Fibromyalgia Impact Questionnaire Scores Research Articles

Thiol-Disulfide Balance in Fibromyalgia: A Case-Control Study

Aim. We aimed to examine the thiol-disulfide (SS) balance, a recognized marker of oxidative stress, in fibromyalgia syndrome (FMS).
 Methods. The study comprised 98 female participants (61 newly diagnosed patients and 37 patients under treatment) with FMS, along with 82 apparently healthy female volunteers. In both groups, assessments were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Short Form-36 (SF-36), Tender Point Count, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Native thiol (NT) and total thiol (TT) levels were measured, SS levels and SS/NT ratio were calculated.
 Results. FMS patients demonstrated significantly lower NT levels, higher SS levels, and an elevated SS/NT ratio compared to the control group (p< 0.05 for all groups). In FMS patients, a statistically significant correlation was found between SS level and the SS/NT ratio, as well as the number of tender points (r=-0.24, p=0.02; r=-0.21, p=0.04), SF-36 pain subscales (r=0.22, p=0.032; r=0.21, p=0.04), and BAI scores (r=-0.22, p=0.01; r=-0.23 p=0.03). In the subgroup analysis, all health assessment scales were observed to exhibit statistically significant differences between the under-treatment group and newly-diagnosed group when compared to the control group (p< 0.05 for all groups). The FIQ, VAS, FSS, and BAI scores were found to be significantly lower in the under-treatment group as compared to the newly-diagnosed group (p< 0.05 for all groups). In the newly-diagnosed group, NT was significantly lower and the SS/NT ratio was significantly higher than those in the control group (p< 0.05). In the under-treatment group, SS levels and SS/NT ratio were significantly higher as compared to the control group (p< 0.05). In the multivariate regression analysis, which incorporated age, health assessment scales, patient subgroups, tender points, and duration of symptoms to predict the SS/NT ratio, variabes such as being in the under-treatment group, tender points, and BAI score were identified as significant predictors (p< 0.05).
 Conclusions. The thiol-SS balance was observed to shift in the oxidative direction, and oxidative stress was higher in the FMS group. The absence of a significant difference between the under-treatment group and the newly-diagnosed group in terms of thiol-SS balance parameters suggests a shift to oxidative stress in patients, independent of the treatment status.

The Effect of Frequency of Sexual Intercourse on Symptoms in Women with Fibromyalgia.

Fibromyalgia is known to affect sexual function, but the effect of frequency of sexual intercourse on fibromyalgia symptom severity is unclear. This study investigated how frequently women with fibromyalgia engaged in sexual activity affected how severe the disease was. The depression status of the participants was evaluated with the Beck Depression Inventory (BDI) and the mean monthly frequency of sexual intercourse in the last 3 months was noted. Pain levels of fibromyalgia patients were evaluated with Visual Analog Scale (VAS), pain prevalence Widespread Pain Index (WPI), symptom level Symptom Severity Scale (SSS), and fibromyalgia exposure status with Fibromyalgia Impact Questionnaire (FIQ). A hundred women with fibromyalgia with a mean age of 37.11±6.2 years and 100 healthy female controls with a mean age of 36.53 ± 5.85 years participated in the study. Female patients with fibromyalgia had higher BDI and VAS scores and lower frequency of sexual intercourse (p<0.001). While no significant relationship was observed between the frequency of sexual intercourse and VAS, FIQ, SSS and WPI scores, it was found that BDI was lower in those with an average monthly frequency of 8 or more sexual intercourses (p=0.02). This study revealed that the frequency of sexual intercourse is low in female patients with FM and that depression is less common in women with FM who have a higher frequency of sexual intercourse.

