BackgroundIn people with hemophilia(PwH) repeated joint bleeding leads to physical limitations.However, there may be some factors,such as fear of movement or kinesiophobia, which may decrease physical activity.All these may reduce psychological well-being, and quality-of-life(QoL) throughout the lifespan in PwH.ObjectiveFor this reason the aim of this study was to examine the presence of fear of movement, physical activity, depression and anxiety levels, and health-related QoL in PwH compared to healthy male controls.MethodsThis was an unmatched case-control study with age- and gender-matched group distributions (frequency matching) including 40 cases and 45 controls.Tampa Scale for Kinesiophobia(TSK),International Physical Activity Questionnaire Short-Form(IPAQ-SF),Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI) and 36-Item Short-Form Health Survey(SF-36) were used to evaluate the participants.ResultsThe average age of participants in the Hemophilia Group was 33.15 ± 10.02 years(range 18-50 years) and in the Control Group was 31.29 ± 8.72 years(range 18-50 years), with no statistically significant difference between the groups (p > 0.05).The results were analyzed using Mann-Whitney U test.When both groups were compared, a significant difference was found in TSK scores measured for kinesiophobia(p = 0.000,r = -0.51).PwH had significantly lower-scores in the General Health(p = 0.001,r = -0.37),Physical Functioning(p = 0.000,r = -0.64),Bodily Pain(reflecting higher pain levels)(p = 0.037,r = -0.23) and Role Physical(p = 0.016,r = -0.26) domains of QoL compared to the healthy subjects.ConclusionThis study demonstrated that PwH had significantly higher levels of kinesiophobia and lower health-related QoL in domains of General Health,Physical Functioning,Role Physical,and Bodily Pain compared to healthy controls.These findings highlight the need for a multidisciplinary approach to treatment in hemophilia patients, addressing not only joint health but also fear of movement and psychological factors.

The global aging population is rapidly increasing, prompting the United Nations to declare the "Decade of Healthy Aging" (2021-2030) to improve the quality of life for older adults. Health-related quality of life (HRQoL) is crucial in this context, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for its evaluation. This study aimed to apply a previously proposed method for converting SF-36 domain scores into ICF qualifiers in community-dwelling older adults attending primary care services in a middle-income country, describing the resulting classification of functioning domains using standardized ICF qualifiers. A cross-sectional study was conducted with older adults aged 60 and above who accessed primary healthcare services and had no cognitive impairment. Participants underwent HRQoL assessment using the SF-36, and ICF codes previously linked to SF-36 domains were classified using ICF qualifiers. A simple calculation method was developed to convert SF-36 scores into ICF qualifiers. The study included 52 participants, with a mean age of 71.6±7.0years, 92.3% of whom were women. The ICF framework qualified 27 codes from SF-36 domains. Moderate impairments were observed in "Bodily Pain," "General Health," and "Vitality" domains, while "Physical Functioning," "Social Functioning," and "Mental Health" domains showed mild impairments. No impairments were noted in the "Role Physical" and "Role Emotional" domains. The application of ICF qualifiers to SF-36 domain scores yielded standardized classifications of HRQoL domains across the ICF framework, allowing HRQoL outcomes to be described according to the severity levels defined by the ICF qualifier scale.

A substantial proportion of patients report no pain after surgery, resulting in an excess of zero values that pose challenges for analysis using traditional statistical models. The current study was designed to test the hypothesis that a two-part model, commonly used in healthcare expenditures research, would demonstrate superior performance in predicting postsurgical pain when compared with traditional models and would secondarily better identify predictors of this clinically important outcome. This study analyzed a prospectively collected single-center data set (n = 3,925) of chronic postsurgical pain to compare a novel two-part modeling framework with logistic and linear regression. The two-part model first estimated the probability of experiencing postsurgical pain at 3 months (binary outcome), followed by the severity of pain among those affected (on a 1 to 10 numeric rating scale). To obtain an unbiased assessment of model performance, the data were randomly split into training (n = 3,000) and testing (n = 925) data sets. The models were trained on the training data set and evaluated on the testing set. This process was repeated 400 times to compute average performance estimates. As a secondary aim, the study assessed the associations of 15 baseline factors, including validated measures of patient-reported pain, functional and psychological measures, comorbidities, and surgical details, across the different modeling approaches. The two-part model demonstrated superior predictive performance compared with linear regression alone, with a higher mean R 2 value (0.075 vs . 0.050; P < 0.0001), lower root mean square error (1.466 vs . 1.485; P < 0.0001), and lower mean absolute error (1.020 vs . 1.030; P < 0.0001). Statistical comparison with logistic regression alone was not possible due to the shared binary component. The two-part model identified seven baseline preoperative covariates as independently associated with postsurgical pain that were missed by either logistic or linear models or both: self-reported race, education level, American Society of Anesthesiologists classification, overall body pain, widespread pain, symptom severity, and anxiety level. Significant baseline factors identified in all three models were patient sex, surgical type, and surgical site pain. A two-part model may offer a superior statistical approach to linear and logistic regression, better identifying patient- and clinical care-related risk factors of chronic postsurgical pain, primarily by distinguishing factors that drive the occurrence of chronic pain from those that are associated with pain severity.

