up Study.

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Atsushi Miyawaki

Full Text Available The purpose of this study was to examine whether periodontitis is associated with incident type 2 diabetes in a Japanese male worker cohort.The study participants were Japanese men, aged 36-55 years, without diabetes. Data were extracted from the MY Health Up study, consisting of self-administered questionnaire surveys at baseline and following annual health examinations for an insurance company in Japan. The oral health status of the participants was classified by two self-reported indicators: (1 gingival hemorrhage and (2 tooth loosening. Type 2 diabetes incidence was determined by self-reporting or blood test data. Modified Poisson regression approach was used to estimate the relative risks and the 95% confidence intervals of incident diabetes with periodontitis. Covariates included age, body mass index, family history of diabetes, hypertension, current smoking habits, alcohol use, dyslipidemia, and exercise habits.Of the 2895 candidates identified at baseline in 2004, 2469 men were eligible for follow-up analysis, 133 of whom were diagnosed with diabetes during the 5-year follow-up period. Tooth loosening was associated with incident diabetes [adjusted relative risk = 1.73, 95% confidence interval = 1.14-2.64] after adjusting for other confounding factors. Gingival hemorrhage displayed a similar trend but was not significantly associated with incident diabetes [adjusted relative risk = 1.32, 95% confidence interval = 0.95-1.85].Tooth loosening is an independent predictor of incident type 2 diabetes in Japanese men.

Worldwide epidemiology of fibromyalgia.

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Queiroz, Luiz Paulo

2013-08-01

Studying the epidemiology of fibromyalgia (FM) is very important to understand the impact of this disorder on persons, families and society. The recent modified 2010 classification criteria of the American College of Rheumatology (ACR), without the need of tender points palpation, allows that larger and nationwide surveys may be done, worldwide. This article reviews the prevalence and incidence studies done in the general population, in several countries/continents, the prevalence of FM in special groups/settings, the association of FM with some sociodemographic characteristics of the population, and the comorbidity of FM with others disorders, especially with headaches.

Suicidal ideation in patients with fibromyalgia: a cross-sectional study.

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Calandre, Elena P; Navajas-Rojas, M Angustias; Ballesteros, Javier; Garcia-Carrillo, Jocelyne; Garcia-Leiva, Juan M; Rico-Villademoros, Fernando

2015-02-01

Chronic pain, sleep disturbances, and depression, which are relevant symptoms of fibromyalgia syndrome, have been demonstrated to be associated with an increased likelihood of suicidal behaviors. Mortality from suicide has been shown to be greater among patients with fibromyalgia. This study aimed to assess the prevalence of suicidal ideation among a sample of patients with fibromyalgia and to evaluate its relationship with the clinical symptomatology of fibromyalgia. Baseline data from fibromyalgia patients willing to participate in different clinical studies were collected. Outcome measures included the Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, the Pittsburgh Sleep Quality Index, the Brief Pain Inventory, and the SF-12 Health Survey. The scores for these scales were compared between patients with and without suicidal ideation. The presence of suicidal ideation was assessed using the answer provided to item 9 of the Beck Depression Inventory. The results were adjusted by age, sex, total comorbidity, and time since diagnosis with multiple linear regression. The sample comprised 373 patients of whom one hundred and seventy-nine (48%) reported suicidal ideation: 148 (39.7%) reported passive suicidal ideation and 31 (8.3%) active suicidal ideation. Suicidal ideation was markedly associated with depression, anxiety, sleep quality, and global mental health, whereas only weak relationships were observed between suicidal ideation and both pain and general physical health. © 2014 World Institute of Pain.

Impact of animal-assisted therapy for outpatients with fibromyalgia.

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Marcus, Dawn A; Bernstein, Cheryl D; Constantin, Janet M; Kunkel, Frank A; Breuer, Paula; Hanlon, Raymond B

2013-01-01

Animal-assisted therapy using dogs trained to be calm and provide comfort to strangers has been used as a complementary therapy for a range of medical conditions. This study was designed to evaluate the effects of brief therapy dog visits for fibromyalgia patients attending a tertiary outpatient pain management facility compared with time spent in a waiting room. Open label with waiting room control. Tertiary care, university-based, outpatient pain management clinic. A convenience sample of fibromyalgia patients was obtained through advertisements posted in the clinic. Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in the outpatient waiting area. When the therapy dog was not available, individuals remained in the waiting area. OUTCOME MEASURES.: Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the therapy dog visit or waiting room time. Data were evaluated from 106 therapy dog visits and 49 waiting room controls, with no significant between-group demographic differences in participants. Average intervention duration was 12 minutes for the therapy dog visit and 17 minutes for the waiting room control. Significant improvements were reported for pain, mood, and other measures of distress among patients after the therapy dog visit, but not the waiting room control. Clinically meaningful pain relief (≥2 points pain severity reduction) occurred in 34% after the therapy dog visit and 4% in the waiting room control. Outcome was not affected by the presence of comorbid anxiety or depression. Brief therapy dog visits may provide a valuable complementary therapy for fibromyalgia outpatients. Wiley Periodicals, Inc.

Struggling With Adversities of Life: The Role of Forgiveness in Patients Suffering from Fibromyalgia.

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Offenbaecher, Martin; Dezutter, Jessie; Kohls, Niko; Sigl, Claudia; Vallejo, Miguel A; Rivera, Javier; Bauerdorf, Felix; Schelling, Jörg; Vincent, Ann; Hirsch, Jameson K; Sirois, Fuschia M; Webb, Jon R; Toussaint, Loren L

2017-06-01

We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being.

Suicidality in chronic pain: predictors of suicidal ideation in fibromyalgia.

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Triñanes, Yolanda; González-Villar, Alberto; Gómez-Perretta, Claudio; Carrillo-de-la-Peña, María T

2015-04-01

Fibromyalgia (FM) has been associated with a higher prevalence of suicidal behavior. Nevertheless, much remains unknown about suicide risk factors for this chronic pain disorder. In the present study, the relationship of suicidal ideation in FM with a number of sociodemographic, clinical, and psychological variables was analyzed. One hundred seventeen women with Fibromyalgia were assessed. The procedure included the exploration of sleep problems (Pittsburgh Sleep Quality Index), depression (Beck Depression Inventory [BDI]), health-related quality of life (SF-36 and Fibromyalgia Impact Questionnaire), the core symptoms of FM (visual analogue scales), and algometry of tender points. Suicidal ideation was evaluated by item 9 of the BDI. Patients with presence vs. absence of suicidal ideation were compared in all the variables studied. The prevalence of suicidal ideation among FM patients was 32.5%. Significant differences between patients with vs. without suicidal ideas emerged mainly for the various indices of depression. Patients with suicidal ideation also reported higher levels of anxiety, more day dysfunction due to sleepiness and more limitations due to emotional and physical problems. Logistic regression analysis revealed that cognitive depression symptoms such as BDI Self-Blame cluster are the more closely related to suicide ideation. The presence of suicidal ideation in FM patients is closely related to comorbid depression, anxiety and to a higher impact of the disease in daily life. © 2014 World Institute of Pain.

Management strategies for fibromyalgia

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Le Marshall KF

2011-07-01

Full Text Available Kim Francis Le Marshall, Geoffrey Owen LittlejohnDepartments of Rheumatology and Medicine, Monash Medical Centre and Monash University, Victoria, AustraliaDate of preparation: 14 June 2011Clinical question: What are the effective, evidence-based strategies available for the management of fibromyalgia?Conclusion: There are a number of management strategies available with robust evidence to support their use in clinical practice.Definition: Fibromyalgia is a complex pain syndrome characterized by widespread, chronic muscular pain and tenderness, disordered sleep, emotional distress, cognitive disturbance, and fatigue. Its prevalence is estimated to be 3%–5% in the population and higher yet in patients with comorbid rheumatic diseases.Level of evidence: Systematic reviews, meta-analyses, randomized controlled trials (RCTs.Search sources: PubMed, Cochrane Library, manual searchConsumer summary: Key messages for patients and clinicians are:1. There are many effective pharmacological management strategies available for fibromyalgia.2. A nonpharmacological, multicomponent approach utilizing education, aerobic exercise, psychological therapy, and other strategies is also effective for fibromyalgia.3. Despite the significant and, at times, disabling physical and psychological symptoms, fibromyalgia can be a manageable condition with a potentially good outcome.Keywords: fibromyalgia, pain, treatment, management, evidence 

Aquatic exercise training for fibromyalgia.

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Bidonde, Julia; Busch, Angela J; Webber, Sandra C; Schachter, Candice L; Danyliw, Adrienne; Overend, Tom J; Richards, Rachel S; Rader, Tamara

2014-10-28

Exercise training is commonly recommended for individuals with fibromyalgia. This review examined the effects of supervised group aquatic training programs (led by an instructor). We defined aquatic training as exercising in a pool while standing at waist, chest, or shoulder depth. This review is part of the update of the 'Exercise for treating fibromyalgia syndrome' review first published in 2002, and previously updated in 2007. The objective of this systematic review was to evaluate the benefits and harms of aquatic exercise training in adults with fibromyalgia. We searched The Cochrane Library 2013, Issue 2 (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, NHS Economic Evaluation Database), MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, WHO international Clinical Trials Registry Platform, and AMED, as well as other sources (i.e., reference lists from key journals, identified articles, meta-analyses, and reviews of all types of treatment for fibromyalgia) from inception to October 2013. Using Cochrane methods, we screened citations, abstracts, and full-text articles. Subsequently, we identified aquatic exercise training studies. Selection criteria were: a) full-text publication of a randomized controlled trial (RCT) in adults diagnosed with fibromyalgia based on published criteria, and b) between-group data for an aquatic intervention and a control or other intervention. We excluded studies if exercise in water was less than 50% of the full intervention. We independently assessed risk of bias and extracted data (24 outcomes), of which we designated seven as major outcomes: multidimensional function, self reported physical function, pain, stiffness, muscle strength, submaximal cardiorespiratory function, withdrawal rates and adverse effects. We resolved discordance through discussion. We evaluated interventions using mean differences

Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem.

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Galvez-Sánchez, Carmen M; Reyes Del Paso, Gustavo A; Duschek, Stefan

2018-01-01

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain accompanied by symptoms like depression, anxiety, sleep disturbance and fatigue. In addition, affected patients frequently report cognitive disruption such as forgetfulness, concentration difficulties or mental slowness. Though cognitive deficits in FMS have been confirmed in various studies, not much is known about the mechanisms involved in their origin. This study aimed to investigate the contribution of affect-related variables to cognitive impairments in FMS. For this purpose, 67 female FMS patients and 32 healthy control subjects completed a battery of cognitive tests measuring processing speed, attention, visuospatial and verbal memory, cognitive flexibility and planning abilities. In addition, participants completed self-report questionnaires pertaining to positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Clinical characteristics including pain severity, symptoms of depression and anxiety, insomnia and fatigue were also assessed. FMS patients showed markedly poorer performance than healthy controls in all of the cognitive domains assessed, in addition to greater levels of depression, anxiety, negative affect, alexithymia and pain catastrophizing, and lower self-esteem and positive affect. In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances

Best Medications to Treat Fibromyalgia

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... open('/content/cro/en/health/prescription-drugs/best-buy-drugs/Evaluating_Prescription_Drugs_Used_to_Treat_Fibromyalgia.print. ... price, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider if you and ...

Prevalence of Fibromyalgia: A Population-Based Study in Olmsted County, Minnesota, Utilizing the Rochester Epidemiology Project

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Vincent, Ann; Lahr, Brian D; Wolfe, Frederick; Clauw, Daniel J; Whipple, Mary O; Oh, Terry H; Barton, Debra L; St Sauver, Jennifer

2014-01-01

Objective Our objective was to estimate and compare the prevalence of fibromyalgia by two different methods, in Olmsted County, Minnesota. Methods The first method was a retrospective review of medical records of potential cases of fibromyalgia in Olmsted County using Rochester Epidemiology Project (from January 1, 2005, to December 31, 2009) to estimate the prevalence of diagnosed fibromyalgia in clinical practice. The second method was a random survey of adults in Olmsted County using the fibromyalgia research survey criteria to estimate the percentage of responders who met fibromyalgia research survey criteria. Results Of the 3,410 potential patients identified by the first method, 1,115 had a fibromyalgia diagnosis documented in the medical record by a health care provider. The age- and sex-adjusted prevalence of diagnosed fibromyalgia by this method was 1.1%. By the second method, of the 2,994 people who received the survey by mail, 830 (27.6%) responded and 44 (5.3%) met fibromyalgia research survey criteria. The age- and sex-adjusted prevalence of fibromyalgia in the general population of Olmsted County by this method was estimated at 6.4%. Conclusion To the best of our knowledge, this is the first report of the rate at which fibromyalgia is being diagnosed in a community. This is also the first report of prevalence as assessed by the fibromyalgia research survey criteria. Our results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia. PMID:23203795

Fibromyalgia, a missed comorbidity in spondyloarthritis: prevalence and impact on assessment and treatment.

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Mease, Philip J

2017-07-01

Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA). Fibromyalgia occurs in 2-8% of the general population. In AxSpA cohorts the prevalence has been reported in 4-25%, and in PsA, 16-22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus. Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.

Fibromyalgia: When Distress Becomes (Unsympathetic Pain

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Manuel Martinez-Lavin

2012-01-01

Full Text Available Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may operate in fibromyalgia. Signs of sympathetic hyperactivity have been described in this condition. Genetic factors and/or distressful lifestyle may lead to this state of sympathetic hyperactivity. Trauma and infection are recognized fibromyalgia triggers. Women who suffer from fibromyalgia have catecholamine-evoked pain. Sympathetic dysfunction may also explain nonpain-related fibromyalgia symptoms. In conclusion, in fibromyalgia, distress could be converted into pain through forced hyperactivity of the sympathetic component of the stress response system.

Towards Tailored Patient’s Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

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Yasser El Miedany

2016-01-01

Full Text Available Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index, in addition to assessment of functional disability, quality of life (QoL, review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982. Content construct assessment of the functional disability and QoL revealed significant correlation (p<0.01 with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p<0.01 variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management.

Usefulness of multiple dimensions of fatigue in fibromyalgia.

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Ericsson, Anna; Bremell, Tomas; Mannerkorpi, Kaisa

2013-07-01

To explore in which contexts ratings of multiple dimensions of fatigue are useful in fibromyalgia, and to compare multidimensional fatigue between women with fibromyalgia and healthy women. A cross-sectional study. The Multidimensional Fatigue Inventory (MFI-20), comprising 5 subscales of fatigue, was compared with the 1-dimensional subscale of fatigue from the Fibromyalgia Impact Questionnaire (FIQ) in 133 women with fibromyalgia (mean age 46 years; standard deviation 8.6), in association with socio-demographic and health-related aspects and analyses of explanatory variables of severe fatigue. The patients were also compared with 158 healthy women (mean age 45 years; standard deviation 9.1) for scores on MFI-20 and FIQ fatigue. The MFI-20 was associated with employment, physical activity and walking capacity (rs = -0.27 to -0.36), while FIQ fatigue was not. MFI-20 and FIQ fatigue were equally associated with pain, sleep, depression and anxiety (rs = 0.32-0.63). Regression analyses showed that the MFI-20 increased the explained variance (R2) for the models of pain intensity, sleep, depression and anxiety, by between 7 and 29 percentage points, compared with if FIQ fatigue alone was included in the models. Women with fibromyalgia rated their fatigue higher than healthy women for all subscales of the MFI-20 and the FIQ fatigue (p fibromyalgia. The patients reported higher levels on all fatigue dimensions in comparison with healthy women.

Fibromyalgia family and relationship impact exploratory survey.

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Marcus, Dawn A; Richards, Karen Lee; Chambers, Janet F; Bhowmick, Amrita

2013-09-01

Fibromyalgia is frequently associated with impairments in activities of daily living and work disability. Limited data have investigated the impact of fibromyalgia on relationships with family and friends. This exploratory study was designed to survey a large community sample of adults with fibromyalgia about the impact on the spouse/partner, children and close friends. A 40-question, multiple-choice survey was made available online for a two-month period, with potential participants recruited through fibromyalgia and migraine community websites. Items included questions about demographics, fibromyalgia symptoms, comorbid mood disturbance and relationship impact, including the Relationship Assessment Scale. The survey was completed by 6,126 adults who had been diagnosed with fibromyalgia. Using updated diagnostic criteria from the American College of Rheumatology, 91% satisfied the criteria for fibromyalgia (Fibromyalgia Severity score ≥13 and pain ≥3 months). Half of participants endorsed that fibromyalgia had mildly to moderately damaged relationship(s) with their spouse(s)/partner(s) or contributed to a break-up with a spouse or partner. Half of participants scored as not being satisfied with their current spouse/partner relationship, with satisfaction negatively affected by the presence of mood disturbance symptoms and higher fibromyalgia severity. Relationships with children and close friends were also negatively impacted for a substantial minority of participants. In addition to physical impairments that are well documented among individuals with fibromyalgia, fibromyalgia can result in a substantial negative impact on important relationships with family and close friends. Copyright © 2012 John Wiley & Sons, Ltd.

Spiritual well-being in individuals with fibromyalgia syndrome: relationships with symptom pattern variability, uncertainty, and psychosocial adaptation.

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Anema, Cheryl; Johnson, Mary; Zeller, Janice M; Fogg, Louis; Zetterlund, Joan

2009-01-01

This study examined relationships among symptom pattern variability, uncertainty, spiritual well-being, and psychosocial adaptation in individuals with fibromyalgia syndrome (FMS). A survey design was used with 58 individuals with FMS. The Fibromyalgia Symptom Pattern Questionnaire, Mishel Uncertainty in Illness Scale--Community Form, Spiritual Well-Being Scale, and Psychosocial Adjustment to Illness Scale-Self Report were used to collect data. Positive relationships were found between symptom pattern variability and uncertainty and between uncertainty and poor psychosocial adaptation; spiritual well-being moderated the relationship between uncertainty and psychosocial adaptation. A positive sense of well-being aided adaptation to symptoms and uncertainties of FMS. Spiritual well-being had a greater effect on the relationship between symptom pattern variability and uncertainty than expected.

Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions.

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Okifuji, Akiko; Bradshaw, David H; Olson, Chrisana

2009-04-01

The aim of this study was to investigate the associations between obesity and fibromyalgia syndrome (FMS). This study was conducted at the University of Utah Pain Management and Research Center, Salt Lake City, Utah. Thirty-eight FMS patients were included in this study. Neuroendocrine indices (catecholamines, cortisol, C-reactive protein [CRP], and interleukin-6), symptom measures (Fibromyalgia Impact Questionnaire), sleep indices (Actigraph), and physical functioning (treadmill testing) were measured. Body mass index (BMI) provided the primary indicator of obesity. Approximately 50% of the patients were obese and an additional 21% were overweight. Strong positive associations were found between BMI and levels of IL-6 (r=0.52) and epinephrine (r=0.54), and somewhat weaker associations with cortisol (r=0.32) and CRP (r=0.37). BMI was also related to maximal heart rate (r=0.33) and inversely related to distance walked (r= -0.41). BMI was associated with disturbed sleep: total sleep time (r= -0.56) and sleep efficiency (r= -0.44). No associations between self-reported symptoms and BMI were found. This study provides preliminary evidence suggesting that obesity plays a role in FMS-related dysfunction.

Newer treatments for fibromyalgia syndrome

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Richard E Harris

2008-12-01

Full Text Available Richard E Harris, Daniel J ClauwDepartment of Anesthesiology, The University of Michigan, Ann Arbor, MI, USAAbstract: Fibromyalgia syndrome is a common chronic pain disorder of unknown etiology. The lack of understanding of the pathophysiology of fibromyalgia has made this condition frustrating for patients and clinicians alike. The most common symptoms of this disorder are chronic widespread pain, fatigue, sleep disturbances, difficulty with memory, and morning stiffness. Emerging evidence points towards augmented pain processing within the central nervous system (CNS as having a primary role in the pathophysiology of this disorder. Currently the two drugs that are approved by the United States Food and Drug Administration (FDA for the management of fibromyalgia are pregabalin and duloxetine. Newer data suggests that milnacipran, a dual norepinephrine and serotonin reuptake inhibitor, may be promising for the treatment of fibromyalgia. A double-blind, placebo-controlled trial of milnacipran in 125 fibromyalgia patients showed significant improvements relative to placebo. Milnacipran given either once or twice daily at doses up to 200 mg/day was generally well tolerated and yielded significant improvements relative to placebo on measures of pain, patient’s global impression of change in their disease state, physical function, and fatigue. Future studies are needed to validate the efficacy of milnacipran in fibromyalgia.Keywords: fibromyalgia, pain, pharmacological, treatment

Subjective Experiences and Sensitivities in Women with Fibromyalgia: A Quantitative and Comparative Study

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P. De Roa

2018-01-01

Full Text Available Fibromyalgia is a chronic widespread pain syndrome associated with chronic fatigue. Its pathogenesis is not clearly understood. This study presents subjective experiences and sensitivities reported by fibromyalgia patients, which should be considered in primary care to avoid medical nomadism, as well as stigmatization of the patients. The prevalence of significant characteristics was compared with others patients consulting at the same pain unit who suffer from rebel and disabling form of chronic migraine. Psychometric tests were anonymously completed by 78 patients of the Pain Unit (44 fibromyalgia patients and 34 migraine patients. Tests evaluated pain (Visual Analog scale, childhood traumas (Childhood Trauma Questionnaire, lack of parental affection, stressful life events (Holmes and Rahe Scale, anxiety and depression (Hospital Anxiety and Depression Scale, perceived hypersensitivity to 10 stimuli, and hyperactivity before illness. However, pain scores were comparable in the two groups, and the prevalence was significantly higher in fibromyalgia patients than in migraine patients for anxiety (81.8% versus 51.5% and depression (57.1% versus 8.8%. Childhood physical abuses were more frequently reported in fibromyalgia than in migraine cases (25% versus 3%. Similarly, the feeling of lack of parental affection, subjective hypersensitivity to stress and stimuli (cold, moisture, heat, full moon, and flavors or hyperactivity (ergomania, appeared as prominent features of fibromyalgia patients. Fibromyalgia patients considered themselves as being hypersensitive (mentally and physically compared to migraine patients. They also have higher depression levels. Beyond somatic symptoms, precociously taking account of psychosocial and behavioral strategies would highly improve treatment efficiency of the fibromyalgia syndrome.

Illness perception and fibromyalgia impact on female patients from Spain and the Netherlands: do cultural differences exist?

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Ruiz-Montero, Pedro J; Van Wilgen, C Paul; Segura-Jiménez, Victor; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel

2015-12-01

The purpose of this study was to examine the differences in illness perception and overall impact on fibromyalgia females from Spain and the Netherlands. A total of 325 fibromyalgia females from Spain (54.3 ± 7.1 years) and the Netherlands (51.8 ± 7.2 years) participated in the study. Illness perception and impact of fibromyalgia were assessed by the Revised Illness Perception Questionnaire and the Fibromyalgia Impact Questionnaire, respectively. Spanish fibromyalgia females perceived more symptoms related to their fibromyalgia (identity) such as nausea, breathlessness, wheezing or fatigue (P fibromyalgia females experienced less timeline (acute/chronic) and consequences (all, P fibromyalgia females reported higher impact of fibromyalgia than Dutch females (61.2 + 14.8 vs. 54.9 + 16.4, respectively; P fibromyalgia and negative views of fibromyalgia were higher in Spanish fibromyalgia females, whereas Dutch fibromyalgia females presented higher score of positive beliefs about the controllability of the illness. Psychological interventions which help patients to cope with their illness perception might lead to an improvement of the impact of the disease on fibromyalgia females.

Physical Trauma and Infection as Precipitating Factors in Patients with Fibromyalgia.

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Jiao, Juan; Vincent, Ann; Cha, Stephen S; Luedtke, Connie A; Kim, Chul H; Oh, Terry H

2015-12-01

The objective of this study was to evaluate both precipitating factors in patients with fibromyalgia and any differences in clinical presentation, symptom severity, and quality-of-life between those with and without precipitating physical trauma or infection. In a retrospective cross-sectional study, the authors compared patient characteristics and fibromyalgia symptom severity and quality-of-life with the Fibromyalgia Impact Questionnaire and the Short Form-36 Health Survey in patients seen in a fibromyalgia treatment program. Of 939 patients, 27% reported precipitating factors (trauma, n = 203; infection, n = 53), with the rest having idiopathic fibromyalgia (n = 683). Patients with precipitating trauma were more likely to have worse Fibromyalgia Impact Questionnaire physical function than patients with idiopathic onset (P = 0.03). Compared with patients with idiopathic onset and precipitating trauma, patients with precipitating infection were more likely to have worse Short Form-36 Health Survey physical component summary (P = 0.01 and P = 0.003) but better role emotional (P = 0.04 and P = 0.005), mental health index (P = 0.02 and P = 0.007), and mental component summary (P = 0.03 and P = 0.004), respectively. One-fourth of this study's patients with fibromyalgia had precipitating physical trauma or infection. Patients with precipitating infection had different sociodemographic characteristics, clinical presentation, and quality-of-life from the idiopathic and trauma groups. Further studies are needed to look into the relationships between precipitating events and fibromyalgia.

Pesticide exposure and self-reported incident depression among wives in the Agricultural Health Study.

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Beard, John D; Hoppin, Jane A; Richards, Marie; Alavanja, Michael C R; Blair, Aaron; Sandler, Dale P; Kamel, Freya

2013-10-01

Depression in women is a public health problem. Studies have reported positive associations between pesticides and depression, but few studies were prospective or presented results for women separately. We evaluated associations between pesticide exposure and incident depression among farmers' wives in the Agricultural Health Study, a prospective cohort study in Iowa and North Carolina. We used data on 16,893 wives who did not report physician-diagnosed depression at enrollment (1993-1997) and who completed a follow-up telephone interview (2005-2010). Among these wives, 1054 reported physician diagnoses of depression at follow-up. We collected information on potential confounders and on ever use of any pesticide, 11 functional and chemical classes of pesticides, and 50 specific pesticides by wives and their husbands via self-administered questionnaires at enrollment. We used inverse probability weighting to adjust for potential confounders and to account for possible selection bias induced by the death or loss of 10,639 wives during follow-up. We used log-binomial regression models to estimate risk ratios and 95% confidence intervals. After weighting for age at enrollment, state of residence, education level, diabetes diagnosis, and drop out, wives' incident depression was positively associated with diagnosed pesticide poisoning, but was not associated with ever using any pesticide. Use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' depression. Among wives who never used pesticides, husbands' ever use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' incident depression. Our study adds further evidence that high level pesticide exposure, such as pesticide poisoning, is associated with increased risk of depression and sets a lower bound on the level of exposure related to depression, thereby providing reassurance that the moderate levels

Double-blind, placebo-controlled cross-over study of intravenous S-adenosyl-L-methionine in patients with fibromyalgia

DEFF Research Database (Denmark)

Volkmann, H; Nørregaard, J; Jacobsen, Søren

1997-01-01

The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial. There was no sign......The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial.......17) and slight improvement only on fatigue, quality of sleep, morning stiffness, and on the Fibromyalgia Impact Questionnaire for pain. No effect could be observed on isokinetic muscle strength, Zerrsen self-assessment questionnaire, and the face scale. No effect of SAMe in patients with FM was found...

Bone mass and turnover in fibromyalgia

DEFF Research Database (Denmark)

Jacobsen, Søren; Gam, A; Egsmose, C

1993-01-01

Physical inactivity accelerates bone loss. Since patients with fibromyalgia are relatively physically inactive, bone mass and markers of bone metabolism were determined in 12 premenopausal women with fibromyalgia and in healthy age matched female control subjects. No differences were found in lum.......01. This was linked to lower urinary creatinine excretion (p = 0.02) probably reflecting lower physical activity in the patients with fibromyalgia. We conclude that bone mass and turnover are generally not affected in premenopausal women with fibromyalgia....

Association between the COMT Val158Met polymorphism and fibromyalgia susceptibility and fibromyalgia impact questionnaire score: a meta-analysis.

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Lee, Young Ho; Kim, Jae-Hoon; Song, Gwan Gyu

2015-01-01

The aim of this study was to explore whether the catechol-O-methyltransferase (COMT) Val158Met polymorphism is associated with susceptibility to fibromyalgia and fibromyalgia impact questionnaire (FIQ) score in fibromyalgia patients. We conducted a meta-analysis of the associations of the COMT Val158Met polymorphism with fibromyalgia risk as well as FIQ score in fibromyalgia patients. A total of 993 fibromyalgia patients and 778 controls from 10 studies on the COMT Val158Met polymorphism and 538 fibromyalgia patients from 5 studies on the COMT Val158Met polymorphism and FIQ score were included in this meta-analysis. The meta-analysis revealed an association between fibromyalgia and the COMT Met/Met + Val/Met genotype in all study subjects (odds ratio (OR) 1.635, 95 % confidence interval (CI) 1.029-2.597, p = 0.037). However, stratification by ethnicity indicated no association between the Met/Met + Val/Met genotype and fibromyalgia in the European and Turkish populations (OR 1.202, 95 % CI 0.876-1.649, p = 0.255; OR 2.132, 95 % CI 0.764-5.949, p = 0.148, respectively). Analysis using other genetic models showed no association between the COMT Val158Met polymorphism and fibromyalgia. The meta-analysis also revealed that the FIQ score was significantly higher in individuals with the COMT Met/Met genotype than in those with the Val/Val genotype [weighted mean difference (WMD) = 14.39, 95 % CI 3.316-25.48, p = 0.011] and the Val/Met genotype (WMD = 5.108, 95 % CI 2.212-4.891, p = 0.021). This meta-analysis identified an association between fibromyalgia risk and the COMT Val158Met polymorphism as well as the FIQ score in fibromyalgia patients.

Problems and accommodation strategies reported by computer users with rheumatoid arthritis or fibromyalgia.

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Baker, Nancy A; Rubinstein, Elaine N; Rogers, Joan C

2012-09-01

Little is known about the problems experienced by and the accommodation strategies used by computer users with rheumatoid arthritis (RA) or fibromyalgia (FM). This study (1) describes specific problems and accommodation strategies used by people with RA and FM during computer use; and (2) examines if there were significant differences in the problems and accommodation strategies between the different equipment items for each diagnosis. Subjects were recruited from the Arthritis Network Disease Registry. Respondents completed a self-report survey, the Computer Problems Survey. Data were analyzed descriptively (percentages; 95% confidence intervals). Differences in the number of problems and accommodation strategies were calculated using nonparametric tests (Friedman's test and Wilcoxon Signed Rank Test). Eighty-four percent of respondents reported at least one problem with at least one equipment item (RA = 81.5%; FM = 88.9%), with most respondents reporting problems with their chair. Respondents most commonly used timing accommodation strategies to cope with mouse and keyboard problems, personal accommodation strategies to cope with chair problems and environmental accommodation strategies to cope with monitor problems. The number of problems during computer use was substantial in our sample, and our respondents with RA and FM may not implement the most effective strategies to deal with their chair, keyboard, or mouse problems. This study suggests that workers with RA and FM might potentially benefit from education and interventions to assist with the development of accommodation strategies to reduce problems related to computer use.

An epidemiologic internet survey of fibromyalgia and chronic pain in Japan.

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Nakamura, Ikuro; Nishioka, Kenya; Usui, Chie; Osada, Kenichi; Ichibayashi, Hisao; Ishida, Mitsuhiro; Turk, Dennis C; Matsumoto, Yoshifuji; Nishioka, Kusuki

2014-07-01

To determine the epidemiologic features and symptom characteristics of fibromyalgia (FM) in Japan, and compare them with those for other chronic pain (CP) diagnoses. An internet survey was conducted in June and July 2011. The questionnaire consisted of 111 questions, including assessments of the Japanese version of the 2010 American College of Rheumatology preliminary diagnostic criteria for FM, the Japanese Fibromyalgia Impact Questionnaire, and additional questions regarding pain and lifestyle. The questionnaire was completed by 20,407 male and female respondents in all prefectures of Japan. Of the survey population, 2,524 respondents (12.4%) reported symptoms consistent with CP; of these, 425 (2.1%) reported symptoms consistent with FM. Among respondents with FM and CP, 61% and 53%, respectively, were women. Pain severity and Widespread Pain Index scores were significantly higher in respondents meeting the diagnostic criteria for FM than in those meeting the criteria for CP. In terms of symptom severity scores, the proportions of respondents reporting the 3 major symptoms as "highly applicable" and greater numbers of 41 somatic symptoms were higher among respondents with FM than among those with CP. The incidence of FM in the present survey was similar to that reported (1.7%) in a study of FM in Japan in 2003, despite the use of the newer, easier to use 2010 diagnostic criteria. Because FM usually presents with more severe and more widely distributed pain, as well as more nonpainful symptoms than CP, our results suggest that FM is a different clinical phenotype of CP. Copyright © 2014 by the American College of Rheumatology.

Fibromyalgia: From treatment to rehabilitation

OpenAIRE

Imamura, Marta; Cassius, David A.; Fregni, Felipe

2009-01-01

Fibromyalgia is a clinical syndrome of chronic widespread pain and reduced pain thresholds to palpation. The pathophysiology remains unknown, but there is increasing evidence that peripheral and central sensitization cause an amplification of sensory impulses that may alter pain perception in fibromyalgia patients. Interventions to treat fibromyalgia should aim at different targets simultaneously in order to reduce peripheral and central sensitization. There are both pharmacologic and non-pha...

Bone mass and turnover in fibromyalgia

DEFF Research Database (Denmark)

Jacobsen, Søren; Gam, A; Egsmose, C

1993-01-01

Physical inactivity accelerates bone loss. Since patients with fibromyalgia are relatively physically inactive, bone mass and markers of bone metabolism were determined in 12 premenopausal women with fibromyalgia and in healthy age matched female control subjects. No differences were found...... in lumbar bone mineral density, femoral neck bone mineral density, serum levels of alkaline phosphatase, osteocalcin, ionized calcium and phosphate. The urinary excretion of both hydroxyproline and calcium relative to urinary creatinine excretion was significantly higher in patients with fibromyalgia, p = 0.......01. This was linked to lower urinary creatinine excretion (p = 0.02) probably reflecting lower physical activity in the patients with fibromyalgia. We conclude that bone mass and turnover are generally not affected in premenopausal women with fibromyalgia....

Effectiveness of multidisciplinary therapy on symptomatology and quality of life in women with fibromyalgia.

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Carbonell-Baeza, A; Aparicio, V A; Chillón, P; Femia, P; Delgado-Fernandez, M; Ruiz, J R

2011-01-01

To study the effects of a 3-month multidisciplinary intervention based on exercise and psychological therapy on symptomatology and quality of life in women with fibromyalgia. Seventy-five women with fibromyalgia volunteered to participate and were allocated to a 3-month (3-times/week) multidisciplinary (pool, land-based and psychological session based on the Acceptance and Commitment Therapy) intervention (n=41), or to a usual care group (n=34). Sixty-five women with fibromyalgia completed the study protocol (n=33 multidisciplinary intervention, aged 51.4±7.4 years and n=32 usual care group, aged 50.0±7.3 years). The outcomes variables were Fibromyalgia Impact Questionnaire (FIQ), Short Form Health Survey 36 (SF-36), Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory and Rosenberg Self-Esteem Scale. We observed a significant interaction effect (group*time) for the FIQ total score, the subscales fatigue, stiffness, anxiety and depression, and the subscales of SF-36 physical role, bodily pain, vitality and social functioning. Post-hoc analysis revealed significant improvements in total score of FIQ (pfibromyalgia symptomatology and quality of life in women with fibromyalgia.

Fibromyalgia in the adult Danish population

DEFF Research Database (Denmark)

Prescott, E; Kjøller, Mette; Jacobsen, S

1993-01-01

Epidemiologic studies of fibromyalgia have so far been based on rheumatologic and general practice settings, which are poor proxies for the underlying population. The study is based on a national health interview survey carried out by the Danish Institute for Clinical Epidemiology in 1990......%). Eight subjects, all female, met the 1990 American College of Rheumatism criteria for fibromyalgia. Dropouts were regarded as not having fibromyalgia. The prevalence of fibromyalgia in the Danish population between 18 and 79 years of age was found to be a minimum estimate of 0.66% (95% confidence limits...

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients.

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Goesling, Jenna; Brummett, Chad M; Meraj, Taha S; Moser, Stephanie E; Hassett, Afton L; Ditre, Joseph W

2015-07-01

As smoking impacts physiological pathways in the central nervous system, it is important to consider the association between smoking and fibromyalgia, a pain condition caused predominantly by central nervous system dysfunction. The objectives were to assess the prevalence of current smoking among treatment-seeking chronic pain patients with (FM+) and without (FM-) a fibromyalgia-like phenotype; test the individual and combined influence of smoking and fibromyalgia on pain severity and interference; and examine depression as a mediator of these processes. Questionnaire data from 1566 patients evaluated for a range of conditions at an outpatient pain clinic were used. The 2011 Survey Criteria for Fibromyalgia were used to assess the presence of symptoms associated with fibromyalgia. Current smoking was reported by 38.7% of FM+ patients compared to 24.7% of FM- patients. FM+ smokers reported higher pain and greater interference compared to FM+ nonsmokers, FM- smokers, and FM- nonsmokers. There was no interaction between smoking and fibromyalgia. Significant indirect effects of fibromyalgia and smoking via greater depression were observed for pain severity and interference. Current smoking and positive fibromyalgia status were associated with greater pain and impairment among chronic pain patients, possibly as a function of depression. Although FM+ smokers report the most negative clinical symptomatology (i.e., high pain, greater interference) smoking does not appear to have a unique association with pain or functioning in FM+ patients, rather the effect is additive. The 38.7% smoking rate in FM+ patients is high, suggesting FM+ smokers present a significant clinical challenge. © 2015 American Academy of Pain Medicine.

Beyond pain in fibromyalgia: insights into the symptom of fatigue

Science.gov (United States)

2013-01-01

Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848

Childhood risk factors for developing fibromyalgia

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Olivieri P

2012-12-01

Full Text Available Patrick Olivieri,1 Bruce Solitar,2,* Michel Dubois3,*1NYU School of Medicine, New York, NY, USA; 2Department of Rheumatology, 3Department of Pain Management, New York University Langone Medical Center, New York, NY, USA*These authors contributed equally to this workBackground: Fibromyalgia is a disease process without an obvious etiology. While some evidence suggests that adverse experiences in childhood contribute to its development, specific evidence has been equivocal.Methods: A total of 36 patients with fibromyalgia from the greater New York area were recruited and surveyed using the Centers for Disease Control's Behavioral Risk Factor Surveillance System survey, and questions from the section on adverse childhood experiences were administered. The results were compared to those obtained from over 400,000 people surveyed by the Centers for Disease control each year, and were monitored for statistically significant differences.Results: A statistically significant difference was noted among the control group, suggesting that individuals reported growing up with someone who was depressed when the respondents were between the ages of 0 and 18 years old. Moreover, respondents reported that they were hit by their parents in some way, were insulted or cursed at by their parents, and had been forced to have sex with someone at least 5 years older than them or with an adult. No correlation was found with the following variables and the development of fibromyalgia: growing up with divorced or separated parents; growing up with someone sentenced to serve time in jail; or having parents that abused each other. Additionally, statistically significant differences were found for the following categories: lack of emotional support; life dissatisfaction; fair or poor health; physical, mental or emotional disability; and being divorced or not married.Discussion: Using this well-validated survey, it became clear that at least six specific adverse childhood

Exercise therapy for fibromyalgia.

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Busch, Angela J; Webber, Sandra C; Brachaniec, Mary; Bidonde, Julia; Bello-Haas, Vanina Dal; Danyliw, Adrienne D; Overend, Tom J; Richards, Rachel S; Sawant, Anuradha; Schachter, Candice L

2011-10-01

Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being.

Facing Fibromyalgia | NIH MedlinePlus the Magazine

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... of this page please turn JavaScript on. Feature: Fibromyalgia Facing Fibromyalgia Past Issues / Spring 2016 Table of Contents Amy ... conditions. When did you start having symptoms of fibromyalgia? I actually think I've had it since ...

Self-reported whole-grain intake and plasma alkylresorcinol concentrations in combination in relation to the incidence of colorectal cancer

DEFF Research Database (Denmark)

Knudsen, Markus Dines; Kyrø, Cecilie; Olsen, Anja

2014-01-01

-grain consumption (HELGA, 1992-1998). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression. Plasma alkylresorcinol concentrations alone and Howe's score with ranks were inversely associated with the incidence of distal colon cancer when the highest quartile...... (colon, proximal, distal or rectum cancer) when using an FFQ as the measure/exposure variable for whole-grain intake. The results suggest that assessing whole-grain intake using a combination of FFQs and biomarkers slightly increases the precision in estimating the risk of colon or rectal cancer......Self-reported food frequency questionnaires (FFQs) have occasionally been used to investigate the association between whole-grain intake and the incidence of colorectal cancer, but the results from those studies have been inconsistent. We investigated this association using intakes of whole grains...

Fibromyalgia is Associated with Impaired Balance and Falls

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Jones, Kim D.; Horak, Fay B.; Winters, Kerri Stone; Morea, Jessica M.; Bennett, Robert M.

2010-01-01

Background/Objective The purpose of this study was to determine whether FM patients differ from matched healthy controls in clinical tests of balance ability and fall frequency. Methods 34 FM patients and 32 age matched controls were administered the Balance Evaluation-Systems Test (BESTest), rated their balance confidence with the Activities-Specific Balance Confidence Scale (ABC) and reported the number of falls in the last 6 months. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess FM severity. Results FM patients had significantly impaired balance in all components of the BESTest compared to controls. They also scored more poorly on balance confidence. Overall fibromyalgia severity (FIQ) correlated significantly with the BESTest, and the ABC scale. The BESTest and ABC correlated significantly with 6 commonly reported FM symptoms (excluding pain). FM patients reported a total of 37 falls over the last six-months compared to 6 falls in healthy controls. Conclusion Fibromyalgia is associated with balance problems and increased fall frequency. Patients were aware of their balance problems. These results suggest that FM may affect peripheral and/or central mechanisms of postural control. Further objective study is needed to identify the relative contributions of neural and musculoskeletal impairments to postural stability in FM, thus providing clinicians with exercise prescriptions that maximize postural stability. PMID:19125137

Kinematic analysis of subtalar eversion during gait in women with fibromyalgia.

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Silva, Ana Paula; Chagas, Daniel das Virgens; Cavaliere, Maria Lúcia; Pinto, Sérgio; de Oliveira Barbosa, José Silvio; Batista, Luiz Alberto

2016-08-01

To analyse the subtalar eversion range of motion during walking in women with fibromyalgia. Twenty women diagnosed with fibromyalgia were directed to walk barefoot at comfortable and self-paced speed on a 7m walkway. Subtalar eversion range of motion was measured using the difference between the maximum and minimum values of subtalar eversion in stance phase. A range of motion between 4°-6° was considered as reference values for subtalar eversion during gait. Descriptive statistics were performed. In both right and left lower limb analysis of subtalar eversion range of motion, five women showed joint hypomobility, and twelve showed hypermobility. Only one patient performed unaltered subtalar eversion range of motion in both lower limbs. Both joints expressed high variability, and there were no significant differences between the right and left sides. The findings suggest that biomechanical function of the subtalar joint eversion during the loading response phase of gait in women with fibromyalgia, by excessive rigidity or complacency joint, tends to be impaired. This finding suggests that the indication of walking as an auxiliary strategy in the treatment of women with fibromyalgia should be preceded by thorough examination of the mechanical conditions of the subtalar joint of the patient. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Methodology report of the 2017 guidelines on fibromyalgia syndrome].

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Häuser, W; Nothacker, M

2017-06-01

The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was planned for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n = 8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of therapies available were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The guidelines are published in several forms, i.e. complete and short scientific versions and clinical practice and patient versions.

Fibromyalgia and Complementary Health Approaches

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... Musculoskeletal and Skin Diseases Web site . What the Science Says About Complementary Health Approaches for Fibromyalgia Mind ... Complementary and alternative medical therapies in fibromyalgia . Current Pharmaceutical Design . 2006;12(1):47–57. Sherman KJ, ...

Metabolic cost and mechanics of walking in women with fibromyalgia syndrome.