Significance of inflammatory markers in primary Fibromyalgia syndrome and their relation in assessing the disease severity

Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse chronic musculoskeletal pain associated with various other symptoms. Although the etiology and pathogenesis of FMS are still unclear, it was reported to have a possible inflammatory basis. No laboratory marker is currently available to diagnose the disease. This study aimed to search for biomarkers useful in diagnosis of FMS. We assessed blood erythrocyte sedimentation rate (ESR), neutrophil lymphocyte ratio (NLR), the mean platelet volume (MPV) and platelet distribution width (PDW), and serum levels of C-reactive protein (CRP), as inflammatory markers in primary FMS patients and their relationship with disease severity and depression scores. The study included 30 FMS patients, diagnosed according to the 2010 ACR (American Colleague of Rheumatology) criteria and 30 normal volunteers as a control group. FMS patients filled out the Revised Fibromyalgia Impact Questionnaire (FIQR) and Montgomery Asberg Depression Score (MADRS) as well. There was a significant difference in the studied parameters including ESR, CRP, NLR, MPV between study patients and control groups (p&lt;0.05 for all). However, PDW did not differ between the two study groups. Based on our study findings, we can conclude that serum levels of the tested inflammatory markers including ESR, CRP, NLR, and MPV were higher in patients than in controls which makes them of good diagnostic value in patients with fibromyalgia. Meanwhile, some of these markers, mainly the acute phase reactants, have a positive relation with disease severity and depression scores, which in turn affect the quality of daily living.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Revised Fibromyalgia Impact Questionnaire (FIQR) for Use in Arabic-Speaking Patients in Saudi Arabia.

Fibromyalgia (FM) is a complex and debilitating condition that significantly impacts patients' daily lives. The continuous assessment of the impact and severity of FM is essential to manage the condition effectively. Assessment tools in Arabic are lacking for use in Saudi Arabia, which might lead to ineffective management. This study aimed to translate and cross-culturally adapt and validate the Arabic version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Following translation guidelines, 2 Arabic translators and 2 English-certified translators performed forward and backward translations of the FIQR. In a cross-sectional study design, the questionnaire was piloted with 5 participants and then subjected to cognitive interviews and psychometric analysis. Participants were FM patients recruited from a University Hospital in Riyadh and FM support groups in Saudi Arabia. The internal consistency, and reliability using the Cronbach α and interclass correlation coefficient (ICC) of 2-week test-retest, and criterion validity were evaluated. The results included a total of 42 participants with FM. Six minor modifications were made during the stepwise translation of the questionnaire. The Arabic version of the FIQR had good internal consistency and test-retest reliability, with a Cronbach α of 0.855 for the physical functioning domain, 0.663 for overall well-being, 0.803 for symptoms, and 0.895 for the total FIQR, and the Pearson correlation coefficient of the ICC for physical functioning was 0.769 (95% confidence interval (CI), 0.541-0.884) for the overall well-being domain, 0.555 (95% CI, 0.129-0.772) for the symptoms domain, and 0.720 (95% CI, 0.370-0.868) and 0.794 (95% CI, 0.579-0.899) for the total FIQR score (p < 0.001), respectively. The Arabic version of the FIQR is a valid, reliable, and practical tool for assessing the impact of FM on Arabic-speaking patients and potentially contributing to the improvement of FM outcomes.

The effect of transnasal sphenopalatine ganglion blockade on pain, functional capacity, sleep, and depression in patients with fibromyalgia.

The Sphenopalatine Ganglion (SPG) is the target of interventional procedures in musculoskeletal pain, especially headaches, due to its role in the autonomic nervous system. Our study aimed to investigate the effect of transnasal sphenopalatine ganglion blockade (SPGB) on pain, functional capacity, sleep, and depression in fibromyalgia patients. The hospital records of fibromyalgia patients who applied to the Algology outpatient clinic between January and May 2021, unresponsive to standard medical treatments, and underwent six sessions of bilateral transnasal SPGB at 10-day intervals were analyzed retrospectively. Numerical Rating Scale (NRS), functional capacity Fibromyalgia Impact Questionnaire (FIQ), sleep status Pittsburgh Sleep Quality Index (PSQI), and depression severity Beck Depression Inventory (BDI) data were collected during the treatment process. The mean NRS score of the patients before the treatment was 8.1852±1.71053, compared with 6.2593±2.29703 after the treatment. The mean FIQ score of the patients before the treatment was 73.0359±13.55302, compared with 54.2507±16.1906 after the treatment. After the treatment, the pain score, functional capacity, sleep quality, and depression of the patients were statistically significantly different than pretreatment (p<0.001). SPGB has been found to positively affect pain, functional capacity, sleep disorders, and depression in patients with fibromyalgia.