To describe health-related quality of life (HRQoL) across the eight SF-36 domains in Albanian adults with type 2 diabetes mellitus (T2DM), identify demographic and clinical correlates of HRQoL, and assess whether associations with multimorbidity were robust to an alternative principal component analysis (PCA)-derived weighted multimorbidity index. In this cross-sectional study, 176 adults with T2DM completed the SF-36 questionnaire. Sociodemographic characteristics, diabetes duration, HbA1c, insulin therapy and physician-confirmed comorbidities were recorded. Multivariable linear regression models with robust standard errors examined adjusted associations between clinical characteristics and SF-36 domains. To address limitations of an unweighted comorbidity count, a PCA-derived weighted multimorbidity index was constructed and used in sensitivity analyses. Interaction analyses were considered exploratory. Participants had a mean age of 65.1 years, mean diabetes duration of 10.8 years, and mean HbA1c of 7.74%; 54.0% were receiving insulin therapy and 43.8% had multimorbidity. General Health, Role-Physical and Vitality were the most impaired SF-36 domains. In adjusted analyses, multimorbidity was independently associated with lower Physical Functioning, Vitality, Mental Health, Social Functioning, Bodily Pain and General Health scores. Older age was also associated with poorer HRQoL across several domains. After adjustment, neither insulin therapy nor HbA1c was independently associated with most physical HRQoL domains. Findings were materially unchanged when multimorbidity was operationalised using the PCA-derived weighted index. In this Albanian outpatient cohort, multimorbidity was the strongest independent cross-sectional correlate of impaired HRQoL across both physical and psychosocial domains. The association remained robust to alternative operationalisations of comorbidity burden. Given the cross-sectional design, modest sample size and potential residual confounding, findings should be interpreted as hypothesis-generating and warrant confirmation in larger longitudinal studies.

Deep infiltrating endometriosis (DIE), particularly when involving the bowel, significantly impairs health-related quality of life (HRQoL) and gastrointestinal function. This study aimed to evaluate the short- and mid-term impact of minimally invasive excision on these parameters in a large multicenter cohort. A retrospective observational study was conducted on 837 patients treated for endometriosis in two tertiary referral centers between 2018 and 2024. All patients underwent laparoscopic or robotic-assisted excision. Quality of life was assessed preoperatively and at 6 months (VAS: n = 69; SF-36: n = 100; GIQLI: n = 98) and 12 months (VAS: n = 30; SF-36: n = 46; GIQLI: n = 44) postoperatively, using validated patient-reported outcome measures (PROMs): the Visual Analog Scale (VAS) for pain, the Short Form-36 (SF-36) survey, and the Gastrointestinal Quality of Life Index (GIQLI). The study population presented with predominantly advanced disease (Stage III-IV in 83.4% of cases), with 39.7% of patients undergoing segmental bowel resection. Postoperatively, a statistically significant reduction was observed in dysmenorrhea (VAS 7.6 vs. 5.0, p < 0.001) and chronic pelvic pain. The SF-36 scores improved significantly across all eight domains at 6 months, with the most dramatic recovery seen in Role Physical (p < 0.001) and Bodily Pain (p < 0.001). Regarding digestive function, the mean GIQLI score showed a progressive increase, reaching statistical significance at 12 months compared to baseline (112.6 vs. 106.6, p = 0.027), indicating superior long-term functional outcomes. Multidisciplinary minimally invasive surgery for deep infiltrating endometriosis was associated with significant and sustained improvements in quality of life among patients with available follow-up. Gastrointestinal quality of life, as measured by GIQLI, improved significantly at 12 months postoperatively, including in patients who underwent segmental bowel resection. Systematic use of PROMs is essential for accurate patient counseling and outcome monitoring.