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MacPhee, Renée S; McFall, Kristen; Perry, Stephen D; Tiidus, Peter M

2013-10-18

Fibromyalgia syndrome (FS) is characterized by the presence of widespread pain, fatigue, muscle weakness and reduced work capacity. Previous research has demonstrated that women with fibromyalgia have altered walking (gait) patterns, which may be a consequence of muscular pain. This altered gait is characterized by greater reliance on hip flexors rather than ankle plantar flexors and resembles gait patterns seen in normal individuals walking at higher speeds, suggesting that gait of individuals with fibromyalgia may be less efficient.This study compared rates of energy expenditure of 6 females with FS relative to 6 normal, age and weight matched controls, at various walking speeds on a motorized treadmill. Metabolic measurements including V02 (ml/kg/min), respirations, heart rate and calculated energy expenditures as well as the Borg Scale of Perceived Exertion scale ratings were determined at baseline and for 10 min while walking at each of 2, 4 and 5 km/hour on 1% grade. Kinematic recordings of limb and body movements while treadmill walking and separate measurements of ground reaction forces while walking over ground were also determined. In addition, all subjects completed the RAND 36-Item Health Survey (1.0). Gait analysis results were similar to previous reports of altered gait patterns in FS females. Despite noticeable differences in gait patterns, no significant differences (p > 0.05) existed between the FS and control subjects on any metabolic measures at any walking speed. Total number of steps taken was also similar between groups. Ratings on the Borg Scale of Perceived Exertion, the RAND and self-reported levels of pain indicated significantly greater (p gait patterns and greater perceptions of effort and pain did not significantly increase the metabolic costs of walking in women with FS and hence, increased sensations of fatigue in FS women may not be related to alteration in metabolic cost of ambulation.

Validity and reliability of self-reported diabetes in the Atherosclerosis Risk in Communities Study.

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Schneider, Andrea L C; Pankow, James S; Heiss, Gerardo; Selvin, Elizabeth

2012-10-15

The objective of this study was to assess the validity of prevalent and incident self-reported diabetes compared with multiple reference definitions and to assess the reliability (repeatability) of a self-reported diagnosis of diabetes. Data from 10,321 participants in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 4 (1996-1998) were analyzed. Prevalent self-reported diabetes was compared with reference definitions defined by fasting glucose and medication use obtained at visit 4. Incident self-reported diabetes was assessed during annual follow-up telephone calls and was compared with reference definitions defined by fasting glucose, hemoglobin A1c, and medication use obtained during an in-person visit attended by a subsample of participants (n = 1,738) in 2004-2005. The sensitivity of prevalent self-reported diabetes ranged from 58.5% to 70.8%, and specificity ranged from 95.6% to 96.8%, depending on the reference definition. Similarly, the sensitivity of incident self-reported diabetes ranged from 55.9% to 80.4%, and specificity ranged from 84.5% to 90.6%. Percent positive agreement of self-reported diabetes during 9 years of repeat assessments ranged from 92.7% to 95.4%. Both prevalent self-reported diabetes and incident self-reported diabetes were 84%-97% specific and 55%-80% sensitive as compared with reference definitions using glucose and medication criteria. Self-reported diabetes was >92% reliable over time.

Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized controlled trial.

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Ceca, Diego; Elvira, Laura; Guzmán, José F; Pablos, Ana

2017-01-01

Fibromyalgia (FM) is a disease with symptoms that significantly limit the life of affected patients. Earlier studies have shown that the application of self-myofascial release provides benefits in variables such as fatigue, range of motion (ROM) or perceived muscle pain in a healthy population. Despite this, the self-myofascial release technique has not yet been used in people with FM. This study aimed to find out the benefits of applying a self-myofascial release program on health-related quality of life in people with FM. Sixty-six participants with FM were randomized into two groups, intervention (N.=33) and control (N.=33). The intervention group (IG) participated in the self-myofascial release program for twenty weeks. The study assessed the impact of a self-myofascial release program on cervical spine, shoulder and hip ROM and self-reported disease impact. Two measurements were performed, one at baseline (preintervention) and one postintervention. Two-way mixed-effect (between-within) ANOVA was used for the statistical analysis. Significant changes (PFibromyalgia Impact Questionnaire (FIQ-S) Score and for five of its seven subscales, including: days per week feeling good, pain intensity, fatigue, stiffness and depression/sadness, as well as all the ROM variables evaluated (neck flexion, neck extension, lateral neck flexion and rotation (bilateral), shoulder flexion and abduction and hip abduction) excluding hip flexion. The application of a self-myofascial release program can improve the health-related quality of life of people with FM, provided that regular, structured practice is carried out.

Assessing knowledge on fibromyalgia among Internet users.

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Moretti, Felipe Azevedo; Heymann, Roberto Ezequiel; Marvulle, Valdecir; Pollak, Daniel Feldman; Riera, Rachel

2011-01-01

To assess knowledge on fibromyalgia in a sample of patients, their families, and professionals interested on the theme from some Brazilian states. Analysis of the results of an electronic fibromyalgia knowledge questionnaire completed by 362 adults who had access to the the support group for fibromyalgia site (www.unifesp.br/grupos/fibromialgia). The answers were grouped according to age, sex, years of schooling, and type of interest in the condition. 92% of the responders were women and 62% had higher educational level. The worst results were observed in the "joint protection and energy conservation" domain, followed by the "medication in fibromyalgia" domain. The best results were recorded in the "exercises in fibromyalgia" domain. The answers differed significantly between sexes, and women achieved a higher percentage of correct answers. The female sex accounted for a statistically superior result in five statistical analyses (four questions and one domain). The study suggests the need for a strategic planning for an educational approach to fibromyalgia in Brazil.

Effectiveness of Aquatic Therapy vs Land-based Therapy for Balance and Pain in Women with Fibromyalgia: a study protocol for a randomised controlled trial.

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Rivas Neira, Sabela; Pasqual Marques, Amélia; Pegito Pérez, Irene; Fernández Cervantes, Ramón; Vivas Costa, Jamile

2017-01-19

Fibromyalgia is a disease with an increasing incidence. It impairs the quality of life of patients and decreases their functional capacity. Aquatic therapy has already been used for managing the symptoms of this syndrome. However, aquatic therapy has only recently been introduced as a treatment modality for improving proprioception in fibromyalgia. The main objective of this study is to determine the effectiveness of two physiotherapy protocols, one in and one out of water, for improving balance and decreasing pain in women with fibromyalgia. The study protocol will be a single-blind randomised controlled trial. Forty women diagnosed with fibromyalgia will be randomly assigned into 2 groups: Aquatic Therapy (n = 20) or Land-based Therapy (n = 20). Both interventions include 60-min therapy sessions, structured into 4 sections: Warm-up, Proprioceptive Exercises, Stretching and Relaxation. These sessions will be carried out 3 times a week for 3 months. Primary outcomes are balance (static and dynamic) and pain (intensity and threshold). Secondary outcomes include functional balance, quality of life, quality of sleep, fatigue, self-confidence in balance and physical ability. Outcome measures will be evaluated at baseline, at the end of the 3-month intervention period, and 6-weeks post-treatment. Statistical analysis will be carried out using the SPSS 21.0 program for Windows and a significance level of p ≤ 0.05 will be used for all tests. This study protocol details two physiotherapy interventions in women with fibromyalgia to improve balance and decrease pain: aquatic therapy and land-based therapy. In current literature there is a lack of methodological rigour and a limited number of studies that describe physiotherapy protocols to manage fibromyalgia symptoms. High-quality scientific works are required to highlight physiotherapy as one of the most recommended treatment options for this syndrome. Date of publication in ClinicalTrials.gov: 18

Nivel de actividad física, calidad de vida y niveles de depresión en mujeres mayores con fibromialgia (Physical activity levels, quality of life and incidence of depression in older women with fibromyalgia

Directory of Open Access Journals (Sweden)

José Ignacio Sañudo

2013-08-01

Full Text Available The aim of the current study was to determine the relationship between levels of depression and perceived quality of life based on the level of physical activity in patients with fibromyalgia in Seville (Spain. A total of 67 women diagnosed with fibromyalgia voluntarily participated in the study. The level of physical activity was assessed using the International Questionnaire of Physical Activity, the incidence of depression was assessed using the Beck Depression Inventory and their perceived quality of life using the SF-36. Significant differences between physical function and general health based on the depression categories in those with a moderate level of physical activity were found. In addition, high correlations were found between levels of depression and physical functioning (r = -.409, p < .05, general health (r = -.453, p < .05 and mental health (r = -.539, p < .05 among the participants. In conclusion, given the close relationship between depression and the perceived quality of life and the ability of physical activity to modulate these relationships in fibromyalgia patients, professionals should establish prevention strategies based on the promotion of physical activity to help improve health in this population.

[Fibromyalgia: behavioral medicine interventions].

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Petermann, F; Holtz, M C; van der Meer, B; Krohn-Grimberghe, B

2007-10-01

The etiology of fibromyalgia as a chronic disease is still unexplained. This article gives an overview of the newest treatment methods of behavioral medicine of the fibromyalgia syndrome with regard to the state of research of etiology and diagnosis of this disease. Methods such as operant conditioning, cognitive-behavioral approaches, patient education and relaxation methods are discussed.

Disability and quality of life in patients with fibromyalgia

OpenAIRE

Verbunt, Jeanine A; Pernot, Dia HFM; Smeets, Rob JEM

2008-01-01

Abstract Background Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia. The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of li...

Mindfulness Meditation for Fibromyalgia: Mechanistic and Clinical Considerations.

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Adler-Neal, Adrienne L; Zeidan, Fadel

2017-09-01

Fibromyalgia is a disorder characterized by widespread pain and a spectrum of psychological comorbidities, rendering treatment difficult and often a financial burden. Fibromyalgia is a complicated chronic pain condition that requires a multimodal therapeutic approach to optimize treatment efficacy. Thus, it has been postulated that mind-body techniques may prove fruitful in treating fibromyalgia. Mindfulness meditation, a behavioral technique premised on non-reactive sensory awareness, attenuates pain and improves mental health outcomes. However, the impact of mindfulness meditation on fibromyalgia-related outcomes has not been comprehensively characterized. The present review delineates the existing evidence supporting the effectiveness and hypothesized mechanisms of mindfulness meditation in treating fibromyalgia-related outcomes. Mindfulness-based interventions premised on cultivating acceptance, non-attachment, and social engagement may be most effective in decreasing fibromyalgia-related pain and psychological symptoms. Mindfulness-based therapies may alleviate fibromyalgia-related outcomes through multiple neural, psychological, and physiological processes. Mindfulness meditation may provide an effective complementary treatment approach for fibromyalgia patients, especially when combined with other reliable techniques (exercise; cognitive behavioral therapy). However, characterizing the specific analgesic mechanisms supporting mindfulness meditation is a critical step to fostering the clinical validity of this technique. Identification of the specific analgesic mechanisms supporting mindfulness-based pain relief could be utilized to better design behavioral interventions to specifically target fibromyalgia-related outcomes.

Complementary and alternative exercise for fibromyalgia: a meta-analysis

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Mist SD

2013-03-01

Full Text Available Scott David Mist, Kari Firestone, Kim Dupree Jones Fibromyalgia Research and Treatment Group, School of Nursing, Oregon Health and Science University, Portland, OR, USA Abstract: Complementary and alternative medicine includes a number of exercise modalities, such as tai chi, qigong, yoga, and a variety of lesser-known movement therapies. A meta-analysis of the current literature was conducted estimating the effect size of the different modalities, study quality and bias, and adverse events. The level of research has been moderately weak to date, but most studies report a medium-to-high effect size in pain reduction. Given the lack of adverse events, there is little risk in recommending these modalities as a critical component in a multimodal treatment plan, which is often required for fibromyalgia management. Keywords: fibromyalgia, exercise, complementary and alternative, efficacy, safety

An internet survey of 2,596 people with fibromyalgia

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Turk Dennis C

2007-03-01

Full Text Available Abstract Background This study explored the feasibility of using an Internet survey of people with fibromyalgia (FM, with a view to providing information on demographics, sources of information, symptoms, functionality, perceived aggravating factors, perceived triggering events, health care utilization, management strategies, and medication use. Methods A survey questionnaire was developed by the National Fibromyalgia Association (NFA in conjunction with a task force of "experts in the field". The questionnaire underwent several rounds of testing to improve its face validity, content validity, clarity and readability before it was mounted on the internet. The questionnaire consisted of 121 items and is available online at the website of the National Fibromyalgia Association. Results The questionnaire was completed by 2,569 people. Most were from the United States, with at least one respondent from each of the 50 states. Respondents were predominantly middle-aged Caucasian females, most of whom had FM symptoms for ≥ 4 years. The most common problems were morning stiffness, fatigue, nonrestorative sleep, pain, concentration, and memory. Aggravating factors included: emotional distress, weather changes, insomnia, and strenuous activity. Respondents rated the most effective management modalities as rest, heat, pain medications, antidepressants, and hypnotics. The most commonly used medications were: acetaminophen, ibuprofen, naproxen, cyclobenzaprine, amitriptyline, and aspirin. The medications perceived to be the most effective were: hydrocodone preparations, aprazolam, oxycodone preparations, zolpidem, cyclobenzaprine, and clonazepam. Conclusion This survey provides a snap-shot of FM at the end of 2005, as reported by a self-selected population of people. This descriptive data has a heuristic function, in that it identifies several issues for further research, such as the prescribing habits of FM health care providers, the role of emotional

Culture, science and the changing nature of fibromyalgia.

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Wolfe, Frederick; Walitt, Brian

2013-12-01

Fibromyalgia is a common but contested illness. Its definition and content have changed repeatedly in the 110 years of its existence. The most important change was the requirement for multiple tender points and extensive pain that arose in the 1980s, features that were not required previously. By 2010, a second shift occurred that excluded tender points, allowed less extensive pain, and placed reliance on patient-reported somatic symptoms and cognitive difficulties ('fibro fog') that had never been part of past definitions or content. Fibromyalgia is closely allied with and often indistinguishable from neurasthenia, a disorder of the late 19th and early 20th centuries that lost favour when it was perceived as being a psychological illness. Fibromyalgia's status as a 'real disease', rather than a psychocultural illness, is buttressed by social forces that include support from official criteria, patient and professional organizations, pharmaceutical companies, disability access, and the legal and academic communities.

The lived experience of fibromyalgia in female patients, a phenomenological study

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Wuytack Francesca

2011-09-01

Full Text Available Abstract Background Fibromyalgia is a chronic syndrome with no cure. A thorough understanding of the illness experience is therefore key in the palliative care of patients with this condition. In search for supportive treatments fibromyalgia patients often attend a chiropractor or other manual therapist. Knowledge of the meaning and reality of living with this condition to the patient could be considered essential to any health care practitioner playing a role in the management. This study aimed to gain a better understanding of the subjective experience of fibromyalgia, focusing on the personal, occupational and social impact of the condition on patients' lives. This included exploring the patients' views about the future. Methods This study employed descriptive phenomenology and adopted Husserl's concept of transcendental subjectivity or "bracketing". This qualitative study involved semi-structured interviews and was undertaken to obtain rich data that reflected the essence of the participants' experience. Participants consisted of six female volunteers, diagnosed with fibromyalgia by the University Hospital Gent, Belgium. Data were analysed using a thematic framework. Results Fibromyalgia pervaded all aspects of life. Four main themes arose from data analysis, namely; the impact of fibromyalgia on patients' occupational and personal life, the impact on their future and aspects of social interaction. Nearly all participants had stopped working, giving rise to feelings of uselessness and loss of identity. Leisure activities were also greatly affected. Fibromyalgia was said to alter family bonds, some of which were reinforced, others were broken. The diagnosis was seen as a relief, marking an end to a period of uncertainty. Participants reported ambivalence in interaction. Despite some positive encounters, frustration arising from perceived incomprehension dominated. Consequently patients preferred not to share their experiences. Conclusions The

Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study.

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Matarín Jiménez, Tamara María; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel; Correa Casado, Matías; Antequera Raynal, Laura Helena; Granero-Molina, José

2017-07-01

The aim of this study was to explore and understand the perceptions and experiences of women with fibromyalgia syndrome regarding their sexuality. Fibromyalgia syndrome is a chronic pathology, which compromises a woman's physical, mental and emotional health. Although concerns related to sexuality are commonly reported, research has tended to focus on the physical symptoms. An interpretive qualitative research methodology using Gadamer's philosophical hermeneutics was carried out. This qualitative study explores the sexuality of women with fibromyalgia syndrome. A focus group and semi-structured interviews were conducted with 13 women with fibromyalgia syndrome. Data were collected between April - June 2014. Participants were recruited until findings reached saturation. Three themes define the perception of sexuality for these women: (i) Physical impact: don't touch, don't look; (ii) Sexuality and identity: fighting against their loss; (iii) Impact on the relationship: sexuality as a way of connecting the couple. Despite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals. Nurses can aid the successful adjustment to sexual problems related to fibromyalgia syndrome. © 2017 John Wiley & Sons Ltd.

Evaluation of Learned Helplessness, Perceived Self-efficacy, and Functional Capacity in Patients With Fibromyalgia and Rheumatoid Arthritis.

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Moyano, Sebastián; Scolnik, Marina; Vergara, Facundo; García, María Victoria; Sabelli, Mirtha Rosa; Rosa, Javier Eduardo; Catoggio, Luis José; Soriano, Enrique Roberto

2018-03-19

The aims of this study were to compare learned helplessness (LH) and perceived self-efficacy (SE) in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) and to assess their correlation with functional disability, level of perceived pain, and fatigue. This multicenter, cross-sectional study included consecutive patients (aged ≥18 years) with RA, according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria, and FM, according to 2010 American College of Rheumatology criteria. Learned helplessness was measured by the Rheumatology Attitude Index, Spanish version; SE with the Arthritis Self-efficacy Scale, Spanish version; functional capacity with the Health Assessment Questionnaire (HAQ), Argentine version; depression with Center for Epidemiological Studies-Depression Scale 7-item version and perceived pain and fatigue by the visual analog scale. Disease activity was measured by the Clinical Disease Activity Index (CDAI) and disease impact with the Fibromyalgia Impact Questionnaire (FIQ). A total of 215 patients, 100 with FM and 115 with RA, were included. Mean age was 59 (SD, 14) years and 58 (SD, 13) years for FM and RA, patients respectively. Whereas LH and depression were significantly higher, SE was significantly lower in FM patients. We found a positive correlation between LH and HAQ, pain, depression, fatigue, FIQ, and CDAI in FM and RA patients. We observed a negative correlation between SE and HAQ, pain, depression, fatigue, FIQ (FM), and CDAI (RA) in both groups. Both LH and SE correlate significantly with functional capacity, perceived pain, disease activity, and disease impact in RA and FM patients. Learned helplessness was higher in patients with active disease or high disease impact, as opposed to those in remission or with low disease impact, and the reverse was true for SE. Patients with FM had significantly more LH, pain, fatigue, and depression and less SE compared with those with RA.

Psychoeducation against depression, anxiety, alexithymia and fibromyalgia: a pilot study in primary care for patients on sick leave.

Science.gov (United States)

Melin, Eva O; Svensson, Ralph; Thulesius, Hans O

2018-06-01

Feasibility testing of a psychoeducational method -The Affect School and Script Analyses (ASSA) - in a Swedish primary care setting. Exploring associations between psychological, and medically unexplained physical symptoms (MUPS). Pilot study. Three Swedish primary care centers serving 20,000 people. 8 weekly 2-hour sessions with a 5-7 participant group led by two instructors - followed by 10 individual hour-long sessions. Thirty-six patients, 29 women (81%), on sick-leave due to depression, anxiety, or fibromyalgia. Feasibility in terms of participation rates and expected improvements of psychological symptoms and MUPS, assessed by self-report instruments pre-, one-week post-, and 18 months post-intervention. Regression coefficients between psychological symptoms and MUPS. The entire 26-hour psychoeducational intervention was completed by 30 patients (83%), and 33 patients (92%) completed the 16-hour Affect School. One-week post-intervention median test score changes were significantly favorable for 27 respondents, with p 80% participation rates, and clear improvements of self-assessed psychological symptoms and MUPS. The ASSA intervention thus showed adequate feasibility in a Swedish primary care setting. Key Points  A pilot study of a psychoeducational intervention - The Affect School and Script Analyses (ASSA) - was performed in primary care   • The intervention showed feasibility for patients on sick-leave due to depression, anxiety, or fibromyalgia   • 92% completed the 8 weeks/16 hours Affect School and 83% completed the entire 26-hour ASSA intervention   • 9 of 11 self-reported measures improved significantly one-week post intervention   • 7 of 11 self-reported measures improved significantly 18 months post-intervention.

Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome

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Treharne GJ

2002-09-01

Full Text Available Abstract Background To investigate the effects of intravenous lignocaine infusions (IV lignocaine in fibromyalgia. Methods Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia. Results Prospective study: Two major (pulmonary oedema and supraventricular tachycardia and 42 minor side-effects were reported. None had long-term sequelae. The commonest was hypotension (17 cases. Retrospective study: Pain and a range of psychosocial measures (on single 11-point scales improved significantly after treatment. There was no effect of the treatment on work status. The average duration of pain relief after the 6-day course of treatment was 11.5 ± 6.5 weeks. Conclusions Intravenous lignocaine appears to be both safe and of benefit in improving pain and quality of life for patients with fibromyalgia. This needs to be confirmed in prospective randomised controlled trials.

What do people search online concerning the "elusive" fibromyalgia? Insights from a qualitative and quantitative analysis of Google Trends.

Science.gov (United States)

Bragazzi, Nicola Luigi; Amital, Howard; Adawi, Mohammad; Brigo, Francesco; Watad, Samaa; Aljadeff, Gali; Amital, Daniela; Watad, Abdulla

2017-08-01

Fibromyalgia is a chronic disease, characterized by pain, fatigue, and poor sleep quality. Patients and mainly those with chronic diseases tend to search for health-related material online. Google Trends (GT), an online tracking system of Internet hit-search volumes that recently merged with its sister project Google Insights for Search (Google Inc.), was used to explore Internet activity related to fibromyalgia. Digital interest in fibromyalgia and related topics searched worldwide has been reported in the last 13 years. A slight decline in this interest has been observed through the years, remaining stable in the last 5 years. Fibromyalgia web behavior exhibited a regular, cyclic pattern, even though no seasonality could be detected. Similar findings have been reported among rheumatoid arthritis and depression. However, differently from rheumatoid arthritis and depression, the focus of the fibromyalgia-related queries was more concentrated on drug side effects and the "elusive" nature of fibromyalgia: is it a real or imaginary condition? Does it really exist or is it all in your head? A tremendous amount of information on fibromyalgia and related topics exist online. Still many queries have been raised and repeated constantly by fibromyalgia patients in the last 13 years. Therefore, physicians should be aware of the common concerns of people or patients regarding fibromyalgia in order to give a proper answers and education.

Fibromyalgia: A Critical and Comprehensive Review.

Science.gov (United States)

Borchers, Andrea T; Gershwin, M Eric

2015-10-01

Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.

Pain, quality of life, self perception of health and depression in patients with fibromyalgia, submited to hydrokinesiotherapy.

Science.gov (United States)

Letieri, Rubens Vinícius; Furtado, Guilherme E; Letieri, Miriangrei; Góes, Suelen M; Pinheiro, Cláudio J Borba; Veronez, Suellen O; Magri, Angela M; Dantas, Estélio M

2013-01-01

The aim of this study was to analyze the effects of treatment by hydrotherapy on quality of life, perception of pain and the severity of depression in a group of patients with fibromyalgia. We evaluated 64 females divided into two groups: hydrocinesiotherapy (n = 33, 58.2 ± 10.6 years) and control group (n = 31 with 59.6 ± 9.4 years) with clinical diagnosis of fibromyalgia. Individuals were assessed by Visual Analog Scale of Pain (VAS), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory. Participants underwent a treatment in a hydrotherapy pool heated to 33ºC over a period of 15 weeks, two sessions per week of 45 minutes, a total of 30 sessions. The exercises were underwater: cardiovascular conditioning, strength training, mobility, coordination, balance and still, stretching exercises and muscle relaxation. The ANOVA 2 × 2 and Kruskall-Wallis was used for statistical analysis There were statistically significant improvements in the perception of pain intensity (Δ% = -28.2%, p quality of life (Δ% = -32.4%, p fibromyalgia, however further studies are recommended to test the associations between the variables and intervention programs and using the water activities, and the modifiability of the parameters of physical and mental health when these individuals undergo programs of short, medium and long duration.

Fibromyalgia

Science.gov (United States)

... they are real. These possible risk factors include: Sex. Women are twice as likely to have fibromyalgia as men. Stressful or traumatic events, such as car accidents, post-traumatic stress disorder (PTSD). Repetitive injuries. Injury from repetitive stress ...

Relational stressors as predictors for repeat aggressive and self-harming incidents in child and adolescent psychiatric inpatient settings.

Science.gov (United States)

Ulke, Christine; Klein, Annette M; von Klitzing, Kai

2014-01-01

This study examined whether relational stressors such as psychosocial stressors, the therapist's absence and a change of therapist are associated with repeat aggressive or self-harming incidents in child and adolescent psychiatric inpatient care. The study data were derived from critical incident reports and chart reviews of 107 inpatients. In multinomial regression analysis, patients with repeat aggressive or self-harming incidents were compared with patients with single incidents. Results suggested that a higher number of psychosocial stressors and a change of therapist, but not the therapist's absence are predictors for repeat aggressive and self-harming incidents. There was a high prevalence of therapist's absence during both, single and repeat, incidents. Repeat aggressive incidents were common in male children and adolescents with disruptive behavior disorders. Repeat self-harming incidents were common in adolescent females with trauma-related disorders. Patients with repeat aggressive or self-harming incidents had a higher number of abnormal intrafamilial relationships and acute life events than patients with single incidents. Interventions to reduce a change of therapist should in particular target children and adolescents with a higher number of psychosocial stressors and/or a known history of traumatic relational experiences. After a first incident, patients should have a psychosocial assessment to evaluate whether additional relational support is needed.

Exercise Therapy for Fibromyalgia

OpenAIRE

Busch, Angela J.; Webber, Sandra C.; Brachaniec, Mary; Bidonde, Julia; Bello-Haas, Vanina Dal; Danyliw, Adrienne D.; Overend, Tom J.; Richards, Rachel S.; Sawant, Anuradha; Schachter, Candice L.

2011-01-01

Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training ...

Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning.

Science.gov (United States)

Garcia-Martin, Elena; Garcia-Campayo, Javier; Puebla-Guedea, Marta; Ascaso, Francisco J; Roca, Miguel; Gutierrez-Ruiz, Fernando; Vilades, Elisa; Polo, Vicente; Larrosa, Jose M; Pablo, Luis E; Satue, Maria

2016-01-01

To investigate whether fibromyalgia induces axonal damage in the optic nerve that can be detected using optical coherence tomography (OCT), as the retinal nerve fiber layer (RNFL) is atrophied in patients with fibromyalgia compared with controls. Fibromyalgia patients (n = 116) and age-matched healthy controls (n = 144) were included in this observational and prospective cohort study. All subjects underwent visual acuity measurement and structural analysis of the RNFL using two OCT devices (Cirrus and Spectralis). Fibromyalgia patients were evaluated according to Giesecke's fibromyalgia subgroups, the Fibromyalgia Impact Questionnaire (FIQ), and the European Quality of Life-5 Dimensions (EQ5D) scale. We compared the differences between fibromyalgia patients and controls, and analyzed the correlations between OCT measurements, disease duration, fibromyalgia subgroups, severity, and quality of life. The impact on quality of life in fibromyalgia subgroups and in patients with different disease severity was also analyzed. A significant decrease in the RNFL was detected in fibromyalgia patients compared with controls using the two OCT devices: Cirrus OCT ganglion cell layer analysis registered a significant decrease in the minimum thickness of the inner plexiform layer (74.99±16.63 vs 79.36±3.38 μm, respectively; p = 0.023), nasal inferior, temporal inferior and temporal superior sectors (p = 0.040; 0.011 and 0.046 respectively). The Glaucoma application of the Spectralis OCT revealed thinning in the nasal, temporal inferior and temporal superior sectors (p = 0.009, 0.006, and 0.002 respectively) of fibromyalgia patients and the Axonal application in all sectors, except the nasal superior and temporal sectors. The odds ratio (OR) to estimate the size effect of FM in RNFL thickness was 1.39. RNFL atrophy was detected in patients with FIQ scores fibromyalgia (FIQ≥60) compared with patients with mild fibromyalgia (FIQfibromyalgia exhibited significant thinning in the

Management strategies for fibromyalgia

OpenAIRE

Le Marshall KF; Littlejohn GO

2011-01-01

Kim Francis Le Marshall, Geoffrey Owen LittlejohnDepartments of Rheumatology and Medicine, Monash Medical Centre and Monash University, Victoria, AustraliaDate of preparation: 14 June 2011Clinical question: What are the effective, evidence-based strategies available for the management of fibromyalgia?Conclusion: There are a number of management strategies available with robust evidence to support their use in clinical practice.Definition: Fibromyalgia is a complex pain syndrome characterized ...

Double-blind, placebo-controlled cross-over study of intravenous S-adenosyl-L-methionine in patients with fibromyalgia

DEFF Research Database (Denmark)

Volkmann, H; Nørregaard, J; Jacobsen, Søren

1997-01-01

The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial. There was no sign......The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial....... There was no significant difference in improvement in the primary outcome: tender point change between the two treatment groups. There was a tendency towards statistical significance in favour of SAMe on subjective perception of pain at rest (p = 0.08), pain on movement (p = 0.11), and overall well-being (p = 0.......17) and slight improvement only on fatigue, quality of sleep, morning stiffness, and on the Fibromyalgia Impact Questionnaire for pain. No effect could be observed on isokinetic muscle strength, Zerrsen self-assessment questionnaire, and the face scale. No effect of SAMe in patients with FM was found...

Perspectives on Living With Fibromyalgia

Directory of Open Access Journals (Sweden)

Ann Gill Taylor

2016-07-01

Full Text Available Perceptions of people living with chronic illness change over time, contributing to health-related stress that necessitates coping skills. Paterson’s shifting perspectives model provides an explanation of chronically ill people’s variations in attention to their symptoms. In this qualitative study, 20 people with fibromyalgia living in a rural setting were interviewed in 2013 with the aim of gaining insight into their experiences and the meaning-making associated with their chronic condition. Analysis of the interview data categorized five recurrent, or common, themes: experiences of loss, feelings of fear and uncertainty, influence of stress, stigmatization of the disease, and coping through courage. Difficulties attendant to losses, distress, and stigma associated with this chronic condition led the participants to report poor health-related quality of life. The study findings can be useful across clinical settings to nurses and other health care providers in understanding those diagnosed with fibromyalgia and their care needs.

Sodium oxybate therapy provides multidimensional improvement in fibromyalgia: results of an international phase 3 trial

Science.gov (United States)

Spaeth, Michael; Bennett, Robert M; Benson, Beverly A; Wang, Y Grace; Lai, Chinglin; Choy, Ernest H

2012-01-01

Background Fibromyalgia is characterised by chronic musculoskeletal pain and multiple symptoms including fatigue, multidimensional function impairment, sleep disturbance and tenderness. Along with pain and fatigue, non-restorative sleep is a core symptom of fibromyalgia. Sodium oxybate (SXB) is thought to reduce non-restorative sleep abnormalities. This study evaluated effects of SXB on fibromyalgia-related pain and other symptoms. Methods 573 patients with fibromyalgia according to 1990 American College of Rheumatology criteria were enrolled at 108 centres in eight countries. Subjects were randomly assigned to placebo, SXB 4.5 g/night or SXB 6 g/night. The primary efficacy endpoint was the proportion of subjects with ≥30% reduction in pain visual analogue scale from baseline to treatment end. Other efficacy assessments included function, sleep quality, effect of sleep on function, fatigue, tenderness, health-related quality of life and subject's impression of change in overall wellbeing. Results Significant improvements in pain, sleep and other symptoms associated with fibromyalgia were seen in SXB treated subjects compared with placebo. The proportion of subjects with ≥30% pain reduction was 42.0% for SXB4.5 g/night (p=0.002) and 51.4% for SXB6 g/night (pQuality of sleep (Jenkins sleep scale) improved by 20% for SXB4.5 g/night (p≤0.001) and 25% for SXB6 g/night (p≤0.001) versus 0.5% for placebo. Adverse events with an incidence ≥5% and twice placebo were nausea, dizziness, vomiting, insomnia, anxiety, somnolence, fatigue, muscle spasms and peripheral oedema. Conclusion These results, combined with findings from previous phase 2 and 3 studies, provide supportive evidence that SXB therapy affordsimportant benefits across multiple symptoms in subjects with fibromyalgia. PMID:22294641

Fibromyalgia: Presentation and management with a focus on pharmacological treatment

OpenAIRE

Sumpton, Janice E; Moulin, Dwight E

2008-01-01

Fibromyalgia is a condition with widespread muscle pain. Prevalence studies showed that 2% to 7% of the population have fibromyalgia, which affects approximately one million Canadians. Fibromyalgia is most common in women, but it also involves men and children. As with most chronic illnesses, the causes of fibromyalgia are unknown. However, recent research supports underlying abnormalities in the central nervous system, which supports fibromyalgia as a chronic disease state and valid clinical...

A patient survey of the impact of fibromyalgia and the journey to diagnosis

Directory of Open Access Journals (Sweden)

Petersel Danielle

2010-04-01

Full Text Available Abstract Background Fibromyalgia is a painful, debilitating illness with a prevalence of 0.5-5.0% that affects women more than men. It has been shown that the diagnosis of fibromyalgia is associated with improved patient satisfaction and reduced healthcare utilization. This survey examined the patient journey to having their condition diagnosed and studied the impact of the condition on their life. Methods A questionnaire survey of 800 patients with fibromyalgia and 1622 physicians in 6 European countries, Mexico and South Korea. Patients were recruited via their physician. Results Over half the patients (61% were aged 36-59 years, 84% were women, and the mean time since experiencing fibromyalgia symptoms was 6.5 years. Patients had experienced multiple fibromyalgia symptoms (mean of 7.3 out of 14, with pain, fatigue, sleeping problems and concentration difficulties being the most commonly reported. Most patients rated their chronic widespread pain as moderate or severe and fibromyalgia symptoms were on average "fairly" to "very" disruptive, and had a "moderate" to "strong" impact on patients' lives. 22% were unable to work and 25% were not able to work all the time because of their fibromyalgia. Patients waited on average almost a year after experiencing symptoms before presenting to a physician, and it took an average of 2.3 years and presenting to 3.7 different physicians before receiving a diagnosis of fibromyalgia. Patients rated receiving a diagnosis as somewhat difficult on average and had difficulties communicating their symptoms to the physician. Over one third (35% felt their chronic widespread pain was not well managed by their current treatment. Conclusions This survey provides further evidence that fibromyalgia is characterized by multiple symptoms and has a notable impact on quality of life and function. The diagnosis of fibromyalgia is delayed. Patients wait a significant period of time before presenting to a physician, adding to

Juvenile fibromyalgia syndrome. Interdisciplinary treatment

Directory of Open Access Journals (Sweden)

Hanna Siuchnińska

2014-11-01

Full Text Available Fibromyalgia syndrome (FM belongs to soft tissue pain syndromes of unknown cause, also referred to as “soft tissue rheumatism”. It is characterized by chronic widespread pain as well as additional symptoms such as fatigue, sleep and mood disturbance and cognitive problems. There is more and more data showing that this condition may start at a young age or even in childhood, adversely affecting development processes and resulting in dysfunctional social and family relationships. Because of the multifaceted character of fibromyalgia the efficient treatment of this disorder can be difficult and requires comprehensive care. This work reviews most recommended procedures used in integrated treatment programmes for juvenile fibromyalgia syndrome (JFM.

Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study.

Science.gov (United States)

Engen, Deborah J; McAllister, Samantha J; Whipple, Mary O; Cha, Stephen S; Dion, Liza J; Vincent, Ann; Bauer, Brent A; Wahner-Roedler, Dietlind L

2015-09-01

Fibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms. To gather preliminary data on whether transdermal magnesium can improve quality of life for women who have fibromyalgia. This is a patient questionnaires and survey in a fibromyalgia clinic at a tertiary medical center. Forty female patients with the diagnosis of fibromyalgia were enrolled. Each participant was provided a spray bottle containing a transdermal magnesium chloride solution and asked to apply 4 sprays per limb twice daily for 4 weeks. Participants were asked to complete the Revised Fibromyalgia Impact Questionnaire, SF-36v2 Health Survey, and a quality-of-life analog scale at baseline, week 2, and week 4. Questionnaire and survey scores, evaluated through intent-to-treat and per-protocol analyses. Twenty-four patients completed the study (mean [SD] age, 57.2 [7.6] years; white, 95%; mean body mass index, 31.3 kg/m2). With intention-to-treat analysis, Revised Fibromyalgia Impact Questionnaire subscale and total scores were significantly improved at week 2 and week 4 (total score, P=0.001). Per-protocol analysis results were similar: all subscales of the Revised Fibromyalgia Impact Questionnaire were significantly improved at week 2 and week 4 (total score, P=0.001). This pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia. ClinicalTrials.gov.ldentifier NCT01968772.

Increased cancer risk in patients referred to hospital with suspected fibromyalgia

DEFF Research Database (Denmark)

Dreyer, Lene; Mellemkjaer, Lene; Kendall, Sally

2007-01-01

OBJECTIVE: To analyze whether fibromyalgia (FM) and FM-like symptoms are related to an increased incidence of cancer. METHODS: We identified 1361 patients referred on suspicion of FM in the period 1984-99 from hospital records. Following the American College of Rheumatology (ACR) criteria, patien...... for FM. These patients should be investigated if they develop any new or warning symptoms of malignancy, and treating physicians should be vigilant with screening procedures such as mammography....

Neuropathic pain and use of PainDETECT in patients with fibromyalgia: a cohort study.

Science.gov (United States)

Gauffin, Jarno; Hankama, Tiina; Kautiainen, Hannu; Hannonen, Pekka; Haanpää, Maija

2013-02-14

Fibromyalgia has a plethorae of symptoms, which can be confusing and even misleading. Accurate evaluation is necessary when patients with fibromyalgia are treated. Different types of instruments are available for the clinicians to supplement evaluation. Our objective was to study the applicability of the PainDETECT instrument to screen neuropathic pain in patients with fibromyalgia. 158 patients with primary fibromyalgia underwent a neurological examination including bedside sensory testing. They also fulfilled four questionnaires: PainDETECT, Beck depression inventory IA (BDI IA), Fibromyalgia Impact Questionnaire (FIQ) and a self-made questionnaire regarding present pain and pain relieving methods of the patients. The results of the clinical evaluation and questionnaires were then compared. Clinically verified neuropathic pain was diagnosed in 53/158 [34% (95% Cl: 26 to 41)] patients. The ROC curve achieved a maximum Youden´s index at score of 17 when sensitivity was 0.79 (95% Cl: 0.66 to 0.89) and specificity 0.53 (95% Cl: 0.43 to 0.63). The PainDETECT total score (OR: 1.14 95% Cl: 1.06 to 1.22), FM as the worst current pain (OR: 0.31; 95% 0.16 to 0.62), body mass index (BMI) (OR: 1.05; 95% Cl: 1.00 to 1.11) and the intensity of current pain (OR: 1.20; 95% Cl: 1.01 to 1.41) were significantly associated with the presence of neuropathic pain in univariate analyses. This study highlights the importance of thorough clinical examination. The Neuropathic pain screening tool PainDETECT is not as useful in patients with fibromyalgia as in patients with uncompromised central pain control.

Neuropathic pain and use of PainDETECT in patients with fibromyalgia: a cohort study

Directory of Open Access Journals (Sweden)

Gauffin Jarno

2013-02-01

Full Text Available Abstract Backround Fibromyalgia has a plethorae of symptoms, which can be confusing and even misleading. Accurate evaluation is necessary when patients with fibromyalgia are treated. Different types of instruments are available for the clinicians to supplement evaluation. Our objective was to study the applicability of the PainDETECT instrument to screen neuropathic pain in patients with fibromyalgia. Methods 158 patients with primary fibromyalgia underwent a neurological examination including bedside sensory testing. They also fulfilled four questionnaires: PainDETECT, Beck depression inventory IA (BDI IA, Fibromyalgia Impact Questionnaire (FIQ and a self-made questionnaire regarding present pain and pain relieving methods of the patients. The results of the clinical evaluation and questionnaires were then compared. Results Clinically verified neuropathic pain was diagnosed in 53/158 [34% (95% Cl: 26 to 41] patients. The ROC curve achieved a maximum Youden´s index at score of 17 when sensitivity was 0.79 (95% Cl: 0.66 to 0.89 and specificity 0.53 (95% Cl: 0.43 to 0.63. The PainDETECT total score (OR: 1.14 95% Cl: 1.06 to 1.22, FM as the worst current pain (OR: 0.31; 95% 0.16 to 0.62, body mass index (BMI (OR: 1.05; 95% Cl: 1.00 to 1.11 and the intensity of current pain (OR: 1.20; 95% Cl: 1.01 to 1.41 were significantly associated with the presence of neuropathic pain in univariate analyses. Conclusion This study highlights the importance of thorough clinical examination. The Neuropathic pain screening tool PainDETECT is not as useful in patients with fibromyalgia as in patients with uncompromised central pain control.

Self-reported physical exposure association with medial and lateral epicondylitis incidence in a large longitudinal study.

Science.gov (United States)

Descatha, Alexis; Dale, Ann Marie; Jaegers, Lisa; Herquelot, Eléonore; Evanoff, Bradley

2013-09-01

Although previous studies have related occupational exposure and epicondylitis, the evidence is moderate and mostly based on cross-sectional studies. Suspected physical exposures were tested over a 3-year period in a large longitudinal cohort study of workers in the USA. In a population-based study including a variety of industries, 1107 newly employed workers were examined; only workers without elbow symptoms at baseline were included. Baseline questionnaires collected information on personal characteristics and self-reported physical work exposures and psychosocial measures for the current or most recent job at 6 months. Epicondylitis (lateral and medial) was the main outcome, assessed at 36 months based on symptoms and physical examination (palpation or provocation test). Logistic models included the most relevant associated variables. Of 699 workers tested after 36 months who did not have elbow symptoms at baseline, 48 suffered from medial or lateral epicondylitis (6.9%), with 34 cases of lateral epicondylitis (4.9%), 30 cases of medial epicondylitis (4.3%) and 16 workers who had both. After adjusting for age, lack of social support and obesity, consistent associations were observed between self-reported wrist bending/twisting and forearm twisting/rotating/screwing motion and future cases of medial or lateral epicondylitis (ORs 2.8 (1.2 to 6.2) and 3.6 (1.2 to 11.0) in men and women, respectively). Self-reported physical exposures that implicate repetitive and extensive/prolonged wrist bend/twisting and forearm movements were associated with incident cases of lateral and medial epicondylitis in a large longitudinal study, although other studies are needed to better specify the exposures involved.

Evaluation of a self-management patient education program for patients with fibromyalgia syndrome: study protocol of a cluster randomized controlled trial.

Science.gov (United States)

Musekamp, Gunda; Gerlich, Christian; Ehlebracht-König, Inge; Faller, Hermann; Reusch, Andrea

2016-02-03

Fibromyalgia syndrome (FMS) is a complex chronic condition that makes high demands on patients' self-management skills. Thus, patient education is considered an important component of multimodal therapy, although evidence regarding its effectiveness is scarce. The main objective of this study is to assess the effectiveness of an advanced self-management patient education program for patients with FMS as compared to usual care in the context of inpatient rehabilitation. We conducted a multicenter cluster randomized controlled trial in 3 rehabilitation clinics. Clusters are groups of patients with FMS consecutively recruited within one week after admission. Patients of the intervention group receive the advanced multidisciplinary self-management patient education program (considering new knowledge on FMS, with a focus on transfer into everyday life), whereas patients in the control group receive standard patient education programs including information on FMS and coping with pain. A total of 566 patients are assessed at admission, at discharge and after 6 and 12 months, using patient reported questionnaires. Primary outcomes are patients' disease- and treatment-specific knowledge at discharge and self-management skills after 6 months. Secondary outcomes include satisfaction, attitudes and coping competences, health-promoting behavior, psychological distress, health impairment and participation. Treatment effects between groups are evaluated using multilevel regression analysis adjusting for baseline values. The study evaluates the effectiveness of a self-management patient education program for patients with FMS in the context of inpatient rehabilitation in a cluster randomized trial. Study results will show whether self-management patient education is beneficial for this group of patients. German Clinical Trials Register, DRKS00008782 , Registered 8 July 2015.