Evaluation of fibromyalgia symptoms in patients with nasal septum deviation

Aim: To examine the symptoms and effects of fibromyalgia in patients with nasal septum deviation, which is an important cause of nasal obstruction. Materials and Methods: Seventy eight patients with nasal septum deviation and 78 healthy volunteers similar in age and gender were included in the study. Patients with systemic rheumatic disease, cardiovascular system disease, infectious disease, any other disease that may affect the respiratory passage other than nasal septum deviation, with a history of regular drug use, and under the age of 18 were not included in the study. Widespread pain score and symptom severity score were calculated for all participants according to the fibromyalgia syndrome American College of Rheumatology 2016 diagnostic criteria, and revised fibromyalgia impact questionnaire was filled out. Results: While the incidence of fibromyalgia syndrome was higher in patients with septal deviation, this difference was not statistically significant(p=0.072). There was no difference between the groups in terms of widespread pain score, symptom severity score, total score and revised fibromyalgia impact questionnaire score (p=0.438; p=0.933; p=0.502; p=0.081, respectively). Conclusion: Although no significant relationship has been found between fibromyalgia and septal deviation, further studies on this subject should be conducted.

Effect of exposure-based vs traditional cognitive behavior therapy for fibromyalgia: a two-site single-blind randomized controlled trial.

Fibromyalgia is a debilitating pain condition for which treatment effects are typically modest. The most evaluated psychological treatment is traditional cognitive behavior therapy (T-CBT), but promising effects have recently been seen in exposure-based cognitive behavior therapy (Exp-CBT). We investigated whether Exp-CBT was superior to T-CBT in a randomized controlled trial. Self-referred participants with fibromyalgia (N = 274) were randomized (1:1) to 10 weeks of Exp-CBT or T-CBT. Treatments were delivered online and presented as "CBT for fibromyalgia." Participants were assessed at baseline, weekly during treatment, posttreatment, and at 6- and 12-month follow-up. Primary outcome was the difference in reduction in fibromyalgia severity as measured using the Fibromyalgia Impact Questionnaire (FIQ) over 11 assessment points from baseline to posttreatment, modelled within an intention-to-treat framework using linear mixed effects models fitted on multiple imputed data. Approximately 91% of weekly FIQ scores were collected over the main phase. There was no significant difference between Exp-CBT and T-CBT in the mean reduction of fibromyalgia severity from pretreatment to posttreatment (b = 1.3, 95% CI -3.0 to 5.7, P = 0.544, d = -0.10). Minimal clinically important improvement was seen 60% in Exp-CBT vs 59% in T-CBT. Effects were sustained up to 12 months posttreatment. This well-powered randomized trial indicated that Exp-CBT was not superior to T-CBT for fibromyalgia. Both treatments were associated with a marked reduction in fibromyalgia severity, and the online treatment format might be of high clinical utility. T-CBT can still be regarded a reference standard treatment that remains clinically relevant when compared to novel treatment approaches.

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study

IntroductionDespite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients. ObjectiveTo compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity. Materials and methodsPre-diagnosed female FM patients (n=7) and age-matched healthy females (n=19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity. ResultsThe mean holding time for trunk extensors (26.14±7.7s), right lateral flexors (20.14±8.3s), and left lateral flexors (20.86±5.3s) was significantly lower in the FM females than the healthy females (trunk extensors=55.21±17.1s; right lateral flexors=36.05±13.2s; left lateral flexors=35.11±13.8s). The endurance of trunk flexors was statistically similar in both groups (FM females=52.14±27.9s; healthy females=74.37±37.7s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p>0.05). ConclusionThe results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

The effectiveness of home-based therapeutic exercises on adults with fibromyalgia: a systematic review and meta-analysis.