This study aimed to evaluate the effect of Huangqin Qingre Chubi capsule (HQC) on self-perception of patients (SPP) with gouty arthritis (GA) and explore its potential action path. Using a nested case-control design, 150 eligible GA patients were matched into neutrophil to lymphocyte ratio (NLR) improved group and NLR unimproved group based on the presence or absence of NLR improvement. Stratified analysis, association rule, binary logistics regression model and mediating effect analysis were used to evaluate the protective effect of HQC on SPP. At baseline, patients in the NLR improved group demonstrated significantly higher scores in the SPP subscales of physical functioning (PF), bodily pain (BP), general health, vitality (VT), role emotional (RE), and health transition compared to those in the NLR unimproved group (P < .001). And they exhibited significantly lower scores on the Visual Analog Scale (VAS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) (P < .01). HQC significantly improved SPP (including PF, role physical, BP, VT, RE, mental health, VAS, SAS, and SDS) in GA patients (P < .05). Stratified analyses and binary logistics regression showed that HQC had a significant protective effect on the SPP. Association rules showed that there was a co-occurrence pattern between HQC and improvement of SPP. Mediation analysis showed that NLR showed a complete mediating effect in the path of HQC improving PF (P < .001), SDS (P < .001), Syndrome of Dampness-Heat Quantitative Score (SDH) (P < .001) and Syndrome of Blood Stasis Quantitative Score (SBS) (P < .001). HQC is related to the improvement of SPP, inflammatory biomarkers and traditional Chinese medicine syndromes in GA patients, and it plays a protective effect on SPP through NLR.

To evaluate postoperative changes in health-related quality of life (HRQoL) after endoscopic stone surgery and to determine whether recovery patterns differ according to stone localization. In this prospective observational study, 50 patients undergoing endourological stone surgery were stratified according to stone localization (renal, ureteral, and bladder). HRQoL was assessed using the SF-36 questionnaire preoperatively, on postoperative day 1, and at 1, 3, and 6months. Stone-free status was evaluated at postoperative month 1 using KUB radiography and/or non-contrast CT when clinically indicated. Statistical analysis was performed using mixed-design repeated-measures ANOVA, with appropriate assumption testing. SF-36 total scores and all subscale scores improved significantly over time in all groups (p < 0.001). No significant overall differences were observed between localization groups (p > 0.05), whereas a significant group × time interaction was detected (p = 0.005), suggesting differences in recovery patterns according to stone localization. Patients with ureteral stones demonstrated a faster improvement in the bodily pain domain (p = 0.002). Stone-free rates were high across groups (100% bladder, 94.7% ureteral, and 92.6% renal stones). Endoscopic stone surgery is associated with significant improvements in HRQoL across all stone localizations. Although recovery patterns vary according to stone location, overall functional and psychosocial outcomes improve consistently over time. However, given the observational design and lack of a comparator group, modality-specific conclusions cannot be drawn.

To determine whether anti-reflux ureteral stents improve postoperative stent-related symptoms and complications compared with conventional Double-J (DJ) stents in children undergoing ureteroscopic lithotripsy (URL) or retrograde intrarenal surgery (RIRS). Children undergoing URL and RIRS were prospectively randomized in a 1:1 ratio by block randomization to receive either a 4.8-Fr anti-reflux stent or a 4.7-Fr conventional DJ stent. Postoperative symptoms were assessed 2 weeks after surgery using age-adapted versions of the pediatric ureteral stent symptom questionnaire (PUSSQ), with separate forms for toilet-trained and pre-toilet-trained children. Stone-free rates and stent-related complications were also evaluated. The trial was registered at ClinicalTrials.gov (NCT06569173). A total of 88 children were included. Baseline characteristics were comparable between the two groups in both strata. Among toilet-trained children, the incidence of flank pain was lower (P = 0.047) in the anti-reflux stent group than the conventional DJ stent group, but body pain scores (P = 0.031) and urinary symptom scores (P = 0.009) were higher in the anti-reflux stent group. In pre-toilet-trained children, body pain scores (P = 0.048) and urinary symptom scores (P = 0.040) were also significantly higher in the anti-reflux group. No significant between-group differences were observed in other body pain manifestations, stent migration, stent extrusion, steinstrasse, or other complications. Stone-free rates were comparable between groups. Anti-reflux stents reduced flank pain in toilet-trained children but were associated with more pronounced LUTS and body pain in both toilet-trained and pre-toilet-trained children. Overall, the anti-reflux ureteral stents may not confer a definitive clinical benefit in children after URL or RIRS.