INVIVO 31P MAGNETIC-RESONANCE SPECTROSCOPY (MRS) OF TENDER POINTS IN PATIENTS WITH PRIMARY FIBROMYALGIA SYNDROME

NARCIS (Netherlands)

DEBLECOURT, AC; WOLF, RF; VANRIJSWIJK, MH; KAMMAN, RL; KNIPPING, AA; MOOYAART, EL

1991-01-01

31P Magnetic Resonance-Spectroscopy was performed at the site of tender points in the trapezius muscle of patients with primary fibromyalgia syndrome. Earlier, in vitro studies have reported changes in the high energy phosphate-metabolism in biopsies taken from tender points of fibromyalgia

Fibromyalgia

Science.gov (United States)

... you could ask a friend to be your exercise buddy. There are also support groups specifically for people who have fibromyalgia. Take medicines exactly as prescribed Your doctor may prescribe medicines to reduce your pain, improve your mood, and help you sleep better. Ask your doctor ...

Homeopathy in the treatment of fibromyalgia--a comprehensive literature-review and meta-analysis.

Science.gov (United States)

Boehm, Katja; Raak, Christa; Cramer, Holger; Lauche, Romy; Ostermann, Thomas

2014-08-01

Coping with the complex nature of fibromyalgia symptoms (FMS) still remains a challenge for patients. Taking into account the possible adverse events of pharmacological treatments patients often seek additional treatments for the management of fibromyalgia and turn towards complementary and alternative medicine (CAM). In this review, we aimed to investigate the current state of literature of homeopathy in the treatment of FMS. We searched Medline, the Cochrane Register of Controlled Trials, Embase, AMED, PsycInfo and CAMbase for the terms "fibromyalgia AND homeopath$" through February 2013. In addition we searched Google Scholar, the library of the Carstens Foundation and that of the Deutsche Homöopathische Union (DHU). Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated and meta-analyzed using the generic inverse variance method. We found 10 case-reports, 3 observational studies, 1 non-randomized and 4 randomized controlled trials (RCTs) on homeopathy for fibromyalgia. Both case reports and observational studies are naturally predominated by the use of qualitative and not validated outcome measures. Meta-analyses of CCTs revealed effects of homeopathy on tender point count (SMD=-0.42; 95%CI -0.78, -0.05; P=0.03), pain intensity (SMD=-0.54; 95%CI -0.97, -0.10; P=0.02), and fatigue (SMD=-0.47; 95%CI -0.90, -0.05; P=0.03) compared to placebo. The results of the studies as well as the case reports define a sufficient basis for discussing the possible benefits of homeopathy for patients suffering from fibromyalgia syndrome although any conclusions based on the results of this review have to be regarded as preliminary. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Japanese version of the modified ACR preliminary diagnostic criteria for fibromyalgia and the fibromyalgia symptom scale: reliability and validity.

Science.gov (United States)

Usui, Chie; Hatta, Kotaro; Aratani, Satoko; Yagishita, Naoko; Nishioka, Kenya; Kanazawa, Teruhisa; Itoh, Kenji; Yamano, Yoshihisa; Nakamura, Hiroyuki; Nakajima, Toshihiro; Nishioka, Kusuki

2013-09-01

The aim of this study is to investigate the reliability and validity of the Japanese version of the modified American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia (mACR 2010-J) and the Fibromyalgia Symptom Scale (mFS-J). According to the ACR 1990 classification criteria, patients with chronic pain were divided into the fibromyalgia group and nonfibromyalgia group (rheumatoid arthritis and osteoarthritis). Patients in both groups were assessed using mACR 2010-J and mFS-J. 294 of 462 (64 %) patients in the fibromyalgia group met mACR 2010-J, whereas 4 % (9/231) of the nonfibromyalgia group did, with sensitivity of 64 %, specificity of 96 %, positive predictive value of 97 %, negative predictive value of 56 %, and positive likelihood ratio of 16.3. Mean total scores on mFS-J significantly differentiated the fibromyalgia from the nonfibromyalgia group. According to the value of the Youden index, the best cutoff score for the mFS-J was 9/10. Our findings indicate that mACR 2010-J as a positive test and mFS-J as a quantification scale might be suitable for assessing fibromyalgia among Japanese chronic pain populations.

Changes in hippocampal metabolites after effective treatment for fibromyalgia: a case study.

Science.gov (United States)

Wood, Patrick B; Ledbetter, Christina R; Patterson, James C

2009-01-01

Fibromyalgia has been associated with disrupted hippocampal brain metabolite ratios by studies using single voxel magnetic resonance spectroscopy (1H-MRS). Exposure to stress is considered a risk factor for the development and exacerbation of fibromyalgia symptoms. Basic science has demonstrated the hippocampus to be exquisitely sensitive to the effects of stressful experience, which results in changes including alterations in metabolite content and frank atrophy. This report details the case of a 47-year-old woman with fibromyalgia who was originally found to have a profound depression of the ratio of N-acetylaspartate to creatine in her right hippocampus during participation in a study to assess brain metabolite disturbances in fibromyalgia utilizing single voxel proton magnetic resonance spectroscopy. An individualized treatment strategy was developed based both on physiological abnormalities associated with the disorder and symptoms that characterized the patient's unique clinical profile. Clinical and spectroscopic evaluation following nine months of treatment demonstrated both an improvement in her clinical profile and normalization of the NAA/Cr ratio within her right hippocampus. Therapeutic strategies aimed at demonstrable lesions associated with fibromyalgia appear to represent rational targets for pharmacological intervention. The rationale for development of novel pharmacotherapies for this unusual disorder is discussed.

Altered Functional Performance in Patients with Fibromyalgia

OpenAIRE

Costa, Isis da Silva; Gamund?, Antoni; Miranda, Jos? G. Vivas; Fran?a, Lucas G. Souza; De Santana, Charles Novaes; Montoya, Pedro

2017-01-01

Fibromyalgia is a common chronic pain condition that exerts a considerable impact on patients' daily activities and quality of life. Objectives: The main objective of the present study was to evaluate kinematic parameters of gait, functional performance, and balance in women with fibromyalgia syndrome. Methods: The study included 26 female patients with fibromyalgia (49.2 ± 8.0 years) according to the criteria of the American College of Rheumatology, as well as 16 pain-free women (43.5 ...

Effects of music on pain in patients with fibromyalgia.

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Alparslan, Güler Balcı; Babadağ, Burcu; Özkaraman, Ayşe; Yıldız, Pınar; Musmul, Ahmet; Korkmaz, Cengiz

2016-05-01

Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by diffuse musculoskeletal system pain and painful tender points in certain areas of the body. The aim of the investigation was to determine the effects of music on pain in fibromyalgia patients. This randomized clinical trial was carried out with 37 fibromyalgia outpatients as an experimental group (n = 21) and control group (n = 16) at a University Hospital Internal Medicine and Rheumatology Clinic between 1 June and 1 December 2014. The research instruments used were descriptive characteristics questionnaire, Visual Analogue Scale (VAS), music CD which includes water and wave sounds recommended by the Turkish Psychological Association for psychological relaxation, and pain evaluation form. According to the findings, the average age of patients was 43.59 years ± 10.30, 94.6 % were women and 81.1 % were married. The fibromyalgia patients had the disease ranged from 1 month to 20 years, the average of disease duration was 23.6 ± 45.5 months, and the average of pain intensity was 6.89 ± 1.64 on the VAS. Average pain was reported in the experimental group in VAS on day 1 (5.45 ± 2.73), day 7 (4.57 ± 2.71), and day 14 (4.14 ± 2.45), and significant reduction in pain in the listening music group was seen (p = 0.026). A repeated measure analysis of variance controlling for differences between days demonstrated a significant decrease in pain between day 1 and day 14 (p = 0.022). There was no significant decrease in pain among control group participants. The effect of music has been found to control pain in fibromyalgia patients. Music therapy should be suggested in pain management for fibromyalgia patients as an non-pharmacologic nursing intervention.

Low-level laser therapy to treat fibromyalgia.

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Ruaro, J A; Fréz, A R; Ruaro, M B; Nicolau, R A

2014-11-01

Several clinical treatments have been proposed to manage symptoms of fibromyalgia. Low-level laser therapy (LLLT) may be a useful tool to treat this dysfunction. The aim of this study was to evaluate the effects of LLLT in patients with fibromyalgia. A placebo-controlled, randomized clinical trial was carried out with 20 patients divided randomly into either an LLLT group (n = 10) or a placebo group (n = 10). The LLLT group was treated with a GaAlAs laser (670 nm, 4 J/cm(2) on 18 tender points) three times a week over 4 weeks. Before and after treatment, patients were evaluated with the Fibromyalgia Impact Questionnaire (FIQ), McGill Pain Questionnaire, and visual analog scale (VAS). Data from the FIQ and McGill questionnaire for the treated and control groups were analyzed by paired t tests, and Wilcoxon tests were used to analyze data from the VAS. After LLLT or sham treatment, the number of tender points was significantly reduced in both groups (LLLT, p fibromyalgia symptoms showed significant improvements after LLLT compared to placebo (FIQ, p = 0.0003; McGill, p = 0.0078; and VAS, p = 0.0020). LLLT provided relief from fibromyalgia symptoms in patients and should be further investigated as a therapeutic tool for management in fibromyalgia.

Fibromyalgia : towards an integration of somatic and psychological aspects

NARCIS (Netherlands)

Blécourt, Alida Cornelia Ebelina de; Knipping, Alexander

1995-01-01

In this dissertation various aspects of the fibromyalgia syndrome are discussed. Fibromyalgia (syndrome) is a common disorder seen in rheumatology practices, and has been known under a variety of names during the years. The introduction to the syndrome and a historical review of fibromyalgia are

Analysis of mass incident diffusion in Weibo based on self-organization theory

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Pan, Jun; Shen, Huizhang

2018-02-01

This study introduces some theories and methods of self-organization system to the research of the diffusion mechanism of mass incidents in Weibo (Chinese Twitter). Based on the analysis on massive Weibo data from Songjiang battery factory incident happened in 2013 and Jiiangsu Qidong OJI PAPER incident happened in 2012, we find out that diffusion system of mass incident in Weibo satisfies Power Law, Zipf's Law, 1/f noise and Self-similarity. It means this system is the self-organization criticality system and dissemination bursts can be understood as one kind of Self-organization behavior. As the consequence, self-organized criticality (SOC) theory can be used to explain the evolution of mass incident diffusion and people may come up with the right strategy to control such kind of diffusion if they can handle the key ingredients of Self-organization well. Such a study is of practical importance which can offer opportunities for policy makers to have good management on these events.

Factor structure of the Positive and Negative Affect Schedule (PANAS) in adult women with fibromyalgia from Southern Spain : the al-Ándalus project

NARCIS (Netherlands)

Estévez-López, F.; Pulido-Martos, M.; Armitage, C.J.; Wearden, A.; Álvarez-Gallardo, I.C.; Arrayás-Grajera, M.J.; Girela-Rejón, M.J.; Carbonell-Baeza, A.; Aparicio, V.A.; Geenen, R.; Delgado-Fernández, M.; Segura-Jiménez, V.

2016-01-01

Background: Fibromyalgia is a syndrome characterized by the presence of widespread chronic pain. People with fibromyalgia report lower levels of Positive Affect and higher levels of Negative Affect than non-fibromyalgia peers. The Positive and Negative Affect Schedule (PANAS)–a widely used

Neurobiology Underlying Fibromyalgia Symptoms

Directory of Open Access Journals (Sweden)

Marta Ceko

2012-01-01

Full Text Available Fibromyalgia is characterized by chronic widespread pain, clinical symptoms that include cognitive and sleep disturbances, and other abnormalities such as increased sensitivity to painful stimuli, increased sensitivity to multiple sensory modalities, and altered pain modulatory mechanisms. Here we relate experimental findings of fibromyalgia symptoms to anatomical and functional brain changes. Neuroimaging studies show augmented sensory processing in pain-related areas, which, together with gray matter decreases and neurochemical abnormalities in areas related to pain modulation, supports the psychophysical evidence of altered pain perception and inhibition. Gray matter decreases in areas related to emotional decision making and working memory suggest that cognitive disturbances could be related to brain alterations. Altered levels of neurotransmitters involved in sleep regulation link disordered sleep to neurochemical abnormalities. Thus, current evidence supports the view that at least some fibromyalgia symptoms are associated with brain dysfunctions or alterations, giving the long-held “it is all in your head” view of the disorder a new meaning.

Exercise recommendations in patients with newly diagnosed fibromyalgia.

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Wilson, Brad; Spencer, Horace; Kortebein, Patrick

2012-04-01

To evaluate exercise recommendations in patients newly diagnosed with fibromyalgia. A retrospective chart review. A public university rheumatology clinic. Patients newly diagnosed with fibromyalgia (N = 122). Frequency and type of exercise recommendations. The mean (standard deviation) age of these patients with fibromyalgia was 45 ± 12 years; 91% were women. Exercise was recommended as part of the documented treatment plan in 47% of these patients (57/122); only 3 patients had a documented contraindication for exercise. Aquatic exercise was most frequently recommended (56% [32/57]), followed by combined aquatic-aerobic exercise (26% [15/57]), and, infrequently, aerobic exercise only (5% [3/57]); only 7% of these patients (4/57) were referred for physical therapy. The primary method of communication was verbal discussion (94% [54/57]). Although there is well-documented evidence that exercise is beneficial for patients with fibromyalgia, we found that less than half of patients with newly diagnosed fibromyalgia in our study were provided recommendations to initiate an exercise program as part of their treatment plan. Further investigation of these findings are warranted, including evaluation of other university and community rheumatology practices as well as that of other physicians caring for patients with fibromyalgia. However, our findings indicate that there appears to be an opportunity to provide more specific and practical education regarding the implementation of an exercise regimen for patients with newly diagnosed fibromyalgia. Physiatrists may be particularly well suited to manage the exercise component of patients with fibromyalgia because of their specialized training in exercise prescription. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Relationship Between Predictors of Incident Deliberate Self-Harm and Suicide Attempts Among Adolescents.

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Huang, Yu-Hsin; Liu, Hui-Ching; Sun, Fang-Ju; Tsai, Fang-Ju; Huang, Kuo-Yang; Chen, Ting-Chun; Huang, Yo-Ping; Liu, Shen-Ing

2017-05-01

Data on the incidence of deliberate self-harm (DSH) and suicide attempts (SAs) are lacking in non-Western adolescents, and no studies have investigated differences in incident DSH and SA worldwide. This study aimed to investigate the incidence rates and relationships between predictors in DSH and SA. The Taiwanese Adolescent Self-Harm Project was a longitudinal study of DSH among adolescents. We recruited 5,879 students from 14 senior high schools in northern Taiwan. Online questionnaires on sociodemographic data, suicidality, depressive symptoms, self-esteem, social support, family discord, impulsivity, and alcohol and tobacco use were assessed at baseline (T1) and at 1 year of follow-up (T2). Logistic regression analyses were performed to evaluate the predictors of incident DSH and SA. The mean age was 16.02 years, and 56.73% of the cohort was female. At T1, the lifetime prevalence rates of DSH and SA were 25.04% and 3.50%, respectively. At T2, 4,331 (73.67%) students had completed follow-up assessments. The 1-year incidence rates of DSH and SA were 4.04% and 1.53%, respectively. The predictors of incident DSH included perceived family discord and more depressive symptoms at T1. The predictors of incident SA were lifetime suicide ideation, more depressive symptoms, and tobacco use at T1. The incidence rates of DSH and SA were similar to those reported in Western countries. The predictors of incident DSH and SA were similar but not identical. Our results highlight the risk factors which should be considered in terms of early identification and intervention among adolescents to prevent suicidality. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Amitriptyline for the treatment of fibromyalgia: a comprehensive review.

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Rico-Villademoros, Fernando; Slim, Mahmoud; Calandre, Elena P

2015-10-01

Fibromyalgia is characterized by chronic generalized pain accompanied by a wide range of clinical manifestations. Most clinical practice guidelines recommend multidisciplinary treatment using a combination of pharmacological and non-pharmacological therapies. The tricyclic antidepressant amitriptyline has been most thoroughly studied in fibromyalgia. Amitriptyline has been evaluated in placebo-controlled studies, and it has served as an active comparator to other therapeutic interventions in the treatment of fibromyalgia. In addition, several systematic reviews and meta-analyses have evaluated its efficacy and safety for the treatment of fibromyalgia. Data from individual studies as well as from systematic reviews indicate that low doses (10-75 mg/day) of amitriptyline are effective for the treatment of fibromyalgia and, despite the limited quality of the data, they do not seem to be associated with relevant tolerability or safety issues. Consistent with some clinical guidelines, we believe amitriptyline in low doses should be considered a first-line drug for the treatment of fibromyalgia.

The discordance between subjectively and objectively measured physical function in women with fibromyalgia: association with catastrophizing and self-efficacy cognitions : The al-Ándalus project

NARCIS (Netherlands)

Estévez-López, F.|info:eu-repo/dai/nl/412501031; Álvarez-Gallardo, I.C.; Segura-Jiménez, V.; Soriano-Maldonado, A.; Borges-Cosic, M; Pulido-Martos, M.; Aparicio, V.A.; Carbonell-Baeza, A.; Delgado-Fernández, M.; Geenen, R.|info:eu-repo/dai/nl/087017571

2018-01-01

Purpose: People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether

Antipsychotics for fibromyalgia in adults.

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Walitt, Brian; Klose, Petra; Üçeyler, Nurcan; Phillips, Tudor; Häuser, Winfried

2016-06-02

This review is one of a series on drugs used to treat fibromyalgia. Fibromyalgia is a clinically well-defined chronic condition of unknown aetiology characterised by chronic widespread pain that often co-exists with sleep problems and fatigue. It affects approximately 2% of the general population. Up to 70% of patients with fibromyalgia meet the criteria for a depressive or anxiety disorder. People often report high disability levels and poor health-related quality of life. Drug therapy focuses on reducing key symptoms and disability, and improving health-related quality of life. Antipsychotics might reduce fibromyalgia and associated mental health symptoms. To assess the efficacy, tolerability and safety of antipsychotics in fibromyalgia in adults. We searched CENTRAL (2016, Issue 4), MEDLINE and EMBASE to 20 May 2016, together with reference lists of retrieved papers and reviews and two clinical trial registries. We also contacted trial authors. We selected controlled trials of at least four weeks duration of any formulation of antipsychotics used for the treatment of fibromyalgia in adults. We extracted the data from all included studies and two review authors independently assessed study risks of bias. We resolved discrepancies by discussion. We performed analysis using three tiers of evidence. We derived first tier evidence from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for drop-outs, at least 200 participants in the comparison, eight to 12 weeks duration, parallel design), second tier evidence from data that failed to meet one or more of these criteria and that we considered at some risk of bias but with adequate numbers in the comparison, and third tier evidence from data involving small numbers of participants that we considered very likely to be biased or used outcomes of limited clinical utility, or both. We rated the

Fibromyalgia: a clinical challenge

DEFF Research Database (Denmark)

Lorenzen, I

1994-01-01

or a rheumatic syndrome. The experience from an Australian epidemic of fibromyalgia indicates that there is an important psychosomatic component in the pathogenesis. Probably, fibromyalgia is not a disease entity; rather, the symptoms reflect difficulties in coping with various types of environmental stress....... Secondary to this, sleep disturbances, fatigue, a low level of physical activity and poor physical fitness may develop, rendering the patients susceptible to muscle pain and tenderness elicited by sleep disturbances. A vicious circle may be responsible for the chronicity of the syndrome. Identification...

Differences in ability to perform activities of daily living among women with fibromyalgia: A cross-sectional study.

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von Bülow, Cecilie; Amris, Kirstine; la Cour, Karen; Danneskiold-Samsøe, Bente; Ejlersen, Eva Wæhrens

2015-11-01

To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences in ability to perform activities of daily living. Cross-sectional study. A total of 257 women with fibromyalgia. Participants were evaluated with the AMPS (measuring activities of daily living motor and activities of daily living process ability), FIQ and SF-36. AMPS independence cut-offs were used to divide the participants into 4 subgroups. Clinically relevant differences between subgroups were investigated based on the AMPS, FIQ PF and SF-36 PF. Participants in the 4 AMPS-derived subgroups demon-strated clinically relevant differences in observed activities of daily living motor and process ability. Neither the FIQ PF nor the SF-36 PF could differentiate between subgroups with clinically relevant differences in AMPS activities of daily living process ability. Activities of daily living process skills reflect underlying organizational and adaptive capacities of the individual and are relevant targets for interventions aiming at improving activities of daily living ability. Since self-report instruments do not capture differences in activities of daily living process ability, clinicians should include observations-based assessment of activities of daily living ability in order to individualize interventions offered.

HPV vaccination syndrome: A clinical mirage, or a new tragic fibromyalgia model.

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Martínez-Lavín, Manuel

2018-03-13

Independent investigators have described the onset of a chronic painful dysautonomic syndrome soon after human papillomavirus (HPV) vaccination. The veracity of this syndrome is hotly debated. Many of the reported post-HPV vaccination cases fullfill fibromyalgia diagnostic criteria. This article discusses the arguments favoring the existence of a syndrome associated to HPV vaccination. We propose that fibromyalgia dysautonomic-neuropathic model could help in the diagnostic and therapeutic process in those patients in whom the onset of a painful chronic illness began after HPV immunization. On the other hand, if its veracity is corroborated, HPV vaccination syndrome may become a new tragic fibromyalgia model. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Relationships between the fibromyalgia impact questionnaire, tender point count, and muscle strength in female patients with fibromyalgia

DEFF Research Database (Denmark)

Henriksen, Marius; Lund, Hans Peter; Christensen, Robin

2009-01-01

To test the hypothesis that fibromyalgia (FM) patients with reduced lower extremity strength are more symptomatic and tender than FM patients with normal muscle strength.......To test the hypothesis that fibromyalgia (FM) patients with reduced lower extremity strength are more symptomatic and tender than FM patients with normal muscle strength....

Selective serotonin reuptake inhibitors for fibromyalgia syndrome

Directory of Open Access Journals (Sweden)

Brian Walitt

Full Text Available ABSTRACT BACKGROUND: Fibromyalgia is a clinically well-defined chronic condition with a biopsychosocial aetiology. Fibromyalgia is characterized by chronic widespread musculoskeletal pain, sleep problems, cognitive dysfunction, and fatigue. Patients often report high disability levels and poor quality of life. Since there is no specific treatment that alters the pathogenesis of fibromyalgia, drug therapy focuses on pain reduction and improvement of other aversive symptoms. OBJECTIVES: To assess the benefits and harms of selective serotonin reuptake inhibitors (SSRIs in the treatment of fibromyalgia. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 5, MEDLINE (1966 to June 2014, EMBASE (1946 to June 2014, and the reference lists of reviewed articles. Selection criteria: We selected all randomized, double-blind trials of SSRIs used for the treatment of fibromyalgia symptoms in adult participants. We considered the following SSRIs in this review: citalopram, fluoxetine, escitalopram, fluvoxamine, paroxetine, and sertraline. Data collection and analysis: Three authors extracted the data of all included studies and assessed the risks of bias of the studies. We resolved discrepancies by discussion. MAIN RESULTS: The quality of evidence was very low for each outcome. We downgraded the quality of evidence to very low due to concerns about risk of bias and studies with few participants. We included seven placebo-controlled studies, two with citalopram, three with fluoxetine and two with paroxetine, with a median study duration of eight weeks (4 to 16 weeks and 383 participants, who were pooled together. All studies had one or more sources of potential major bias. There was a small (10% difference in patients who reported a 30% pain reduction between SSRIs (56/172 (32.6% and placebo (39/171 (22.8% risk difference (RD 0.10, 95% confidence interval (CI 0.01 to 0.20; number needed to treat for an

Selective serotonin reuptake inhibitors for fibromyalgia syndrome

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Walitt, Brian; Urrútia, Gerard; Nishishinya, María Betina; Cantrell, Sarah E; Häuser, Winfried

2016-01-01

Background Fibromyalgia is a clinically well-defined chronic condition with a biopsychosocial aetiology. Fibromyalgia is characterized by chronic widespread musculoskeletal pain, sleep problems, cognitive dysfunction, and fatigue. Patients often report high disability levels and poor quality of life. Since there is no specific treatment that alters the pathogenesis of fibromyalgia, drug therapy focuses on pain reduction and improvement of other aversive symptoms. Objectives The objective was to assess the benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in the treatment of fibromyalgia. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 5), MEDLINE (1966 to June 2014), EMBASE (1946 to June 2014), and the reference lists of reviewed articles. Selection criteria We selected all randomized, double-blind trials of SSRIs used for the treatment of fibromyalgia symptoms in adult participants. We considered the following SSRIs in this review: citalopram, fluoxetine, escitalopram, fluvoxamine, paroxetine, and sertraline. Data collection and analysis Three authors extracted the data of all included studies and assessed the risks of bias of the studies. We resolved discrepancies by discussion. Main results The quality of evidence was very low for each outcome. We downgraded the quality of evidence to very low due to concerns about risk of bias and studies with few participants. We included seven placebo-controlled studies, two with citalopram, three with fluoxetine and two with paroxetine, with a median study duration of eight weeks (4 to 16 weeks) and 383 participants, who were pooled together. All studies had one or more sources of potential major bias. There was a small (10%) difference in patients who reported a 30% pain reduction between SSRIs (56/172 (32.6%)) and placebo (39/171 (22.8%)) risk difference (RD) 0.10, 95% confidence interval (CI) 0.01 to 0.20; number needed to treat for an additional

Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.

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Wang, Chenchen; Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

2018-03-21

To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Prospective, randomized, 52 week, single blind comparative effectiveness trial. Urban tertiary care academic hospital in the United States between March 2012 and September 2016. 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient's global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient's global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group

Prevalence of fibromyalgia and quality of life in women with and without endometriosis.

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Nunes, Fabiana R; Ferreira, Jessica M; Bahamondes, Luis

2014-04-01

The objectives of the study were to assessed if there is any difference in the prevalence of fibromyalgia and in quality of life (QoL) between women with and without endometriosis. A cross-sectional study was conducted in 2011-2013, involving 257 women with surgically and histopathologically confirmed endometriosis and 253 women with no history of endometriosis and no endometriosis-related symptoms. Women were recruited both at the family planning and endometriosis clinic, Department of Obstetrics and Gynecology, University of Campinas, Brazil. The Short Form 36 questionnaire (SF-36) was used to assess QoL, while the 1990 and 2010 American College of Rheumatology (ACR) criteria were used to evaluate fibromyalgia. According to the 1990 ACR criteria, there were no cases of fibromyalgia in either group. Nevertheless, according to the 2010 ACR criteria, four women, two with endometriosis and two without the disease, were diagnosed with fibromyalgia. Scores were significantly lower in all the domains of the QoL questionnaire for the women with endometriosis compared to those without the disease. This study reports no difference in the prevalence of fibromyalgia between women with and without endometriosis; however QoL was poorer among women with endometriosis when compared to women without the disease.

Symptoms, the Nature of Fibromyalgia, and Diagnostic and Statistical Manual 5 (DSM-5) Defined Mental Illness in Patients with Rheumatoid Arthritis and Fibromyalgia

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Wolfe, Frederick; Walitt, Brian T.; Katz, Robert S.; Häuser, Winfried

2014-01-01

Purpose To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA) and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5) criteria for somatic symptom disorder. Methods We administered the Patient Health Questionnaire-15 (PHQ-15), a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD) scale. Results 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3%) compared with 84.3% and 93.7% (correctly classified = 91.7%) for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. Conclusions All patients with fibromyalgia will satisfy the DSM-5 “A” criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 “B” criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the “B” designation requires special knowledge that symptoms are “disproportionate” or “excessive,” something that is

Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5 defined mental illness in patients with rheumatoid arthritis and fibromyalgia.

Directory of Open Access Journals (Sweden)

Frederick Wolfe

Full Text Available PURPOSE: To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5 criteria for somatic symptom disorder. METHODS: We administered the Patient Health Questionnaire-15 (PHQ-15, a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD scale. RESULTS: 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3% compared with 84.3% and 93.7% (correctly classified = 91.7% for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. CONCLUSIONS: All patients with fibromyalgia will satisfy the DSM-5 "A" criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 "B" criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the "B" designation requires special knowledge that symptoms are "disproportionate" or "excessive," something that is

Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5) defined mental illness in patients with rheumatoid arthritis and fibromyalgia.

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Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-01-01

To describe and evaluate somatic symptoms in patients with rheumatoid arthritis (RA) and fibromyalgia, determine the relation between somatization syndromes and fibromyalgia, and evaluate symptom data in light of the Diagnostic and Statistical Manual-5 (DSM-5) criteria for somatic symptom disorder. We administered the Patient Health Questionnaire-15 (PHQ-15), a measure of somatic symptom severity to 6,233 persons with fibromyalgia, RA, and osteoarthritis. PHQ-15 scores of 5, 10, and 15 represent low, medium, and high somatic symptom severity cut-points. A likely somatization syndrome was diagnosed when PHQ-15 score was ≥10. The intensity of fibromyalgia diagnostic symptoms was measured by the polysymptomatic distress (PSD) scale. 26.4% of RA patients and 88.9% with fibromyalgia had PHQ-15 scores ≥10 compared with 9.3% in the general population. With each step-wise increase in PHQ-15 category, more abnormal mental and physical health status scores were observed. RA patients satisfying fibromyalgia criteria increased from 1.2% in the PHQ-15 low category to 88.9% in the high category. The sensitivity and specificity of PHQ-15≥10 for fibromyalgia diagnosis was 80.9% and 80.0% (correctly classified = 80.3%) compared with 84.3% and 93.7% (correctly classified = 91.7%) for the PSD scale. 51.4% of fibromyalgia patients and 14.8% with RA had fatigue, sleep or cognitive problems that were severe, continuous, and life-disturbing; and almost all fibromyalgia patients had severe impairments of function and quality of life. All patients with fibromyalgia will satisfy the DSM-5 "A" criterion for distressing somatic symptoms, and most would seem to satisfy DSM-5 "B" criterion because symptom impact is life-disturbing or associated with substantial impairment of function and quality of life. But the "B" designation requires special knowledge that symptoms are "disproportionate" or "excessive," something that is uncertain and controversial. The reliability and validity

Fibromyalgia Pathogenesis and Treatment Options Update.

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Chinn, Steven; Caldwell, William; Gritsenko, Karina

2016-04-01

This review article presents and summarizes up-to-date literature on the clinical manifestations, diagnosis, pathophysiological mechanisms, and treatment options for fibromyalgia patients. First, the most recent diagnostic criteria for fibromyalgia, as put forth by the American College of Rheumatology will be summarized. Clinical features, including chronic widespread pain, hyperalgesia, mood disorders, anxiety, and disturbed sleep patterns will be explored in-depth. The pathogenesis and pathophysiology of fibromyalgia involves alterations in multiple ascending and descending central nervous system pathways, as well as peripheral pathways, leading to heightened pain sensitivity. Risk factors have been studied extensively, and the most recent research focuses on various genetic influences and the contributions of stress and poor sleep. Lastly, the discussion in this article focuses on treatment options for fibromyalgia; some have been mainstay options for many years. Pharmacological agents include tricyclic antidepressants, anti-epileptic drugs, selective serotonin reuptake inhibitors, norepinephrine/serotonin reuptake inhibitors, as well as some investigational agents. The evidence behind non-pharmacologic treatments, including massage therapy, exercise, and acupuncture, are discussed.

Reactor incident status 1981 annual report

International Nuclear Information System (INIS)

Kiser, S.H.

1982-01-01

Reactor Incident followup action is summarized through periodic status reports. This annual report summarizes action taken or anticipated for Reactor Incidents through December 1981. Incidents for which action has been completed, have been deleted from the report. Quarterly addende will update the report by tabulating incidents for each three month period through the coming year. The report consists of a part for the P, K, and C Reactors. Each reactor part is divided into three sections: Further Technical Analysis or Followup Needed; Funding and/or Implementation Needed; and No Further Technical Analysis Anticipated

Gait disorders in patients with fibromyalgia.

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Auvinet, Bernard; Bileckot, Richard; Alix, Anne-Sophie; Chaleil, Denis; Barrey, Eric

2006-10-01

The objective of this study was to compare gait in patients with fibromyalgia and in matched controls. Measurements must be obtained in patients with fibromyalgia, as the evaluation scales for this disorder are semi-quantitative. We used a patented gait analysis system (Locometrix Centaure Metrix, France) developed by the French National Institute for Agricultural Research. Relaxed walking was evaluated in 14 women (mean age 50+/-5 years; mean height 162+/-5 cm; and mean body weight 68+/-13 kg) meeting American College of Rheumatology criteria for fibromyalgia and in 14 controls matched on sex, age, height, and body weight. Gait during stable walking was severely altered in the patients. Walking speed was significantly diminished (Pfibromyalgia.

Longitudinal observation of treatment patterns and outcomes for patients with fibromyalgia: 12-month findings from the reflections study.

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Robinson, Rebecca L; Kroenke, Kurt; Williams, David A; Mease, Philip; Chen, Yi; Faries, Douglas; Peng, Xiaomei; Hann, Danette; Wohlreich, Madelaine; McCarberg, Bill

2013-09-01

To describe 12-month treatment patterns and outcomes for patients starting a new medication for fibromyalgia in routine clinical practice. Data from 1,700 patients were collected at baseline and 1, 3, 6, and 12 months. Repeated measures and Poisson regression models controlling for demographic, clinical, and baseline outcomes were used to assess changes in health outcomes (Brief Pain Inventory severity and interference, Sheehan Disability Scale, Fibromyalgia Impact Questionnaire), satisfaction, and economic factors for patients who initiated on pregabalin (214, 12.6%), duloxetine (264, 15.5%), milnacipran (134, 7.9%), or tricyclic antidepressants (66, 3.9%). Sensitivity analyses were run using propensity-matched cohorts. Patients started on 145 unique drugs for fibromyalgia, and over 75% of patients took two or more medications concurrently for fibromyalgia at each time point assessed. Overall, patients showed improvement on the four health outcomes, with few differences across medication cohorts. At baseline, patients reported annual averages of 20.3 visits for outpatient care, 27.7 missed days of work, and 32.6 days of care by an unpaid caregiver. The duloxetine and milnacipran (vs pregabalin or tricyclic antidepressant) cohorts had fewer outpatient visits during the 12-month study. Patients reported satisfaction with overall treatment and their fibromyalgia medication (46.0% and 42.8%, respectively). In this real-world setting, patients with fibromyalgia reported modest improvements, high resource, and medication use, and were satisfied with the care they received. Cohort differences were difficult to discern because of the high rates of drug discontinuation and concomitant medication use over the 12-month study period. Wiley Periodicals, Inc.

Neural and psychosocial mechanisms of pain sensitivity in fibromyalgia.

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English, Brian

2014-06-01

Fibromyalgia is a chronic musculoskeletal pain disorder that affects an estimated 5 million adults in the U.S. The hallmark is burning, searing, tingling, shooting, stabbing, deep aching, or sharp pain. Fibromyalgia is generally considered to be a "central sensitivity syndrome" where central sensitization is regarded as the cause of pain in its own right. Nonetheless, the case continues to be made that all central and spatially distributed peripheral components of fibromyalgia pain would fade if the peripheral generators could be silenced. Although neural mechanisms are clearly important in pain sensitivity, cognitive and social mechanisms also need to be considered. The aim of this review is to examine four mechanisms responsible for heightened pain sensitivity in fibromyalgia: peripheral sensitization, central sensitization, cognitive-emotional sensitization, and interpersonal sensitization. The purpose of framing the review in terms of pain sensitivity in fibromyalgia is to highlight that different mechanisms of sensitization are appropriately regarded as intervening variables when it comes to understanding individual differences in the experience of pain. The paper concludes by considering the implications of the findings of the review for explanations of fibromyalgia pain by nurses working in multidisciplinary teams. The trend appears to be able to explain the cause of fibromyalgia pain in terms of sensitization per se. The recommended alternative is to explain fibromyalgia pain in terms of changes in pain sensitivity and the role of underlying neural and psychosocial mechanisms. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Fibromyalgia Is Correlated with Retinal Nerve Fiber Layer Thinning.

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Elena Garcia-Martin

Full Text Available To investigate whether fibromyalgia induces axonal damage in the optic nerve that can be detected using optical coherence tomography (OCT, as the retinal nerve fiber layer (RNFL is atrophied in patients with fibromyalgia compared with controls.Fibromyalgia patients (n = 116 and age-matched healthy controls (n = 144 were included in this observational and prospective cohort study. All subjects underwent visual acuity measurement and structural analysis of the RNFL using two OCT devices (Cirrus and Spectralis. Fibromyalgia patients were evaluated according to Giesecke's fibromyalgia subgroups, the Fibromyalgia Impact Questionnaire (FIQ, and the European Quality of Life-5 Dimensions (EQ5D scale. We compared the differences between fibromyalgia patients and controls, and analyzed the correlations between OCT measurements, disease duration, fibromyalgia subgroups, severity, and quality of life. The impact on quality of life in fibromyalgia subgroups and in patients with different disease severity was also analyzed.A significant decrease in the RNFL was detected in fibromyalgia patients compared with controls using the two OCT devices: Cirrus OCT ganglion cell layer analysis registered a significant decrease in the minimum thickness of the inner plexiform layer (74.99±16.63 vs 79.36±3.38 μm, respectively; p = 0.023, nasal inferior, temporal inferior and temporal superior sectors (p = 0.040; 0.011 and 0.046 respectively. The Glaucoma application of the Spectralis OCT revealed thinning in the nasal, temporal inferior and temporal superior sectors (p = 0.009, 0.006, and 0.002 respectively of fibromyalgia patients and the Axonal application in all sectors, except the nasal superior and temporal sectors. The odds ratio (OR to estimate the size effect of FM in RNFL thickness was 1.39. RNFL atrophy was detected in patients with FIQ scores <60 (patients in early disease stages compared with controls in the temporal inferior sector (78.74±17.75 vs 81.65±3

A systematic review of the efficacy of venlafaxine for the treatment of fibromyalgia.

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VanderWeide, L A; Smith, S M; Trinkley, K E

2015-02-01

Fibromyalgia is a painful disease affecting 1-2% of the United States population. Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and milnacipran, are well studied and frequently used for treating this disorder. However, efficacy data are limited for the SNRI venlafaxine despite its use in nearly a quarter of patients with fibromyalgia. Accordingly, we systematically reviewed the efficacy of venlafaxine for treatment of fibromyalgia. PubMed, Web of Science and the Cochrane Database were searched using the terms 'venlafaxine' and 'fibromyalgia'. Results were classified as primary studies or review articles based on abstract review. References of review articles were evaluated to ensure no primary studies evaluating venlafaxine were overlooked. All clinical studies that investigated venlafaxine for the treatment of fibromyalgia were included and graded on strength of evidence. Five studies met the inclusion criteria, including 4 open-label cohort studies and 1 randomized, controlled trial. Study durations ranged from 6 weeks to 6 months, and study sizes ranged from 11 to 102 participants. Four of the five published studies reported improvement in at least one outcome. Generally consistent improvements were observed in pain-related outcome measures, including the Fibromyalgia Impact Questionnaire (range, 26-29% reduction; n = 2 studies), Visual Analog Scale (range, 36-45% reduction; n = 2 studies), McGill Pain Questionnaire (48% reduction; n = 1 study) and Clinical Global Impression scale (51% had significant score change; n = 1 study). However, the few studies identified were limited by small sample size, inconsistent use of outcomes and methodological concerns. Studies assessing the efficacy of venlafaxine in the treatment of fibromyalgia to date have been limited by small sample size, inconsistent venlafaxine dosing, lack of placebo control and lack of blinding. In the context of these limitations, venlafaxine appears to be at least

Segregating the cerebral mechanisms of antidepressants and placebo in fibromyalgia.

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Jensen, Karin B; Petzke, Frank; Carville, Serena; Choy, Ernest; Fransson, Peter; Gracely, Richard H; Vitton, Olivier; Marcus, Hanke; Williams, Steven C R; Ingvar, Martin; Kosek, Eva

2014-12-01

Antidepressant drugs are commonly used to treat fibromyalgia, but there is little knowledge about their mechanisms of action. The aim of this study was to compare the cerebral and behavioral response to positive treatment effects of antidepressants or placebo. Ninety-two fibromyalgia patients participated in a 12-week, double-blind, placebo-controlled clinical trial with milnacipran, a serotonin-norepinephrine reuptake inhibitor. Before and after treatment, measures of cerebral pain processing were obtained using functional magnetic resonance imaging. Also, there were stimulus response assessments of pressure pain, measures of weekly pain, and fibromyalgia impact. Following treatment, milnacipran responders exhibited significantly higher activity in the posterior cingulum compared with placebo responders. The mere exposure to milnacipran did not explain our findings because milnacipran responders exhibited increased activity also in comparison to milnacipran nonresponders. Stimulus response assessments revealed specific antihyperalgesic effects in milnacipran responders, which was also correlated with reduced clinical pain and with increased activation of the posterior cingulum. A short history of pain predicted positive treatment response to milnacipran. We report segregated neural mechanisms for positive responses to treatment with milnacipran and placebo, reflected in the posterior cingulum. The increase of pain-evoked activation in the posterior cingulum may reflect a normalization of altered default mode network processing, an alteration implicated in fibromyalgia pathophysiology. This study presents neural and psychophysical correlates to positive treatment responses in patients with fibromyalgia, treated with either milnacipran or placebo. The comparison between placebo responders and milnacipran responders may shed light on the specific mechanisms involved in antidepressant treatment of chronic pain. Copyright © 2014 American Pain Society. Published by

Fibromyalgia: adapted, positive, and fit people : Breaking stereotypes!

OpenAIRE

Estévez-López, F.

2018-01-01

The rationale of the present thesis is provided in chapter I. Briefly, the aims of this thesis were (i) to better understand the characteristics of fibromyalgia, chapters II-V; (ii) to either confirm or identify resilience and vulnerability resources involved in adaptation to fibromyalgia, chapters VI-X; (iii) to identify clinically meaningful subgroups of people with fibromyalgia, chapter XI. To address these aims, and many others that are not part of this thesis, the al-Ándalus project was ...

Prevalence of fibromyalgia in France: a multi-step study research combining national screening and clinical confirmation: The DEFI study (Determination of Epidemiology of FIbromyalgia

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Ravaud Philippe

2011-10-01

Full Text Available Abstract Background Fibromyalgia is a common disease, but little is known on its real prevalence in France. This epidemiological study aimed to assess fibromyalgia (FM prevalence in the French metropolitan population, based on a multi-step sampling analysis, combining national screening and clinical confirmation by trained specialists. Methods a sampling method on the entire national territory was used: patients over 18 years of age accepting to take part in the study were contacted by telephone using the LFES Questionnaire, a screening test for FM. The, for patients detected by the LFESQ, a visit with a FM-trained rheumatologist was proposed to confirm FM, based on 1990 ACR criteria. Each detected patient completed the following self-questionnaires: SF36, HADS, stress VAS, Co-morbidities and Regional pain score. Results 3081 patients were contacted in 5 representative French regions, of which 232 patients were screened for FM. A fibromyalgia diagnosis was then confirmed by rheumatologist in 20 cases (17 female and 3 male, 56.9 ± 13.2 years. The final estimated FM prevalence was 1.6 (CI95: 1.2%; 2.0%. No significant difference was detected between the patients accepting (CS+ and refusing (CS- rheumatologist visit for the SF36 score, regional pain score, stress VAS scale and co-morbidities. In patients detected for FM by the LFESQ, we found a statistically significant decrease in quality of life and a statistically significant increase in stress level in patients with a confirmed diagnosis (FM+ (6.3 ± 1.9 compared to patients with an invalidated diagnosis (FM- (4.4 ± 2.8; p = 0.007. The study also demonstrated a significant association, independently of ACR criteria, between the diagnosis of FM and several factors such as regional pain score > 10, elevated stress level, low SF36 scale score and presence of gastro-intestinal disorder co-morbidities. Conclusion Fibromyalgia is a common condition; the 1.6% prevalence calculated in the French

Social comparison processes and catastrophising in fibromyalgia: A path analysis.

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Cabrera-Perona, V; Buunk, A P; Terol-Cantero, M C; Quiles-Marcos, Y; Martín-Aragón, M

2017-06-01

In addition to coping strategies, social comparison may play a role in illness adjustment. However, little is known about the role of contrast and identification in social comparison in adaptation to fibromyalgia. To evaluate through a path analysis in a sample of fibromyalgia patients, the association between identification and contrast in social comparison, catastrophising and specific health outcomes (fibromyalgia illness impact and psychological distress). 131 Spanish fibromyalgia outpatients (mean age: 50.15, SD = 11.1) filled out a questionnaire. We present a model that explained 33% of the variance in catastrophising by direct effects of more use of upward contrast and downward identification. In addition, 35% of fibromyalgia illness impact variance was explained by less upward identification, more upward contrast and more catastrophising and 42% of the variance in psychological distress by a direct effect of more use of upward contrast together with higher fibromyalgia illness impact. We suggest that intervention programmes with chronic pain and fibromyalgia patients should focus on enhancing the use of upward identification in social comparison, and on minimising the use of upward contrast and downward identification in social comparison.