The objective of this systematic review and meta-analysis is to evaluate the effectiveness of home-based exercises (HBE) in alleviating pain, fatigue, depression, and anxiety and enhancing the quality of life (QOL) among adults with fibromyalgia. A comprehensive search was conducted across four databases PubMed, Cochrane, CINAHL (EBSCO), and PEDro to identify eligible randomized controlled trials (RCTs). Standardized mean differences (SMDs) at a 95% confidence interval (CI) were computed. Ten RCTs met the inclusion criteria, involving 601 participants, with a good-to-fair quality according to the PEDro scale. Of the 10 included studies, 3 compared HBE to no exercise, while 7 compared HBE to center-based exercises (CBE). HBE showed significant pain reduction (SMD = 0.775, P = 0.003) and improved QOL as measured by the fibromyalgia impact questionnaire (FIQ) (SMD = 0.621, P = 0.001) compared with no exercise, but there were no significant differences in depression and QOL as measured by SF-36 compared with CBE. In contrast, CBE demonstrated greater pain reduction (SMD = -1.325, P < 0.001) and improved FIQ scores (SMD = -0.843, P = 0.017) compared with HBE. In conclusion, HBE exhibit effectiveness in alleviating pain, and depression and enhancing QOL among fibromyalgia patients in comparison to no exercise. However, CBE are more effective in reducing pain and enhancing QOL than HBE, although HBE can be valuable for maintaining activity levels in fibromyalgia patients between treatment cycles.

Evaluation of the Effectiveness of Wet Cupping Therapy in Fibromyalgia Patients: A Randomized Controlled Trial

Introduction: The aim of this study was to investigate the efficacy of wet cupping therapy (WCT) in patients diagnosed with fibromyalgia syndrome (FMS) as a complementary method in fibromyalgia treatment. Materials and Methods: A total of 120 participants between 18 and 65 years who were diagnosed with FMS were included in the study. They were randomized into two groups: 60 patients as the intervention and 60 patients as the control group. Each participant in the intervention group received 3 sessions of WCT once a month in addition to their ongoing treatment whereas the control group received only routine medical treatment. The evaluation was conducted in both groups based on the fibromyalgia impact questionnaire (FIQ), visual analog scale (VAS), and quality of life scale (QoL) parameters initially (at 0th week) and 1 week after the WCT sessions (at the 10th week). For the comparison of quantitative variables showing a normal distribution between the two groups, the Student’s t test was used, while the Mann-Whitney U test was employed for variables not showing a normal distribution. The χ2 test and Continuity (Yates) Correction were used for the comparison of qualitative data. The significance level was set at p < 0.05. Results: The study included 107 female and 13 male participants, with a mean age of 45.79 ± 8.49 years. When comparing the pretreatment FIQ, VAS, and QoL scores with the scores obtained after three sessions of WCT, it was observed that in the WCT group, the FIQ and VAS values significantly decreased compared to the control group while the QoL significantly increased compared to the control group (p < 0.001 in all). Conclusion: The findings obtained from this study indicate that WCT can be an effective treatment option for patients with FMS.

Exogenous Supplementation with DAO Enzyme in Women with Fibromyalgia: A Double-Blind Placebo-Controlled Clinical Trial.