Higher preoperative Central Sensitization Inventory (CSI) scores may be associated with poor pain improvement after total knee arthroplasty (TKA); sex differences in this association remain unclear. We investigated whether sex modifies the association between preoperative CSI scores and pain improvement after TKA. This multicenter prospective cohort study included patients undergoing primary unilateral TKA. Poor postoperative pain improvement at threemonths after TKA was defined as failure to achieve the minimal clinically important difference (10 points) on the Knee injury and Osteoarthritis Outcome Score pain subscale. Logistic regression analyses were performed to examine associations between preoperative CSI scores and poor pain improvement, including an interaction term between CSI scores and sex, with adjustment for age, body mass index, pain intensity, pain catastrophizing, anxiety, and depression. Of 210 enrolled patients(48 males, 162 females; mean age, 73.8 ± 7.8 years), 192 were included. Higher preoperative CSI scores were associated with greater odds of poor postoperative pain improvement (odds ratio, 1.115; 95% confidence interval [CI], 1.060-1.173; P <0.001), whereas sex was not associated with the outcome. In the interaction model, higher CSI scores remained associated with poor pain improvement (OR, 1.142; 95% CI, 1.026-1.271; P = 0.015), whereas neither sex (OR, 1.022; 95% CI, 0.380-2.751; P = 0.966) nor the CSI × sex interaction term (OR, 0.973; 95% CI, 0.873-1.084; P = 0.615) was associated with the outcome. Higher preoperative CSI scores were associated with poor postoperative pain improvement after TKA, without a sex interaction.

1988-P: Beyond Glycemic Control: Health-Related Quality-of-Life Benefits of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 2 Diabetes

Placenta accreta spectrum (PAS) is an increasingly prevalent condition in women, often necessitating cesarean hysterectomy, which can significantly impact various aspects of life. This study aimed to evaluate the quality of life and postpartum depression in women with PAS and compare them with women who underwent repeated cesarean sections. In this case-control study, we conducted interviews with women after delivery. The SF-36 questionnaire was used to assess quality of life, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depression. Data on demographics, neonatal outcomes, complications, rehospitalization, blood loss, ICU admission, and neonatal NICU admission were collected from hospital records. All data were entered into SPSS and analyzed using descriptive statistics, the Kruskal-Wallis test, Spearman's Rho correlation, the Mann-Whitney U test, and post hoc tests. Among 62 cases with PAS and cesarean hysterectomy and 75 control subjects with repeated cesarean sections, there was a significant difference between the groups in the physical function and pain domains of the SF-36, with lower scores observed in the case group (p-value < 0.001). Significant relationships were found between blood loss and both physical function (p-value = 0.005) and pain (p-value = 0.003). NICU admission was also significantly associated with bodily pain (p-value = 0.01) and physical function (p-value = 0.005). Maternal ICU admission significantly affected physical function (p-value = 0.016), and surgical complications were related to role limitations due to emotional problems (p-value = 0.028). Probable depression was observed in 37 cases and 39 controls(p-value = 0.89). Women with PAS face meaningful postoperative limitations-particularly in physical function and pain-that extend beyond surgical morbidity and highlight the need for specialized perioperative counseling, proactive rehabilitation strategies, and multidisciplinary follow-up. Despite these physical burdens, postpartum depressive symptoms were comparable between groups, indicating that mental health outcomes may depend on factors other than PAS alone.