Acupoint Stimulation for Fibromyalgia: A Systematic Review of Randomized Controlled Trials

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Huijuan Cao

2013-01-01

Full Text Available Background. Acupoint stimulation is popular for treatment of fibromyalgia though there is lack of comprehensive evaluation of current clinical evidence for its effect and safety. Objective. To systematically review the beneficial effects and safety of acupoint stimulation for fibromyalgia. Methods. We searched six electronic databases for randomized trials on acupoint stimulation for treatment of fibromyalgia. Two authors extracted data and assessed the trial quality independently. RevMan 5.2 software was used for data analyses with effect estimate presented as (standard mean difference and a 95% confidence interval. We defined minimum, medium, and large SMD effect sizes as 0.3, 0.5, and 0.75. Results. 16 RCTs with 1081 participants were involved in this review. Only two trials were evaluated as low risk of bias. Meta-analysis showed that acupuncture alone or combined with cupping therapy was superior to conventional medications on reducing pain scores and/or the number of tender points. However, acupuncture showed no better than sham acupuncture on pain reduction. There was no serious adverse event reported to be related to acupoint stimulation. Conclusions. Acupoint stimulation appears to be effective in treating fibromyalgia compared with medications. However, further large, rigorously designed trials are warranted due to insufficient methodological rigor in the included trials.

Self-reported whole-grain intake and plasma alkylresorcinol concentrations in combination in relation to the incidence of colorectal cancer.

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Knudsen, Markus Dines; Kyrø, Cecilie; Olsen, Anja; Dragsted, Lars O; Skeie, Guri; Lund, Eiliv; Aman, Per; Nilsson, Lena M; Bueno-de-Mesquita, H B; Tjønneland, Anne; Landberg, Rikard

2014-05-15

Self-reported food frequency questionnaires (FFQs) have occasionally been used to investigate the association between whole-grain intake and the incidence of colorectal cancer, but the results from those studies have been inconsistent. We investigated this association using intakes of whole grains and whole-grain products measured via FFQs and plasma alkylresorcinol concentrations, a biomarker of whole-grain wheat and rye intake, both separately and in combination (Howe's score with ranks). We conducted a nested case-control study in a cohort from a research project on Nordic health and whole-grain consumption (HELGA, 1992-1998). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression. Plasma alkylresorcinol concentrations alone and Howe's score with ranks were inversely associated with the incidence of distal colon cancer when the highest quartile was compared with the lowest (for alkylresorcinol concentrations, incidence rate ratio = 0.34, 95% confidence interval: 0.13, 0.92; for Howe's score with ranks, incidence rate ratio = 0.35, 95% confidence interval: 0.15, 0.86). No association was observed between whole-grain intake and any colorectal cancer (colon, proximal, distal or rectum cancer) when using an FFQ as the measure/exposure variable for whole-grain intake. The results suggest that assessing whole-grain intake using a combination of FFQs and biomarkers slightly increases the precision in estimating the risk of colon or rectal cancer by reducing the impact of misclassification, thereby increasing the statistical power of the study.

Agomelatine for the treatment of patients with fibromyalgia and depressive symptomatology: an uncontrolled, 12-week, pilot study.

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Calandre, E P; Slim, M; Garcia-Leiva, J M; Rodriguez-Lopez, C M; Torres, P; Rico-Villademoros, F

2014-03-01

Agomelatine, a melatonin agonist and selective 5-HT2C antagonist, is a novel antidepressant with sleep-enhancing properties. The purpose of this study was to assess the efficacy and tolerability of agomelatine among patients with fibromyalgia and depression. 23 patients with fibromyalgia and depressive symptomatology received 25-50 mg of agomelatine daily for 12 weeks. The primary outcome measure was the change of the Beck depression inventory score. Secondary outcome measures included the hospital anxiety and depression scale, Pittsburgh sleep quality index, Fibromyalgia Impact Questionnaire, short-form health survey, brief pain inventory and patient's global impression scale. Agomelatine significantly improved depression, global fibromyalgia severity and pain intensity but effect sizes were small. No improvement was seen in sleep quality. Patients categorized as responders to treatment had milder disease severity than non-responders. Agomelatine therapy was well tolerated and patients only reported mild and transient side effects. Agomelatine slightly improved depressive and fibromyalgia symptomatology but did not improve sleep quality. Our data do not support agomelatine as a first-line treatment option for the treatment of fibromyalgia and depression. © Georg Thieme Verlag KG Stuttgart · New York.

Juvenile Fibromyalgia: A Multidisciplinary Approach to Treatment.

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Tesher, Melissa S

2015-06-01

A 14-year-old boy presented with months of severe widespread musculoskeletal pain. He was profoundly fatigued and unable to attend school. Laboratory evaluation, including complete blood count, comprehensive metabolic panel, inflammatory markers, and thyroid function, was unrevealing. Physical examination was also normal except for multiple tender points. The patient was diagnosed with juvenile primary fibromyalgia syndrome and referred for multidisciplinary treatment including physical therapy, exercise, and counseling, and his daily functioning gradually improves. Juvenile fibromyalgia is a complex syndrome that often severely limits patients' activities and can impede normal adolescent development. Effective treatment requires an understanding of the biologic, psychologic, and social factors contributing to the perpetuation of chronic pain. The author reviews the diagnostic criteria, pathophysiology, and treatment of juvenile fibromyalgia. Medications, particularly antidepressants and anticonvulsants, can be useful adjuncts to therapy. However, multimodal pain management including intensive physical therapy, exercise, counseling, and sleep hygiene is most effective in treating fibromyalgia. Copyright 2015, SLACK Incorporated.

The Treatment of Juvenile Fibromyalgia with an Intensive Physical and Psychosocial Program.

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Sherry, David D; Brake, Lori; Tress, Jenna L; Sherker, Jennifer; Fash, Katherine; Ferry, Kelly; Weiss, Pamela F

2015-09-01

To assess the short-term and 1-year outcomes of children with fibromyalgia treated with intensive physical and occupational therapy (PT/OT) and psychotherapy. Children with fibromyalgia seen at a tertiary care hospital were treated with 5-6 hours of intensive PT/OT daily and at least 4 hours of psychosocial services weekly. All medications used for fibromyalgia were discontinued. Children underwent standardized testing, including a visual analog scale for pain; the Bruininks-Oseretsky Test of Motor Performance, Second Edition; the Bruce treadmill protocol; the Functional Disability Inventory; the Pain Stages of Change Questionnaire, adolescent version; and the Pediatric Quality of Life Inventory, Teen Report, at 3 time points: at program entry, at the end of the intensive program, and 1 year after the end of the program. Sixty-four children (median age, 16 years; 95% Caucasian; 94% female; median duration of symptoms, 21 months) were studied. The mean pain score decreased significantly from program entry to the end of the program (from 66 of 100 to 25 of 100; P = .001). At the 1-year follow-up, 33% reported no pain. All measures of function on the Bruininks-Oseretsky Test of Motor Performance, Second Edition improved significantly and remained at that level or continued to improve over the subsequent year. The mean Bruce treadmill protocol time first increased from 588 seconds to 801 seconds (P fibromyalgia can be successfully treated without medications with a very intensive PT/OT and psychotherapy program. They have significantly improved pain and function by subject report and objective measures of function. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey

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Butterworth Peter

2010-03-01

Full Text Available Abstract Background Traumatic or serious brain injury (BI has persistent and well documented adverse outcomes, yet 'mild' or 'moderate' BI, which often does not result in hospital treatment, accounts for half the total days of disability attributed to BI. There are currently few data available from community samples on the incidence and correlates of these injuries. Therefore, the study aimed to assess the 1 incidence of self-reported mild (not requiring hospital admission and moderate (admitted to hospital brain injury (BI, 2 causes of injury 3 physical health scores and 4 relationship between BI and problematic alcohol or marijuana use. Methods An Australian community sequential-cohort study (cohorts aged 20-24, 40-44 and 60-64 years at wave one used a survey methodology to assess BI and substance use at baseline and four years later. Results Of the 7485 wave one participants, 89.7% were re-interviewed at wave two. There were 56 mild (230.8/100000 person-years and 44 moderate BI (180.5/100000 person-years reported between waves one and two. Males and those in the 20-24 year cohort had increased risk of BI. Sports injury was the most frequent cause of BI (40/100 with traffic accidents being a greater proportion of moderate (27% than mild (7% BI. Neither alcohol nor marijuana problems at wave one were predictors of BI. BI was not a predictor of developing substance use problems by wave two. Conclusions BI were prevalent in this community sample, though the incidence declined with age. Factors associated with BI in community samples differ from those reported in clinical samples (e.g. typically traumatic brain injury with traffic accidents the predominate cause. Further, detailed evaluation of the health consequences of these injuries is warranted.

Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

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Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

Experiences of women living with fibromyalgia: an exploratory study of their information needs and preferences

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Lubna Daraz

2011-12-01

Full Text Available Women living with fibromyalgia consistently report experiencing a change in their lives in terms of stigma, inability to work, isolation from society and difficulty in managing their illness. Lack of understanding and knowledge about their disease has been linked to compromised health and quality of life. The aim of this study was to explore the experiences of information use of women living with fibromyalgia. A descriptive phenomenology was used for this study. Participants were identified through gatekeepers for women living with fibromyalgia across Canada. Data was collected via taperecorded interviews. The study was conducted in Canada between 2009-2010. Ten women (18 or older participated in the research. Three essential themes emerged from the analysis that were vital to understand the unique experiences of women: i understanding the need for information required to live with fibromyalgia, ii struggling to meet vital and fundamental information needs and iii transforming themselves to improve health and quality of life. Women living with fibromyalgia have vital and specific information needs and struggle to find and access appropriate information. They use diverse strategies in overcoming some of the challenges in accessing information. Most significantly, women draw on the information to make changes and to begin to coordinate their lives to live with fibromyalgia. For women living with fibromyalgia, the phenomenon of information use has a significant effect on their lives. Healthcare providers are perceived as an important source of information and need to be better informed, more prepared and dedicated to assisting women with their information needs.

Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis.

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Ahmad, Jowairiyya; Blumen, Helena; Tagoe, Clement E

2015-08-01

To investigate how autoimmune thyroiditis (ATD) affects the clinical presentation of established rheumatoid arthritis (RA) with particular reference to fibromyalgia and chronic widespread pain (CWP). A cohort of 204 patients with RA for whom the presence or absence of autoimmune thyroid antibodies was documented was examined for the relationships between thyroid autoantibodies and fibromyalgia or CWP. We identified 29 % who tested positive for antithyroid peroxidase antibodies (TPOAb). The anti-thyroglobulin antibody (TgAb) was found in 24 %. Among the thyroid autoantibody-positive patients, 40 % had a diagnosis of fibromyalgia or CWP versus 17 % for antibody negative patients. Logistic regression analyses (adjusted by age, sex, diabetes and BMI) indicated that TPOAb-positive patients were more likely to have fibromyalgia or CWP, with an odds ratio (OR) of 4.641, 95 % confidence interval (CI) (2.110-10.207) P fibromyalgia, OR 4.458, 95 % CI (1.950-10.191), P fibromyalgia was not significant (P > .05). Additional logistic regression analyses (adjusted by age, sex and BMI) indicated a significant relationship between TPOAb and fibromyalgia or CWP in patients without diabetes and those without hypothyroidism (OR of 4.873, 95 % CI (1.877-12.653), P = .001 and OR of 4.615 95 % CI (1.810-11.770), P = .001, respectively). There may be a positive association between the ATD antibody TPOAb, and fibromyalgia syndrome and CWP in patients with established RA.

The Power of Visualization: Back to the Future for Pain Management in Fibromyalgia Syndrome.

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Molinari, Guadalupe; García-Palacios, Azucena; Enrique, Ángel; Roca, Pablo; Fernández-Llanio Comella, Nagore; Botella, Cristina

2017-12-26

Previous studies have demonstrated the effects of positive psychological factors on pain adjustment. Specifically, optimism has been linked to better physical functioning and less psychological distress. Until recently, these beneficial effects have mostly been examined in correlational studies or laboratory settings. The aim of this study was to test the efficacy of the Best Possible Self intervention using information and communication technologies with fibromyalgia patients. Seventy-one patients were randomly allocated to the Best Possible Self intervention or a Daily Activities control condition. The Best Possible Self intervention used an interactive multimedia system with the support of an Internet platform to practice the guided imagery exercise online. Intent-to-treat analyses showed that, compared with the control condition, Best Possible Self patients showed significant improvements in depression, positive affect, and self-efficacy at postintervention. Moreover, at three-month follow-up, patients who received the intervention improved their optimism and negative affect significantly more than participants in the control condition. This study shows how a technology-supported intervention aimed at augmenting positive affect and promoting positive functioning works in the case of fibromyalgia, expanding the intervention's efficacy data in clinical populations and adding knowledge about the role that positive psychological factors play in pain experience. Moreover, it demonstrates the specific effects of the Best Possible Self intervention in order to incorporate this exercise in pain treatment protocols. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The relationship between childhood adversities and fibromyalgia in the general population.

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Varinen, Aleksi; Kosunen, Elise; Mattila, Kari; Koskela, Tuomas; Sumanen, Markku

2017-08-01

Fibromyalgia is a syndrome characterized by widespread pain and a variety of somatic symptoms. The international prevalence of fibromyalgia is 2-5%, but its current prevalence in Finland is unclear. Various adversities are linked to the onset of fibromyalgia. However, there is need for more data regarding the association between childhood physical abuse and fibromyalgia. Further, the association of childhood emotional stressors and fibromyalgia is disputed. The aim of the current study is to produce more information about that relationship using data from the Health and Social Support (HeSSup) Study. HeSSup is a postal study consisting of a random sample of the Finnish population. The study setting is cross-sectional. Participants in the study were asked if they have been diagnosed with fibromyalgia. Those responding affirmatively were classified as fibromyalgia patients. Six childhood adversities were enquired, and the relationship between fibromyalgia and these events were analysed by cross tabulation and logistic regression. There were associations between examined adversities and fibromyalgia before and after adjustments for demographic features and depression (being afraid of a family member: odds ratio after adjustment 1.60, 95% CI 1.28-2.01; long-lasting financial difficulties 1.45, 1.18-1.77; serious conflicts in the family 1.40, 1.14-1.72; parental divorce 1.34, 1.05-1.72; serious or chronic illnesses in the family 1.27, 1.05-1.55; alcohol problems in the family 1.25, 1.02-1.53). All six enquired adversities were associated with fibromyalgia after adjustments. These findings emphasize the importance of preventing adverse childhood experiences. Copyright © 2017. Published by Elsevier Inc.

Psychometric properties of the Fibromyalgia Assessment Status (FAS) index: a national web-based study of fibromyalgia.

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Iannuccelli, C; Sarzi-Puttini, P; Atzeni, F; Cazzola, M; di Franco, M; Guzzo, M P; Bazzichi, L; Cassisi, G A; Marsico, A; Stisi, S; Salaffi, F

2011-01-01

Fibromyalgia (FM) is a generalized chronic pain condition that is often accompanied by symptoms such as fatigue, sleep disturbances, psychological and cognitive alterations, headache, migraine, variable bowel habits, diffuse abdominal pain, and urinary frequency. Its key assessment domains include pain, fatigue, disturbed sleep, physical and emotional functioning, and patient global satisfaction and health-related quality of life (HRQL). A number of evaluation measures have been adapted from the fields of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, and others such as the Fibromyalgia Assessment Status (FAS) index and the Fibromyalgia Impact Questionnaire (FIQ) have been specifically developed. The aim of this study was to assess the impact of FM on HRQL by comparing the performance of the FAS index, the FIQ and the Health Assessment Questionnaire [HAQ] in 541 female and 31 male FM patients (mean age 50 years; mean disease duration 7.7 years) entered in the database of a web-based survey registry developed by the Italian Fibromyalgia Network (IFINET). Tests of convergent validity showed that the FAS index and FIQ significantly correlated with each other (rho=0.608, pFIQ in FM patients, and is simpler to administer and score. Both questionnaires may be useful when screening FM patients, with the choice of the most appropriate instrument depending on the setting.

[Gait characteristics of women with fibromyalgia: a premature aging pattern].

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Góes, Suelen M; Leite, Neiva; de Souza, Ricardo M; Homann, Diogo; Osiecki, Ana C V; Stefanello, Joice M F; Rodacki, André L F

2014-01-01

Fibromyalgia is a condition which involves chronic pain. Middle-aged individuals with fibromyalgia seem to exhibit changes in gait pattern, which may prematurely expose them to a gait pattern which resembles that found in the elderly population. To determine the 3D spatial (linear and angular) gait parameters of middle-aged women with fibromyalgia and compare to elderly women without this condition. 25 women (10 in the fibromyalgia group and 15 in the elderly group) volunteered to participate in the study. Kinematics was performed using an optoelectronic system, and linear and angular kinematic variables were determined. There was no difference in walking speed, stride length, cadence, hip, knee and ankle joints range of motion between groups, except the pelvic rotation, in which the fibromyalgia group showed greater rotation (P<0.05) compared to the elderly group. Also, there was a negative correlation with pelvic rotation and gluteus pain (r = -0.69; P<0.05), and between pelvic obliquity and greater trochanter pain (r = -0.69; P<0.05) in the fibromyalgia group. Middle-aged women with fibromyalgia showed gait pattern resemblances to elderly, women, which is characterized by reduced lower limb ROM, stride length and walking speed. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

Morning Versus Evening Bright Light Treatment at Home to Improve Function and Pain Sensitivity for Women with Fibromyalgia: A Pilot Study.

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Burgess, Helen J; Park, Margaret; Ong, Jason C; Shakoor, Najia; Williams, David A; Burns, John

2017-01-01

To test the feasibility, acceptability, and effects of a home-based morning versus evening bright light treatment on function and pain sensitivity in women with fibromyalgia. A single blind randomized study with two treatment arms: 6 days of a 1 hour morning light treatment or 6 days of a 1 hour evening light treatment. Function, pain sensitivity, and circadian timing were assessed before and after treatment. Participants slept at home, except for two nights in Sleep Center. Ten women meeting the American College of Rheumatology's diagnostic criteria for fibromyalgia, including normal blood test results. Self-reported function was assessed with the Fibromyalgia Impact Questionnaire (FIQ). Pain sensitivity was assessed using a heat stimulus that gave measures of threshold and tolerance. Circadian timing was assessed with the dim light melatonin onset. Both morning and evening light treatments led to improvements in function and pain sensitivity. However, only the morning light treatment led to a clinically meaningful improvement in function (>14% reduction from baseline FIQ) and morning light significantly increased pain threshold more than evening light ( P  treatment appears to be a feasible and acceptable adjunctive treatment to women with fibromyalgia. Those who undergo morning light treatment may show improvements in function and pain sensitivity. Advances in circadian timing may be one mechanism by which morning light improves pain sensitivity. Findings can inform the design of a randomized controlled trial. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia?

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Kaleth, Anthony S; Slaven, James E; Ang, Dennis C

2014-12-01

To examine the concurrent and predictive associations between the number of steps taken per day and clinical outcomes in patients with fibromyalgia (FM). A total of 199 adults with FM (mean age 46.1 years, 95% women) who were enrolled in a randomized clinical trial wore a hip-mounted accelerometer for 1 week and completed self-report measures of physical function (Fibromyalgia Impact Questionnaire-Physical Impairment [FIQ-PI], Short Form 36 [SF-36] health survey physical component score [PCS], pain intensity and interference (Brief Pain Inventory [BPI]), and depressive symptoms (Patient Health Questionnaire-8 [PHQ-8]) as part of their baseline and followup assessments. Associations of steps per day with self-report clinical measures were evaluated from baseline to week 12 using multivariate regression models adjusted for demographic and baseline covariates. Study participants were primarily sedentary, averaging 4,019 ± 1,530 steps per day. Our findings demonstrate a linear relationship between the change in steps per day and improvement in health outcomes for FM. Incremental increases on the order of 1,000 steps per day were significantly associated with (and predictive of) improvements in FIQ-PI, SF-36 PCS, BPI pain interference, and PHQ-8 (all P physical activity. An exercise prescription that includes recommendations to gradually accumulate at least 5,000 additional steps per day may result in clinically significant improvements in outcomes relevant to patients with FM. Future studies are needed to elucidate the dose-response relationship between steps per day and patient outcomes in FM. Copyright © 2014 by the American College of Rheumatology.

Positive associations between physical and cognitive performance measures in fibromyalgia.

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Cherry, Barbara J; Zettel-Watson, Laura; Chang, Jennifer C; Shimizu, Renee; Rutledge, Dana N; Jones, C Jessie

2012-01-01

To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). Correlational study. Exercise testing laboratory in Southern California. Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). Not applicable. Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effect of duloxetine in patients with fibromyalgia: tiredness subgroups

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Bradley, Laurence A; Bennett, Robert; Russell, Irwin J; Wohlreich, Madelaine M; Chappell, Amy S; Wang, Fujun; D'Souza, Deborah N; Moldofsky, Harvey

2010-01-01

Introduction This study tested the hypothesis that baseline ratings of fatigue/tiredness would be negatively associated with the efficacy of duloxetine on measures of pain and functional ability in patients with fibromyalgia. Methods A post hoc analysis of pooled data from 4 double-blind, placebo-controlled studies of duloxetine in fibromyalgia was performed. The fibromyalgia impact questionnaire (FIQ) tiredness item score (0 to 10 scale) was used to define tiredness subgroups. Patients were ...

Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

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Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

2010-01-01

Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

Information preferences of people living with fibromyalgia – a survey of their information needs and preferences

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Lubna Daraz

2011-09-01

Full Text Available A lack of understanding about fibromyalgia and how to live with it may undermine the foundations of self-management and may compromise quality of life. The purpose of this study was to determine the information needs and preferences pertinent to people living with fibromyalgia. A cross-sectional web-based survey was developed based on conceptual and qualitative work informing information needs. Recruitment took place through hospitals, clinics, physicians and fibromyalgia support groups across Canada. Descriptive statistics using SPSS and graphical representations were employed to summarize and represent data. A total of 442 respondents (93% female, mode age 51-65 participated in the survey. No statistical differences in information needs were found between males and females or education level. Respondents (74% frequently searched for information about fibromyalgia using a variety of resources including Internet (91%, doctors (75%, support groups (76%, and people with same condition (87%. Respondents expressed a strong need for information about symptoms (81%, implications (79%, treatments (87%, resources (85% and coping (79%. However, concerns were expressed about the reliability of information and majority (93% wanted information to be available online that is provided by healthcare providers or from reputable sources. Internet (48%, people with similar condition (35% and support groups (35% were perceived as useful resources for people living with fibromyalgia. Information resources need to be developed on the basis of both content and knowledge of the information needs of the target end-user. Healthcare providers and the Internet are expected to be reliable resources of information.

Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ in Patients with Fibromyalgia Syndrome

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Albert Feliu-Soler

2017-12-01

Full Text Available Given that Fibromyalgia Syndrome (FMS is associated with problems in emotion regulation, the importance of assessing this construct is widely acknowledged by clinical psychologists and pain specialists. Although the Cognitive Emotion Regulation Questionnaire (CERQ is a self-report measure used worldwide, there are no data on its psychometric properties in patients with FMS. This study analyzed the dimensionality, reliability, and validity of the CERQ in a sample of 231 patients with FMS. Given that “fibrofog” is one of the most disabling FMS symptoms, in the present study, items in the CERQ were grouped by dimension. This change in item presentation was conceived as an efficient way of facilitating responses as a result of a clear understanding of what the items related to each dimension are attempting to measure. The following battery of measures was administered: the CERQ, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Center for Epidemiologic Studies Depression Scale, and the State-Trait Anxiety Inventory. Four models of the CERQ structure were examined and confirmatory factor analyses supported the original factor model, consisting of nine factors—Self-blame, Acceptance, Rumination, Positive refocusing, Refocus on planning, Positive reappraisal, Putting into perspective, Catastrophizing, and Other-blame. There was minimal overlap between CERQ subscales and their internal consistency was adequate. Correlational and regression analyses supported the construct validity of the CERQ. Our findings indicate that the CERQ (items-grouped version is a sound instrument for assessing cognitive emotion regulation in patients with FMS.

Influence of moderate training on gait and work capacity of fibromyalgia patients: a preliminary field study.

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Tiidus, Peter M; Pierrynowski, Michael; Dawson, Kimberley A

2002-12-01

This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS). FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0 ± 7.6 y) who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients.

Daytime napping associated with increased symptom severity in fibromyalgia syndrome.

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Theadom, Alice; Cropley, Mark; Kantermann, Thomas

2015-02-07

Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The purpose of this study was to explore how people use daytime naps and to determine the links between daytime napping and symptom severity in fibromyalgia syndrome. A community based sample of 1044 adults who had been diagnosed with fibromyalgia syndrome by a clinician completed an online questionnaire. Associations between napping behavior, sleep quality and fibromyalgia symptoms were explored using Spearman correlations, with possible predictors of napping behaviour entered into a logistic regression model. Differences between participants who napped on a daily basis and those who napped less regularly, as well as nap duration were explored. Daytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems. Sleep problems and fatigue explained the greatest amount of variance in napping behaviour, p naps for >30 minutes had higher memory difficulties (t = -3.45) and levels of depression (t = -2.50) than those who napped for shorter periods (napping was linked with greater symptom severity in people with fibromyalgia. Given the common use of daytime napping in people with fibromyalgia evidence based guidelines on the use of daytime napping in people with chronic pain are urgently needed.

Trazodone for the treatment of fibromyalgia: an open-label, 12-week study

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Morillas-Arques Piedad

2010-09-01

Full Text Available Abstract Background Despite its frequent use as a hypnotic, trazodone has not been systematically assessed in fibromyalgia patients. In the present study have we evaluated the potential effectiveness and tolerability of trazodone in the treatment of fibromyalgia. Methods A flexible dose of trazodone (50-300 mg/day, was administered to 66 fibromyalgia patients for 12 weeks. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI. Secondary outcome measures included the Fibromyalgia Impact Questionnaire (FIQ, the Beck Depression Inventory (BDI, the Hospital Anxiety and Depression Scale (HADS, the Brief Pain Inventory (BPI, the Short-Form Health Survey (SF-36, and the Patients' Global Improvement Scale (PGI. Trazodone's emergent adverse reactions were recorded. Data were analyzed with repeated measures one-way ANOVA and paired Student's t test. Results Trazodone markedly improved sleep quality, with large effect sizes in total PSQI score as well on sleep quality, sleep duration and sleep efficiency. Significant improvement, although with moderate effect sizes, were also observed in total FIQ scores, anxiety and depression scores (both HADS and BDI, and pain interference with daily activities. Unexpectedly, the most frequent and severe side effect associated with trazodone in our sample was tachycardia, which was reported by 14 (21.2% patients. Conclusions In doses higher than those usually prescribed as hypnotic, the utility of trazodone in fibromyalgia management surpasses its hypnotic activity. However, the emergence of tachycardia should be closely monitored. Trial registration This trial has been registered with ClinicalTrials.gov number NCT-00791739.

GANODERMA LUCIDUM IMPROVES PHYSICAL FITNESS IN WOMEN WITH FIBROMYALGIA.

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Collado Mateo, Daniel; Pazzi, Francesco; Domínguez Muñoz, Francisco J; Martín Martínez, Juan Pedro; Olivares, Pedro R; Gusi, Narcis; Adsuar, José C

2015-11-01

fibromyalgia is a chronic disease characterized by generalized pain, stiffness, poor physical conditioning, non-restorative sleep and poor health-related quality of life. Ganoderma lucidum a type of mushroom that has demonstrated several benefits in different populations. Ceratonia siliqua is a natural therapy rich in antioxidants with potential benefits on health. to evaluate the effects of 6-week treatment of Ganoderma lucidum and Ceratonia siliqua on physical fitness in patients suffering from fibromyalgia. sixty-four women with fibromyalgia participated in the study. They took 6 g of Ganoderma lucidum or Ceratonia siliqua per day for 6 weeks. Different fitness tests were selected in order to evaluate functional capacity. after the 6-week treatment period, Ganoderma lucidum significantly improved aerobic endurance, lower body flexibility, and velocity (p Ganoderma lucidum may improve physical fitness in women with fibromyalgia, whereas, Ceratonia siliqua seemed to be ineffective at increasing physical fitness. These results may indicate that Ganoderma lucidum might be a useful dietary supplement to enhance physical performance of the patients suffering from fibromyalgia. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Hazmat Yearly Incident Summary Reports

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Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

Fibromyalgia: adapted, positive, and fit people : Breaking stereotypes!

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Estévez-López, F.

2018-01-01

The rationale of the present thesis is provided in chapter I. Briefly, the aims of this thesis were (i) to better understand the characteristics of fibromyalgia, chapters II-V; (ii) to either confirm or identify resilience and vulnerability resources involved in adaptation to fibromyalgia, chapters

Disability evaluation of fibromyalgia.

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Wolfe, C V

2001-08-01

These cases represent individuals who feel they have a severe impairment and are "disabled." They have been labeled with fibromyalgia. They are truly distressed. Their symptoms, their courses, are more chronic and refractory than those of medically ill patients, and they are high users of medical services, laboratory investigations, and surgical procedures. These patients see multiple providers simultaneously and frequently switch physicians. They are difficult to care for, and they reject psychosocial factors as an influence on their symptoms. Such persons "see themselves as victims worthy of a star appearance on the Oprah Winfrey show. A sense of bitterness emerges...." Shorter, a historian, believes that fibromyalgia is "heaven-sent to doctors as a diagnostic label for pain patients who display an important neurotic component in their illness. Our culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness...." Regarding the finding of "disability," this is a social construct, and many authors believe it is society and the judicial system who must decide who can work. To remain objective, the physician should report the objective clinical information. Physicians need not and should not sit in judgment of the veracity of another human being.

Does body composition differ between fibromyalgia patients and controls? the al-Ándalus project.

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Segura-Jimenez, Victor; Aparicio, Virginia A; Alvarez-Gallardo, Inmaculata C; Carbonell-Baeza, Ana; Tornero-Quinones, Inmaculada; Delgado-Fernandez, Manuel

2015-01-01

To characterise the anthropometric and body composition profile of a sample of fibromyalgia women and men from southern Spain and compare them with non-fibromyalgia controls. The cross-sectional study comprised 566 (51.9 ± 8.3 years) fibromyalgia women vs. 249 (49.3 ± 9.9 years) control women; and 24 (47.0 ± 8.4 years) fibromyalgia men vs. 56 (49.7 ± 11.5 years) control men. Body composition and cardiorespiratory fitness were assessed by means of a bioelectric impedanciometer and the 6-minute walk test, respectively. All body composition para-meters (except muscle mass) differed between fibromyalgia and control women (all, pbody composition was no longer different between the women study groups. No differences in body composition were observed between fibromyalgia and control men (all, p>0.05). Weight status differed between women groups, with 11% lower normal-weight and 17% higher obesity prevalence for the fibromyalgia women group (pfibromyalgia women and 79% of the fibromyalgia men were overweight-obese. Sixty-one percent of the control women and 83% of the control men were overweight-obese. Obesity is a greater common condition among fibromyalgia women compared to their counterparts from southern Spain, which might be explained by lower levels of cardiorespiratory fitness in fibromyalgia. However, fibromyalgia and control men do not differ on either body composition or weight status, in spite of the lower cardiorespiratory fitness found in the fibromyalgia men group.

The influence of diet on the evolution of symptoms presented in fibromyalgia patients

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José Eduardo Martinez

2015-06-01

Full Text Available This research seeks to relate fibromyalgia and nutritional factors. Objective: to determine the influence of the food habits on the intensity of the symptoms of fibromyalgia patients. Methods: we interviewed 40 female patients, aged 15 to 59, in the clinic of the Hospital pain set of Sorocaba (CHS through about the fibromyalgia clinical picture and their eating habits. Results: the mean duration of symptoms of fibromyalgia among the interviewed patients was 6.75 years. The average impact of fibromyalgia on the quality of life was about 64 measured by the Fibromyalgia Impact Questionnaire. The only food that was related to symptom improvement by the patients was the banana (17.5%. The majority of respondents did not noticed relationship between such foods and modification of disease symptoms. Conclusion: there was not observed association between food intenak and fibromyalgia symptom severity.

Fibromyalgia as a cause of uncontrolled asthma: a case-control multicenter study.

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Martinez-Moragon, Eva; Plaza, Vicente; Torres, Isabel; Rosado, Ana; Urrutia, Isabel; Casas, Xavier; Hinojosa, Belen; Blanco-Aparicio, Marina; Delgado, Julio; Quirce, Santiago; Sabadell, Carles; Cebollero, Pilar; Muñoz-Fernández, Ana

2017-12-01

Fibromyalgia can affect the control of asthma when both diseases are present in a single patient. To characterize asthma in patients with concomitant fibromyalgia to assess whether fibromyalgia is an independent factor of asthma severity that influences poor asthma control. We also evaluated how dyspnea is perceived by patients in order to demonstrate that alterations in the perception of airway obstruction may be responsible for poor asthma control. This was a cross-sectional case-control multicenter study, in which 56 patients in the asthma and fibromyalgia group were matched to 36 asthmatics by sex, approximate age, and asthma severity level. All patients were women. Study variables included the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), the Nijmegen hyperventilation syndrome questionnaire, the Hospital Anxiety and Depression Scale, and perception of dyspnea after acute bronchoconstriction. Although patients in both study groups showed similar asthma severity and use of anti-asthmatic drugs, patients in the asthma and fibromyalgia group showed lower scores on the ACT and MiniAQLQ questionnaires, and higher scores of anxiety and depression as well as hyperventilation compared to asthma patients without fibromyalgia. All these differences were statistically significant. Fibromyalgia in patients with asthma influences poor control of the respiratory disease and is associated with altered perception of dyspnea, hyperventilation syndrome, high prevalence of depression and anxiety, and impaired quality of life. Fibromyalgia may be considered a risk factor for uncontrolled asthma in patients suffering from asthma and fibromyalgia concomitantly.

Affective-Cognitive Behavioral Therapy for Fibromyalgia: A Randomized Controlled Trial

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Robert L. Woolfolk

2012-01-01

Full Text Available A randomized controlled trial was conducted to assess the efficacy of an individually administered form of cognitive behavioral treatment for fibromyalgia. In an additive design, 76 patients diagnosed with fibromyalgia were randomly assigned to either the experimental treatment (affective-cognitive behavioral therapy, 10 individual sessions, one per week administered concurrently with treatment-as-usual or to an unaugmented treatment-as-usual condition. Statistical analysis conducted at the end of treatment (3 months after the baseline assessment and at a followup (9 months after the baseline assessment indicated that the patients receiving the experimental treatment reported less pain and overall better functioning than control patients, both at posttreatment and at followup. The implications of these findings for future research are discussed.

Does exercise improve symptoms in fibromyalgia?

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Rain, Carmen; Seguel, Willy; Vergara, Luis

2015-12-14

It has been proposed that fibromyalgia could be managed by pharmacological and non-pharmacological interventions. Regular physical exercise is commonly used as a non-pharmacological intervention. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 14 systematic reviews including 25 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We conclude that regular physical exercise probably reduces pain in patients with fibromyalgia.

Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia

International Nuclear Information System (INIS)

Zammurrad, S.; Munir, W.; Farooqi, A.

2013-01-01

Objective: To correlate disease activity score (DAS-28) in the patients with rheumatoid arthritis (RA) with and without secondary fibromyalgia. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, from November 2011 to April 2012. Methodology: Patients aged above 16 years diagnosed to have rheumatoid arthritis according to ACR/EULAR criteria 2010 were included in the study. Fibromyalgia (FM) was diagnosed by ACR 1990 criteria. Patients of other autoimmune diseases or psychiatric illnesses were excluded. DAS was determined and compared using t-test with significance at p < 0.05. Results: The mean age of study subjects was 42.9 years. Thirty one out of total 138 patients had fibromyalgia (22.4%). Female gender was predominant (92.0%); being 96.8% in patients with and in 88.2% without fibromyalgia. The average DAS score was high (5.3 + 1.5) in fibromyalgia patients compared to those without fibromyalgia (3.9 + 1.2); this difference in mean value was statistically significant (p = < 0.001). Conclusion: DAS-28 is a useful tool for assessing rheumatoid arthritis disease status in outpatient setting, however, increased disease activity must be assessed for possible co-existence of fibromyalgia which can spuriously give high DAS value and adversely affect treatment decision. (author)

Physicians' and Nurses' Perceptions of and Attitudes Toward Incident Reporting in Palestinian Hospitals.

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Rashed, Anan; Hamdan, Motasem

2015-06-22

Underreporting of incidents that happen in health care services undermines the ability of the systems to improve patient safety. This study assessed the attitudes of physicians and nurses toward incident reporting and the factors influencing reporting in Palestinian hospitals. It also examined clinicians' views about the preferred features of incident reporting system. Cross-sectional self-administered survey of 475 participants, 152 physicians and 323 nurses, from 11 public hospitals in the West Bank; response rate, 81.3%. There was a low level of event reporting among participants in the past year (40.3%). Adjusted for sex and age, physicians were 2.1 times more likely to report incidents than nurses (95% confidence interval, 1.32-3.417; P = 0.002). Perceived main barriers for reporting were grouped under lack of proper structure for reporting, prevalence of blame, and punitive environment. The clinicians indicated fear of administrative sanctions, social and legal liability, and of their competence being questioned (P > 0.05). Getting help for patients, learning from mistakes, and ethical obligation were equally indicated motivators for reporting (P > 0.05). Meanwhile, clinicians prefer formal reporting (77.8%) of all type of errors (65.5%), disclosure of reporters (52.7%), using reports to improve patient safety (80.3%), and willingness to report to immediate supervisors (57.6%). Clinicians acknowledge the importance of reporting incidents; however, prevalence of punitive culture and inadequate reporting systems are key barriers. Improving feedback about reported errors, simplifying procedures, providing clear guidelines on what and who should report, and avoiding blame are essential to enhance reporting. Moreover, health care organizations should consider the opinions of the clinicians in developing reporting systems.

[Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study].

Science.gov (United States)

Reuter, E; Tafelski, S; Thieme, K; West, C; Haase, U; Beck, L; Schäfer, M; Spies, C

2017-04-01

The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. The aim of the study was to investigate whether low dose GHB as a growth-hormone releasing substance reduces pain intensity and improves depressive mood, physical impairment and sleep quality in outpatients with fibromyalgia. Additionally, adverse events were recorded. The pilot study was conducted in the outpatient clinic for pain at the clinic for anesthesiology and surgical intensive care of the Charité Universitätsmedizin Berlin. In the study 25 female patients with fibromyalgia according to the criteria of the American College of Rheumatology were randomized into 2 groups. Over 15 weeks patients of the intervention group received 25 mg/kg body weight oral GHB before going to bed and were compared with a placebo control group. In addition, all patients participated in operant behavioral pain treatment in a group setting. Dependent variables were pain intensity, depressive mood, physical impairment and quality of sleep. There were no group differences in the course of pain intensity (p = 0.61), depressive mood (p = 0.16), physical impairment (p = 0.25) and quality of sleep (p = 0.44); however, all symptoms improved across the groups from pretherapy to posttherapy. Low dose GHB did not increase growth hormone blood concentrations. The number of adverse events that were reported more than two times was similar in both groups. Administration of low dose GHB did not yield clinical improvements in female outpatients with fibromyalgia. General improvement in the course of treatment may have resulted from operant behavioral pain therapy. Future studies on GHB should control hypothetical risk factors for identification of non-responders.

The effect of laparoscopic Roux-en-Y gastric bypass on fibromyalgia.

Science.gov (United States)

Saber, Alan A; Boros, Michael J; Mancl, Tara; Elgamal, Mohamed H; Song, Susrap; Wisadrattanapong, Therawat

2008-06-01

Fibromyalgia is a chronic debilitating disorder affecting 3-5% of the US population. Treatment of this disorder is a challenge. The incidental finding of improvement of fibromyalgia following laparoscopic Roux-en-Y gastric bypass stimulated us to study this phenomenon. A retrospective chart review of patients with fibromyalgia who underwent laparoscopic Roux-en-Y gastric bypass. Postoperative decrease in median of BMI from 49.4 to 29.7 was significant (p value = 0.0010). This was associated with statistically significant improvement in median of pain score (p value = 0.0010) and median points of tenderness (p value = 0.0010). Significant weight loss following laparoscopic Roux-en-Y gastric bypass is associated with resolution or improvement of fibromyalgia. Consequently, the bariatric surgeon should be a member of the multidisciplinary team approach for treating fibromyalgia.

Psychological Resilience, Affective Mechanisms, and Symptom Burden in a Tertiary Care Sample of Patients with Fibromyalgia

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McAllister, Samantha J; Vincent, Ann; Hassett, Afton L; Whipple, Mary O; Oh, Terry H; Benzo, Roberto P; Toussaint, Loren L

2014-01-01

Research demonstrates that patients with fibromyalgia who have higher positive and lower negative affect have lower symptom burden. Affect has been shown to be associated with resilience. This study examined the relationship between affect, resilience, and fibromyalgia symptom burden in a clinical sample of patients with fibromyalgia. We hypothesized that (a) positive and negative affect would be associated with fibromyalgia symptom burden; (b) resilience would be associated with positive and negative affect; (c) resilience would be associated with fibromyalgia symptom burden; and (d) the connection between resilience and fibromyalgia symptom burden would be mediated by both positive and negative affect. A sample of 858 patients with fibromyalgia completed questionnaires. Mediation modeling revealed statistically significant direct effects of resilience on fibromyalgia symptom burden (β =−.10, P fibromyalgia symptom burden through affect (β =−.36, P fibromyalgia symptom burden. Our results suggest that improving affect through resiliency training could be studied as a modality for improving fibromyalgia symptom burden. PMID:24376184

Interdisciplinary consensus document for the treatment of fibromyalgia.

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de Miquel, C Alegre; Campayo, J García; Flórez, M Tomás; Arguelles, J M Gómez; Tarrio, E Blanco; Montoya, M Gobbo; Martin, Á Pérez; Salio, A Martínez; Fuentes, J Vidal; Alberch, E Altarriba; de la Cámara, A Gómez

2010-01-01

Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.Objective. To develop a consensus on the treatment of fibromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry,rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes,having specific symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.Methods. The different clinical classifications proposed in fibromyalgia and the scientific evidence of the treatments used in this disease were reviewed. For the selection of the classification used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.Conclusion. The classification of Giesecke of fibromyalgia into 3 subgroups seems to have the greatest scientific evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fibromyalgia. However, in addition, for each subgroup, there are a series of specific pharmacological and psychological-type recommendations and those of modification of the environment, which will make it possible to have a personalized approach to the patient with fibromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).

Obesity Moderates the Effects of Motivational Interviewing Treatment Outcomes in Fibromyalgia.

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Kaleth, Anthony S; Slaven, James E; Ang, Dennis C

2018-01-01

Obesity is a common comorbid condition among patients with fibromyalgia (FM). Our objective was to assess if obesity moderates the treatment benefits of exercise-based motivational interviewing (MI) for FM. This is a secondary data analysis of a completed clinical trial of 198 FM patients who were randomized to receive either MI or attention control (AC). Using body mass index (BMI) to divide participants into obese (BMI≥30 kg/m) and nonobese (BMIFibromyalgia Impact Questionnaire, FIQ). Secondary measures included pain intensity (Brief Pain Inventory), 6-Minute Walk Test, and self-reported physical activity (Community Health Activities Model Program for Seniors). Of the 198 participants, 91 (46%) were nonobese and 107 (54%) were obese. On global FM symptom severity (FIQ), the interaction between treatment arms and obesity status was significant (P=0.02). In the nonobese group, MI was associated with a greater improvement in FIQ than AC. In the obese group, MI participants reported less improvement in FIQ compared with AC. The interaction analysis was also significant for Brief Pain Inventory pain intensity (P=0.01), but not for the walk test and self-reported physical activity. This is the first study to show that obesity negatively affects the treatment efficacy of MI in patients with FM. Our findings suggest that exercise-based MI may be more effective if initiated after weight loss is achieved.

BET 2: Acupuncture and fibromyalgia.

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Goldie, Laura; Hogg, Kerstin

2016-10-01

A shortcut review was carried out to see if acupuncture is an effective pain treatment in fibromyalgia. One Cochrane review and five subsequent papers and conference abstracts were identified. There are no large studies addressing this question and acupuncture has been compared with many different treatment modalities. Acupuncture may be a valid treatment for pain in fibromyalgia, but more research is required to validate this. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Water sanitation, access, use and self-reported diarrheal disease in rural Honduras.