Fibromyalgia (FM) is characterized by chronic musculoskeletal pain, muscle tension, joint mobility loss, and several psychological symptoms severely affecting patient well-being. Histamine is naturally degraded in the small intestine by diamine oxidase (DAO). Hereditary or acquired DAO deficiency causes extracellular histamine accumulation, leading to symptoms similar to those of individuals diagnosed with FM. Thus, this study aimed to assess the efficacy of adding DAO supplementation for 8 weeks to their standard therapy. We randomly assigned 100 women with FM (age: 33-61 years) to the supplementation and control groups. The Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), and intensity scales were applied for a series of clinical symptoms together with the Bristol scale to assess the added value of DAO supplementation. Patients in both groups were receiving complete pharmacological support but some differences in the number of subjects receiving analgesics, antidepressants, and anxiolytics was noted. Patients in both study groups experienced favorable changes during the evaluation period as indicated by their final FIQ and PCS scores, particularly in the DAO group in the latter questionnaire. Qualitatively, the patients assigned to the DAO treatment group had lower scores for fatigue, anxiety, depression, burning and for rumination, magnification, and helplessness.

Patients with fibromyalgia in Finnish healthcare center – one-year follow up

Objectives The study aimed to find whether Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) predicts the severity of fibromyalgia symptoms after one year in patients with fibromyalgia. The second aim of the study was to observe how symptoms evolved during a one-year follow-up. Design Prospective cohort and observational study. Five questionnaires were sent to patients. The same questionnaires (excluding ÖMPSQ) were sent after one year. The patients were allocated into two cohorts using the results of ÖMPSQ. Other variables were analyzed and observed separately. Setting Primary healthcare center in the city of Nokia, Pirkanmaa, Finland Subjects Patients with fibromyalgia were included in the study after a physician’s examination and confirmation of diagnosis with the assistance of the American College of Rheumatology (ACR) 2010 criteria. Main outcome measures Fibromyalgia impact questionnaire (FIQ) scores Results The FIQ scores increased slightly in both ÖMPSQ-cohorts with no statistically significant differences. The patients mostly reported that the symptoms were unchanged or got worse when asked separately from other questionnaires. There was a statistically significant decrease in PHQ-9 score in depressed patients who received antidepressants and/or psychological therapy. In addition, FIQ scores also decreased in depressed patients. Patients who received alterations to the treatment plan reported positive changes in the symptoms more often. Conclusion With these results, we cannot conclude that ÖMPSQ predicts the patient’s severity of symptoms. On the contrary, we can conclude that antidepressants and/or psychological therapy might reduce fibromyalgia symptoms for depressed patients with fibromyalgia. Patients with fibromyalgia might benefit from clinical evaluation and modifications to the treatment plan if necessary.

Relationship Between Chronic Spontaneous Urticaria and Fibromyalgia Syndrome

Aim: Autoimmunity, peripheral nerve dysfunction, and neurogenic inflammation are common mechanisms in chronic spontaneous urticaria (CSU) and fibromyalgia syndrome (FMS). We aimed to detect the prevalence of FMS in patients with CSU and to determine whether this prevalence was affected by the severity of urticaria, and dermatology life quality.&#x0D; Material and Methods: Fifty-three patients with CSU and 49 controls were enrolled in this prospective, controlled, cross-sectional study. The severity of CSU was assessed using Urticaria Activity Scores (UAS), and Dermatology Life Quality Index (DLQI) scores were recorded. The 2016 fibromyalgia diagnostic criteria were used for the diagnosis of FMS, and FMS-related functional disability was assessed using the Fibromyalgia Impact Questionnaire (FIQ).&#x0D; Results: Fibromiyalgia prevalence and the FIQ scores were higher in the CSU group than in the control (p=0.033 and p=0.004, respectively). There was no statistically significant difference between the urticaria durations and UAS of CSU with and without FMS (p&gt;0.05), but DLQI scores were statistically significantly higher in CSU with FMS (p=0.007). A statistically significant moderate positive correlation was present between DLQI and FIQ, Widespread Pain Index, and Symptom Severity Scale scores (r=0.500, r=0.408, r=0.469, r=0.507, respectively).&#x0D; Conclusions: The prevalence of FMS and the disability due to FMS was increased in CSU. Furthermore, the FMS prevalence was not affected by the duration and severity of urticaria; however, it was associated with decreased quality of life.