Background/Objectives: Fibromyalgia (FM) is a complex disease with symptoms such as brain fog, widespread body pain, sleep disturbances, and mood changes, and its etiology is not clearly understood. Our main aim in this study was to evaluate emotional eating and emotional dysregulation in patients with FM and examine the possible effects of these disorders on disease severity. Materials and Methods: This observational study included 94 patients with FM (6 males, 88 females; mean age: 44.64 ± 9.04 years; range, 19–65 years) and 76 controls (7 males, 69 females; mean age: 41.91 ± 10.874 years; range, 18–64 years). The patient and control group participants completed a form including sociodemographic data. Participants also completed the Fibromyalgia Impact Questionnaire (FIQ), Emotional Eating Questionnaire (EEQ), and Difficulties in Emotion Regulation Scale (DERS). Results: In unadjusted comparisons, DERS-goals and DERS-strategies scores were higher in the FM group than in controls; however, these differences did not remain statistically significant after Bonferroni correction. In the linear regression model, it was found that the total score of the Difficulties in Emotion Regulation Scale (DERS-Total) (p = 0.010) was the only variable that significantly affected the FIQ value. Even though the patient group had slightly higher EEQ scores, there was no statistically significant difference between the two groups (p = 0.721). Conclusions: Emotional regulation difficulties were associated with FM symptom severity, whereas emotional eating did not differ significantly between groups and was not associated with symptom severity. These findings suggest that emotion-related psychological processes should be considered within the biopsychosocial framework of FM.

PurposeTo characterize a patient group with refractory orofacial pain (OFP) at a tertiary pain clinic with emphasis on subtype distribution, comorbidities, sex differences and psychological factors.Patients and MethodsThis retrospective study reviewed 98 consecutive patients assessed at the National Unit of Orofacial Pain, Haukeland University Hospital, Bergen, Norway (2017–2021). All patients were investigated by an interdisciplinary team that used a structured clinical interview and assessments and patients completed a series of standardized questionnaires that formed the basis for the final diagnosis and treatment plan. The International Classification of Orofacial Pain (ICOP-2020) was launched later and therefore retrospectively used forming the basis for this study. Five primary subtypes were analyzed: primary myofascial orofacial pain (pMOP), post-traumatic trigeminal neuropathic pain (PTTNP), persistent idiopathic facial pain (PIFP), trigeminal neuralgia (TN) and burning mouth syndrome (BMS). Secondary MOP (sMOP) was recorded when myalgia co-occurred with another primary diagnosis. Descriptive statistics, χ2-tests and one-way ANOVA was performed.ResultsThe most frequent diagnosis was pMOP (60.2%), followed by PTTNP (20.4%), PIFP (14.3%), TN (4.1%), and BMS (3.1%). Twenty-five patients had more than one diagnosisa(aPercentages do not sum to 100%. A total of 25 patients with overlapping diagnoses, including 23 patients with secondary MOP and 2 patients with dual primary diagnoses.). Significantly more women (82.6%) had OFP (p<0.05). Patients with pMOP experienced longest mean pain duration (9.9 years) and reported comorbidities such as body pain, headaches and arthritis more frequently than non-MOP groups (p < 0.05). sMOP was present in 75% of PTTNP cases (p = 0.0038). Psychometric and functional measures varied across subtypes: patients with pMOP exhibited the highest scores on HADS (15.3), MFIQ (14.4), and RS (7.0).ConclusionRefractory OFP is dominated by pMOP and female patients. The strong association between PTTNP and sMOP suggests early combined management of neuropathic- and muscle pain which may limit chronification. Together, our findings support a personalized, interdisciplinary approach to OFP that can improve diagnostic precision and optimize long-term patient outcomes.

ABSTRACT This article examines how the counternarratives deployed by fat activists from the Mexican collective Gordas Expansivas challenge and redefine dominant discourses on corporeality and female beauty in urban contexts in Mexico. Based on a qualitative ethnography, focus on depth interviews, and analysis of Instagram posts, the study reveals that activist resistance operates from three fundamental dimensions: the redefinition of bodily and emotional pain as a starting point for collective action, the creation of supportive and caring communities that strengthen autonomy and self-esteem, and the promotion of direct actions to educate and transform social perceptions about fat bodies, especially among children and adolescents. The results highlight how the interrelation between digital and physical spaces enhances the movement’s political effectiveness. Finally, the article argues for the need to incorporate intersectional perspectives that broaden the representative diversity within Latin American fat activism, emphasizing the relevance of these findings for developing public policies against body discrimination.