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Halder, Gabriela E; Bearman, Gonzalo; Sanogo, Kakotan; Stevens, Michael P

2013-01-01

Only 79% of individuals living in rural Honduras use improved water sources. Inadequate drinking water quality is related to diarrheal illness, which in Honduras contributes to 18.6 episodes of diarrhea per child year in children under five years of age. The purpose of this study was to examine and compare access to drinking water and sanitation, as well as self-reported diarrheal disease incidence among three proximal communities in the Department of Yoro area of Honduras. An 11-item language-specific, interviewer-administered, anonymous questionnaire was administered to 263 randomly selected adults attending a June 2011 medical brigade held in the communities of Coyoles, La Hicaca, and Lomitas. Chi-square with Fisher exact tests were utilized to compare water access, sanitation, and self-reported diarrheal incidence among these communities. Coyoles and La Hicaca used private faucets as their primary water sources. Coyoles had the greatest use of bottled water. Lomitas used rivers as their primary water source, and did not use bottled water. Mostly, females were responsible for acquiring water. Usage of multiple water sanitation methods was most common in Coyoles, while no sanitation method was most common in Lomitas. In Lomitas and La Hicaca, water filters were mostly provided via donation by non-governmental organizations. Lomitas had the highest reported incidence of diarrhea among self and other household members. Critical differences in water access, sanitation, and self-reported diarrheal incidence among three geographically distinct, yet proximal, communities highlights the need for targeted interventions even in geographically proximal rural areas.

Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults.

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Derry, Sheena; Wiffen, Philip J; Häuser, Winfried; Mücke, Martin; Tölle, Thomas Rudolf; Bell, Rae F; Moore, R Andrew

2017-03-27

daily, ibuprofen 2400 mg daily, naproxen 1000 mg daily, and tenoxicam 20 mg daily; 146 participants received NSAID and 146 placebo. The duration of treatment in the double-blind phase varied between three and eight weeks.Not all studies reported all the outcomes of interest. Analyses consistently showed no significant difference between NSAID and placebo: substantial benefit (at least 50% pain intensity reduction) (risk difference (RD) -0.07 (95% confidence interval (CI) -0.18 to 0.04) 2 studies, 146 participants; moderate benefit (at least 30% pain intensity reduction) (RD -0.04 (95% CI -0.16 to 0.08) 3 studies, 192 participants; withdrawals due to adverse events (RD 0.04 (95% CI -0.02 to 0.09) 4 studies, 230 participants; participants experiencing any adverse event (RD 0.08 (95% CI -0.03 to 0.19) 4 studies, 230 participants; all-cause withdrawals (RD 0.03 (95% CI -0.07 to 0.14) 3 studies, 192 participants. There were no serious adverse events or deaths. Although most studies had some measures of health-related quality of life, fibromyalgia impact, or other outcomes, none reported the outcomes beyond saying that there was no or little difference between the treatment groups.We downgraded evidence on all outcomes to very low quality, meaning that this research does not provide a reliable indication of the likely effect. The likelihood that the effect could be substantially different is very high. This is based on the small numbers of studies, participants, and events, as well as other deficiencies of reporting study quality allowing possible risks of bias. There is only a modest amount of very low-quality evidence about the use of NSAIDs in fibromyalgia, and that comes from small, largely inadequate studies with potential risk of bias. That bias would normally be to increase the apparent benefits of NSAIDs, but no such benefits were seen. Consequently, NSAIDs cannot be regarded as useful for treating fibromyalgia.

Fibromyalgia is Associated With Altered Skeletal Muscle Characteristics Which May Contribute to Post-Exertional Fatigue in Post-Menopausal Women

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Srikuea, Ratchakrit; Symons, T. Brock; Long, Douglas E.; Lee, Jonah D.; Shang, Yu; Chomentowski, Peter J.; Yu, Guoqiang; Crofford, Leslie J.; Peterson, Charlotte A.

2012-01-01

Objective To identify muscle physiological properties that may contribute to post-exertional fatigue and malaise in women with fibromyalgia (FM). Methods Healthy postmenopausal women with (n=11) and without (n=11) fibromyalgia, age 51–70 years, participated in this study. Physical characteristics along with self-reported questionnaires were evaluated. Strength loss and tissue oxygenation in response to a fatiguing exercise protocol were used to quantify fatigability and the local muscle hemodynamic profile. Muscle biopsies were obtained to assess between-group differences in baseline muscle properties using histochemical, immunohistochemical and electron microscopic analyses. Results No significant difference in muscle fatigue in response to exercise was apparent between healthy controls and subjects with FM. However, self-reported fatigue and pain were correlated to prolonged loss of strength following 12-min of recovery in subjects with FM. Although there was no difference in percent SDH positive (type I) and SDH negative (type II) fibers or in mean fiber cross-sectional area between groups, subjects with FM showed greater size variability and altered fiber size distribution. Only in healthy controls, fatigue-resistance was strongly correlated with the size of SDH positive fibers and hemoglobin oxygenation. By contrast, subjects with FM with the highest percentage of SDH positive fibers recovered strength most effectively, which was correlated to capillary density. However, overall, capillary density was lower in subjects with FM. Conclusion Peripheral mechanisms i.e. altered muscle fiber size distribution and decreased capillary density may contribute to post-exertional fatigue in subjects with FM. Understanding these defects in fibromyalgic muscle may provide valuable insight for treatment. PMID:23124535

Monosodium glutamate and aspartame in perceived pain in fibromyalgia.

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Vellisca, María Y; Latorre, José I

2014-07-01

Our aim was to assess the effect of dietary elimination of monosodium glutamate (MSG) and aspartame on perceived pain in fibromyalgia. A total of 72 female patients with fibromyalgia were randomized to discontinuation of dietary MSG and aspartame (n = 36) or waiting list (n = 36). Patients were requested to rate their pain using a seven-point scale. Comparisons between both groups showed no significant differences on pain referred during the baseline or after the elimination of dietary MSG and aspartame. The discontinuation of dietary MSG and aspartame did not improve the symptoms of fibromyalgia.

Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms.

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Dean, Linda E; Arnold, Lesley; Crofford, Leslie; Bennett, Robert; Goldenberg, Don; Fitzcharles, Mary-Ann; Paiva, Eduardo S; Staud, Roland; Clauw, Dan; Sarzi-Puttini, Piercarlo; Jones, Gareth T; Ayorinde, Abimbola; Flüß, Elisa; Beasley, Marcus; Macfarlane, Gary J

2017-12-01

To investigate whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread pain (CWP) compared to multisite pain (MSP), with or without joint areas. Six studies were used: 1958 British birth cohort, Epidemiology of Functional Disorders, Kid Low Back Pain, Managing Unexplained Symptoms (Chronic Widespread Pain) in Primary Care: Involving Traditional and Accessible New Approaches, Study of Health and its Management, and Women's Health Study (WHEST; females). MSP was defined as the presence of pain in ≥8 body sites in adults (≥10 sites in children) indicated on 4-view body manikins, conducted first to include joints (positive joints) and second without (negative joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms, and mood impairment was assessed using logistic regression. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). There were 34,818 participants across the study populations (adults age range 42-56 years, male 43-51% [excluding WHEST], and CWP prevalence 12-17%). Among those reporting MSP, the proportion reporting CWP ranged between 62% and 76%. Among those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which was similar regardless of the definition used. For example, within WHEST, reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with a >5-fold increase in likelihood of reporting pain (CWP OR 5.2 [95% CI 3.9-6.9], MSP-positive joints OR 6.5 [95% CI 5.0-8.6], and MSP-negative joints OR 6.5 [95% CI 4.7-9.0]). This large-scale study demonstrates that regardless of the pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia is similar. This finding supports the continued collection of both when classifying fibromyalgia, but highlights the fact that pain may

The relationship between balance and vitamin 25(OH)D in fibromyalgia patients.

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Kasapoğlu Aksoy, Meliha; Altan, Lale; Ökmen Metin, Burcu

2017-09-01

Fibromyalgia syndrome (FMS) is a chronic disease characterized by diffuse pain of unknown cause, fatigue, sleep disorders, cognitive dysfunction, and sensitivity. Fibromyalgia was shown to be associated with balance problems and increased incidence of falls. There are many theoretical mechanisms related to the impact of vitamin D on postural control. The aim of the current study was to investigate the relationship between vitamin 25(OH)D levels and pain, balance and daily activities in patients with FMS. Patients aged 35-65 years who were diagnosed with FMS according to 1990 ACR diagnostic criteria were screened. Seventy patients diagnosed with FMS and 60 healthy controls with comparable age and gender were included in the study. Fibromyalgia impact scale (FIQ), Berg Balance Scale (BBS), the Nottingham Health Profile (NHP), and visual analog scale (VAS) were applied to the subjects. The subjects were divided into two groups by vitamin 25(OH)D level being above or below 30 ng/ml. A statistically significant difference was established between VAS, BBS value and all NHP subscale and NHP total values of FMS patients and those of healthy control group. The relationship between BBS and the level of vitamin 25(OH)D of all participants was investigated, a positive statistically significant relationship was found with Vit-D at r = 0.481 level (p < 0.05). It was observed that low vitamin D levels affected balance in both FMS group and healthy control group. It should be kept in mind that vitamin D level is likely to negatively affect balance and VAS values in FMS.

Combining motivational and volitional strategies to promote unsupervised walking in patients with fibromyalgia: study protocol for a randomized controlled trial.

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Pastor, María-Ángeles; López-Roig, Sofía; Lledó, Ana; Peñacoba, Cecilia; Velasco, Lilian; Schweiger-Gallo, Inge; Cigarán, Margarita; Ecija, Carmen; Limón, Ramón; Sanz, Yolanda

2014-04-11

Fibromyalgia patients are often advised to engage in regular low- to moderate-intensity physical exercise. The need of fibromyalgia patients to walk has been stressed in previous research. Behavioral self-regulation theories suggest that a combination of motivational aspects (to develop or strengthen a behavioral intention: Theory of Planned Behavior) and volitional aspects (engagement of intention in behavior: implementation intentions) is more effective than a single intervention. In this paper, we describe a protocol for identifying the motivational processes (using the Theory of Planned Behavior) involved in the practice of walking (phase I) and for studying the efficacy of an intervention that combines motivational and volitional contents to enhance the acquisition and continuation of this exercise behavior (phase II). The paper also shows the characteristics of eligible individuals (women who do not walk) and ineligible populations (women who walk or do not walk because of comorbidity without medical recommendation to walk). Both groups consist of members of any of four patients' associations in Spain who are between 18 and 70 years of age and meet the London Fibromyalgia Epidemiology Study Screening Questionnaire criteria for fibromyalgia. Furthermore, using this study protocol, we will explore the characteristics of participants (eligible women who agreed to participate in the study) and nonparticipants (eligible women who refused to participate). Two studies will be conducted: Phase I will be a cross-sectional study, and phase II will be a triple-blind, randomized longitudinal study with two treatment groups and one active control group. The questionnaires were sent to a total of 2,227 members of four patients' associations in Spain. A total of 920 participants with fibromyalgia returned the questionnaires, and 582 were ultimately selected to participate. The first data gathered have allowed us to identify the characteristics of the study population and

A critical incident reporting system in anaesthesia.

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Madzimbamuto, F D; Chiware, R

2001-01-01

To audit the recently established Critical Incident Reporting System in the Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe Medical School. The system was set up with the purpose of improving the quality of care delivered by the department. Cross sectional study. A critical incident was defined as 'any adverse and reversible event in theatre, during or immediately after surgery that if it persisted without correction would cause harm to the patient'. The anaesthetic or recovery room staff filled a critical incident form anonymously. Data was collected from critical incident reporting forms for analysis. The anaesthetic service in the two teaching hospitals of Harare Central and Parirenyatwa General Hospitals. Between May and October 2000, 62 completed critical incident forms were collected. The nature of the incident and the monitoring used were recorded, the cause was classified as human, equipment or monitoring failure and the outcome for each patient reported. There was no formal system for reminding staff to fill in their critical incident forms. A total of 14,165 operations were performed over the reporting period: 62 critical incident forms were collected, reporting 130 incidents, giving a rate of 0.92% (130/14,165). Of these, 42 patients were emergencies and 20 elective. The incidents were hypotension, hypoxia, bradycardia, ECG changes, aspiration, laryngospasm, high spinal, and cardiac arrest. Monitoring present on patients who had critical incidents was: capnography 57%, oxymetry 90% and ECG 100%. Other monitors are not reported. Human error contributed in 32/62 of patients and equipment failure in 31/62 of patients. Patient outcome showed 15% died, 23% were unplanned admissions to HDU while 62% were discharged to the ward with little or no adverse outcome. Despite some under reporting, the critical incident rate was within the range reported in the literature. Supervision of juniors is not adequate, especially on call. The

INFLUENCE OF MODERATE TRAINING ON GAIT AND WORK CAPACITY OF FIBROMYALGIA PATIENTS: A PRELIMINARY FIELD STUDY

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Michael Pierrynowski

2002-12-01

Full Text Available This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS. FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0± 7.6 y who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p < 0.05 and a trend toward a more normal gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients

Management of fibromyalgia syndrome in 2016.

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Okifuji, Akiko; Gao, Jeff; Bokat, Christina; Hare, Bradford D

2016-05-01

Fibromyalgia syndrome is a chronic pain disorder and defies definitively efficacious therapy. In this review, we summarize the results from the early treatment research as well as recent research evaluating the pharmacological, interventional and nonpharmacological therapies. We further discuss future directions of fibromyalgia syndrome management; we specifically focus on the issues that are associated with currently available treatments, such as the need for personalized approach, new technologically oriented and interventional treatments, the importance of understanding and harnessing placebo effects and enhancement of patient engagement in therapy.

The Incidence of Human Papillomavirus in Tanzanian Adolescent Girls Before Reported Sexual Debut.

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Houlihan, Catherine F; Baisley, Kathy; Bravo, Ignacio G; Kapiga, Saidi; de Sanjosé, Silvia; Changalucha, John; Ross, David A; Hayes, Richard J; Watson-Jones, Deborah

2016-03-01

Acquisition of human papillomavirus (HPV) in women occurs predominantly through vaginal sex. However, HPV has been detected in girls reporting no previous sex. We aimed to determine incidence and risk factors for HPV acquisition in girls who report no previous sex in Tanzania, a country with high HPV prevalence and cervical cancer incidence. We followed 503 adolescent girls aged 15-16 years in Mwanza, Tanzania, with face-to-face interviews and self-administered vaginal swabs every 3 months for 18 months; 397 girls reported no sex before enrollment or during follow-up; of whom, 120 were randomly selected. Samples from enrollment, 6-, 12-, and 18-month visits were tested for 37 HPV genotypes. Incidence, clearance, point prevalence, and duration of any HPV and genotype-specific infections were calculated and associated factors were evaluated. Of 120 girls who reported no previous sex, 119 were included, contributing 438 samples. HPV was detected in 51 (11.6%) samples. The overall incidence of new HPV infections was 29.4/100 person-years (95% confidence interval: 15.9-54.2). The point prevalence of vaccine types HPV-6,-11,-16, and -18 was .9%, .9%, 2.0%, and 0%, respectively. Spending a night away from home and using the Internet were associated with incident HPV, and reporting having seen a pornographic movie was inversely associated with HPV incidence. Incident HPV infections were detected frequently in adolescent girls who reported no previous sex over 18 months. This is likely to reflect under-reporting of sex. A low-point prevalence of HPV genotypes in licensed vaccines was seen, indicating that vaccination of these girls might still be effective. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

SU-E-P-07: Retrospective Analysis of Incident Reports at a Radiology Department: Feedback From Incident Reporting System

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Kakinohana, Y; Toita, T; Heianna, J; Murayama, S [School of medicine, University of the Ryukyus, Nishihara-cho, Okinawa (Japan)

2015-06-15

Purpose: To provide an overview of reported incidents that occurred in a radiology department and to describe the most common causal source of incidents. Methods: Incident reports from the radiology department at the University of the Ryukyus Hospital between 2008 and 2013 were collected and analyzed retrospectively. The incident report form contains the following items, causal factors of the incident and desirable corrective actions to prevent recurrence of similar incidents. These items allow the institution to investigate/analyze root causes of the incidents and suggest measures to be taken to prevent further, similar incidents. The ‘causal factors of the incident’ item comprises multiple selections from among 24 selections and includes some synonymous selections. In this study, this item was re-categorized into four causal source types: (i) carelessness, (ii) lack of skill or knowledge, (iii) deficiencies in communication, and (iv) external factors. Results: There were a total of 7490 incident reports over the study period and 276 (3.7%) were identified as originating from the radiology department. The most frequent causal source type was carelessness (62%). The other three types showed similar frequencies (10–14%). The staff members involved in incidents indicate three predominant desirable corrective actions to prevent or decrease the recurrence of similar incidents. These are ‘improvement in communication’ (24%), ‘staff training/education’ (19%), and ‘daily medical procedures’ (22%), and the most frequent was ‘improvement in communication’. Even though the most frequent causal factor was related to carelessness, the most desirable corrective action indicated by the staff members was related to communication. Conclusion: Our finding suggests that the most immediate causes are strongly related to carelessness. However, the most likely underlying causes of incidents would be related to deficiencies in effective communication. At our

Efficacy of Biodanza for treating women with fibromyalgia.

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Carbonell-Baeza, Ana; Aparicio, Virginia A; Martins-Pereira, Clelia M; Gatto-Cardia, Claudia M; Ortega, Francisco B; Huertas, Francisco J; Tercedor, Pablo; Ruiz, Jonatan R; Delgado-Fernandez, Manuel

2010-11-01

The objective of this study was to determine the effects of a 3-month Biodanza intervention in women with fibromyalgia (FM). This was a controlled trial. The study was conducted at a university research laboratory and social center. The study comprised 59 women with FM recruited from a local association of patients with FM. Participants were allocated to the Biodanza intervention group (n = 27) or usual-care group (n = 32). The Biodanza intervention was carried out once a week for 3 months. The outcome measures included the following: Pain threshold, body composition (body-mass index and estimated body fat percentage), physical fitness (30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go, and 6-minute walk test) and psychologic outcomes (Fibromyalgia Impact Questionnaire [FIQ], Short-Form Health Survey 36, Vanderbilt Pain Management Inventory, Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and Rosenberg Self-Esteem Scale). We observed a significant interaction effect (group*time) for pain threshold of several tender points (left [L] and right [R] side of the anterior cervical and supraspinatus, trapezius L and lateral epicondyle R, algometer score, tender points count), body fat percentage, and FIQ total score. In the intervention group, post hoc analysis revealed a significant improvement in pain threshold of the anterior cervical R and L and supraspinatus R and L tender points (all p body fat percentage (p = 0.001), and FIQ total score (p = 0.003). A 3-month (one session per week) Biodanza intervention shows improvements on pain, body composition, and FM impact in female patients.

Ambroxol for fibromyalgia: one group pretest-posttest open-label pilot study.

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Martínez-Martínez, Laura-Aline; Pérez, Luis-Fernando; Becerril-Mendoza, Lizbeth-Teresa; Rodríguez-Henriquez, Pedro; Muñoz, Omar-Eloy; Acosta, Gumaro; Silveira, Luis H; Vargas, Angélica; Barrera-Villalpando, María-Isabel; Martínez-Lavín, Manuel

2017-08-01

A consistent line of investigation proposes that fibromyalgia is a sympathetically maintained neuropathic pain syndrome. Dorsal root ganglia sodium channels may play a major role in fibromyalgia pain transmission. Ambroxol is a secretolytic agent used in the treatment of various airway disorders. Recently, it was discovered that this compound is also an efficient sodium channel blocker with potent anti-neuropathic pain properties. We evaluated the add-on effect of ambroxol to the treatment of fibromyalgia. We studied 25 patients with fibromyalgia. Ambroxol was prescribed at the usual clinical dose of 30 mg PO 3 times a day × 1 month. At the beginning and at the end of the study, all participants filled out the Revised Fibromyalgia Impact Questionnaire (FIQ-R) and the 2010 ACR diagnostic criteria including the widespread pain index (WPI). At the end of the study, FIQ-R decreased from a baseline value of 62 ± 15 to 51 ± 19 (p = 0.013). Pain visual analogue scale decreased from 77 ± 14 to 56 ± 30 (p = 0.018). WPI diminished from 14.6 ± 3.1 to 10.4 ± 5.3 (p = 0.001). Side effects were minor. In this pilot study, the use of ambroxol was associated to decreased fibromyalgia pain and improved fibromyalgia symptoms. The open nature of our study does not allow extracting the placebo effect from the positive results. The drug was well tolerated. Ambroxol newly recognized pharmacological properties could theoretically interfere with fibromyalgia pain pathways. Dose escalating-controlled studies seem warranted.

Talking to patients with fibromyalgia about physical activity and exercise.

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Rooks, Daniel S

2008-03-01

The purpose of this article is to describe the application of basic exercise principles to individuals with fibromyalgia to encourage clinicians to discuss with their patients ways of becoming more physically active. The goals of increased physical activity and exercise for individuals with fibromyalgia are to improve or maintain general fitness, physical function, emotional well being, symptoms and overall health, and provide them with a feeling of control over their well being. Describing ways of increasing activity through home, work and leisure-related tasks or exercise provides a universal approach to increasing physical activity that applies to individuals with fibromyalgia and fits a counseling model of health behavior familiar to clinicians. The patient-clinician relationship provides a unique opportunity for health professionals to counsel individuals with fibromyalgia to become and remain more physically active. Regular physical activity and exercise has numerous physical, psychological, and functional benefits for individuals with fibromyalgia and should be included in treatment plans. Clinicians can help patients adopt a more physically active lifestyle through targeted discussions, support and consistent follow up.

Etiopathogenetic mechanisms of fibromyalgia syndrome

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R.H. Gracely

2011-09-01

Full Text Available Fibromyalgia syndrome (FMS is a common chronic condition of widespread pain with causal mechanisms that are largely unknown. It is characterized by moderate to severe musculoskel - etal pain and allodynia, but its pathogenesis appears confined to the nociceptive structures of the central nervous system. From a pathogenetic point of view, indeed, no clear muscle pathology has been demonstrated in FMS (1, 2, while increasing evidence suggests a disturbance in pain perception that is genetically conditioned. In our review we will consider five “keypoints” that we think determine the origin and maintenance of the pain syndrome that we define as fibromyalgia...

A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis.

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Joharatnam, Nalinie; McWilliams, Daniel F; Wilson, Deborah; Wheeler, Maggie; Pande, Ira; Walsh, David A

2015-01-20

Pain remains the most important problem for people with rheumatoid arthritis (RA). Active inflammatory disease contributes to pain, but pain due to non-inflammatory mechanisms can confound the assessment of disease activity. We hypothesize that augmented pain processing, fibromyalgic features, poorer mental health, and patient-reported 28-joint disease activity score (DAS28) components are associated in RA. In total, 50 people with stable, long-standing RA recruited from a rheumatology outpatient clinic were assessed for pain-pressure thresholds (PPTs) at three separate sites (knee, tibia, and sternum), DAS28, fibromyalgia, and mental health status. Multivariable analysis was performed to assess the association between PPT and DAS28 components, DAS28-P (the proportion of DAS28 derived from the patient-reported components of visual analogue score and tender joint count), or fibromyalgia status. More-sensitive PPTs at sites over or distant from joints were each associated with greater reported pain, higher patient-reported DAS28 components, and poorer mental health. A high proportion of participants (48%) satisfied classification criteria for fibromyalgia, and fibromyalgia classification or characteristics were each associated with more sensitive PPTs, higher patient-reported DAS28 components, and poorer mental health. Widespread sensitivity to pressure-induced pain, a high prevalence of fibromyalgic features, higher patient-reported DAS28 components, and poorer mental health are all linked in established RA. The increased sensitivity at nonjoint sites (sternum and anterior tibia), as well as over joints, indicates that central mechanisms may contribute to pain sensitivity in RA. The contribution of patient-reported components to high DAS28 should inform decisions on disease-modifying or pain-management approaches in the treatment of RA when inflammation may be well controlled.

Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

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Bellato, Enrico; Marini, Eleonora; Castoldi, Filippo; Barbasetti, Nicola; Mattei, Lorenzo; Bonasia, Davide Edoardo; Blonna, Davide

2012-01-01

Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud's phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy. PMID:23213512

Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management

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Firdous Jahan

2012-05-01

Full Text Available Fibromyalgia Syndrome (FMS is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression, and disturbances in bowel functions. The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem.

Fibromyalgia: Prevalence, epidemiologic profiles and economic costs.

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Cabo-Meseguer, Asensi; Cerdá-Olmedo, Germán; Trillo-Mata, José Luis

2017-11-22

Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases. Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Dropout of a multidisciplinary treatment program for women with fibromyalgia

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Tatiana Rehder Gonçalves

2010-03-01

Full Text Available 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.

Management of fibromyalgia syndrome in 2016

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Okifuji, Akiko; Gao, Jeff; Bokat, Christina; Hare, Bradford D

2016-01-01

Fibromyalgia syndrome is a chronic pain disorder and defies definitively efficacious therapy. In this review, we summarize the results from the early treatment research as well as recent research evaluating the pharmacological, interventional and nonpharmacological therapies. We further discuss future directions of fibromyalgia syndrome management; we specifically focus on the issues that are associated with currently available treatments, such as the need for personalized approach, new technologically oriented and interventional treatments, the importance of understanding and harnessing placebo effects and enhancement of patient engagement in therapy. PMID:27306300

Self-poisoning in rural Sri Lanka: small-area variations in incidence

DEFF Research Database (Denmark)

Manuel, Celie; Gunnell, David J; van der Hoek, Wim

2008-01-01

measures in these settings, this study investigates small-area variation in self-poisoning incidence and its association with area-based socioeconomic and agricultural factors. METHODS: Ecological analysis of intentional self-poisoning in a rural area (population 267,613) of Sri Lanka in 2002.......01). CONCLUSION: Considerable small-area variation in incidence rates of intentional self-poisoning was found. The noteworthy concentration of cases in certain areas and the inverse association with socioeconomic deprivation merit attention and should be investigated using individual-level exposure data....... of intentional self-poisoning in the study area was 315 per 100,000 (range: 0 - 2168 per 100,000 across GNs). Socioeconomic disadvantage, as indexed by poor housing quality (p = 0.003) and low levels of education (p

Advances in diagnostic and treatment options in patients with fibromyalgia syndrome

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Ali Gur

2009-12-01

Full Text Available Ali Gur1, Pelin Oktayoglu21Department of Physical Medicine and Rehabilitation, Medical Faculty, Gaziantep University, Gaziantep, Turkey; 2Department of Physical Medicine and Rehabilitation, Batman State Hospital, Batman, TurkeyAbstract: Fibromyalgia (FM is characterized as a chronic, painful, noninflammatory syndrome affecting the musculoskeletal system. In addition to pain, common co-morbid symptoms associated with FM include sleep disturbances, fatigue, morning stiffness, affective disorders, chronic daily headache, dyscognition, irritable bowel syndrome, and irritable bladder. Fibromyalgia is usually classified by application of the American College of Rheumatology (ACR criteria. Although these criteria are accepted among investigators who agree with the concept of fibromyalgia, they do so with some reservations. Tender points and widespread pain alone does not describe the esence of fibromyalgia. New diagnostic tools including either clinical or radiological components are studied to diminish these problems. Although various pharmacological solutions have been studied for treating fibromyalgia, no single drug or groups of drugs have proved to be useful in treating fibromyalgia patients. Recently, three drugs, pregabalin, duloxetine and milnacipran, were approved for the treatment of FM by the US Food and Drug Administration (FDA. Novel therapeutic approaches to the management of FM include cannabinoids, sodium channel blockade and new generation antiepileptics. This review evaluates both new diagnostic tools, including clinical or radiological regimes, and tries to highlight the efficacy of medicinal and nonmedicinal treatments with new therapeutic approaches in the management of FM with a wide perspective.Keywords: diagnosis, fibromyalgia, rehabilitation, treatment

Fibromyalgia and Risk of Dementia-A Nationwide, Population-Based, Cohort Study.

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Tzeng, Nian-Sheng; Chung, Chi-Hsiang; Liu, Feng-Cheng; Chiu, Yu-Hsiang; Chang, Hsin-An; Yeh, Chin-Bin; Huang, San-Yuan; Lu, Ru-Band; Yeh, Hui-Wen; Kao, Yu-Chen; Chiang, Wei-Shan; Tsao, Chang-Hui; Wu, Yung-Fu; Chou, Yu-Ching; Lin, Fu-Huang; Chien, Wu-Chien

2018-02-01

Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia. A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up. Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P dementia in this study. The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Fibromyalgia: When Distress Becomes (Un)sympathetic Pain

OpenAIRE

Martinez-Lavin, Manuel

2012-01-01

Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may...

High Frequency of Fibromyalgia in Patients With Acne Vulgaris.

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Yazmalar, Levent; Çelepkolu, Tahsin; Batmaz, İbrahim; Sariyildiz, Mustafa Akif; Sula, Bilal; Alpayci, Mahmut; An, İsa; Burkan, Yahya Kemal; Uçak, Haydar; Çevik, Remzi

2016-06-01

This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age, sex- and body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included. Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulgaris patients than controls. This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21.6% versus 5.3%, respectively).

Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?

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Bagis, Selda; Tamer, Lulufer; Sahin, Gunsah; Bilgin, Ramazan; Guler, Hayal; Ercan, Bahadir; Erdogan, Canan

2005-04-01

The role of free radicals in fibromyalgia is controversial. In this study, 85 female patients with primary fibromyalgia and 80 age-, height-, and weight-matched healthy women were evaluated for oxidant/antioxidant balance. Malondialdehyde is a toxic metabolite of lipid peroxidation used as a marker of free radical damage. Superoxide dismutase is an intracellular antioxidant enzyme and shows antioxidant capacity. Pain was assessed by visual analog scale. Tender points were assessed by palpation. Age, smoking, body mass index (BMI), and duration of disease were also recorded. Malondialdehyde levels were significantly higher and superoxide dismutase levels significantly lower in fibromyalgic patients than controls. Age, BMI, smoking, and duration of disease did not affect these parameters. We found no correlation between pain and number of tender points. In conclusion, oxidant/antioxidant balances were changed in fibromyalgia. Increased free radical levels may be responsible for the development of fibromyalgia. These findings may support the hypothesis of fibromyalgia as an oxidative disorder.

NEA incident reporting system: Three years' experience

International Nuclear Information System (INIS)

Otsuka, Y.; Haeussermann, W.

1984-01-01

The paper presents an overview of the NEA Incident Reporting System (IRS) which was set up to collect, assess and disseminate on safety-related incidents in nuclear power plants. The IRS information exchange is significant in two senses. First, it enables regulatory authorities and utilities in participating countries to take appropriate action to prevent the reported mishaps occurring again elsewhere. Secondly, the continuous collection and systematic analysis of such information allows identification of areas of concern where safety research should be strengthened. There are two stages in the IRS information exchange. First, the national IRS Co-ordinator selects information on significant incidents, in accordance with a common reporting threshold, from the abnormal occurrences reported to the regulatory body, to be distributed through the NEA Secretariat. This screening is intended to exclude minor events, so that only significant information is sent to participating countries. Secondly, a group of experts periodically reviews the incidents reported during the preceding twelve months to identify major areas of concern. To assist this process, a computer-based data retrieval system is being developed for IRS incident reports. The paper gives some details of the IRS mechanism and discusses reporting criteria and the information included in a report. Areas of concern derived from reported incidents, an outline of the data retrieval system, and examples of feedback of lessons learned and possibilities for international co-operation are also discussed. (author)

Association of body mass index with symptom severity and quality of life in patients with fibromyalgia.

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Kim, Chul-Hyun; Luedtke, Connie A; Vincent, Ann; Thompson, Jeffrey M; Oh, Terry H

2012-02-01

To examine the association between body mass index (BMI) and symptom severity and quality of life (QOL) in patients with fibromyalgia. We assessed BMI status and its association with symptom severity and QOL in 888 patients with fibromyalgia who were seen in a fibromyalgia treatment program and who completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form 36 (SF-36) health survey. The BMI distribution of nonobese (BMI fibromyalgia-related symptoms with worse FIQ total scores (P fibromyalgia, severe obesity (BMI ≥35.0 kg/m(2)) is associated with higher levels of fibromyalgia symptoms and lower levels of QOL. Copyright © 2012 by the American College of Rheumatology.

Executive function in fibromyalgia: Comparing subjective and objective measures.

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Gelonch, Olga; Garolera, Maite; Valls, Joan; Rosselló, Lluís; Pifarré, Josep

2016-04-01

There is evidence to suggest the existence of an executive dysfunction in people diagnosed with fibromyalgia, although there are certain inconsistencies between studies. Here, we aim to compare executive performance between patients with fibromyalgia and a control group by using subjective and objective cognitive tests, analyzing the influence of patient mood on the results obtained, and studying associations between the two measures. 82 patients diagnosed with fibromyalgia and 42 healthy controls, matched by age and years of education, were assessed using the Behavioral Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a subjective measure of executive functioning. A selection of objective cognitive tests were also used to measure a series of executive functions and to identify symptoms of depression and anxiety. Patients with fibromyalgia perceived greater difficulties than the control group on all of the BRIEF-A scales. However, after adjustments were made for depression and anxiety the only differences that remained were those associated with the working memory scale and the Metacognition and Global Executive Composite index. In the case of the objective cognitive tests, a significantly worse overall performance was evidenced for the fibromyalgia patients. However, this also disappeared when adjustments were made for depression and anxiety. After this adjustment, fibromyalgia patients only performed significantly worse for the interference effect in the Stroop Test. Although there were no significant associations between most of the objective cognitive tests and the BRIEF-A scales, depression and anxiety exhibited strong associations with almost all of the BRIEF-A scales and with several of the objective cognitive tests. Patients with fibromyalgia showed executive dysfunction in subjective and objective measures, although most of this impairment was associated with mood disturbances. Exceptions to this general rule were observed in the

Vestibular findings in fibromyalgia patients

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Zeigelboim, Bianca Simone

2011-07-01

Full Text Available Introduction: Fibromyalgia (FM is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by a diffuse pain, increase in palpation sensitivity and such symptoms as tiredness, insomnia, anxiety, depression, cold intolerance and otologic complaints. Objective: Evaluate the vestibular behavior in fibromyalgia patients. Method: A retrospective transversal study was performed. 25 patients aged between 26 and 65 (average age - 52.2 and standard deviation - 10.3 were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic and vestibular evaluation by way of vector electronystamography. Results: a The most evident otoneurologic symptoms were: difficulty or pain when moving the neck and pain was spread to an arm or shoulder (92.0% in each, dizziness (84.0% and headache (76.0%. The different clinical symptoms mostly reported were: depression (80.0%, anxiety (76.0% and insomnia (72.0%; b vestibular examination showed an alteration in 12 patients (48.0% in the caloric test; c an alteration in the peripheral vestibular system prevailed, and d deficient peripheral vestibular disorders were prevalent. Conclusion: This study enabled the importance of the labyrinthic test to be verified, thus emphasizing that this kind of people must be studied better, since a range of rheumatologic diseases can cause severe vestibular changes as a result of their manifestations and impairment areas.

49 CFR 225.11 - Reporting of accidents/incidents.

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2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Reporting of accidents/incidents. 225.11 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD ACCIDENTS/INCIDENTS: REPORTS CLASSIFICATION, AND INVESTIGATIONS § 225.11 Reporting of accidents/incidents. Each railroad subject to this part shall submit to FRA...

Cultural adaptation and validation of the "Fibromyalgia Impact Questionnaire"--Portuguese version

OpenAIRE

Rosado, Maria da Lapa; Pereira, José Pascoalinho; da Fonseca, João Pedro; Branco, Jaime

2006-01-01

The aim of this study was to translate the Fibromyalgia Impact Questionnaire (FIQ) into Portuguese (Portugal) and to evaluate its reliability and validity by use with Portuguese--speaking patients with Fibromyalgia. After translating the FIQ into Portuguese we administered it to 68 patients with Fibromyalgia together with an informed consent, a Portuguese version of the Health Assessment Questionnaire (HAQ) and a formulary with the socio-demographic characteristics and duration of the complai...

Effect of whole body cryotherapy interventions on health-related quality of life in fibromyalgia patients: A randomized controlled trial.

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Vitenet, M; Tubez, F; Marreiro, A; Polidori, G; Taiar, R; Legrand, F; Boyer, F C

2018-02-01

Although fibromyalgia syndrome (SFM) affects 2-4 percent of adults, research has not identified a preferred therapeutic option for patients worldwide yet. Based on recent findings, it can be expected that whole body cryotherapy can improve health-reported quality of life by alleviating the symptoms of musculoskeletal pain and fatigue. Our aim was to determine whether whole body cryotherapy only can result in improved perceived health and quality of life in fibromyalgia patients. 24 patients with fibromyalgia diagnosis were randomized into 2 groups (n=11 in the whole body cryotherapy group, n=13 in the control group). In the whole body cryotherapy group, 10 sessions of whole body cryotherapy were performed (in addition to usual care) in a standard cryotherapy room over a duration of 8days. Subjects in the control group did not change anything in their everyday activities. Quality of life was assessed just before and one month after treatment. Compared with the control group, patients in the whole body cryotherapy group reported significantly improved for health-reported quality of life. These effects lasted for at least one month following intervention. Based on these findings, whole body cryotherapy can be recommended as an effective clinically adjuvant approach in the improvement of health-related quality of life in fibromyalgia patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Time to Talk: 6 Things to Know about Mind and Body Practices for Fibromyalgia

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... To Know About Mind and Body Practices for Fibromyalgia Share: Fibromyalgia syndrome is a chronic disorder characterized by widespread ... carry out daily activities. It is estimated that fibromyalgia affects 5 million American adults. Most people with ...

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

OpenAIRE

Kim Lawson

2017-01-01

Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of li...

Neuropathic pain and use of PainDETECT in patients with fibromyalgia: a cohort study

OpenAIRE

Gauffin, Jarno; Hankama, Tiina; Kautiainen, Hannu; Hannonen, Pekka; Haanp??, Maija

2013-01-01

Abstract Backround Fibromyalgia has a plethorae of symptoms, which can be confusing and even misleading. Accurate evaluation is necessary when patients with fibromyalgia are treated. Different types of instruments are available for the clinicians to supplement evaluation. Our objective was to study the applicability of the PainDETECT instrument to screen neuropathic pain in patients with fibromyalgia. Methods 158 patients with primary fibromyalgia underwent a neurological examination includin...

"Fibromyalgia and quality of life: mapping the revised fibromyalgia impact questionnaire to the preference-based instruments".

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Collado-Mateo, Daniel; Chen, Gang; Garcia-Gordillo, Miguel A; Iezzi, Angelo; Adsuar, José C; Olivares, Pedro R; Gusi, Narcis

2017-05-30

The revised version of the Fibromyalgia Impact Questionnaire (FIQR) is one of the most widely used specific questionnaires in FM studies. However, this questionnaire does not allow calculation of QALYs as it is not a preference-based measure. The aim of this study was to develop mapping algorithm which enable FIQR scores to be transformed into utility scores that can be used in the cost utility analyses. A cross-sectional survey was conducted. One hundred and 92 Spanish women with Fibromyalgia were asked to complete four general quality of life questionnaires, i.e. EQ-5D-5 L, 15D, AQoL-8D and SF-12, and one specific disease instrument, the FIQR. A direct mapping approach was adopted to derive mapping algorithms between the FIQR and each of the four multi-attribute utility (MAU) instruments. Health state utility was treated as the dependent variable in the regression analysis, whilst the FIQR score and age were predictors. The mean utility scores ranged from 0.47 (AQoL-8D) to 0.69 (15D). All correlations between the FIQR total score and MAU instruments utility scores were highly significant (p fibromyalgia specific questionnaire.

[Prevalence of fibromyalgia in diabetes mellitus and obesity].

Science.gov (United States)

Patucchi, Emanuele; Fatati, Giuseppe; Puxeddu, Adolfo; Coaccioli, Stefano

2003-04-01

To determine the prevalence of fibromyalgia in diabetes mellitus and obesity, 121 consecutive patients have been observed: 27 with obesity (6 males and 21 females; mean age 57 years, range 20-57; mean body mass index [BMI] 34); 88 with type 2 diabetes mellitus (T2DM; 40 males and 48 females; mean age 63 years, range 44-78; mean BMI 28.8; mean glycated haemoglobin [HbA1c] in the last year 8.3%); 6 with type 1 diabetes mellitus (T1DM; 2 males and 4 females; mean age 52 years, range 26-76; mean BMI 24.5; mean HbA1c BMI less that 26 the diagnosis of fibromyalgia was negative. Our data seem to reveal the presence of a significant clinical association between obesity, diabetes mellitus and fibromyalgia.

Assessment of nutritional status and eating disorders in female adolescents with fibromyalgia.

Science.gov (United States)

da Silva, Simone Guerra L; Sarni, Roseli O S; de Souza, Fabíola I S; Molina, Juliana; Terreri, Maria Teresa R A; Hilário, Maria Odete E; Len, Claudio A

2012-11-01

To assess eating disorders, nutritional status, body composition, and food intake in adolescents presenting with fibromyalgia. In a cross-sectional study, we evaluated the nutritional status (z score of body mass index [ZBMI]), waist circumference, body fat percentage by bioelectrical impedance analysis, symptoms of disordered eating, and possible eating disorders (Kids' Eating Disorders Survey [KEDS]) of 23 female adolescents with fibromyalgia and 23 matched healthy control subjects. Median age for both groups was 15 years. In the fibromyalgia group, the median time for diagnosis was 13.5 months. We did not observe a statistically significant difference between the control and fibromyalgia groups in relation to ZBMI, fat mass percentage, food intake, and symptoms of disordered eating (KEDS). In the fibromyalgia group, there was a significant correlation between fat mass percentage and the total KEDS score (r = .587, p = .003); the same correlation was observed for ZBMI (r = .0778, p fibromyalgia that, in addition to the correlation between adiposity indexes and KEDS total score, emphasizes the importance of nutritional and body composition assessment, allowing an early and adequate nutritional intervention. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients.

Science.gov (United States)

Jones, Kim D; Sherman, Christy A; Mist, Scott D; Carson, James W; Bennett, Robert M; Li, Fuzhong

2012-08-01

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), self-efficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p = 0.0002), BPI pain severity (1.2 vs. 0.4, p = 0.0008), BPI pain interference (2.1 vs. 0.6, p = 0.0000), sleep (2.0 vs. -0.03, p = 0.0003), and self-efficacy for pain control (9.2 vs. -1.5, p = 0.0001). Functional mobility variables including timed get up and go (-.9 vs. -.3, p = 0.0001), static balance (7.5 vs. -0.3, p    0.0001), and dynamic balance (1.6 vs. 0.3, p = 0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. (ClinicalTrials.gov Identifier, NCT01311427).

Daytime napping associated with increased symptom severity in fibromyalgia syndrome

NARCIS (Netherlands)

Theadom, Alice; Cropley, Mark; Kantermann, Thomas

2015-01-01

Background: Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The

Assessment of Sexual Dysfunction in Patients with Fibromyalgia Syndrome

Directory of Open Access Journals (Sweden)

Rahime Nur Ülker

2013-12-01

Full Text Available Objectives: The aim of our study is to determine the presence, quality of sexual dysfunction in patients with fibromyalgia syndrome and to compare with normal population. Material and Methods: A total of 55 sexually active women who were admitted to Department of Physical Therapy and Rehabilitation of Antalya Research and Training Hospital and diagnosed with fibromyalgia syndrome according to 1990 and 2010 American College of Rheumatology (ACR criteria. A control group composed of 50 sexually active women who were admitted to our clinic with various musculoskeletal system complaints were also included in the study in order to compare the parameters used for clinical assessment of patients and to determine whether the patients differ from normal population. Patients and controls who met inclusion criteria were applied Female Sexual Function Index (FSFI for assessment of sexual function. This test was developed by Rosen and colleagues in 2000, it is composed of 19 questions and inquires six different dimensions including desire, arousal, lubrication, orgasm, sexual satisfaction and pain. Turkish validation test was done by Turkish Society Of Andrology in 2003, answers are multiplied with a coefficient and each section is evaluated on six scores. Minimum score is 2.4 and maximum is 36 and standardly used for assessment of female sexual dysfunction in Turkey. Results: Subscale and total score of Female Sexual Function Index of Fibromyalgia syndrome patients were found statistically significantly lower than those of control group (p<0.05. Conclusion: Disorders of sexual function or its quality are one of the problems seen in fibromyalgia syndrome patients. It should be noticed that sexual function assessment must be a part of treatment of fibromyalgia syndrome. It is quite difficult to determine the mechanism between sexual dysfunction and fibromyalgia syndrome and new and larger studies are needed to determine this mechanism. (Turkish Journal of

Health-related quality of life in fibromyalgia and refractory angina pectoris: a comparison between two chronic non-malignant pain disorders.