The effect of vitamin D treatment on quality of life in patients with fibromyalgia

BackgroundFibromyalgia is a syndrome characterized by chronic widespread pain accompanied by fatigue, disrupted sleep quality, cognitive impairments, subjective soft tissue swelling, and somatic symptoms. There are conflicting results in the literature regarding the prevalence of vitamin D deficiency in fibromyalgia patients and the reduction of symptoms after supplementation.AimsOur study aims to evaluate the effectiveness and reliability of vitamin D supplementation in patients diagnosed with fibromyalgia.MethodsIn our cross-sectional clinical study, 180 female patients aged 18 to 65 diagnosed with fibromyalgia according to the 2010 American College of Rheumatology Diagnostic Criteria were included. Oral vitamin D3 replacement of 50,000 IU was administered for 12 weeks. Patients' Fibromyalgia Impact Questionnaire (FIQ)and Visual Analogue Scale (VAS) scores were evaluated before and after the study.ResultsSignificant differences were observed in the FIQ scores of the 180 fibromyalgia patients before and after vitamin D supplementation (p < 0.05). There was also a significant improvement in VAS scores (p < 0.01). A negative correlation between vitamin D and VAS as well as FIQ scores was found in the study.ConclusionWe determined that vitamin D deficiency is significantly more prevalent in patients diagnosed with fibromyalgia. Vitamin D supplementation was observed to have a positive effect on quality of life and reduction of pain.

The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia, compared to passive muscle stretching and a control group: a randomized controlled clinical trial

Objective To explore the potential effectiveness of myofascial release compared to passive muscle stretching and to a control group in modulating pain intensity and health status in adults diagnosed with fibromyalgia (FM). Materials and Methods A preliminary randomized controlled clinical trial was conducted, consisting of eight weekly sessions. The participants were divided into three groups: myofascial release group (RG = 13), a muscle stretching group (SG = 13), and a control group (CG = 12), which received advice from a rheumatologist. The outcomes measured were the visual analogue pain scale (VAS), the fibromyalgia impact questionnaire (FIQ) (representing health status), and the number of painful areas. Univariate analyzes of covariance (ANCOVA) were performed at baseline, after 4 weeks (during treatment), after 8 weeks (post-treatment), and after 12 weeks (follow-up). The International Physical Activity Questionnaire (IPAQ), the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale (PCS) were included as covariates. Clinical trial registration number: NCT: 03408496. Results After eight weeks, the RG showed lower VAS scores compared to the CG (mean difference 95% CI: −5.10 to −1.26) and the SG (mean difference 95% CI: −4.9 to −0.23) with no difference between the SG and the CG. The total FIQ score for the RG was lower than the CG after 4 weeks (95% CI: −49.92 to −5.61), and 8 weeks (mean difference 95% CI: −52.72 to −15.73), although there was no difference between the RG and SG, as well as between the SG and CG, at both time points. The number of painful body areas was similar in all groups at the four time points. Conclusion Preliminary results suggest that the RG possibly showed greater improvements in pain intensity and health status compared to the CG, and possibly greater improvements in pain intensity compared to the SG.

Short‑term effects of pregabalin plus exercise therapy on pain, emotional status, physical function and nociceptive responses in patients with fibromyalgia.

The aim of the present study was to investigate the effects of pregabalin plus exercise vs. pregabalin treatment alone on the electromyographic nociceptive flexion reflex (NFR) threshold in patients with fibromyalgia (FM). For this purpose, the present study included a total of 40 patients diagnosed with FM according to the American College of Rheumatology 2010 criteria. The patients were divided into two groups as follows: Group 1 received pregabalin treatment only and group 2 received exercise therapy in addition to pregabalin treatment. Assessments were made at baseline and at the 1st month using a visual analog scale (VAS) to measure pain, the Fibromyalgia Impact Questionnaire (FIQ) to measure the severity of FM, Beck's Depression Inventory (BDI) to measure depression and the NFR to measure the compressive forces on peripheral nerves. In both groups, the NFR threshold following treatment was significantly higher than that at the baseline results (P#x003C;0.001). There was no significant difference between the groups as regards the difference from pre- to post-treatment NFR threshold values (P=0.610 and P=0.555, respectively). There was a strong, negative correlation between the pre-treatment NFR threshold and VAS resting, VAS motion and FIQ scores (Rho=-0.62, Rho=-0.69 and Rho=-0.60, respectively). There was a moderate negative correlation between the pre-treatment NFR threshold and BDI scores (Rho=-0.35). On the whole, the present study demonstrates that in the treatment of FM, pregabalin improves the clinical scores and leads to an increase in the NFR threshold. Herewith, it should be noted that short-term exercise therapy does not appear to provide additional benefits.