ABSTRACTBackgroundAdrenal insufficiency often presents with nonspecific symptoms, impeding early diagnosis. Taste and smell disturbances are rarely recognized as presenting features.Case PresentationWe report the case of a 54‐year‐old man with a 3‐month history of persistent taste and smell disturbances accompanied by fatigue, loss of appetite, weight loss, and diffuse body pain, including thigh stiffness. Endocrine evaluation with stimulation tests revealed markedly low levels of cortisol and adrenocorticotropic hormone, leading to a diagnosis of secondary adrenal insufficiency. After glucocorticoid replacement therapy, taste and smell disturbances gradually improved.ConclusionClinicians should consider adrenal insufficiency in patients presenting with unexplained sensory disturbances, particularly when accompanied by systemic symptoms such as fatigue, anorexia, or weight loss.

Sedentary time negatively influences health and is a risk factor for chronic low back pain (CLBP). Emerging evidence suggests breaking up prolonged sedentary behaviors may improve CLBP. This pilot trial examined the influence of decreasing sedentary behaviors on pain, mood, and quality of life in CLBP. Forty adults with CLBP and elevated depressive symptoms were randomized to wear an activity tracker with an idle alert along with receiving health coaching based on Motivational Interviewing and Habit Theory (INT) or a wait-list control condition (WLC) for eight weeks with a 12-week follow-up. Actigraphy-assessed time in total and prolonged sedentary behaviors, pain, depressed mood, quality of life, Patient Global Impression of Change (PGIC), and habits surrounding sedentary behavior were assessed at pre-intervention, post-intervention, and at follow-up. Repeated measures ANOVAs were used to examine changes in outcomes. Results demonstrated that INT reduced time spent in prolonged sedentary bouts by an average of ~ 53min/day (95% CI - 111.8 to 5.4), compared to WLC who decreased by an average of less than 1min/day, based on wearable activity monitor data (difference between groups, 52.9min/day, 95% CI - 27.2 to 133.1). There were no significant group-by-time interactions for pain nor depressed mood. Significant improvements for INT over WLC were demonstrated with moderate-to-large effects in Quality of life (physical health, g = 0.95, and bodily pain, g = 0.70), PGIC (g = 1.14), and sedentary behavior habit automaticity (g = 0.71). These results demonstrate potentially meaningful improvements in patient quality of life and physical activity after an intervention that decreased prolonged sedentary time in those with CLBP, although further study in larger scale efficacy trials is warranted. Perspective: This article presents the findings from a pilot trial examining whether breaking up prolonged bouts of sedentary time improves symptoms and quality of life in chronic low back pain. Results can be used to determine whether this strategy is worthy of further investigation.

Seizure-related physical injuries and Quality of Life in patients with epilepsy: A cross-sectional single-center study.

Fibromyalgia syndrome (FMS) is a chronic rheumatic disorder characterised by body pain, decreased pain threshold and psychological distress. Our aim is to investigate the effects of breathing exercises on sexual function, sleep, and mood in FMS. This is a cross-sectional study comparing psychological assessments conducted prior to and following breathing exercises. Participants completed the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS) and Female Sexual Function Index (FSFI). Scores were analysed for comparison to controls. A total of 56 women were enrolled to the study (30 intervention group, 26 controls). The mean age was 50.79 ± 9.06 years in intervention group. There were no statistical difference between groups occupational status (p > 0.05). The FIQ, HADS-depression, HADS anxiety, JSS and FSFI scores were similar between groups before breathing exercises (p > 0.05). FIQ, HADS depression- HADS anxiety, JSS scores after breathing exercises were better comparing to controls, p<0.001, p<0.001, p=0.002 and p=0.001, respectively. Although all symptoms were alleviated, the FSFI scores were not higher than FSD (Female sexual dysfunction) cut off value in intervention group after breathing exercises (p=0.033). The total FSFI score less than 26.55 was the cut-off for FSD. All of the participants had FSD. Breathing exercises can positively influence quality of sleep, anxiety, depression, and sexual life in patients with FMS. Incorporating breathing exercises into the curriculum may be considered to balance the quality of life for women with FMS.

Effects of exercise interventions on clinical outcomes in pre-clinical and early rheumatoid arthritis: a systematic review and meta-analysis.

Defining Discordance Between Signs and Symptoms in Dry Eye Disease: Insights From the DRy Eye Assessment and Management (DREAM) Study.