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Andréll, Paulin; Schultz, Tomas; Mannerkorpi, Kaisa; Nordeman, Lena; Börjesson, Mats; Mannheimer, Clas

2014-04-01

To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life. The Short-Form 36 was used to assess health- related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score. The patients with fibromyalgia (n = 203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health- related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.

Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization

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Costantini, Raffaele; Affaitati, Giannapia; Massimini, Francesca; Tana, Claudio; Innocenti, Paolo; Giamberardino, Maria Adele

2016-01-01

Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1week, 1,3,6 and 12months after laparoscopic cholecystectomy in fibromyalgia patients with symptomatic calculosis (n = 31) vs calculosis patients without fibromyalgia (n. 26) and at comparable time points in fibromyalgia patients not undergoing cholecystectomy, with symptomatic (n = 27) and asymptomatic (n = 28) calculosis, and no calculosis (n = 30). At basis, fibromyalgia+symptomatic calculosis patients presented a significant linear correlation between the number of previously experienced biliary colics and fibromyalgia pain (direct) and muscle thresholds (inverse)(pfibromyalgia pain significantly increased and all thresholds significantly decreased at 1week and 1month (1-way ANOVA, pFibromyalgia pain and thresholds returned to preoperative values at 3months, then pain significantly decreased and thresholds significantly increased at 6 and 12months (pfibromyalgia patients undergoing cholecystectomy thresholds did not change; in all other fibromyalgia groups not undergoing cholecystectomy fibromyalgia pain and thresholds remained stable, except in fibromyalgia+symptomatic calculosis at 12months when pain significantly increased and muscle thresholds significantly decreased (pfibromyalgia symptoms and that laparoscopic cholecystectomy produces only a transitory worsening of these symptoms, largely compensated by the long-term improvement/desensitization due to gallbladder removal. This study provides new insights into the role of visceral pain comorbidities and the effects of

Evaluating relationship in cytokines level, Fibromyalgia Impact Questionnaire and Body Mass Index in women with Fibromyalgia syndrome.

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Ghizal, Fatima; Das, Siddharth Kumar; Verma, Narsingh; Mahdi, Abbas Ali

2016-01-01

Cytokines (TNF-α and IL-6) levels are reported to be perturbed in Fibromyalgia syndrome (FMS) patients. Moreover, Body Mass Index (BMI) may also be related to disturbed cytokines level. Therefore, the present study was planned to evaluate the levels of cytokines and to correlate them with BMI and Fibromyalgia Impact Questionnaire Revised (FIQR) in female FMS patients (n= 60) and control group (n= 60). 4 ml of blood samples were taken from both the group of patients and controls to measure the levels of IL-6 and TNF-α . Symptoms of FMS were assessed by FIQR. BMI was calculated by a standard formula of weight in kilograms divided by height in meter square. There were significant differences in BMI levels in FMS patients than in control group. However, no significant association was found between BMI and TNF-α levels, and BMI and IL-6 levels in patient and control groups. However, a significant association was found between FIQR and BMI in patients group. On the basis of the results we conclude that the levels of IL-6 and TNF-alpha are not associated with BMI in FMS patients. Furthermore, patients with higher BMI may fall at the risk of FMS. Therefore, weight management may be an important aspect for treatment of FMS patients.

Cognitive Performance Is Related to Central Sensitization and Health-related Quality of Life in Patients with Chronic Whiplash-Associated Disorders and Fibromyalgia.

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Coppieters, Iris; Ickmans, Kelly; Cagnie, Barbara; Nijs, Jo; De Pauw, Robby; Noten, Suzie; Meeus, Mira

2015-01-01

A growing body of research has demonstrated that impaired central pain modulation or central sensitization (CS) is a crucial mechanism for the development of persistent pain in chronic whiplash-associated disorders (WAD) and fibromyalgia (FM) patients. Furthermore, there is increasing evidence for cognitive dysfunctions among these patients. In addition, chronic WAD and FM patients often report problems with health-related quality of life (QoL). Yet, there is limited research concerning the interrelations between cognitive performance, indices of CS, and health-related QoL in these patients. (1) Examining the presence of cognitive impairment, CS, and limitations on health-related QoL in patients with chronic WAD and FM compared to healthy controls. (2) Examining interrelations between performance-based cognitive functioning, CS, and self-reported health-related QoL in these 3 study groups. A case-control study was conducted. The present study took place at the University Hospital Brussels, the University of Brussels, and the University of Antwerp. Fifty-nine patients (16 chronic WAD patients, 21 FM patients, and 22 pain-free volunteers) filled out the Short Form 36 item Health Survey (SF-36), a self-reported psychosocial questionnaire, to assess health-related QoL. Next, they were subjected to various pain measurements (pressure hyperalgesia, deep-tissue hyperalgesia, temporal summation [TS], and conditioned pain modulation [CPM]). Finally, participants completed a battery of performance-based cognitive tests (Stroop task, psychomotor vigilance task [PVT], and operation span task [OSPAN]). Significant cognitive impairment, bottom-up sensitization, and decreased health-related QoL were demonstrated in patients with chronic WAD and FM compared to healthy controls (P fibromyalgia, whiplash, central sensitization, conditioned pain modulation, temporal summation, cognition, quality of life.

A critical analysis of the tender points in fibromyalgia.

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Harden, R Norman; Revivo, Gadi; Song, Sharon; Nampiaparampil, Devi; Golden, Gary; Kirincic, Marie; Houle, Timothy T

2007-03-01

To pilot methodologies designed to critically assess the American College of Rheumatology's (ACR) diagnostic criteria for fibromyalgia. Prospective, psychophysical testing. An urban teaching hospital. Twenty-five patients with fibromyalgia and 31 healthy controls (convenience sample). Pressure pain threshold was determined at the 18 ACR tender points and five sham points using an algometer (dolorimeter). The patients "algometric total scores" (sums of the patients' average pain thresholds at the 18 tender points) were derived, as well as pain thresholds across sham points. The "algometric total score" could differentiate patients with fibromyalgia from normals with an accuracy of 85.7% (P pain across sham points than across ACR tender points, sham points also could be used for diagnosis (85.7%; Ps tested vs other painful conditions. The points specified by the ACR were only modestly superior to sham points in making the diagnosis. Most importantly, this pilot suggests single points, smaller groups of points, or sham points may be as effective in diagnosing fibromyalgia as the use of all 18 points, and suggests methodologies to definitively test that hypothesis.

Incidence of bruxism in TMD population.

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Chandwani, Briesh; Ceneviz, Caroline; Mehta, Noshir; Scrivani, Steven

2011-01-01

The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study.

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Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

2017-05-30

Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PSYCHOLOGICAL-ASPECTS OF FIBROMYALGIA COMPARED WITH CHRONIC AND NONCHRONIC PAIN

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BIRNIE, DJ; KNIPPING, AA; VANRIJSWIJK, MH; DEBLECOURT, AC; DEVOOGD, N

1991-01-01

The description of psychological aspects of fibromyalgia are similar to those of other patients with chronic pain. Three groups, a chronic pain group (n = 99), a nonchronic pain group (n = 34) and a fibromyalgia group (n = 36) were compared, using a standardized interview and psychological

Psychometric properties of the Revised Fibromyalgia Impact Questionnaire (FIQR – a contribution to the Portuguese validation of the scale

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Carlos Costa

2016-07-01

Full Text Available Background: Fibromyalgia (FM remains a relatively misunderstood and clinically challenging condition that impact significantly in the individual´s life, impairing global functioning and diminishing quality of life. Management is complex and frequently unsatisfactory, requiring personal tailoring and adaptation of interventions according to the fluctuations of the disease manifestations and their response to therapy. The use of comprehensive and quantified assessment tools constitutes, therefore, an essential component of the management of patients with FM. The Revised Fibromyalgia Impact Questionnaire (FIQR is currently one of the most used and well validated instruments to assess functional (incapacity and global impact of FM and associated symptoms. Objectives: To translate to Portuguese the FIQR and to study its psychometric properties. Material and Methods: The total sample comprised 103 women with fibromyalgia, defined according to the established criteria for FM. A self-report battery composed by the Revised Fibromyalgia Impact Questionnaire (FIQR, the Portuguese version of Beck Depression Inventory-II (BDI-II and the Profile of Mood States (PoMS was administered. The FIQR was re-administered to twenty-four participants, six weeks after the first evaluation. Internal reliability was assessed through Cronbach’s alpha, corrected item-total score correlations and alpha if item deleted. Spearman and Pearson correlations along with repeated measures tests were computed to assess the temporal stability of the scale. Convergent and divergent validity were assessed via Spearman and Pearson correlations. Results: The FIQR demonstrated a good to very good internal consistency (from α = 0.87 to α = 0.94. All items correlated to a good degree (above 0.30 to the total score and contributed significantly to the overall reliability. Moreover, FIQR presented a good temporal stability (from r = .617 to r = .886, p ≤ .001 and favorable convergent and

Association between adolescents' self-perceived oral health and self-reported experiences of abuse.

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Kvist, Therese; Annerbäck, Eva-Maria; Sahlqvist, Lotta; Flodmark, Olof; Dahllöf, Göran

2013-12-01

This study investigated the association between self-perceived oral health and self-reported exposure to different types of child abuse. It was hypothesized that self-perceived oral health is compromised in exposed adolescents. All Grade-9 compulsory school and second-year high-school pupils in Södermanland County, Sweden (n = 7,262) were invited to take part in a population-based survey; 5,940 adolescents responded. Survey items on health and social wellbeing included self-perceived oral health and exposure to abuse. The results showed that poor self-perceived oral health was associated with self-reported experience of physical abuse, intimate partner violence, forced sex, and bullying (adjusted OR = 2.3-14.7). The likelihood of reporting poor oral health increased from an adjusted OR of 2.1 for a single incident of abuse to an adjusted OR of 23.3 for multiple abuses. In conclusion, poor self-perceived oral health and previous exposure to child physical abuse, intimate partner violence, bullying, and forced sex is associated. It is important that dental professionals recognize adolescents with poor subjective oral health and take into consideration child abuse as a possible cause in order to prevent these adolescents from further victimization. These results further strengthen that dental professionals are an important resource in child protection. © 2013 Eur J Oral Sci.

Results of a multidisciplinary program for patients with fibromyalgia implemented in the primary care

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van Wilgen, C.P.; Bloten, H.; Oeseburg, B.

2007-01-01

Purpose. Fibromyalgia is a syndrome of unknown origin with a high prevalence. Multimodal approaches seem to be the treatment of choice in fibromyalgia. A multidisciplinary program was developed and implemented for patients with fibromyalgia in the primary care setting. The program included education

Perceived job insecurity as a risk factor for incident coronary heart disease

DEFF Research Database (Denmark)

Virtanen, Marianna; Nyberg, Solja T; Batty, George David

2013-01-01

To determine the association between self reported job insecurity and incident coronary heart disease.......To determine the association between self reported job insecurity and incident coronary heart disease....

Assessment of anxiety and quality of life in fibromyalgia patients

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Tathiana Pagano

Full Text Available CONTEXT: Fibromyalgia is a syndrome characterized by chronic, diffuse musculoskeletal pain, and by a low pain threshold at specific anatomical points. The syndrome is associated with other symptoms such as fatigue, sleep disturbance, morning stiffness and anxiety. Because of its chronic nature, it often has a negative impact on patients' quality of life. OBJECTIVE: To assess the quality of life and anxiety level of patients with fibromyalgia. TYPE Of STUDY: Cross-sectional. SETTING: Rheumatology outpatient service of Hospital das Clínicas (Medical School, Universidade de São Paulo. METHODS: This study evaluated 80 individuals, divided between test and control groups. The test group included 40 women with a confirmed diagnosis of fibromyalgia. The control group was composed of 40 healthy women. Three questionnaires were used: two to assess quality of life (FIQ and SF-36 and one to assess anxiety (STAI. They were applied to the individuals in both groups in a single face-to-face interview. The statistical analysis used Student's t test and Pearson's correlation test (r, with a significance level of 95%. Also, the Pearson chi-squared statistics test for homogeneity, with Yates correction, was used for comparing schooling between test and control groups. RESULTS: There was a statistically significant difference between the groups (p = 0.000, thus indicating that fibromyalgia patients have a worse quality of life and higher levels of anxiety. The correlations between the three questionnaires were high (r = 0.9. DISCUSSION: This study has confirmed the efficacy of FIQ for evaluating the impact of fibromyalgia on the quality of life. SF-36 is less specific than FIQ, although statistically significant values were obtained when analyzed separately, STAI showed lower efficacy for discriminating the test group from the control group. The test group showed worse quality of life than did the control group, which was demonstrated by both FIQ and SF-36. Even

The influence of depression on personality traits in patients with fibromyalgia: a case-control study.

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Santos, Daniela M; Lage, Laís V; Jabur, Eleonora K; Kaziyama, Helena H S; Iosifescu, Dan V; De Lucia, Mara Cristina S; Fráguas, Renério

2017-01-01

We developed this study to investigate the association of fibromyalgia with personality traits, controlling for depression and other potential confounders. We assessed personality traits using the Cloninger's Temperament and Character Inventory (TCI) in 78 female patients with fibromyalgia and in a control group of 78 subjects without fibromyalgia. The Mini-International Neuropsychiatric Interview was used to assess depression and anxiety diagnoses. To investigate the association between fibromyalgia and the Cloninger's Temperament and Character Inventory we performed unadjusted and adjusted analyses of covariance, using the TCI score as dependent variable and adjusting the model for depression, anxiety and for clinical and socio-demographic variables. We used a backward selection method to choose the final model. In the unadjusted analysis, fibromyalgia was associated with all personality traits, except persistency. After adjusting for depression and anxiety, patients with fibromyalgia presented decreased novelty seeking compared to controls; the differences in other personality traits were no longer significant. Novelty seeking was also correlated with the length of history of fibromyalgia and pain intensity. Decreased novelty seeking may be a personality trait associated with fibromyalgia. Depression and anxiety should be considered potential confounders in the evaluation of personality traits in this population.

Quality of life and discriminating power of two questionnaires in fibromyalgia patients: Fibromyalgia Impact Questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey.

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Assumpção, Ana; Pagano, Tatiana; Matsutani, Luciana A; Ferreira, Elizabeth A G; Pereira, Carlos A B; Marques, Amélia P

2010-01-01

Fibromyalgia is a painful syndrome characterized by widespread chronic pain and associated symptoms with a negative impact on quality of life. Considering the subjectivity of quality of life measurements, the aim of this study was to verify the discriminating power of two quality of life questionnaires in patients with fibromyalgia: the generic Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the specific Fibromyalgia Impact Questionnaire (FIQ). A cross-sectional study was conducted on 150 participants divided into Fibromyalgia Group (FG) and Control Group (CG) (n=75 in each group). The participants were evaluated using the SF-36 and the FIQ. The data were analyzed by the Student t-test (α=0.05) and inferential analysis using the Receiver Operating Characteristics (ROC) Curve--sensitivity, specificity and area under the curve (AUC). The significance level was 0.05. The sample was similar for age (CG: 47.8 ± 8.1; FG: 47.0 ± 7.7 years). A significant difference was observed in quality of life assessment in all aspects of both questionnaires (pquality of life in fibromyalgia patients, and we suggest that both should be used in parallel because they evaluate relevant and complementary aspects of quality of life.

Fibromyalgia revisited: the challenge to a diagnoses remains

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José Eduardo Martinez

2010-12-01

Full Text Available ABSTRACT Fibromyalgia is a clinical syndrome characterized by widespread musculoskeletal pain associated with areas of the body known as tender points which, when pressured gently, cause an exaggerated pain response. The most accepted physiopathological theory is that the pain in fibromyalgia results from an unbalance between the pain transmission stimulus mechanism and the pain inhibition one. The symptoms range from widespread musculoskeletal pain; disruptive sleep patterns; fatigue; short-lived generalized stiffness (generally in the morning; edema sensation and paresthesia. There is a constant association with other functional syndrome such as: depression, anxiety, migraine and irritable bowel syndrome. In 1990 The American College of Rheumatology developed a set of criteria to diagnose fibromyalgia and include it in scientific studies so as to help with the upcoming of a patient´s diagnosis and its follow up.

Acupuncture for treating fibromyalgia

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Deare, John C; Zheng, Zhen; Xue, Charlie CL; Liu, Jian Ping; Shang, Jingsheng; Scott, Sean W; Littlejohn, Geoff

2014-01-01

Background One in five fibromyalgia sufferers use acupuncture treatment within two years of diagnosis. Objectives To examine the benefits and safety of acupuncture treatment for fibromyalgia. Search methods We searched CENTRAL, PubMed, EMBASE, CINAHL, National Research Register, HSR Project and Current Contents, as well as the Chinese databases VIP and Wangfang to January 2012 with no language restrictions. Selection criteria Randomised and quasi-randomised studies evaluating any type of invasive acupuncture for fibromyalgia diagnosed according to the American College of Rheumatology (ACR) criteria, and reporting any main outcome: pain, physical function, fatigue, sleep, total well-being, stiffness and adverse events. Data collection and analysis Two author pairs selected trials, extracted data and assessed risk of bias. Treatment effects were reported as standardised mean differences (SMD) and 95%confidence intervals (CI) for continuous outcomes using different measurement tools (pain, physical function, fatigue, sleep, total well-being and stiffness) and risk ratio (RR) and 95% CI for dichotomous outcomes (adverse events).We pooled data using the random-effects model. Main results Nine trials (395 participants) were included. All studies except one were at low risk of selection bias; five were at risk of selective reporting bias (favouring either treatment group); two were subject to attrition bias (favouring acupuncture); three were subject to performance bias (favouring acupuncture) and one to detection bias (favouring acupuncture). Three studies utilised electro-acupuncture (EA) with the remainder using manual acupuncture (MA) without electrical stimulation. All studies used ’formula acupuncture’ except for one, which used trigger points. Low quality evidence from one study (13 participants) showed EA improved symptoms with no adverse events at one month following treatment. Mean pain in the non-treatment control group was 70 points on a 100 point scale

LEVEL OF HABITUAL PHYSICAL ACTIVITY AND QUALITY OF LIFE OF WOMEN WITH FIBROMYALGIA

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Manoela de Oliveira Nascimento Araújo

2015-03-01

Full Text Available The syndrome of fibromyalgia (FM is a condition of chronic pain, general, difficult to treat and contributes to the decline of cardiorespiratory fitness and quality of life. This study aimed to analyze the association between physical activity and quality of life of women with FM. Was characterized as cross-sectional study and the population consisted 22 women with FM care in the city of Itabuna - BA. The diagnosis of fibromyalgia was according to criteria to American College of Rheumatology. The data collection instrument was established by the Fibromyalgia Impact Questionnaire and the International Physical Activity Questionnaire. Atividade física e qualidade de vida For data analysis, we used the procedure descriptive statistics (mean, standard deviation, frequency and percentage and inferential (Chi-square test and Fisher's test, significance level of p≤0.05. The average age of respondents was 41.05 (SD = 6.543 years, ranging between 27 and 56 years. In general physical activity, 45.5% were considered physically active. By analyzing the dimensions of physical activity as a means transportation, only 31.8% are active and in the dimension of leisure, only 27.3%. The assessment of the level of quality of life of the subjects revealed that 72.7% had negative quality of life, while only 27.3% reported having a positive quality of life. The present study showed that fibromyalgia affects mainly women and that this syndrome interfere with the patients' quality of life.

The effect of relaxation therapy on autonomic functioning, symptoms and daily functioning, in patients with chronic fatigue syndrome or fibromyalgia: a systematic review.

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Meeus, Mira; Nijs, Jo; Vanderheiden, Tanja; Baert, Isabel; Descheemaeker, Filip; Struyf, Filip

2015-03-01

To establish the effects of relaxation therapy on autonomic function, pain, fatigue and daily functioning in patients with chronic fatigue syndrome or fibromyalgia. A systematic literature study was performed. Using specific keywords related to fibromyalgia or chronic fatigue syndrome and relaxation therapy, the electronic databases PubMed and Web of Science were searched. Included articles were assessed for their risk of bias and relevant information regarding relaxation was extracted. The review was conducted and reported according to the PRISMA-statement. Thirteen randomized clinical trials of sufficient quality were included, resulting in a total of 650 fibromyalgia patients (11 studies) and 88 chronic fatigue syndrome patients (3 studies). None of the studies reported effects on autonomic function. Six studies reported the effect of guided imagery on pain and daily functioning in fibromyalgia. The acute effect of a single session of guided imagery was studied in two studies and seems beneficial for pain relief. For other relaxation techniques (eg. muscle relaxation, autogenic training) no conclusive evidence was found for the effect on pain and functioning in fibromyalgia patients comparison to multimodal treatment programs. For fatigue a multimodal approach seemed better than relaxation, as shown in the sole three studies on chronic fatigue syndrome patients. There is moderate evidence for the acute effect of guided imagery on pain, although the content of the visualization is a matter of debate. Other relaxation formats and the effects on functionality and autonomic function require further study. © The Author(s) 2014.

Relationship of self-liking, self-competence with self-reported oral health status among 15-year-old children of Davangere city: A cross-sectional survey

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Anjan Giriraju

2015-01-01

Full Text Available Introduction: Psychological constructs have been found to have potential effects in the improvement of health. Self-esteem (expressed in the form of sub-constructs: Self-liking and self-competence is a construct, which makes one realize the self. This in turn will result in positive oral-health-seeking behavior and improvement in oral health status. Aim: To assess the relationship of self-liking, self-competence with self-reported oral health status in children aged 15 years, in Davangere city. Materials and Methods: A descriptive, cross-sectional survey was conducted on 220 15-year-old subjects in Davangere City. Specially designed pro forma containing Romanian self-administered questionnaire to record the self-reported oral health status and Tafarodi's SLC scale to measure self-liking/self-competence was used. Chi-square test was used for statistical analysis. Results: A majority of the participants were found to have moderate self-competence and self-liking and their self-reported oral health status was expressed as "excellent." They reported very less or no untreated decayed teeth and no extracted teeth or gingival bleeding. Conclusion: The participants with better self-competence and self-liking perceived their oral health status as good. They reported lesser incidence of oral diseases and discomfort. Self-esteem and oral health were found to be positively related.

Effects of low sleep quality on sexual function, in women with fibromyalgia.

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Amasyali, A S; Taştaban, E; Amasyali, S Y; Turan, Y; Kazan, E; Sari, E; Erol, B; Cengiz, M; Erol, H

2016-01-01

Sexual dysfunction is a common experience in women with fibromyalgia. However, the physiopathology of this association is unclear. We aimed to evaluate whether sleep disturbance has an influence on sexual function in women with fibromyalgia. Fifty-four sexually active premenopausal women with fibromyalgia were enrolled in the study. The following questionnaires were used: the Female Sexual Function Index (FSFI), the Pittsburgh Sleep Quality Index (PSQI), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory (BDI). Appropriate statistical analyses were used by using SPSS 18. The mean FSFI score was 25.344 ± 6.52 and showed no correlation with age, body mass index, BDI or duration of fibromyalgia. However, a positive correlation between sexual dysfunction and low sleep quality was found (r=0.43; P=0.001). In addition, the median FSFI score was 29.2 (27.2-32.4) in patients with higher sleep quality (PSQI⩽5), whereas it was 21.4 (18.9-25.3) in patients with lower sleep quality (PSQI>5) (Pfibromyalgia as indicated by a higher FIQ score (r=0.37; P=0.006). Sexual dysfunction in female patients with fibromyalgia may be due to low sleep quality. Treatment of the sleep disorder may improve female sexual function.

Combination pharmacotherapy for the treatment of fibromyalgia in adults.

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Thorpe, Joelle; Shum, Bonnie; Moore, R Andrew; Wiffen, Philip J; Gilron, Ian

2018-02-19

Fibromyalgia is a chronic widespread pain condition affecting millions of people worldwide. Current pharmacotherapies are often ineffective and poorly tolerated. Combining different agents could provide superior pain relief and possibly also fewer side effects. To assess the efficacy, safety, and tolerability of combination pharmacotherapy compared to monotherapy or placebo, or both, for the treatment of fibromyalgia pain in adults. We searched CENTRAL, MEDLINE, and Embase to September 2017. We also searched reference lists of other reviews and trials registries. Double-blind, randomised controlled trials comparing combinations of two or more drugs to placebo or other comparators, or both, for the treatment of fibromyalgia pain. From all studies, we extracted data on: participant-reported pain relief of 30% or 50% or greater; patient global impression of clinical change (PGIC) much or very much improved or very much improved; any other pain-related outcome of improvement; withdrawals (lack of efficacy, adverse events), participants experiencing any adverse event, serious adverse events, and specific adverse events (e.g. somnolence and dizziness). The primary comparison was between combination and one or all single-agent comparators. We also assessed the evidence using GRADE and created a 'Summary of findings' table. We identified 16 studies with 1474 participants. Three studies combined a non-steroidal anti-inflammatory drug (NSAID) with a benzodiazepine (306 participants); two combined amitriptyline with fluoxetine (89 participants); two combined amitriptyline with a different agent (92 participants); two combined melatonin with an antidepressant (164 participants); one combined carisoprodol, paracetamol (acetaminophen), and caffeine (58 participants); one combined tramadol and paracetamol (acetaminophen) (315 participants); one combined malic acid and magnesium (24 participants); one combined a monoamine oxidase inhibitor with 5-hydroxytryptophan (200

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

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Kim Lawson

2017-05-01

Full Text Available Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development.

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

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Lawson, Kim

2017-01-01

Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development. PMID:28536367

Humanistic and economic burden of fibromyalgia in Japan [Corrigendum

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Lee LK

2016-12-01

Full Text Available Lee LK, Ebata N, Hlavacek P, DiBonaventura M, Cappelleri JC, Sadosky A. Humanistic and economic burden of fibromyalgia in Japan. Journal of Pain Research. 2016;9:967–978.Figures 3, 4, 5, and 6 contain errors in the key. Fibromyalgia should be dark gray and matched controls should be light gray.Read the original article.

Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia

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Matarán-Peñarrocha, Guillermo A.; Castro-Sánchez, Adelaida María; García, Gloria Carballo; Moreno-Lorenzo, Carmen; Carreño, Tesifón Parrón; Zafra, María Dolores Onieva

2011-01-01

Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patien...

Is there a role for opioids in the treatment of fibromyalgia?

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Littlejohn, Geoffrey O; Guymer, Emma K; Ngian, Gene-Siew

2016-05-01

The use of opioids for chronic pain has increased significantly due to a combination of the high patient burden of pain and the more widespread availability of a range of long-acting opioid preparations. This increased opioid use has translated into the care of many patients with fibromyalgia. The pain mechanism in fibromyalgia is complex but does not seem to involve disturbance of opioid analgesic functions. Hence, there is general concern about the harms in the absence of benefits of opioids in this setting. There is no evidence that pure opioids are effective in fibromyalgia but there is some evidence that opioids with additional actions on the norepinephrine-related pain modulatory pathways, such as tramadol, can be clinically useful in some patients. Novel actions of low-dose opioid antagonists may lead to better understanding of the role of opioid function in fibromyalgia.

Preliminary findings of a 4-month Tai Chi intervention on tenderness, functional capacity, symptomatology, and quality of life in men with fibromyalgia.

Science.gov (United States)

Carbonell-Baeza, Ana; Romero, Alejandro; Aparicio, Virginia A; Ortega, Francisco B; Tercedor, Pablo; Delgado-Fernández, Manuel; Ruiz, Jonatan R

2011-09-01

The study aimed to determine the effects of a 4-month Tai Chi intervention on tenderness, functional capacity, symptomatology, and quality of life in men with fibromyalgia. The effect of a 3-month detraining period was also analyzed. Six men with fibromyalgia (age 52.3 ± 9.3 years) followed a 4-month Tai Chi intervention. The outcome variables were tenderness, functional capacity (30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go, and 6-minute walk tests), and self-administered questionnaires. A significant improvement (p = .028) after the intervention period for the chair sit and reach test was found, such improvement was maintained after the detraining phase. Tenderness, symptomatology, and quality of life did not significantly change after the intervention period or the detraining phase. In summary, a 4-month Tai Chi intervention improved lower body flexibility in men with fibromyalgia. This improvement persisted after the detraining period.

A Qualitative Examination of a New Combined Cognitive-Behavioral and Neuromuscular Training Intervention for Juvenile Fibromyalgia.

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Kashikar-Zuck, Susmita; Tran, Susan T; Barnett, Kimberly; Bromberg, Maggie H; Strotman, Daniel; Sil, Soumitri; Thomas, Staci M; Joffe, Naomi; Ting, Tracy V; Williams, Sara E; Myer, Gregory D

2016-01-01

Adolescents with juvenile fibromyalgia (JFM) are typically sedentary despite recommendations for physical exercise, a key component of pain management. Interventions such as cognitive-behavior therapy (CBT) are beneficial but do not improve exercise participation. The objective of this study was to obtain preliminary information about the feasibility, safety, and acceptability of a new intervention--Fibromyalgia Integrative Training for Teens (FIT Teens), which combines CBT with specialized neuromuscular exercise training modified from evidence-based injury prevention protocols. Participants were 17 adolescent females (aged 12 to 18 y) with JFM. Of these, 11 completed the 8-week (16 sessions) FIT Teens program in a small-group format with 3 to 4 patients per group. Patients provided detailed qualitative feedback via individual semistructured interviews after treatment. Interview content was coded using thematic analysis. Interventionist feedback about treatment implementation was also obtained. The intervention was found to be feasible, well tolerated, and safe for JFM patients. Barriers to enrollment (50% of those approached) included difficulties with transportation or time conflicts. Treatment completers enjoyed the group format and reported increased self-efficacy, strength, and motivation to exercise. Participants also reported decreased pain and increased energy levels. Feedback from participants and interventionists was incorporated into a final treatment manual to be used in a future trial. Results of this study provided initial support for the new FIT Teens program. An integrative strategy of combining pain coping skills via CBT enhanced with tailored exercise specifically designed to improve confidence in movement and improving activity participation holds promise in the management of JFM.

Effects of Reflexology on Pain in Patients With Fibromyalgia.

Science.gov (United States)

Akin Korhan, Esra; Uyar, Meltem; Eyigör, Can; Yönt, Gülendam Hakverdioğlu; Khorshid, Leyla

The aim of this study was to investigate the effect of reflexology on pain intensity in patients with fibromyalgia, using an experimental repeated-measures design, and a convenience sample of 30 fibromyalgia inpatients. Thirty patients aged 18 to 70 years with fibromyalgia and hospitalized in the algology clinic were taken as a convenience sample. Patients received a total of 12 60-minute sessions of reflexology over a period of 6 consecutive weeks. Reflexology was carried out bilaterally on the hands and feet of patients at the reflex points relating to their pain at a suitable intensity and angle. Subjects had pain scores taken immediately before the intervention (0 minute), and at the 60th minute of the intervention. Data were collected over a 10-month period in 2012. The patients' mean pain intensity scores were reduced by reflexology, and this decrease improved progressively in the first and sixth weeks of the intervention, indicating a cumulative dose effect. The results of this study implied that the inclusion of reflexology in the routine care of patients with fibromyalgia could provide nurses with an effective practice for reducing pain intensity in these patients.

An update on pharmacotherapy for the treatment of fibromyalgia.

Science.gov (United States)

Calandre, Elena P; Rico-Villademoros, Fernando; Slim, Mahmoud

2015-06-01

Fibromyalgia is a syndrome characterized by chronic generalized pain in addition to different symptoms such as fatigue, sleep disturbances, stiffness, cognitive impairment, and psychological distress. Multidisciplinary treatment combining pharmacological and nonpharmacological therapies is advised. Publications describing randomized controlled trials and long-term extension studies evaluating drug treatment for fibromyalgia were searched in PubMed and Scopus and included in this review. Different drugs are recommended for the treatment of fibromyalgia by different published guidelines, although only three of them have been approved for this indication by the US FDA, and none have been approved by the European Medicines Agency. According to the available evidence, pregabalin, duloxetine and milnacipran should be the drugs of choice for the treatment of this disease, followed by amitriptyline and cyclobenzaprine. Other drugs with at least one positive clinical trial include some selective serotonin reuptake inhibitors, moclobemide, pirlindole, gabapentin, tramadol, tropisetron, sodium oxybate and nabilone. None of the currently available drugs are fully effective against the whole spectrum of fibromyalgia symptoms, namely pain, fatigue, sleep disturbances and depression, among the most relevant symptoms. Combination therapy is an option that needs to be more thoroughly investigated in clinical trials.

Social support for female sexual dysfunction in fibromyalgia

OpenAIRE

Granero-Molina, José; Matarín Jimenez, Tamara María; Ramos Rodríguez, Carmen; Hernández-Padilla, José Manuel; Castro-Sánchez, Adelaida Maria; Fernández-Sola, Cayetano

2016-01-01

The aim of this study is to describe and understand experiences related to social support for women with fibromyalgia who suffer from sexual dysfunction. An interpretive qualitative research methodology based on Gadamer’s philosophical hermeneutics was used. Data collection included a focus group and in-depth interviews with 13 women who averaged 44.8 years of age and 14.3 years since being diagnosed with fibromyalgia. Data were analyzed using Fleming’s method and two themes were identified: ...

Clinical Manifestations Associated with Overweight/Obesity in Puerto Ricans with Fibromyalgia Syndrome

Directory of Open Access Journals (Sweden)

Ruth M. Fred-Jiménez

2016-01-01

Full Text Available Objective. To determine the clinical manifestations associated with overweight/obesity in Hispanics from Puerto Rico with fibromyalgia syndrome (FMS. Methods. A cross-sectional study was performed in 144 patients with FMS (per American College of Rheumatology (ACR classification criteria. Sociodemographic features, FMS-related symptoms, tender points (per ACR criteria, comorbidities, and FMS treatment were examined. BMI was calculated and patients were grouped into two categories: BMI ≤ 24.9 kg/m2 (nonoverweight/obese and BMI ≥ 25 kg/m2 (overweight/obese. Bivariate and multivariate analyses were used to evaluate differences between the study groups. Results. The mean (standard deviation (SD age of patients was 50.2 (9.9 years; 95.1% were females and 75.7% were overweight/obese. In the bivariate analysis, overweight/obese patients were more likely to have self-reported memory impairment, anxiety, shortness of breath, and urinary frequency than nonoverweight/obese patients. In addition, the tender point count was higher in the overweight/obese group. In the logistic regression analyses, self-reported memory impairment and urinary frequency differences remained significant after adjusting for confounding variables. Conclusion. In this population of Puerto Ricans with FMS, overweight/obese patients experienced more FMS-related manifestations than nonoverweight/obese individuals. However, prospective studies are needed to confirm these associations and to elucidate if weight reduction interventions could favorably impact the severity of FMS.

Clinical Manifestations Associated with Overweight/Obesity in Puerto Ricans with Fibromyalgia Syndrome.

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Fred-Jiménez, Ruth M; Arroyo-Ávila, Mariangelí; Mayor, Ángel M; Ríos, Grissel; Vilá, Luis M

2016-01-01

Objective. To determine the clinical manifestations associated with overweight/obesity in Hispanics from Puerto Rico with fibromyalgia syndrome (FMS). Methods. A cross-sectional study was performed in 144 patients with FMS (per American College of Rheumatology (ACR) classification criteria). Sociodemographic features, FMS-related symptoms, tender points (per ACR criteria), comorbidities, and FMS treatment were examined. BMI was calculated and patients were grouped into two categories: BMI ≤ 24.9 kg/m(2) (nonoverweight/obese) and BMI ≥ 25 kg/m(2) (overweight/obese). Bivariate and multivariate analyses were used to evaluate differences between the study groups. Results. The mean (standard deviation (SD)) age of patients was 50.2 (9.9) years; 95.1% were females and 75.7% were overweight/obese. In the bivariate analysis, overweight/obese patients were more likely to have self-reported memory impairment, anxiety, shortness of breath, and urinary frequency than nonoverweight/obese patients. In addition, the tender point count was higher in the overweight/obese group. In the logistic regression analyses, self-reported memory impairment and urinary frequency differences remained significant after adjusting for confounding variables. Conclusion. In this population of Puerto Ricans with FMS, overweight/obese patients experienced more FMS-related manifestations than nonoverweight/obese individuals. However, prospective studies are needed to confirm these associations and to elucidate if weight reduction interventions could favorably impact the severity of FMS.

Music reduces pain and increases functional mobility in fibromyalgia

DEFF Research Database (Denmark)

Garza-Villarreal, Eduardo A.; Wilson, Andrew D; Vase, Lene

2014-01-01

task (not during), therefore the effect cannot be explained merely by motor entrainment to a fast rhythm. Cognitive and emotional mechanisms seem to be central to music-induced analgesia. Our findings encourage the use of music as a treatment adjuvant to reduce chronic pain in FM and increase......The pain in Fibromyalgia (FM) is difficult to treat and functional mobility seems to be an important comorbidity in these patients that could evolve into a disability. In this study we wanted to investigate the analgesic effects of music in FM pain. Twenty-two FM patients were passively exposed...... to (1) self-chosen, relaxing, pleasant music, and to (2) a control auditory condition (pink noise). They rated pain and performed the “timed-up & go task (TUG)” to measure functional mobility after each auditory condition. Listening to relaxing, pleasant, self-chosen music reduced pain and increased...

Fibromyalgia with Gabapentin and Osteopathic Manipulative Medicine: A Pilot Study.

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Marske, Cynthia; Bernard, Natasha; Palacios, Alison; Wheeler, Cary; Preiss, Ben; Brown, Mackenzie; Bhattacharya, Saveri; Klapstein, Gloria

2018-04-01

This pilot study compares the safety and efficacy of three treatments in reducing pain and improving fibromyalgia symptoms. This study was an 8-week prospective, single center feasibility study. Forty subjects were recruited from Solano, Sonoma, and Contra Costa counties of California in 2006-2009. Subjects were aged 18-65 and met the American College of Rheumatology (ACR) 1990 criteria for fibromyalgia. This study had three treatment arms: gabapentin only (900 mg/day), osteopathic manipulative medicine (OMM) only, and combined treatment of gabapentin plus OMM. OMM treatment was administered by advanced medical students for 30 min, once a week. The trial lasted for 8 weeks, which included 6 weeks of treatment plus initial and final visits. Key outcome measures included Wong-Baker FACES Pain Rating Scale (WBF), Clinical Global Impression of Health (CGI), Fibromyalgia Impact Questionnaire (FIQ), and number of tender points. Twenty-nine subjects completed the trial; 8 subjects received gabapentin only, 11 patients received OMM only, and 10 patients received gabapentin plus OMM. Subjects receiving OMM alone and subjects receiving the combined treatment of OMM and gabapentin displayed clinical improvements based on WBF (p treatment and gabapentin are safe and clinically efficacious treatment of pain and other constitutional and somatic symptoms associated with fibromyalgia. A larger trial using the new ACR 2010 Fibromyalgia criteria is needed to confirm these findings.

Current status of atypical antipsychotics for the treatment of fibromyalgia.

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Rico-Villademoros, F; Calandre, E P; Slim, M

2014-06-01

The treatment of fibromyalgia requires pharmacological and nonpharmacological therapies. The pharmacological treatment of fibromyalgia is limited to a few drugs that have been demonstrated to be moderately effective in some but not all dimensions of the disease. Therefore, the search for new drugs to treat this condition is warranted. Atypical antipsychotics offered an attractive alternative because they had been shown to be active against several key symptoms of fibromyalgia. The results of open-label studies, however, appear to indicate that atypical antipsychotics are poorly tolerated in patients with fibromyalgia, and only quetiapine XR has been studied in randomized controlled trials. Quetiapine XR has demonstrated effectiveness in treating comorbid major depression, anxiety and sleep disturbance. However, in two randomized controlled trials, quetiapine XR was not differentiated from placebo and failed to demonstrate noninferiority to amitriptyline in terms of improving overall symptomatology. The effect of quetiapine XR on pain and its usefulness as part of a combination pharmacological regimen should be further evaluated. Overall, the use of quetiapine (initiated at a low dose and slowly titrated) in fibromyalgia should be limited to patients with comorbid major depression or patients who are currently receiving other treatments and have unresolved and disabling depressive and/or anxiety symptoms. Copyright 2014 Prous Science, S.A.U. or its licensors. All rights reserved.

Epidemiology of fibromyalgia.

Science.gov (United States)

Neumann, Lily; Buskila, Dan

2003-10-01

Chronic widespread pain, the cardinal symptom of fibromyalgia (FM), is common in the general population, with comparable prevalence rates of 7.3% to 12.9% across different countries. The prevalence of FM in the general population was reported to range from 0.5% to 5% and up to 15.7% in the clinic. The common association of FM with other rheumatic disorders, chronic viral infections, and systemic illnesses has been well documented in several studies. Up to 65% of patients with systemic lupus erythematosus meet the criteria for FM. FM is considered a member of the family of functional somatic syndromes. These syndromes are very common and share a similar phenomenology, epidemiologic characteristics, high rates of occurrence, a common pathogenesis, and similar management strategies. A high prevalence of FM was demonstrated among relatives of patients with FM and it may be attributed to genetic and environmental factors.

The adaptation of a Danish version of the Pain Self-Efficacy Questionnaire

DEFF Research Database (Denmark)

Rasmussen, M. U.; Rydahl-Hansen, Susan; Amris, K.

2016-01-01

The aim of this study was to translate, culturally adapt and evaluate the psychometric properties of the Pain Self-Efficacy Questionnaire (PSEQ) in a population of patients with fibromyalgia in Denmark. The study sample included 102 patients diagnosed with fibromyalgia referred to a specialist...... clinic. The PSEQ was translated and adapted to a Danish setting using a standard stepw-ise forward-backward translation procedure, followed by initial testing and focus group interview. Reliability was examined by analysing internal consistency and test-retest agreement. Construct validity was exami......-factor model and IRT models supported acceptable construct validity. The PSEQ-DK showed acceptable psychometric properties and can therefore represent a reliable and valid measure for evaluating self-efficacy in patients with fibromyalgia in Denmark. © 2016 Nordic College of Caring Science....

The role of tendinitis in fibromyalgia syndrome.

Science.gov (United States)

Genç, Hakan; Saracoğlu, Meryem; Duyur, Burcu; Erdem, Hatice Rana

2003-08-30

Fibromyalgia Syndrome (FS) is a common disease characterized by diffuse, widespread pain and multiple tender points. The syndrome has been subclassified as primary (PFS) and secondary (SFS) fibromyalgia. The aim of this study was to evaluate the role of common tendinitis (rotator cuff tendinitis, bicipital tendinitis, lateral epicondylitis, De-Quervain's tendinitis and pes anserinus tendinitis) in FS. Twenty female patients with PFS, 20 with SFS and 20 female controls, matched by age and body mass index, participated in the study. Existence of common tendinitis was evaluated with specific examination methods. Right and left rotator cuff tendinitis, pes anserinus tendinitis and left lateral epicondylitis were significantly more common in patients with PFS and SFS than in control subjects. As a result, considering the central hyperexcitability present in the fibromyalgia patients, concomitant pathologies such as tendinitis which lead to shoulder, arm, and leg pain must be evaluated. Follow up and therapy for the disease must be planned according to these factors which are not only probable symptoms of FS, but also leading causes for the occurrence and continuity of the pain in this disease.

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

Science.gov (United States)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

Correlates of body mass index in women with fibromyalgia.

Science.gov (United States)

Timmerman, Gayle M; Calfa, Nicolina A; Stuifbergen, Alexa K

2013-01-01

Excess weight in women with fibromyalgia syndrome (FMS) may further contribute to joint pain and fatigue. However, there is little research addressing weight issues in this population. This study examined the relationship of body mass index (BMI) to quality of life. Quality of life was measured by the 36-Item Short Form Health Survey, severity of FMS, nutritional intake, Barriers to Health Promoting Behaviors for Disabled Persons Scale (BS), and self-efficacy for health-promoting behaviors (Self-Rated Abilities for Health Practices Scale) in women with FMS. Baseline data were collected on 179 women diagnosed with FMS. Controlling for age, BMI was significantly (p < .05) correlated with 36-Item Short Form Health Survey subscales of physical functioning, bodily pain and vitality, severity of FMS using the Tender Point Index, calories, protein, fat, saturated fat, BS, and Self-Rated Abilities for Health Practices Scale subscale for exercise. The findings support a growing body of evidence that excess weight is negatively related to quality of life and pain in women with FMS.

The Potential of Established Fitness Cut-off Points for Monitoring Women with Fibromyalgia: The al-Ándalus Project.

Science.gov (United States)

Castro-Piñero, José; Aparicio, Virginia A; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Borges-Cosic, Milkana; Soriano-Maldonado, Alberto; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

2017-05-01

The aim of the present study was to determinate whether fitness cut-off points discriminate the severity of major fibromyalgia symptoms and health-related quality of life. Additionally, we investigated which American Colleague of Rheumatology (ACR) fibromyalgia criteria (1990 vs. modified 2010) better discriminate fibromyalgia symptomatology. A total of 488 women with fibromyalgia and 200 non-fibromyalgia (control) women participated. All participants underwent both the 1990 and the modified 2010 ACR preliminary criteria (hereinafter 1990c and m-2010c, respectively). We used fitness cut-off points (Senior Fitness Tests Battery plus handgrip strength test) to discriminate between presence and absence of fibromyalgia. Additionally, we employed several instruments to assess fibromyalgia symptoms. Fitness cut-off points discriminated between high and low levels of the main symptoms the disease in all age groups (P from fibromyalgia diagnosis and monitoring. Moreover, the effect size of the differences in symptoms between women with fibromyalgia and controls were overall larger using the m-2010c compared with the 1990c, except for the tender points count, reflecting better the polysymptomatic distress condition of fibromyalgia. © Georg Thieme Verlag KG Stuttgart · New York.

National Fire Incident Reporting System (NFIRS)

Data.gov (United States)

Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial

Science.gov (United States)

Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

2018-01-01

Abstract Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Design Prospective, randomized, 52 week, single blind comparative effectiveness trial. Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016. Participants 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Interventions Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. Main outcome measures The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. Results FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with

Comparison of the Big Five personality traits in fibromyalgia and other rheumatic diseases.

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Bucourt, Emilie; Martaillé, Virginie; Mulleman, Denis; Goupille, Philippe; Joncker-Vannier, Isabelle; Huttenberger, Brigitte; Reveillere, Christian; Courtois, Robert

2017-03-01

The personality of patients with fibromyalgia is still under debate. Some studies found high neuroticism associated with low extraversion, while others found that these traits do not differ from the normal population. Personality factors intervene in the emotional regulation and modulation of pain. The aim of the study was to determine the personality traits of patients with fibromyalgia compared to other rheumatic diseases. In a multicentric study, women with fibromyalgia, rheumatoid arthritis, spondyloarthritis or Sjögren's syndrome were asked to complete the Big Five Inventory, which encompasses five main personality dimensions, namely (1) extraversion vs. introversion, (2) agreeableness vs. antagonism, (3) conscientiousness vs. impulsivity, (4) neuroticism vs. emotional stability, and (5) openness vs. closed-mindedness. Variance analysis (Student's t-test and ANOVA with post-hoc comparisons or Bonferroni correction) was performed. We also conducted hierarchical and non-hierarchical cluster analyses. Participants were 163 women with fibromyalgia (n=48), rheumatoid arthritis (n=46), spondyloarthritis (n=46) and Sjögren's syndrome (n=23). The mean age was 47.18years (±10.81years, range 21 to 65). Patients with fibromyalgia had higher scores on agreeableness (F(3, 159)=3.39, Ppersonality in fibromyalgia. It also underlines the protective role of personality traits: in the fibromyalgia group, high neuroticism and low conscientiousness (high impulsivity) were associated with a high level of chronic pain. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Impact of Fibromyalgia in the Sit-to-Stand-to-Sit Performance Compared With Healthy Controls.

Science.gov (United States)

Collado-Mateo, Daniel; Adsuar, Jose C; Dominguez-Muñoz, Francisco J; Olivares, Pedro R; Gusi, Narcis

2017-06-01

Fibromyalgia is associated with a reduction in the ability to perform activities of daily living. Sit-to-stand-to-sit performance is one of the most common activities of daily living and often is evaluated by counting the number of repetitions of the 30-second chair-stand test. No study, however, has examined the performance over the 30 seconds of this test of female patients with fibromyalgia on a phase-by-phase basis. To evaluate the impact of fibromyalgia on performance of the 30-second chair-stand test and to analyze how the kinematic performance changed over the 30-second test period. A cross-sectional study. Local association of fibromyalgia. Fifteen females with fibromyalgia and nine healthy female controls. Participants performed the 30-second chair-stand test while wearing a motion capture device. Duration of each sit-to-stand-to-sit phase within the 30-second time limit was compared between groups using repeated measures analysis of variance. The association between duration of phases and scores from the revised version of the Fibromyalgia Impact Questionnaire was tested using bivariate correlations. The duration of impulse and sit-to-stand phases were gradually increased over the 30 seconds of the chair-stand test for women with fibromyalgia compared with healthy controls (P = .04 and P = .02, respectively). The mean duration of these 2 phases was associated with symptom duration and the function domain of the revised version of the Fibromyalgia Impact Questionnaire (P fibromyalgia and healthy controls. Since sit-to-stand from a chair is a common daily activity, women with fibromyalgia may require specific exercises to improve performance of this task. Not applicable. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Characteristics of Fibromyalgia Independently Predict Poorer Long‐Term Analgesic Outcomes Following Total Knee and Hip Arthroplasty

Science.gov (United States)

Urquhart, Andrew G.; Hassett, Afton L.; Tsodikov, Alex; Hallstrom, Brian R.; Wood, Nathan I.; Williams, David A.; Clauw, Daniel J.

2015-01-01

Objective While psychosocial factors have been associated with poorer outcomes after knee and hip arthroplasty, we hypothesized that augmented pain perception, as occurs in conditions such as fibromyalgia, may account for decreased responsiveness to primary knee and hip arthroplasty. Methods A prospective, observational cohort study was conducted. Preoperative phenotyping was conducted using validated questionnaires to assess pain, function, depression, anxiety, and catastrophizing. Participants also completed the 2011 fibromyalgia survey questionnaire, which addresses the widespread body pain and comorbid symptoms associated with characteristics of fibromyalgia. Results Of the 665 participants, 464 were retained 6 months after surgery. Since individuals who met criteria for being classified as having fibromyalgia were expected to respond less favorably, all primary analyses excluded these individuals (6% of the cohort). In the multivariate linear regression model predicting change in knee/hip pain (primary outcome), a higher fibromyalgia survey score was independently predictive of less improvement in pain (estimate −0.25, SE 0.044; P fibromyalgia survey score (P = 0.00032). The fibromyalgia survey score was also independently predictive of change in overall pain and patient global impression of change. Conclusion Our findings indicate that the fibromyalgia survey score is a robust predictor of poorer arthroplasty outcomes, even among individuals whose score falls well below the threshold for the categorical diagnosis of fibromyalgia. PMID:25772388

Exercise for adults with fibromyalgia: an umbrella systematic review with synthesis of best evidence.

Science.gov (United States)

Bidonde, Julia; Busch, Angela Jean; Bath, Brenna; Milosavljevic, Stephan

2014-01-01

The objective of this umbrella systematic review was to identify, evaluate, and synthesize systematic reviews of physical activity interventions for adults with fibromyalgia (FM) focussing on four outcomes: pain, multidimensional function (wellness or quality of life), physical function (self-reported physical function or measured physical fitness) and adverse effects. A further objective was to link these outcomes with details of the interventions so as to guide and shape future practice and research. Electronic databases including Medline, EMBASE, CINAHL, AMED, the Cochrane Library, and DARE, were searched for the January 1(st) 2007 to March 31(st) 2013 period. Nine systematic reviews (60 RCTs with 3816 participants) were included. Meta-analysis was not conducted due to the heterogeneity of the sample. We found positive results of diverse exercise interventions on pain, multidimensional function, and self-reported physical function, and no supporting evidence for new (to FM) interventions (i.e., qigong, tai chi). There were no serious adverse effects reported. The variability of the interventions in the reviews prevented us from answering important clinical questions to guide practical decisions about optimal modes or dosages (i.e., frequency, intensity, duration). Finally, the number of review articles is proliferating, leading researchers and reviewers to consider the rigor and quality of the information being reviewed. As well, consumers of these reviews (i.e., clinicians, individuals with FM) should not rely on them without careful consideration.

Potential Mediators between Fibromyalgia and C-Reactive protein: Results from a Large U.S. Community Survey.

Science.gov (United States)

Feinberg, Termeh; Sambamoorthi, Usha; Lilly, Christa; Innes, Kim Karen

2017-07-07

Fibromyalgia, a potentially debilitating chronic pain syndrome of unknown etiology, may be characterized by inflammation. In this study, we investigated the relation of FMS to serum C-reactive protein (CRP) in a large population of adults (18+) and investigated the influence of other factors on this relationship, including BMI, comorbidities, as well as mood and sleep disturbance. Participants were 52,535 Ohio Valley residents (Fibromyalgia n = 1125). All participants completed a comprehensive health survey (2005-2006) part of the C8 Health Project; serum levels of CRP were obtained, as was history of Fibromyalgia physician diagnosis. Logistic and linear regressions were used for this cross-sectional analysis. Mean CRP was higher among participants reporting Fibromyalgia than those without (5.54 ± 9.8 vs.3.75 ± 7.2 mg/L, p BMI) and comorbidities to the model markedly weakened this relationship (AORs, respectively, for highest vs lowest CRP quartile = 1.2 (CI 1.0,1.4) and 1.1 (CI 0.9,1.3). In contrast, inclusion of mood and sleep impairment only modestly reduced the adjusted risk estimate (AORs for highest vs. lowest quartile = 1.3 (CI 1.1,1.5) for each)). Findings from this large cross-sectional study indicate a significant positive cross-sectional association of Fibromyalgia to serum C-reactive protein may be explained, in part, by BMI and comorbidity. Prospective research is needed to confirm this, and clarify the potential mediating influence of obesity and comorbid conditions on this relationship.

Quality of life, depression, and sexual dysfunction in spouses of female patients with fibromyalgia.

Science.gov (United States)

Tutoglu, Ahmet; Boyaci, Ahmet; Koca, Irfan; Celen, Esra; Korkmaz, Nurdan

2014-08-01

The aim of this study was to investigate the effects of the quality of life and psychological condition of female patients with fibromyalgia and their spouses on sexual function. A total of 32 female patients diagnosed with fibromyalgia and their spouses were analyzed. Thirty married couples were included in the study as the control group. The demographic data of the fibromyalgia patients were recorded, a visual analog scale was used to evaluate the level of pain, and the Fibromyalgia Impact Questionnaire was used to evaluate the impact of the symptoms on the quality of life of the patients. The quality of life of both the patients and the control group were evaluated using the Short Form 36 (SF-36), and psychological variables were evaluated using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory. Sexual function was assessed using the Female Sexual Function Index for female participants and the International Index of Erectile Function (IIEF) for male participants. The IIEF erectile dysfunction scores were significantly lower in the spouses of female patients with fibromyalgia than in the control group (p fibromyalgia (p fibromyalgia (p = 0.003 and p = 0.004, respectively). In all spouses of FMS patients and controls, there was a significantly negative correlation between erectile function, the BDI score, and to be married with FMS patient and positive correlations between erectile function and emotional role, social function, mental health, SF-36 pain score, and general health (p fibromyalgia might significantly interfere with quality of life and lead to a high rate of sexual dysfunction. Spouses of patients with fibromyalgia might also be investigated for sexual dysfunction and quality of life. Treatment programs for this group should be considered.

Passive body heating improves sleep patterns in female patients with fibromyalgia

Directory of Open Access Journals (Sweden)

Andressa Silva

2013-01-01

Full Text Available OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36 ±1 °C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline, the first day of the intervention (acute, the last day of the intervention (chronic, and three weeks after the end of the intervention (follow-up. Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia.

Passive body heating improves sleep patterns in female patients with fibromyalgia

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Silva, Andressa; de Queiroz, Sandra Souza; Andersen, Monica Levy; Mônico-Neto, Marcos; da Silveira Campos, Raquel Munhoz; Roizenblatt, Suely; Tufik, Sergio; de Mello, Marco Túlio

2013-01-01

OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36±1°C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia. PMID:23525306

A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial.

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Wang, Chenchen; McAlindon, Timothy; Fielding, Roger A; Harvey, William F; Driban, Jeffrey B; Price, Lori Lyn; Kalish, Robert; Schmid, Anna; Scott, Tammy M; Schmid, Christopher H

2015-01-30

Fibromyalgia is a chronic musculoskeletal pain syndrome that causes substantial physical and psychological impairment and costs the US healthcare system over $25 billion annually. Current pharmacological therapies may cause serious adverse effects, are expensive, and fail to effectively improve pain and function. Finding new and effective non-pharmacological treatments for fibromyalgia patients is urgently needed. We are currently conducting the first comparative effectiveness randomized trial of Tai Chi versus aerobic exercise (a recommended component of the current standard of care) in a large fibromyalgia population. This article describes the design and conduct of this trial. A single-center, 52-week, randomized controlled trial of Tai Chi versus aerobic exercise is being conducted at an urban tertiary medical center in Boston, Massachusetts. We plan to recruit 216 patients with fibromyalgia. The study population consists of adults ≥21 years of age with fibromyalgia who meet American College of Rheumatology 1990 and 2010 diagnostic criteria. Participants are randomized to one of four Tai Chi intervention groups: 12 or 24 weeks of supervised Tai Chi held once or twice per week, or a supervised aerobic exercise control held twice per week for 24 weeks. The primary outcome is the change in Revised Fibromyalgia Impact Questionnaire total score from baseline to 24 weeks. Secondary outcomes include measures of widespread pain, symptom severity, functional performance, balance, muscle strength and power, psychological functioning, sleep quality, self-efficacy, durability effects, and health-related quality of life at 12, 24, and 52 week follow-up. This study is the first comparative effectiveness randomized trial of Tai Chi versus aerobic exercise in a large fibromyalgia population with long-term follow up. We present here a robust and well-designed trial to determine the optimal frequency and duration of a supervised Tai Chi intervention with regard to short

Spatio-temporal gait disorder and gait fatigue index in a six-minute walk test in women with fibromyalgia.

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Heredia-Jimenez, Jose; Latorre-Roman, Pedro; Santos-Campos, Maria; Orantes-Gonzalez, Eva; Soto-Hermoso, Victor M

2016-03-01

Gait disorders in fibromyalgia patients affect several gait parameters and different muscle recruitment patterns. The aim of this study was to assess the gait differences observed during a six-minute walk test between fibromyalgia patients and healthy controls. Forty-eight women with fibromyalgia and 15 healthy women were evaluated. Fibromyalgia patients met the American College of Rheumatology criteria for fibromyalgia selected of an ambulatory care. Both patients and controls had a negative history of musculoskeletal disease, neurological disorders, and gait abnormalities. The 15 controls were healthy women matched to the patients in age, height and body weight. Spatio-temporal gait variables and the rate of perceived exertion during the six-minute walk test (all subjects) and Fibromyalgia Impact Questionnaire (fibromyalgia subjects) were evaluated. All walking sets on the GaitRITE were collected and the gait variables were selected at three stages during the six-minute walk test: two sets at the beginning, two sets at 3 min and two sets at the end of the test. In addition, the Fibromyalgia Impact Questionnaire was used for the fibromyalgia patients. Fibromyalgia patients showed a significant decrease in all spatio-temporal gait variables at each of the three stages and had a lower walk distance covered in the six-minute walk test and higher rate of perceived exertion. No correlations were found between the Fibromyalgia Impact Questionnaire and gait variables. The fibromyalgia and control subjects showed lower gait fatigue indices between the middle and last stages. Gait analysis during a six-minute walk test is a good tool to assess the fatigue and physical symptoms of patients with fibromyalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Research to encourage exercise for fibromyalgia (REEF): use of motivational interviewing, outcomes from a randomized-controlled trial.

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Ang, Dennis C; Kaleth, Anthony S; Bigatti, Silvia; Mazzuca, Steven A; Jensen, Mark P; Hilligoss, Janna; Slaven, James; Saha, Chandan

2013-04-01

Regular exercise is associated with important benefits in patients with fibromyalgia (FM). Unfortunately, long-term maintenance of exercise after a structured program is rare. The present study tested the efficacy of Motivational Interviewing (MI) to promote exercise and improve symptoms in patients with FM. A total of 216 patients with FM were randomized to 6 MI sessions (n=107) or an equal number of FM self-management lessons (education control/EC, n=109). Co-primary endpoints were an increase of 30 minutes in moderate-vigorous physical activity and improvement in the Fibromyalgia Impact Questionnaire (FIQ)-Physical Impairment score, assessed at pretreatment, posttreatment, and 3-month and 6-month follow-up. Secondary outcomes included clinically meaningful improvements in FIQ score, pain severity ratings, and a 6-minute walk test. There were no significant treatment group differences in either co-primary endpoint at 6-month follow-up. However, more MI participants than controls exhibited meaningful improvements in FIQ score at 6-month follow-up (62.9% vs. 49.5%, P=0.06). Compared with EC participants, MI participants also displayed a larger increment in their 6-minute walk test (43.9 vs. 24.8 m, P=0.03). In addition, MI was superior to EC in increasing the number of hours of physical activity immediately postintervention and in reducing pain severity both immediately after the intervention and at 3-month follow-up. Despite a lack of benefits on long-term outcome, MI seems to have short-term benefits with respect to self-report physical activity and clinical outcomes. This is the first study in FM that explicitly addresses exercise maintenance as a primary aim.

Utility of Periodontal exploration in patients with Fibromyalgia

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Santos-García, Rocío; Sánchez-Domínguez, Benito; Cordero, Mario D.; Rios-Santos, José V.; Jaramillo-Santos, María R.; Climent, Mariano H.

2012-01-01

Objetive: Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology, which affects predominantly women. Mitochondrial alteration could have a role in the pathophysilogical mechanisms of inflammatory conditions as FM and periodontitis. The aim of the present study was assay the relationship between both diseases and mitochondrial dysfunction. Patient and Methods: We study the presence of periodontitis in twelve patients diagnosed of FM and mitochondrial dysfunction described. The diagnosis of FM was established according to ACR criteria and clinical symptoms were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI). Results: Only one patients of twelve included and agreed to participate in the study were diagnosed with periodontitis. Conclusions: Pending studies with larger numbers of patients, we can conclude that mitochondrial dysfunction in FM is a itself event not related with periodontitis. Periodontitis could be considered a exclusion criterion in all studies about mitochondrial dysfunction in patients. Key words:Peridontitis, fibromyalgia, mitocondrial dysfunction, oxidative stress. PMID:24558523

Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions

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Okifuji, Akiko; Bradshaw, David H.; Olson, Chrisana

2009-01-01

The aim of this study was to investigate the associations between obesity and fibromyalgia syndrome (FMS). This study was conducted at the University of Utah Pain Management and Research Center, Salt Lake City, Utah. Thirty-eight FMS patients were included in this study. Neuroendocrine indices (catecholamines, cortisol, C-reactive protein [CRP], and interleukin-6), symptom measures (Fibromyalgia Impact Questionnaire), sleep indices (Actigraph), and physical functioning (treadmill testing) wer...

Postural control deficits in people with fibromyalgia: a pilot study

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2011-01-01

Introduction Postural instability and falls are increasingly recognized problems in patients with fibromyalgia (FM). The purpose of this study was to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability. We further sought to determine whether postural instability is associated with strength, proprioception and lower-extremity myofascial trigger points (MTPs); FM symptoms and physical function; dyscognition; balance confidence; and medication use. Last, we evaluated self-reported of falls over the past six months. Methods In this cross-sectional study, we compared middle-aged FM patients and age-matched HCs who underwent computerized dynamic posturography testing and completed the Fibromyalgia Impact Questionnaire-Revised (FIQR) and balance and fall questionnaires. All subjects underwent a neurological and musculoskeletal examination. Descriptive statistics were used to characterize the sample and explore the relationships between variables. The relationships between subjective, clinical and objective variables were evaluated by correlation and regression analyses. Results Twenty-five FM patients and twenty-seven HCs (combined mean age ± standard deviation (SD): 48.6 ± 9.7 years) completed testing. FM patients scored statistically lower on composite sensory organization tests (primary outcome; P < 0.010), as well as with regard to vestibular, visual and somatosensory ratio scores on dynamic posturography. Balance confidence was significantly different between groups, with FM patients reporting less confidence than HCs (mean ± SD: 81.24 ± 19.52 vs. 98.52 ± 2.45; P < 0.001). Interestingly, 76% to 84% of FM patients had gastrocnemius and/or anterior tibialis MTPs. Postural stability was best predicted by dyscognition, FIQR score and body mass index. Regarding falls, 3 (11%) of 27 HCs had fallen only once during the past 6 months, whereas 18 (72

Is panic disorder associated with clinical severity of fibromyalgia? A preliminary study in a tertiary-care centre.

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Alciati, Alessandra; Caldirola, Daniela; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola; Grassi, Massimiliano; Perna, Giampaolo

2016-01-01

To investigate the influence of panic disorder (PD) with/without agoraphobia on the clinical severity of fibromyalgia (FM). Eighty-one patients with FM, among those consecutively referring to a tertiary-care setting, were included in this cross-sectional study. Psychiatric diagnoses were made by the structured clinical interview in accordance with the 4th-TR version of the diagnostic and statistical manual of mental disorders. The clinical severity of FM was measured by means of the following self-administered scales: Fibromyalgia Impact Questionnaire (FIQ), Fibromyalgia Assessment Status (FAS), Health Assessment Questionnaire (HAQ). A final sample of 66 females with FM with or without past PD was included in the analyses. The two groups did not significantly differ in age, years of education, length of illness or medication distribution. We did not find significant differences between the two groups in the FIQ and FAS scale scores, whereas subjects with FM and past PD showed significantly higher HAQ scale scores than those without past PD (p<.001). A history of PD in patients with FM increases the severity of functional impairment in performing a wide range of daily-life activities, as measured by the HAQ scale, with no effects on the severity of other clinical dimensions of FM. Potential underlying mechanisms and clinical implications will be discussed.

Development of Incident Report Database for Organizational Learning

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Otsuka, Yuichi; Abe, Tomotaka; Noguchi, Hiroshi; Makinouchi, Akifumi

The necessity of an incident reporting system has recently been increasing for hospitals. Japan Council for Quality Health Care (JCQHC) started operating a national incident reporting system to which domestic hospitals would report their incidents. However, the reporting system obtained an additional problem for the hospitals. They managed their own systems which collected reports by papers. The purposes of the reporting systems was to analyze considerable causes involved in incidents to improve the quality of patient safety management. On the contrary, the national reporting system aimed at collecting a statistical tendency of normal incidents. Simultaneously operating the two systems would be too much workload for safety managers. The load may have the managers rest only a short time for summarizing occurrences, not enough for analyzing their causes. However, to the authors' knowledge, there has not been an integrating policy of the two forms to adapt them to practical situations in patient safety management. The scope of this paper is to establish the integrated form in order to use in analyzing the causes of incidents as well as reporting for the national system. We have developed new data base system using XML + XSLT and Java Servlet. The developed system is composed of three computers; DB server , DB client and Data sending server. To investigate usability of the developed system, we conducted a monitoring test by real workers in reporting workplaces. The result of subjective evaluations by examinees was so preferable for the developed system. The results of usability test and the achievement of increasing the number of reports after the introduction can demonstrate the enough effectiveness of the developed system for supporting the activity of patient safety management.

Differences in quality of life determinants according to the presence of fibromyalgia in middle-aged female patients with systemic lupus erythematosus: a multicenter, cross-sectional, single-ethnicity cohort.

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Moon, Su-Jin; Kang, Kwi Young; Kwok, Seung-Ki; Ju, Ji Hyeon; Hong, Yeon-Sik; Park, Sung-Hwan; Jeon, Chan Hong; Choi, Sang Tae; Song, Jung-Soo; Min, Jun-Ki

2018-06-01

The purpose of this study was to identify whether determinants of health-related quality of life (HRQoL) in middle-aged female patients with systemic lupus erythematosus (SLE) differed according to the presence or absence of fibromyalgia. One hundred and fifty-two patients with SLE and 139 healthy controls (HCs) completed the Medical Outcomes Study 36-Item Short Form (SF-36) and EuroQol EQ-5D questionnaires about HRQoL. Disease activity and cumulative disease damage were assessed with standard indices. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI). The mean EQ-5D and physical and mental components of SF-36 were lower in SLE patients with fibromyalgia (n = 41) than in those without fibromyalgia (n = 111) and HCs. The scores in all eight domains of the SF-36 were lower in SLE patients with fibromyalgia than in patients without fibromyalgia and HCs. Poor sleep (defined as a K-PSQI > 5) was reported by 85% of SLE patients with fibromyalgia, by 51% of patients without fibromyalgia, and by 33% of HCs. Multivariate logistic regression analysis showed that lower educational level, cumulative organ damage severity and poor sleep quality were independent determinants of HRQoL in SLE patients with fibromyalgia, whereas disease activity, sleep quality and depressive mood were independent determinants of HRQoL in those without fibromyalgia. Poor sleep quality is the common independent risk factor for poor HRQoL in both middle-aged SLE patients with fibromyalgia and without fibromyalgia. Sleep quality improvement may improve HRQoL in female SLE patients, even in those without fibromyalgia. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Safety culture and learning from incidents: the role of incident reporting and causal analyses

International Nuclear Information System (INIS)

Wilpert, B.

1994-01-01

Nuclear industry more than any other industrial branch has developed and used predictive risk analysis as a method of feedforward control of safety and reliability. Systematic evaluation of operating experience, statistical documentation of component failures, systematic documentation and analysis of incidents are important complementary elements of feedback control: we are dealing here with adjustment and learning from experience, in particular from past incidents. Using preliminary findings from ongoing research at the Research Center Systems Safety at the Berlin University of Technology the contribution discusses preconditions for an effective use of lessons to be learnt from closely matched incident reporting and in depth analyses of causal chains leading to incidents. Such conditions are especially standardized documentation, reporting and analyzing methods of incidents; structured information flows and feedback loops; abstaining from culpability search; mutual trust of employees and management; willingness of all concerned to continually evaluate and optimize the established learning system. Thus, incident related reporting and causal analyses contribute to safety culture, which is seen to emerge from tightly coupled organizational measures and respective change in attitudes and behaviour. (author) 2 figs., 7 refs

Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia.

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Dogru, Atalay; Balkarli, Ayse; Cobankara, Veli; Tunc, Sevket Ercan; Sahin, Mehmet

2017-06-01

The role of vitamin D in the etiopathogenesis of fibromyalgia and non-specific musculoskeletal pain is controversial. In our study, we aimed to investigate the effect of vitamin D therapy on quality of life in patients with fibromyalgia. Seventy patients diagnosed with fibromyalgia and 65 age- and sex-matched controls were included in the study. Patients were grouped as deficient (30 ng/mL) according to the levels of vitamin D. Vitamin D replacement was performed for patients with deficiencies and inadequacies. Before and after vitamin D therapy, patients filled in the assessment tools, fibromyalgia impact questionnaire (FIQ), Arizona sexual experience scale (ASEX), Beck depression inventory (BDI), visual analog scale (VAS), and short form-36 (SF-36). Vitamin D deficiencies and inadequacies were observed in 60% of the patients (n=42). Among patients with low and normal levels of vitamin D, no statistically significant difference was observed in their values. In scales examined after vitamin D replacement therapy, statistically significant differences were observed in the FIQ, BDI, VAS, and SF-36 compared with pre-treatment. Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia. Vitamin D supplementation may improve the quality of life in patients with fibromyalgia.

Factor structure of the Positive and Negative Affect Schedule (PANAS) in adult women with fibromyalgia from Southern Spain: the al-Ándalus project.

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Estévez-López, Fernando; Pulido-Martos, Manuel; Armitage, Christopher J; Wearden, Alison; Álvarez-Gallardo, Inmaculada C; Arrayás-Grajera, Manuel Javier; Girela-Rejón, María J; Carbonell-Baeza, Ana; Aparicio, Virginia A; Geenen, Rinie; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

2016-01-01

Fibromyalgia is a syndrome characterized by the presence of widespread chronic pain. People with fibromyalgia report lower levels of Positive Affect and higher levels of Negative Affect than non-fibromyalgia peers. The Positive and Negative Affect Schedule (PANAS)-a widely used questionnaire to assess two core domains of affect; namely 'Positive Affect' and 'Negative Affect' -has a controversial factor structure varying across studies. The internal structure of a measurement instrument has an impact on the meaning and validity of its score. Therefore, the aim of the present study was to assess the structural construct validity of the PANAS in adult women with fibromyalgia. This population-based cross-sectional study included 442 adult women with fibromyalgia (age: 51.3 ± 7.4 years old) from Andalusia (Southern Spain). Confirmatory factor analyses were conducted to test the factor structure of the PANAS. A structure with two correlated factors (Positive Affect and Negative Affect) obtained the best fit; S-B χ(2) = 288.49, df = 155, p Positive Affect and Negative Affect are core dimensions of affect in adult women with fibromyalgia. A structure with two correlated factors of the PANAS emerged from our sample of women with fibromyalgia from Andalusia (Southern Spain). In this model, the amount of variance shared by Positive Affect and Negative Affect was small. Therefore, our findings support to use and interpret the Positive Affect and Negative Affect subscales of the PANAS as separate factors that are associated but distinctive as well.

Progression of fibromyalgia: results from a 2-year observational fibromyalgia and chronic pain study in the US

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Adams, Edgar H; McElroy, Heather J; Udall, Margarita; Masters, Elizabeth T; Mann, Rachael M; Schaefer, Caroline P; Cappelleri, Joseph C; Clair, Andrew G; Hopps, Markay; Daniel, Shoshana R; Mease, Philip; Silverman, Stuart L; Staud, Roland

2016-01-01

Background A previous fibromyalgia (FM) research reports that 20%–47% of diagnosed patients may not meet the study definition of FM 1–2 years after diagnosis. The aim of this study was to gain a better understanding of the progression of FM in a geographically diverse cohort over a 2-year time period. Methods This cohort study followed 226 subjects recruited online to assess FM and chronic widespread pain (CWP) diagnosis stability over time. At enrollment (baseline), subjects provided informed consent, completed an online questionnaire consisting of the London Fibromyalgia Epidemiology Study Screening Questionnaire to screen for CWP (bilateral pain above/below waist lasting ≥1 week in the past 3 months), visited a site for physician evaluation for FM, and completed a questionnaire with validated patient-reported outcome instruments. Subjects were classified into mutually exclusive groups: FM+CWP+ (screened positive for CWP and received physician diagnosis of FM), FM−CWP+ (screened positive for CWP but did not receive physician diagnosis of FM), and FM−CWP− (screened negative for CWP). Approximately 2 years later (follow-up), subjects were reassessed at the same study site and completed a questionnaire with the same patient-reported outcomes. Results Seventy-six FM+CWP+ subjects completed assessments at both time points; 56 (73.7%) met the FM study definition at follow-up. Twenty subjects no longer met the FM study definition (eleven became FM−CWP− and nine became FM−CWP+). Ten subjects (two from FM−CWP− and eight from FM−CWP+) transitioned into the FM+CWP+ group at follow-up; they reported more tender points and pain interference with sleep and worse physical function at baseline compared with subjects who did not transition to FM+CWP+. Most (76.7%) of the subjects who transitioned into/out of FM+CWP+ experienced changes in CWP, number of positive tender points, or both. Conclusion The results suggest that some FM+CWP+ patients experience

Differential pain modulation in patients with peripheral neuropathic pain and fibromyalgia.

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Gormsen, Lise; Bach, Flemming W; Rosenberg, Raben; Jensen, Troels S

2017-12-29

Background The definition of neuropathic pain has recently been changed by the International Association for the Study of Pain. This means that conditions such as fibromyalgia cannot, as sometimes discussed, be included in the neuropathic pain conditions. However, fibromyalgia and peripheral neuropathic pain share common clinical features such as spontaneous pain and hypersensitivity to external stimuli. Therefore, it is of interest to directly compare the conditions. Material and methods In this study we directly compared the pain modulation in neuropathic pain versus fibromyalgia by recording responses to a cold pressor test in 30 patients with peripheral neuropathic pain, 28 patients with fibromyalgia, and 26 pain-free age-and gender-matched healthy controls. Patients were asked to rate their spontaneous pain on a visual analog scale (VAS (0-100 mm) immediately before and immediately after the cold pressor test. Furthermore the duration (s) of extremity immersion in cold water was used as a measure of the pain tolerance threshold, and the perceived pain intensity at pain tolerance on the VAS was recorded on the extremity in the water after the cold pressor test. In addition, thermal (thermo tester) and mechanical stimuli (pressure algometer) were used to determine sensory detection, pain detection, and pain tolerance thresholds in different body parts. All sensory tests were done by the same examiner, in the same room, and with each subject in a supine position. The sequence of examinations was the following: (1) reaction time, (2) pressure thresholds, (3) thermal thresholds, and (4) cold pressor test. Reaction time was measured to ensure that psychomotoric inhibitions did not influence pain thresholds. Results Pain modulation induced by a cold pressor test reduced spontaneous pain by 40% on average in neuropathic pain patients, but increased spontaneous pain by 2.6% in fibromyalgia patients. This difference between fibromyalgia and neuropathic pain patients was

Self-reported and reported injury patterns in contemporary dance students.

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Baker, Jo; Scott, Daniel; Watkins, Katherine; Keegan-Turcotte, Sheramy; Wyon, Matthew

2010-03-01

Injury is a major concern among dancers, as currently rates are reported as being high. The purpose of the present study was to assess the incidence and details of injuries across an academic year at a full-time contemporary dance school. A questionnaire was distributed to 57 dancers at the end of their first academic year. Reported injury information was also retrieved from a database as collected from a physiotherapist over the same period. Differences were found between the reported and self-reported information, particularly with reference to shin injuries. The majority of injuries occurred in November and May, noted to be close to assessment periods. Injury rates in contemporary dance are high; notably, 89% of dancers reported one or more injuries. This problem is particularly evident in the lower limb. Med Probl Perform Art 2010; 25:10-15.

Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach.

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Lee, Jeong-Won; Lee, Kyung-Eun; Park, Dong-Jin; Kim, Seong-Ho; Nah, Seong-Su; Lee, Ji Hyun; Kim, Seong-Kyu; Lee, Yeon-Ah; Hong, Seung-Jae; Kim, Hyun-Sook; Lee, Hye-Soon; Kim, Hyoun Ah; Joung, Chung-Il; Kim, Sang-Hyon; Lee, Shin-Seok

2017-01-01

Health-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM). HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software. Of the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI. In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL.

Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach.

Directory of Open Access Journals (Sweden)

Jeong-Won Lee

Full Text Available Health-related quality of life (HRQOL in patients with fibromyalgia (FM is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM.HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI, the State-Trait Anxiety Inventory (STAI, the Arthritis Self-Efficacy Scale (ASES, and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software.Of the 336 patients, 301 (89.6% were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506. The final model showed that Physical Component Summary (PCS was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS was inversely related to FIQ, BDI, and STAI.In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL.

Autonomic nervous system profile in fibromyalgia patients and its modulation by exercise: a mini review.

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Kulshreshtha, Poorvi; Deepak, Kishore K

2013-03-01

This review imparts an impressionistic tone to our current understanding of autonomic nervous system abnormalities in fibromyalgia. In the wake of symptoms present in patients with fibromyalgia (FM), autonomic dysfunction seems plausible in fibromyalgia. A popular notion is that of a relentless sympathetic hyperactivity and hyporeactivity based on heart rate variability (HRV) analyses and responses to various physiological stimuli. However, some exactly opposite findings suggesting normal/hypersympathetic reactivity in patients with fibromyalgia do exist. This heterogeneous picture along with multiple comorbidities accounts for the quantitative and qualitative differences in the degree of dysautonomia present in patients with FM. We contend that HRV changes in fibromyalgia may not actually represent increased cardiac sympathetic tone. Normal muscle sympathetic nerve activity (MSNA) and normal autonomic reactivity tests in patients with fibromyalgia suggest defective vascular end organ in fibromyalgia. Previously, we proposed a model linking deconditioning with physical inactivity resulting from widespread pain in patients with fibromyalgia. Deconditioning also modulates the autonomic nervous system (high sympathetic tone and a low parasympathetic tone). A high peripheral sympathetic tone causes regional ischaemia, which in turn results in widespread pain. Thus, vascular dysregulation and hypoperfusion in patients with FM give rise to ischaemic pain leading to physical inactivity. Microvascular abnormalities are also found in patients with FM. Therapeutic interventions (e.g. exercise) that result in vasodilatation and favourable autonomic alterations have proven to be effective. In this review, we focus on the vascular end organ in patients with fibromyalgia in particular and its modulation by exercise in general. © 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

How to Report a Pesticide Incident Involving Exposures to People

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Pesticides incidents must be reported by pesticide registrants. Others, such as members of the public and environmental professionals, would like to report pesticide incidents. This website will facilitate such incident reporting.

Vitamin D deficiency in Fibromyalgia

International Nuclear Information System (INIS)

Bhatty, S.A.; Shaikh, N.A.; Irfan, M.; Kashif, S.M.; Vaswani, A.S.; Sumbhai, A.; Gunpat

2010-01-01

Objective: To check the Vitamin D levels in patients diagnosed as fibromyagia in our population. Methods: Study was done at Medical OPD of Civil Hospital Karachi, from January to March 2009. Female patients diagnosed as Fibromyalgia according to American College of Rheumatology (ACR) criteria and exclusion of systemic illness on examination, and normal reports of blood CP, ESR, serum calcium, phosphate and Alkaline Phosphatase, were asked to get Vitamin D levels in their serum. Vitamin D deficiency is defined as 30 ng/ml. Result: Forty female patients were included in the study. The mean age was 37.65 +- 11.5 years. Mean Vitamin D level was 17.41 +- 5.497 ng/ml. Thirty two (80%) of patients had Vitamin D deficiency, mean levels of 15.855 +- 4.918 ng/ml and 8(20%) had Vitamin D insufficiency, mean levels of 23.64 +- 2.39 ng/ml. Patients with vitamin D deficiency and age less than 45 years were 22 (68.75%), had mean vitamin D level 16.87 +- 4.48 ng/ml whereas in age ranging from 46-75 years were 10 (31.25%) had mean vitamin D level 16.09 +- 6.45 ng/ml. Conclusion: Vitamin D deficiency is frequently seen in patients diagnosed as fibromyalgia and nonspecific musculoskeletal pain in our population. Although the sample size of the study is small, but the figures are so alarming that it is an eye opener towards the need of a population based study, including normal population as well as those presenting with musculoskeletal pain. (author)

Clinical utility, safety, and efficacy of pregabalin in the treatment of fibromyalgia

Directory of Open Access Journals (Sweden)

Bhusal S

2016-02-01

Full Text Available Santosh Bhusal,1 Sherilyn Diomampo,1 Marina N Magrey2 1Division of Rheumatology, Metrohealth Medical Center, 2Case Western Reserve University School of Medicine at Metrohealth Medical Center, Cleveland OH, USA Abstract: Fibromyalgia is a chronic debilitating medical syndrome with limited therapeutic options. Pregabalin, an anticonvulsant and α-2-Δ subunit receptor ligand, is one of the anchor drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. The drug has shown clinically meaningful benefits across multiple symptom domains of fibromyalgia. Efficacy of pregabalin in fibromyalgia pain has been evaluated in at least five high-quality randomized trials, two long-term extension studies, a meta-analysis, a Cochrane database systematic review, and several post hoc analyses. These studies also hint towards a meaningful benefit on sleep, functioning, quality of life, and work productivity. Side effects of pregabalin, although common, are mild to moderate in intensity. They are noted early during therapy, improve or disappear with dose reduction, and are not usually life- or organ threatening. In most patients, tolerance develops to the most common side effects, dizziness, and somnolence, with time. With close clinical monitoring at initiation or dose titration, pregabalin can be effectively used in primary care setting. Pregabalin is cost saving with long-term use and its cost-effectiveness profile is comparable, if not better, to that of other drugs used in fibromyalgia. In the present era of limited therapeutic options, pregabalin undoubtedly retains its role as one of cardinal drugs used in the treatment of fibromyalgia. This review intends to discuss the clinical utility of pregabalin in the management of fibromyalgia with a focus on efficacy, safety, and cost-effectiveness. Keywords: fibrositis, myofascial pain, diffuse pain syndrome, lyrica

Depressive-like symptoms in a reserpine-induced model of fibromyalgia in rats.

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Blasco-Serra, Arantxa; Escrihuela-Vidal, Francesc; González-Soler, Eva M; Martínez-Expósito, Fernando; Blasco-Ausina, M Carmen; Martínez-Bellver, Sergio; Cervera-Ferri, Ana; Teruel-Martí, Vicent; Valverde-Navarro, Alfonso A

2015-11-01

Since the pathogenesis of fibromyalgia is unknown, treatment options are limited, ineffective and in fact based on symptom relief. A recently proposed rat model of fibromyalgia is based on central depletion of monamines caused by reserpine administration. This model showed widespread musculoskeletal pain and depressive-like symptoms, but the methodology used to measure such symptoms has been criticized. Evidence relates the high prevalence of pain and depression in fibromyalgia to common pathogenic pathways, most probably focused on the monoaminergic system. The present study aims at a validation of the reserpine model of fibromyalgia. For this purpose, rats undergoing this model have been tested for depressive-like symptoms with a Novelty-Suppressed Feeding Test adaptation. Animals administered with reserpine and subjected to forced food deprivation performed a smaller number of incursions to the center of the open field, evidenced by a decrease in the per-minute rate of the rats' approaching, smelling or touching the food. They also took more time to eat from the central food than control rats. These NSFT findings suggest the presence of depressive-like disorders in this animal model of fibromyalgia. Copyright © 2015 Elsevier Inc. All rights reserved.

RECENT DRUGS FOR THE MANAGEMENT AND TREATMENT OF FIBROMYALGIA

OpenAIRE

Abida*, Md. Tauqir Alam, Mohd. Imran, Said A.H. El-Feky, Mohamed A.M. Hagga

2016-01-01

Fibromyalgia is a disorder, which is characterized by widespread musculoskeletal pain accompanied by fatigue, memory, mood, and sleep issues. Scientists believe that this condition may be due to injury, emotional distress, or viruses that change the way the brain perceives pain, but the exact cause is unclear. Generally, fibromyalgia is treated with antidepressants, pain relievers, and Anti-seizure drugs. There is not much specific treatment available for the treatment and management of fibro...

Quality of life and associated clinical distress in fibromyalgia

OpenAIRE

G. Perpignano; L. Minerba; A. Denotti; C. Anedda; V. Ruggiero; E. Cacace

2011-01-01

Objectives: Fibromyalgia (FM) is a syndrome characterized by chronic, diffuse musculoskeletal pain and by a low pain threshold at specific anatomical points (tender points). Numerous other conditions (Irritable bowel syndrome, tension-type headache, migraine headaches, etc.) may overlap with FM. Aim of this study was to evaluate the quality of life and associated clinical distress in patients with FM. Methods: 53 females affected by primary fibromyalgia and 40 healthy females were examined we...

Music as a sleep aid in fibromyalgia.

Science.gov (United States)

Picard, Larry M; Bartel, Lee R; Gordon, Allan S; Cepo, Davor; Wu, Qi; Pink, Leah R

2014-01-01

Interventions to improve sleep in fibromyalgia may generalize to improvements in multiple symptom domains. Delta-embedded music, pulsating regularly within the 0.25 Hz to 4 Hz frequency band of brain wave activity, has the potential to induce sleep. To assess the effects of a delta-embedded music program over four weeks for sleep induction in patients with fibromyalgia. The present unblinded, investigator-led pilot study used a within-subject design. Analysis was based on 20 individuals with fibromyalgia who completed the study, of the 24 recruited into the study. The primary outcome variables were the change from baseline in Fibromyalgia Impact Questionnaire (FIQ) and Jenkins Sleep Scale scores. A patient global impression of change was measured on a seven-point Likert scale. Secondary outcome measures, comprised of items 5, 6 and 7 of the FIQ, were used as indicators of pain, tiredness and being tired on awakening. The FIQ median score of 76.4 (95% CI 61.3 to 82.1) at baseline improved to 60.3 (95% CI 53.1 to 72.0; P=0.004). The Jenkins Sleep Scale median value of 17.5 (95% CI 15.5 to 18.5) at baseline fell to 12.5 (95% CI 8.5 to 14.5; P=0.001) at study completion. The outcomes of the patient global impression of change ratings were mostly positive (P=0.001). Being tired on awakening declined significantly from a median of 9.0 (95% CI 8.0 to 10.0) to 8.0 (95% CI 5.5 to 9.0; P=0.021). However, there was no significant improvement in pain level (baseline median 7.5 [95% CI 7.0 to 8.5] versus study completion median 7.0 [95% CI 6.5 to 8.0]; P=0.335) or tiredness (baseline median 9.0 [95% CI 8.0 to 9.5] versus study completion median 8.0 [95% CI 6.0 to 8.5]; P=0.061). There were no serious adverse events. Delta-embedded music is a potential alternative therapy for fibromyalgia.

Do participation and personalization matter? A model-driven evaluation of an Internet-based patient education intervention for fibromyalgia patients.

Science.gov (United States)

Camerini, Luca; Camerini, Anne-Linda; Schulz, Peter J

2013-08-01

To evaluate the effectiveness of an Internet-based patient education intervention, which was designed upon principles of personalization and participatory design. Fifteen months after the first release of the website, 209 fibromyalgia patients recruited through health professionals completed an online questionnaire to assess patients' use of the website, health knowledge, self-management behavior, and health outcomes. These constructs were combined into an a-priory model that was tested using a structural equation modeling approach. Results show that the usage of certain tools of the website - designed and personalized involving the end users - impacts patients' health knowledge, which in turn impacts self-management. Improvements in self-management ultimately lower the impact of Fibromyalgia Syndrome leading to better health outcomes. This study empirically confirmed that the adoption of a participatory approach to the design of eHealth interventions and the use of personalized contents enhance the overall effectiveness of systems. More time and effort should be invested in involving patients in the preliminary phases of the development of Internet-based patient education interventions and in the definition of models that can guide the systems' evaluation beyond technology-related variables such as usability, accessibility or adoption. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism.

Science.gov (United States)

Ohara, Nobumasa; Katada, Shinichi; Yamada, Takaho; Mezaki, Naomi; Suzuki, Hiroshi; Suzuki, Akiko; Hanyu, Osamu; Yoneoka, Yuichiro; Kawachi, Izumi; Shimohata, Takayoshi; Kakita, Akiyoshi; Nishizawa, Masatoyo; Sone, Hirohito

A 39-year-old woman with a 3-year history of a rounded face developed widespread myalgia. Detailed examinations revealed no disorders that could explain the pain other than concomitant Cushing's disease and central hypothyroidism. Both the hypercortisolemia and hypothyroidism completely resolved after the patient underwent surgery to treat Cushing's disease, but she continued to experience unresolved myalgia and met the diagnostic criteria for fibromyalgia. Few studies have so far investigated patients with fibromyalgia associated with Cushing's syndrome. In our case, the hypothyroidism caused by Cushing's disease probably played an important role in triggering and exacerbating fibromyalgia. This highlights the need to examine the endocrine function in patients with muscle pain.

Investigating Subjective Experience and the Influence of Weather Among Individuals With Fibromyalgia: A Content Analysis of Twitter.

Science.gov (United States)

Delir Haghighi, Pari; Kang, Yong-Bin; Buchbinder, Rachelle; Burstein, Frada; Whittle, Samuel

2017-01-19

Little is understood about the determinants of symptom expression in individuals with fibromyalgia syndrome (FMS). While individuals with FMS often report environmental influences, including weather events, on their symptom severity, a consistent effect of specific weather conditions on FMS symptoms has yet to be demonstrated. Content analysis of a large number of messages by individuals with FMS on Twitter can provide valuable insights into variation in the fibromyalgia experience from a first-person perspective. The objective of our study was to use content analysis of tweets to investigate the association between weather conditions and fibromyalgia symptoms among individuals who tweet about fibromyalgia. Our second objective was to gain insight into how Twitter is used as a form of communication and expression by individuals with fibromyalgia and to explore and uncover thematic clusters and communities related to weather. Computerized sentiment analysis was performed to measure the association between negative sentiment scores (indicative of severe symptoms such as pain) and coincident environmental variables. Date, time, and location data for each individual tweet were used to identify corresponding climate data (such as temperature). We used graph analysis to investigate the frequency and distribution of domain-related terms exchanged in Twitter and their association strengths. A community detection algorithm was applied to partition the graph and detect different communities. We analyzed 140,432 tweets related to fibromyalgia from 2008 to 2014. There was a very weak positive correlation between humidity and negative sentiment scores (r=.009, P=.001). There was no significant correlation between other environmental variables and negative sentiment scores. The graph analysis showed that "pain" and "chronicpain" were the most frequently used terms. The Louvain method identified 6 communities. Community 1 was related to feelings and symptoms at the time

Performance of women with fibromyalgia in walking up stairs while carrying a load

OpenAIRE

Collado-Mateo, Daniel; Adsuar, Jos? C.; Olivares, Pedro R.; Dominguez-Mu?oz, Francisco J.; Maestre-Cascales, Cristina; Gusi, Narcis

2016-01-01

Background. Fibromyalgia is a chronic disease characterized by widespread pain and other associated symptoms. It has a relevant impact on physical fitness and the ability to perform daily living tasks. The objective of the study was to analyze the step-by-step-performance and the trunk tilt of women with fibromyalgia in the 10-step stair climbing test compared with healthy controls. Methods. A cross-sectional study was carried out. Twelve women suffering from fibromyalgia and eight healthy co...

49 CFR 225.15 - Accidents/incidents not to be reported.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Accidents/incidents not to be reported. 225.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD ACCIDENTS/INCIDENTS: REPORTS CLASSIFICATION, AND INVESTIGATIONS § 225.15 Accidents/incidents not to be reported. A railroad need not report: (a) Casualties which...

Altered cerebral blood flow velocity features in fibromyalgia patients in resting-state conditions.

Science.gov (United States)

Rodríguez, Alejandro; Tembl, José; Mesa-Gresa, Patricia; Muñoz, Miguel Ángel; Montoya, Pedro; Rey, Beatriz

2017-01-01

The aim of this study is to characterize in resting-state conditions the cerebral blood flow velocity (CBFV) signals of fibromyalgia patients. The anterior and middle cerebral arteries of both hemispheres from 15 women with fibromyalgia and 15 healthy women were monitored using Transcranial Doppler (TCD) during a 5-minute eyes-closed resting period. Several signal processing methods based on time, information theory, frequency and time-frequency analyses were used in order to extract different features to characterize the CBFV signals in the different vessels. Main results indicated that, in comparison with control subjects, fibromyalgia patients showed a higher complexity of the envelope CBFV and a different distribution of the power spectral density. In addition, it has been observed that complexity and spectral features show correlations with clinical pain parameters and emotional factors. The characterization features were used in a lineal model to discriminate between fibromyalgia patients and healthy controls, providing a high accuracy. These findings indicate that CBFV signals, specifically their complexity and spectral characteristics, contain information that may be relevant for the assessment of fibromyalgia patients in resting-state conditions.

Impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia: A quasi-experimental design.

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Torres Belmonte, Susanna; Benachi Sandoval, Narly

To evaluate the impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia. Out of 132 eligible candidates, 128 patients participated with a diagnosis of fibromyalgia (ACR 1990/2010), over 18 years of age, who did not have cognitive problems or mental disorders in acute phase and lived in the catchment area of the participating CAPs. The patients underwent intervention for 5 weeks to strengthen self-management of pain and improve quality of life. Socio-demographic variables, satisfaction and quality of life (SF-36) were studied. Pre-post measurements were made on the 128 participants and follow-up at 2 months on 120 (8 did not agree to be contacted). Comparing the pre-post-intervention scores (non-parametric Wilcoxon test), it was found that 71.09% reported a higher perception of quality of life in the Mental health domain and lower percentage of improvement (28.91%) in the Physical role domain. When comparing pre-post-follow-up scores (Friedman's test), mean perception improved in all domains and remained at 2-month follow-up (P<.001). Finally, the average satisfaction with the intervention received was 90.55% (SD 9.86; min. 41, max. 100). When assessing the impact of the intervention, there was an improvement in the post and follow-up scores. This finding is largely due to the fact that the intervention strengthens the patient's self-mastery of their abilities to control pain and improve their perception of quality of life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Effects of 12-week combined exercise therapy on oxidative stress in female fibromyalgia patients.

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Sarıfakıoğlu, Banu; Güzelant, Aliye Yıldırım; Güzel, Eda Celik; Güzel, Savaş; Kızıler, Ali Rıza

2014-10-01

The aims of this study were to investigate the effect of exercise therapy on the oxidative stress in fibromyalgia patients and relationship between oxidative stress and fibromyalgia symptoms. Thirty women diagnosed with fibromyalgia according to the American College of Rheumatology preliminary criteria, and 23 healthy women whose age- and weight-matched women were enrolled the study. Pain intensity with visual analog scale (VAS), the number of tender points, the fibromyalgia impact questionnaire (FIQ), the Beck depression inventory (BDI) were evaluated. The oxidative stress parameters thiobarbituric acid reactive substances, protein carbonyls, and nitric oxide, and antioxidant parameters thiols and catalase were investigated in patients and control group. After, combined aerobic and strengthen exercise regimen was given to fibromyalgia group. Exercise therapy consisted of a warming period of 10 min, aerobic exercises period of 20 min, muscle strengthening exercises for 20 min, and 10 min cooling down period. Therapy was lasting 1 h three times per week over a 12-week period. All parameters were reevaluated after the treatment in the patient group. The oxidative stress parameters levels were significantly higher, and antioxidant parameters were significantly lower in patients with fibromyalgia than in the controls. VAS, FIQ, and BDI scores decreased significantly with exercise therapy. The exercise improved all parameters of oxidative stress and antioxidant parameters. Also, all clinical parameters were improved with exercise. We should focus on oxidative stress in the treatment for fibromyalgia with the main objective of reducing oxidative load.

Dietary Soy Supplement on Fibromyalgia Symptoms: A Randomized, Double-Blind, Placebo-Controlled, Early Phase Trial

Science.gov (United States)

Wahner-Roedler, Dietlind L.; Thompson, Jeffrey M.; Luedtke, Connie A.; King, Susan M.; Cha, Stephen S.; Elkin, Peter L.; Bruce, Barbara K.; Townsend, Cynthia O.; Bergeson, Jody R.; Eickhoff, Andrea L.; Loehrer, Laura L.; Sood, Amit; Bauer, Brent A.

2011-01-01

Most patients with fibromyalgia use complementary and alternative medicine (CAM). Properly designed controlled trials are necessary to assess the effectiveness of these practices. This study was a randomized, double-blind, placebo-controlled, early phase trial. Fifty patients seen at a fibromyalgia outpatient treatment program were randomly assigned to a daily soy or placebo (casein) shake. Outcome measures were scores of the Fibromyalgia Impact Questionnaire (FIQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and after 6 weeks of intervention. Analysis was with standard statistics based on the null hypothesis, and separation test for early phase CAM comparative trials. Twenty-eight patients completed the study. Use of standard statistics with intent-to-treat analysis showed that total FIQ scores decreased by 14% in the soy group (P = .02) and by 18% in the placebo group (P fibromyalgia treatment program, provide a decrease in fibromyalgia symptoms. Separation between the effects of soy and casein (control) shakes did not favor the intervention. Therefore, large-sample studies using soy for patients with fibromyalgia are probably not indicated. PMID:18990724

78 FR 63223 - Fibromyalgia Public Meeting on Patient-Focused Drug Development; Correction

Science.gov (United States)

2013-10-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-N-2013-1041] Fibromyalgia Public Meeting on Patient-Focused Drug Development; Correction AGENCY: Food and Drug... 23, 2013 (78 FR 58313). The document announced a public meeting entitled ``Fibromyalgia Public...

Factors influencing incident reporting in surgical care.

Science.gov (United States)

Kreckler, S; Catchpole, K; McCulloch, P; Handa, A

2009-04-01

To evaluate the process of incident reporting in a surgical setting. In particular: the influence of event outcome on reporting behaviour; staff perception of surgical complications as reportable events. Anonymous web-based questionnaire survey. General Surgical Department in a UK teaching hospital. Of 203 eligible staff, 55 (76.4%) doctors and 82 (62.6%) nurses participated. Knowledge and use of local reporting system; propensity to report incidents which vary by outcome (harm, no harm, harm prevented); propensity to report surgical complications; practical and psychological barriers to reporting. Nurses were significantly more likely to know of the local reporting system and to have recently completed a report than doctors. The level of harm (F(1.8,246) = 254.2, pvs 53%, z = 4.633, psystems.

Prevalence of fibromyalgia in a low socioeconomic status population

Directory of Open Access Journals (Sweden)

Pereira Carlos AB

2009-06-01

Full Text Available Abstract Background The aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil. Methods We cross-sectionally sampled individuals assisted by the public primary health care system (n = 768, 35–60 years old. Participants were interviewed by phone and screened about pain. They were then invited to be clinically assessed (304 accepted. Pain was estimated using a Visual Analogue Scale (VAS. Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ, as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level = 5%. Results From the phone-interview screening, we divided participants (n = 768 in three groups: No Pain (NP (n = 185; Regional Pain (RP (n = 388 and Widespread Pain (WP (n = 106. Among those participating in the clinical assessments, (304 subjects, the prevalence of fibromyalgia was 4.4% (95% confidence interval [2.6%; 6.3%]. Symptoms of pain (VAS and FIQ, feeling well, job ability, fatigue, morning tiredness, stiffness, anxiety and depression were statically different among the groups. In multivariate analyses we found that individuals with FM and WP had significantly higher impairment than those with RP and NP. FM and WP were similarly disabling. Similarly, RP was no significantly different than NP. Conclusion Fibromyalgia is prevalent in the low socioeconomic status population assisted by the public primary health care system. Prevalence was similar to other studies (4.4% in a more diverse socioeconomic population. Individuals with FM and WP have significant impact in their well being.

Dance for Adults With Fibromyalgia-What Do We Know About It? Protocol for a Scoping Review.

Science.gov (United States)

Bidonde, Julia; Boden, Catherine; Busch, Angela J; Goes, Suelen M; Kim, Soo; Knight, Emily

2017-02-22

Fibromyalgia is a chronic disorder characterized by widespread muscular tenderness, pain, fatigue, and cognitive difficulties. Nonpharmacological treatment options, such as physical activity, are important for people with fibromyalgia. There are strong recommendations to support engagement in physical activity for symptom management among adults with fibromyalgia. Dance is a mode of physical activity that may allow individuals with fibromyalgia to improve their physical function, health, and well-being. Dance has the potential to promote improved pain processing while simultaneously providing the health and social benefits of engaging in physical activity that contributes to symptom management. However, we are unaware of current evidence on dance as a nonpharmacological/physical activity intervention for adults with fibromyalgia. The aims of the study are to provide an overview of the extant evidence to understand how dance is used for individuals with fibromyalgia; to examine the extent, range, and nature of research activity in the area; and to determine the value of undertaking a full systematic review. Scoping reviews are useful to comprehensively and systematically map the literature and identify key evidence, or research gaps. The search strategy will involve electronic databases including Medline, Embase, Cochrane Library, PsycInfo, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Literature in the Health Sciences in Latin America and the Caribbean (LILACS), Allied and Complementary Medicine (AMED), International Bibliography of Theatre and Dance, Physiotherapy Evidence Database (PEDro), Trip, Proquest Theses/Dissertations, Web of Science, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. The study will be mapped in seven stages: (1) identifying the research questions, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, (5) collating, summarizing and reporting

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

Science.gov (United States)

Yuan, Susan Lee King; Matsutani, Luciana Akemi; Marques, Amélia Pasqual

2015-04-01

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multicomponent interdisciplinary group intervention for self-management of fibromyalgia: a mixed-methods randomized controlled trial.

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Patricia Bourgault

Full Text Available This study evaluated the efficacy of the PASSAGE Program, a structured multicomponent interdisciplinary group intervention for the self-management of FMS.A mixed-methods randomized controlled trial (intervention (INT vs. waitlist (WL was conducted with patients suffering from FMS. Data were collected at baseline (T0, at the end of the intervention (T1, and 3 months later (T2. The primary outcome was change in pain intensity (0-10. Secondary outcomes were fibromyalgia severity, pain interference, sleep quality, pain coping strategies, depression, health-related quality of life, patient global impression of change (PGIC, and perceived pain relief. Qualitative group interviews with a subset of patients were also conducted. Complete data from T0 to T2 were available for 43 patients.The intervention had a statistically significant impact on the three PGIC measures. At the end of the PASSAGE Program, the percentages of patients who perceived overall improvement in their pain levels, functioning and quality of life were significantly higher in the INT Group (73%, 55%, 77% respectively than in the WL Group (8%, 12%, 20%. The same differences were observed 3 months post-intervention (Intervention group: 62%, 43%, 38% vs Waitlist Group: 13%, 13%, 9%. The proportion of patients who reported ≥ 50% pain relief was also significantly higher in the INT Group at the end of the intervention (36% vs 12% and 3 months post-intervention (33% vs 4%. Results of the qualitative analysis were in line with the quantitative findings regarding the efficacy of the intervention. The improvement, however, was not reflected in the primary outcome and other secondary outcome measures.The PASSAGE Program was effective in helping FMS patients gain a sense of control over their symptoms. We suggest including PGIC in future clinical trials on FMS as they appear to capture important aspects of the patients' experience.International Standard Randomized Controlled Trial Number

Real-world comparison of health care utilization between duloxetine and pregabalin initiators with fibromyalgia

Directory of Open Access Journals (Sweden)

Peng X

2014-01-01

Full Text Available X Peng,1 P Sun,2 D Novick,1 J Andrews,1 S Sun2 1Eli Lilly and Company, Indianapolis, IN, USA; 2Kailo Research Group, Indianapolis, IN, USA Objectives: To compare health care utilization of duloxetine initiators and pregabalin initiators among fibromyalgia patients in a real-world setting. Methods: A retrospective cohort study was conducted based on a US national commercial health claims database (2006–2009. Fibromyalgia patients who initiated duloxetine or pregabalin in 2008, aged 18–64 years, and who maintained continuous health insurance coverage 1 year before and 1 year after initiation were assigned to duloxetine or pregabalin cohorts on the basis of their initiated agent. Patients who had pill coverage of the agents over the course of 90 days preceding the initiation were excluded. The two comparative cohorts were constructed using propensity score greedy match methods. Descriptive analysis and paired t-test were performed to compare health care utilization rates in the postinitiation year and the changes of these rates from the preinitiation year to the postinitiation year. Results: Both matched cohorts (n=1,265 pairs had a similar mean initiation age (49–50 years, percentage of women (87%–88%, and prevalence of baseline comorbid conditions (neuropathic pain other than diabetic peripheral neuropathic pain, low back pain, cardiovascular disease, hypertension, headache or migraine, and osteoarthritis. In the preinitiation year, both cohorts had similar inpatient, outpatient, and medication utilization rates (inpatient, 15.7%–16.1%; outpatient, 100.0%; medication, 97.9%–98.7%. The utilization rates diverged in the postinitiation year, with the pregabalin cohort using more fibromyalgia-related inpatient care (3.2% versus 2.2%; P<0.05, any inpatient care (19.3% versus 16.8%; P<0.05, and fibromyalgia-related outpatient care (62.1% versus 51.8%; P<0.05. From the preinitiation period to the postinitiation period, the duloxetine cohort

Clinical researches on the efficacy of spa therapy in fibromyalgia: a systematic review

Directory of Open Access Journals (Sweden)

Antonio Fraioli

2013-06-01

Full Text Available BACKGROUND: Fibromyalgia is characterized by chronic widespread pain, tenderness at muscle and tendon insertions point when digital pressure is applied, sleep disorders, chronic fatigue, depressive episodes, anxiety, and other functional somatic syndromes. OBJECTIVE: The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia. METHODS: We conducted a systematic review of the literature regarding spa therapy in the treatment of the fibromyalgia. We searched many databases for articles published between 2000 and 2012 and we selected 7 studies among 65 articles retrieved. A total of 142 patients received balneotherapy and 129 were controls. CONCLUSIONS: Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain, depression and minor symptoms.

Whole body vibration exercise training for fibromyalgia.

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Bidonde, Julia; Busch, Angela J; van der Spuy, Ina; Tupper, Susan; Kim, Soo Y; Boden, Catherine

2017-09-26

measured outcomes), attrition, and other biases; as unclear for selection bias (allocation concealment); and as high for performance, detection (self-report outcomes), and selective reporting biases.The WBV versus control comparison reported on three major outcomes assessed at 12 weeks post intervention based on the Fibromyalgia Impact Questionnaire (FIQ) (0 to 100 scale, lower score is better). Results for HRQL in the control group at end of treatment (59.13) showed a mean difference (MD) of -3.73 (95% confidence interval [CI] -10.81 to 3.35) for absolute HRQL, or improvement of 4% (11% better to 3% worse) and relative improvement of 6.7% (19.6% better to 6.1% worse). Results for withdrawals indicate that 14 per 100 and 10 per 100 in the intervention and control groups, respectively, withdrew from the intervention (RR 1.43, 95% CI 0.27 to 7.67; absolute change 4%, 95% CI 16% fewer to 24% more; relative change 43% more, 95% CI 73% fewer to 667% more). The only adverse event reported was acute pain in the legs, for which one participant dropped out of the program. We judged the quality of evidence for all outcomes as very low. This study did not measure pain intensity, fatigue, stiffness, or physical function. No outcomes in this comparison met the 15% threshold for clinical relevance.The WBV plus mixed exercise (aerobic, strength, flexibility, and relaxation) versus control study (N = 21) evaluated symptoms at six weeks post intervention using the FIQ. Results for HRQL at end of treatment (59.64) showed an MD of -16.02 (95% CI -31.57 to -0.47) for absolute HRQL, with improvement of 16% (0.5% to 32%) and relative change in HRQL of 24% (0.7% to 47%). Data showed a pain intensity MD of -28.22 (95% CI -43.26 to -13.18) for an absolute difference of 28% (13% to 43%) and a relative change of 39% improvement (18% to 60%); as well as a fatigue MD of -33 (95% CI -49 to -16) for an absolute difference of 33% (16% to 49%) and relative difference of 47% (95% CI 23% to 60%); and a

A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients

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Sherman, Christy A.; Mist, Scott D.; Carson, James W.; Bennett, Robert M.; Li, Fuzhong

2017-01-01

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), self-efficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p=0.0002), BPI pain severity (1.2 vs. 0.4, p=0.0008), BPI pain interference (2.1 vs. 0.6, p=0.0000), sleep (2.0 vs. −0.03, p=0.0003), and self-efficacy for pain control (9.2 vs. −1.5, p=0.0001). Functional mobility variables including timed get up and go (−.9 vs. −.3, p=0.0001), static balance (7.5 vs. −0.3, p= 0.0001), and dynamic balance (1.6 vs. 0.3, p=0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. (ClinicalTrials.gov Identifier, NCT01311427) PMID:22581278

The impact of increased body mass index on systemic lupus erythematosus: data from LUMINA, a multiethnic cohort (LUMINA XLVI) [corrected].

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Chaiamnuay, Sumapa; Bertoli, Ana M; Fernández, Mónica; Apte, Mandar; Vilá, Luis M; Reveille, John D; Alarcón, Graciela S

2007-06-01

The aim of this study was to examine the impact of an increased body mass index (BMI) on disease activity, damage accrual, fatigue, self-reported health-related quality of life (HRQOL), and fibromyalgia in patients with lupus using longitudinal data from LUMINA, a large multiethnic cohort. SLE patients (>/=4 ACR revised criteria), BMI was ascertained at T0 or first recorded. The average scores from all visits for disease activity (SLAM-R), self-reported HRQOL (physical and mental component summary measures of the SF-36) and fatigue (Fatigue Severity Scale), the score at last visit for damage accrual (SLICC Damage Index), and fibromyalgia (ACR criteria), if present at any visit, were examined for their association with an increased BMI by univariable and multivariable analyses. Three-hundred sixty-four patients were included; 28% were obese (BMI >/=30 kg/m). An increased BMI was associated with older age, less social support, higher degree of helplessness, depression, more abnormal illness-related behaviors, poorer self-reported HRQOL, fatigue, and fibromyalgia, but not with disease activity or damage accrual by univariable analyses. In multivariable analyses, BMI was independently associated with fibromyalgia but not with disease activity, fatigue, or self-reported HRQOL. An increased BMI is independently associated with presence of fibromyalgia but not with disease activity, damage accrual, fatigue or self-reported quality of life in patients with SLE. Optimizing weight merits investigation to see if it can significantly impact this pervasive SLE-associated manifestation.

Preliminary evidence of altered biomechanics in adolescents with juvenile fibromyalgia.

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Sil, Soumitri; Thomas, Staci; DiCesare, Christopher; Strotman, Daniel; Ting, Tracy V; Myer, Gregory; Kashikar-Zuck, Susmita

2015-01-01

Juvenile fibromyalgia (FM) is characterized by chronic musculoskeletal pain and marked reduction in physical activity. Despite recommendations for exercise to manage juvenile FM pain, exercise adherence is poor. Because of pain and activity avoidance, adolescents with juvenile FM are at risk for altered joint mechanics that may make them susceptible to increased pain and reduced tolerance for exercise. The primary aim of this study was to assess functional deficits in patients with juvenile FM compared to healthy controls using objective biomechanical assessment. Female adolescent patients with juvenile FM (n = 17) and healthy controls (n = 14) completed biomechanical assessments, including gait analysis and tests of lower extremity strength (isokinetic knee extension/flexion and hip abduction) and functional performance (drop vertical jump test) along with self-reported measures of disability (Functional Disability Inventory), pain intensity, depressive symptoms (Children's Depression Inventory), and fear of movement (Tampa Scale of Kinesiophobia). Patients with juvenile FM demonstrated mild deficiencies in walking gait and functional performance (P < 0.05 for both) and significantly lower left knee extension and flexion strength (18-22% deficit) and bilateral hip abduction strength (34-38%) compared with healthy controls (P < 0.008 for all). Patients with juvenile FM reported significantly higher functional disability, pain intensity, depressive symptoms, and fear of movement relative to controls (P < 0.01 for all). This study showed that adolescents with juvenile FM exhibited objective alterations in biomechanics and self-reported fear of movement that may have reinforced their activity avoidance. Interventions for juvenile FM should include a focus on correcting functional deficits and instilling greater confidence in adolescents with juvenile FM to engage in exercise to improve functional outcomes. Copyright © 2015 by the American College of Rheumatology.

Adolescent Self-Reported and Peer-Reported Self-Esteem.

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O'Donnell, William James

1979-01-01

The study is an examination of the relationship between adolescents' self-reported and peer-reported self-esteem and how this relationship is affected by sex, race, and age variables. Significant sex and race variations interacted with age. Explanatory hypotheses for these findings are given. (Author/KC)

Impact of fibromyalgia on functioning in obese patients undergoing comprehensive rehabilitation.

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Arreghini, Marco; Manzoni, Gian Mauro; Castelnuovo, Gianluca; Santovito, Cristina; Capodaglio, Paolo

2014-01-01

A possible link between fibromyalgia (FM) and obesity has been recently suggested but very scanty data on the prevalence of FM in obese populations are available. The aims of the present cross-sectional study were: 1) to estimate the prevalence of FM in a population of obese patients undergoing rehabilitation and 2) to investigate the effect of FM on obese patients' functional capacities. One hundred and thirty Italian obese (Body Mass Index, BMI ≥ 30) patients admitted to hospital for 1-month rehabilitation treatment took part in the study. All participants were interviewed by a rheumatologist according to the 2010 American College of Rheumatology (ACR) diagnostic criteria for FM. At admission and discharge from hospital (on average, after 28 days), the following measures were compared between the group of patients with FM and the other patients: body weight, body mass index, functional independence (FIM), obesity-related disability (TSD-OC), self-reported functioning and the Timed-Up-Go (TUG) test. Thirty seven patients out of 130 fulfilled the diagnostic criteria for FM. The prevalence rate was 27.7% (95% CI: 20 to 35.4). Between-group comparisons showed that FM patients had higher disability level at the first assessment, had lower scores on the FIM at the final assessment, scored lower on self-reported functioning both at the first and the final assessments and had a lower body weight. The prevalence of FM in our study is much higher than the rates reported in the general normal-weight population (on average, 3.5%) and the 5.15% rate previously reported in a bariatric population. Functional data showed that the FM obese group yielded lower performance capacity and higher disability level as compared to the non-FM obese group. However, due to the relatively small sample size and the selected population, such results need to be confirmed in larger obese subpopulations.

TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia.

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Rasouli, Omid; Stensdotter, Ann-Katrin; Van der Meer, Audrey L H

2016-08-01

Impaired postural control has been reported in static conditions in chronic fatigue syndrome and fibromyalgia, but postural control in dynamic tasks have not yet been investigated. Thus, we investigated measurements from a force plate to evaluate dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia compared to matched healthy controls. Thirty female participants (10 per group) performed five trials of gait initiation. Center of pressure (CoP) trajectory of the initial weight shift onto the supporting foot in the mediolateral direction (CoPX) was analyzed using General Tau Theory. We investigated the hypothesis that tau of the CoPX motion-gap (τCoPx) is coupled onto an intrinsic tauG-guide (τG) by keeping the relation τCoPx=KτG, where K is a scaling factor that determines the relevant kinematics of a movement. Mean K values were 0.57, 0.55, and 0.50 in fibromyalgia, chronic fatigue syndrome, and healthy controls, respectively. Both patient groups showed K values significantly higher than 0.50 (P0.5). The findings revealed a lower level of dynamic postural control in both fibromyalgia and chronic fatigue syndrome compared to controls. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing the Accuracy of Self-Reported Self-Talk

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Thomas M. Brinthaupt

2015-05-01

Full Text Available Self-Talk Scale (STS; Brinthaupt, Hein, & Kramer, 2009 is a self-report measure of self-talk frequency that has been shown to possess acceptable reliability and validity. However, no research using the STS has examined the accuracy of respondents’ self-reports. In the present paper, we report a series of studies directly examining the measurement of self-talk frequency and functions using the STS. The studies examine ways to validate self-reported self-talk by (1 comparing STS responses from 6 weeks earlier to recent experiences that might precipitate self-talk, (2 using experience sampling methods to determine whether STS scores are related to recent reports of self-talk over a period of a week, and (3 comparing self-reported STS scores to those provided by a significant other who rated the target on the STS. Results showed that (1 overall self-talk scores, particularly self-critical and self-reinforcing self-talk, were significantly related to reports of context-specific self-talk; (2 high STS scorers reported talking to themselves significantly more often during recent events compared to low STS scorers, and, contrary to expectations, (3 friends reported less agreement than strangers in their self-other self-talk ratings. Implications of the results for the validity of the STS and for measuring self-talk are presented.

Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review.

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Ratter, Julia; Radlinger, Lorenz; Lucas, Cees

2014-09-01

Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders? Systematic review of studies of the psychometric properties of exercise tests. People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders. Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included. Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates. Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia. Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue. Copyright © 2014. Published by Elsevier B.V.

Food intake assessment and quality of life in women with fibromyalgia

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Emmanuelle Dias Batista

2016-04-01

Full Text Available ABSTRACT Objective: To compare the food intake of women with and without fibromyalgia and verify if the food intake of patients with fibromyalgia interferes with the pain and quality of life. Methods: Study participants were women with fibromyalgia (FM seen in Fibromyalgia Outpatient Clinic, Hospital das Clínicas/UFPR and a control group (CT with healthy women. Data collection was conducted from March to October 2012. For the assessment of food intake we used the Food Registration and analyzed items were: total calories, carbohydrates, proteins, lipids, vitamins (A, C, B12, D and E and minerals (folate, selenium, zinc, iron, calcium and magnesium. The software used was Avanutri Online®. To evaluate the quality of life, the Fibromyalgia Impact Questionnaire (FIQ and pain threshold were used. Results: 43 patients with FM and 44 healthy women were evaluated. CT group showed a mean consumption of nutrients greater than FM group except for iron. However, only caloric intake, carbohydrates, proteins and lipids in grams and percentage of lipids, vitamin A, E, B12, folate, selenium and calcium were statistically significant. In FM group there was a negative correlation between vitamin E and FIQ and a positive correlation between percentage of protein and pain threshold. Conclusion: Women with FM showed a lower qualitatively and quantitatively intake in comparison with CT group. Only vitamin E correlated with quality of life and percentage of protein in the diet with sensation of pain.

Norepinephrine-evoked pain in fibromyalgia. A randomized pilot study [ISRCTN70707830

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Casanova Jose-Miguel

2002-01-01

Full Text Available Abstract Background Fibromyalgia syndrome displays sympathetically maintained pain features such as frequent post-traumatic onset and stimuli-independent pain accompanied by allodynia and paresthesias. Heart rate variability studies showed that fibromyalgia patients have changes consistent with ongoing sympathetic hyperactivity. Norepinephrine-evoked pain test is used to assess sympathetically maintained pain syndromes. Our objective was to define if fibromyalgia patients have norepinephrine-evoked pain. Methods Prospective double blind controlled study. Participants: Twenty FM patients, and two age/sex matched control groups; 20 rheumatoid arthritis patients and 20 healthy controls. Ten micrograms of norepinephrine diluted in 0.1 ml of saline solution were injected in a forearm. The contrasting substance, 0.1 ml of saline solution alone, was injected in the opposite forearm. Maximum local pain elicited during the 5 minutes post-injection was graded on a visual analog scale (VAS. Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection. Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores. Results Norepinephrine-evoked pain was seen in 80 % of FM patients (95% confidence intervals 56.3 – 94.3%, in 30 % of rheumatoid arthritis patients and in 30 % of healthy controls (95% confidence intervals 11.9 – 54.3 (p Conclusions Fibromyalgia patients have norepinephrine-evoked pain. This finding supports the hypothesis that fibromyalgia may be a sympathetically maintained pain syndrome.

Aerobic exercise training for adults with fibromyalgia.

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Bidonde, Julia; Busch, Angela J; Schachter, Candice L; Overend, Tom J; Kim, Soo Y; Góes, Suelen M; Boden, Catherine; Foulds, Heather Ja

2017-06-21

data, performed a risk of bias assessment, and assessed the quality of the body of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences between groups. We included 13 RCTs (839 people). Studies were at risk of selection, performance, and detection bias (owing to lack of blinding for self-reported outcomes) and had low risk of attrition and reporting bias. We prioritized the findings when aerobic exercise was compared with no exercise control and present them fully here.Eight trials (with 456 participants) provided low-quality evidence for pain intensity, fatigue, stiffness, and physical function; and moderate-quality evidence for withdrawals and HRQL at completion of the intervention (6 to 24 weeks). With the exception of withdrawals and adverse events, major outcome measures were self-reported and were expressed on a 0 to 100 scale (lower values are best, negative mean differences (MDs)/standardized mean differences (SMDs) indicate improvement). Effects for aerobic exercise versus control were as follows: HRQL: mean 56.08; five studies; N = 372; MD -7.89, 95% CI -13.23 to -2.55; absolute improvement of 8% (3% to 13%) and relative improvement of 15% (5% to 24%); pain intensity: mean 65.31; six studies; N = 351; MD -11.06, 95% CI -18.34 to -3.77; absolute improvement of 11% (95% CI 4% to 18%) and relative improvement of 18% (7% to 30%); stiffness: mean 69; one study; N = 143; MD -7.96, 95% CI -14.95 to -0.97; absolute difference in improvement of 8% (1% to 15%) and relative change in improvement of 11.4% (21.4% to 1.4%); physical function: mean 38.32; three studies; N = 246; MD -10.16, 95% CI -15.39 to -4.94; absolute change in improvement of 10% (15% to 5%) and relative change in improvement of 21.9% (33% to 11%); and fatigue: mean 68; three studies; N = 286; MD -6.48, 95% CI -14.33 to 1.38; absolute change in improvement of 6% (12% improvement to 0.3% worse) and relative change in improvement

[Effects of a programme of aquatic Ai Chi exercise in patients with fibromyalgia. A pilot study].

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Perez-De la Cruz, Sagrario; Lambeck, Johan

2015-01-16

Fibromyalgia is rheumathological disease a combination of physical, psychological and social limitations. The aim of the present study is to determinate the benefits of Ai Chi program on quality of life, depression and pain. An experimental study was performed with 20 fibromyalgia patients two different cities. Outcome measures were functional capacity (Fibromyalgia Impact Questionnaire), pain (Visual Analogue Scale) and quality of life (Short Form-36). Measures were performed at baseline and after ten weeks post-intervention. After ten weeks of treatment, the results showed significant reduction (p physical and mental health in patients with fibromyalgia.

Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls.

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Toussaint, Loren; Sirois, Fuschia; Hirsch, Jameson; Weber, Annemarie; Vajda, Christian; Schelling, Jorg; Kohls, Niko; Offenbacher, Martin

2017-09-01

Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls. Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics. Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables. Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.

Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia

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Guillermo A. Matarán-Peñarrocha

2011-01-01

Full Text Available Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patients diagnosed with fibromyalgia were randomly assigned to an intervention group (craniosacral therapy or placebo group (simulated treatment with disconnected ultrasound. The treatment period was 25 weeks. Anxiety, pain, sleep quality, depression and quality of life were determined at baseline and at 10 minutes, 6 months and 1-year post-treatment. State anxiety and trait anxiety, pain, quality of life and Pittsburgh sleep quality index were significantly higher in the intervention versus placebo group after the treatment period and at the 6-month follow-up. However, at the 1-year follow-up, the groups only differed in the Pittsburgh sleep quality index. Approaching fibromyalgia by means of craniosacral therapy contributes to improving anxiety and quality of life levels in these patients.

Fibromyalgia Complicating Disease Management in Rheumatoid Arthritis

International Nuclear Information System (INIS)

Abbasi, L.; Haidri, F. R.

2014-01-01

Objective: To evaluate frequency of fibromyalgia in rheumatoid arthritis and its effect on disease activity score. Study Design: Cross-sectional study. Place and Duration of Study: The Indus Hospital, Karachi, from December 2010 to May 2011. Methodology: All adult patients of either gender diagnosed as rheumatoid arthritis on the basis of clinical, laboratory and X-ray criteria were included in the study. The sample data was separated into two groups depending on presence or absence of fibromyalgia and 28 joint disease activity score (DAS-28) value was evaluated. Results: There were 31 (25.83%) patients with rheumatoid arthritis and fibromyalgia (RAFM) out of the total 120. The median (IQR) age of patients was 40 (32 - 51) years. All were females. The overall female frequency was 79 (88.8%). The median (IQR) DAS-28 score in RA group was 4.9 (3.66 - 5.71), while the median (IQR) DAS-28 score in RAFM was 7.04 (6.62 - 7.64) [p < 0.0001]. The number of patient getting combination therapy of DMARD in RAFM group was 61.3% while in RA group was 42.7%. Conclusion: DAS-28 was found to be significantly higher in RAFM patients probably because of higher perception of pain. (author)

Sexual behavior in a cohort of patient affected by fibromyalgia and/or vulvodynia

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Anna Ghizzani

2015-08-01

Full Text Available Fibromyalgia, characterized by widespread musculoskeletal pain, negatively impacts sexuality by provoking dispareunia, and loss of desire and of dyadic gratification. Chronic pain syndromes tend to associate and FM women have a higher probability to develop vulvodynia than women not affected by fibromyalgia. Vulvodynia, characterized by burning pain that interferes with sexual penetration, is classified as Genitopelvic/Penetration Disorders in DSM 5. The association between Fibromyalgia and vulvodynia is difficult to recognize because patients tend to attribute all symptoms to disease spread and not think that dyspareunia may have different origins. To establish the necessary criteria for the differential diagnosis between the two syndromes, we evaluated the characteristics of dyspareunia and sexual behavior of fibromyalgia patients versus vulvodynia patients and we found significant differences on the onset of burning pain, orgasmic capability, and sexual frequency.

Muscle fatigue in fibromyalgia is in the brain, not in the muscles

DEFF Research Database (Denmark)

Bandak, Elisabeth; Amris, Kirstine; Bliddal, Henning

2013-01-01

To investigate relationships between perceived and objectively measured muscle fatigue during exhausting muscle contractions in women with fibromyalgia (FM) compared with healthy controls (HC).......To investigate relationships between perceived and objectively measured muscle fatigue during exhausting muscle contractions in women with fibromyalgia (FM) compared with healthy controls (HC)....

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

Differences in ability to perform activities of daily living among women with fibromyalgia

DEFF Research Database (Denmark)

von Bülow, Cecilie; Amris, Kirstine; La Cour, Karen

2015-01-01

Objective: To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences...... in ability to perform activities of daily living. Design: Cross-sectional study. Subjects: A total of 257 women with fibromyalgia. Methods: Participants were evaluated with the AMPS (measuring activities of daily living motor and activities of daily living process ability), FIQ and SF-36. AMPS independence...

The Evaluation of Effectiviness of Conventional Corset on Walking Potential in Patients with Fibromyalgia

OpenAIRE

İnanır, Ahmet; Habiboğlu, Abdulkadir; Erkorkmaz, Ünal; İnanır, Sema

2011-01-01

Objective: It has been aimed whether the corset changes the potential to exercise in patients with fibromyalgia syndrome. Material and Methods: In this study, classified according to body mass index (BMI), 51 patients diagnosed Rehabilitation clinic with fibromyalgia and tested in walking 6 minutes with and without the corset were compared in their test results. Findings: In their walking test scores with/without the corset of the Groups 1, 2 and 3 fibromyalgia patients were identified statis...

Free amino acids in fibromyalgia syndrome: relationship with clinical picture.

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Ruggiero, Valeria; Mura, Massimiliano; Cacace, Enrico; Era, Benedetta; Peri, Marcella; Sanna, Giuseppina; Fais, Antonella

2017-04-01

The objectives of our study were to evaluate free amino acid (FAA) concentrations in the serum of patients affected by fibromyalgia syndrome (FMS) and to determine the relationships between FAA levels and FMS clinical parameters. Thus, serum amino acid concentrations were quantified (HPLC analysis) in 23 females with fibromyalgia (according to the American College of Rheumatology classification criteria) and 20 healthy females. The results showed significantly higher serum concentrations of aspartate, cysteine, glutamate, glycine, isoleucine, leucine, methionine, ornithine, phenylalanine, sarcosine, serine, taurine, tyrosine and valine in FMS patients vs. healthy controls. Patients with higher Fibromyalgia Impact Questionnaire (FIQ) scores showed increased levels of alanine, glutamine, isoleucine, leucine, phenylalanine, proline and valine. In conclusion, our results indicate an imbalance in some FAAs in FMS patients. Increased Glu is particularly interesting, as it could explain the deficit in monoaminergic transmission involved in pain.

Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

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Morthorst, Britt Reuter; Soegaard, Bodil; Nordentoft, Merete

2016-01-01

Background: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate selfharm have been presented. Aim: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records...... incidence of deliberate self-harm among young Danish women was observed, despite detection bias. An improved registration procedure of suicidal behavior is needed....

Seventy Years of Asthma in Italy: Age, Period and Cohort Effects on Incidence and Remission of Self-Reported Asthma from 1940 to 2010.

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Giancarlo Pesce

Full Text Available It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma.To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010.The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC were modelled using Poisson regression and APC models.The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years. The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1-4.5, from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease.After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias.

Ethnicity, desirable responding, and self-reports of abuse: a comparison of European- and Asian-ancestry undergraduates.

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Meston, C M; Heiman, J R; Trapnell, P D; Carlin, A S

1999-02-01

One thousand fifty-two (582 non-Asian, 470 Asian) university students were assessed regarding levels of physical abuse, emotional abuse, sexual abuse, neglect, and socially desirable responding. Differences between Asian-ancestry and European-ancestry students in self-reported incidence and expression of abuse were evaluated, as was gender and the relation between self-reported abuse and socially desirable responding. Asian-ancestry men and women reported higher levels of physical abuse, emotional abuse, and neglect than did their Euro-ancestry counterparts, and Euro-ancestry women reported a higher incidence of sexual abuse than did Asian-ancestry women. Across ethnicity, men reported higher levels of physical abuse and neglect but lower levels of sexual abuse than did women. Socially desirable responding was not related to measures of abuse. Findings are discussed in terms of cultural influences on child-rearing and disciplinary practices.

Symptoms of Fibromyalgia According to the 2016 Revised Fibromyalgia Criteria in Chronic Pain Patients Referred to Multidisciplinary Pain Rehabilitation: Influence on Clinical and Experimental Pain Sensitivity

DEFF Research Database (Denmark)

Plesner, Karin Bruun; Vaegter, Henrik Bjarke

2018-01-01

Fibromyalgia is a condition with chronic widespread pain and signs of generalized pain hypersensitivity. FM has previously been classified according to the ACR1990 criteria, where the presence of hypersensitivity is estimated by a tender point examination. Due to the limitations of these classifi......Fibromyalgia is a condition with chronic widespread pain and signs of generalized pain hypersensitivity. FM has previously been classified according to the ACR1990 criteria, where the presence of hypersensitivity is estimated by a tender point examination. Due to the limitations...... of these classification criteria, new diagnostic criteria have been proposed, abandoning this examination. This cross-sectional study investigated the prevalence of FM according to the revised 2016 FM criteria in a large cohort of chronic pain patients. Pain drawings, the Fibromyalgia Symptom Severity Scale...