Impact of fibromyalgia and related factors on foot function and quality of life: Cross-sectional study

BackgroundThe aim of study is to examine the factors that may influence pain, disability and the limitation of activity due to the presence of fibromyalgia in the foot. Methods323 patients diagnosed with fibromyalgia were recruited. Each participant completed the Foot Function Index questionnaire (FFI) and the Revised Fibromyalgia Impact Questionnaire (FIQR). A multivariate analysis was performed to determine the factors associated with high scores in each of these questionnaires. ResultsIn both questionnaires, the subscales presenting the highest scores were foot pain (FFI score: 71.18 ± 20.40) and symptom intensity (FIQR score: 36.23 ± 8.04). According to the multivariate analysis, foot function is influenced by age (p = <0.001), BMI (p = 0.001), lack of physical activity (p = <0.001), the presence of rheumatoid arthritis (p = 0.012), retirement due to disability (p = <0.001) and being unemployed (p < 0.001). ConclusionFibromyalgia affects foot function, provoking significant pain. Related factors include age, BMI, lack of physical activity, the presence of rheumatoid arthritis, and employment status.

The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial.

This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had started duloxetine treatment (30 mg/day). The patients in the study group received six sessions of posterior tibial nerve stimulation, twice weekly, 3-4 days apart, in addition to duloxetine; the controls received duloxetine only. The patients were evaluated three times (at baseline, 1st month, and 3rd month). Pain was evaluated using a numeric rating scale, the short-form McGill Pain Questionnaire, and quality of life with a 36-item short-form health survey (SF-36). Patient functional status and disease severity were evaluated using the fibromyalgia impact questionnaire (FIQ). A total of 64 patients met the inclusion criteria: 22 were ultimately included in the study group and 30 in the control group. Statistical improvements in pain and FIQ scores were observed after treatment in both groups. The SF-36 scores indicated improved vitality only in the 1st month in both groups, with no significant changes in the other quality-of-life subscales in either group. There was no statistical difference between the two groups in terms of changes in pain, FIQ, and SF-36 scores compared with baseline at the 1st month and 3rd month. The addition of PTNS to pharmacological treatment did not contribute to the reduction in pain or improvement in quality of life in fibromyalgia either in the 1st or 3rd month. NIH Clinical Trial Registration Number NCT05937711.

Can the monocyte-to-HDL ratio be used as an inflammation marker in patients with fibromyalgia syndrome?

The monocyte-to-high-density lipoprotein (HDL) ratio (MHR) may be used as a marker of inflammation and oxidative stress. This study aimed to evaluate the use of MHR and platelet markers in patients with fibromyalgia syndrome (FMS) and demonstrate MHR's relationship with inflammation, the Fibromyalgia Impact Questionnaire (FIQ), and quality of life. Ninety FMS patients and 90 healthy controls, whose clinical and laboratory evaluations were performed simultaneously, were included in the study. The monocyte, platelet, HDL, MHR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), mean platelet volume (MPV), and platelet distribution width (PDW) values of all patients were evaluated. The quality of life of the participants was assessed using the FIQ and their general health using the health assessment questionnaire (HAQ). Age, body mass index (BMI), and marital status distribution were similar in both groups. The FMS patients had a mean disease duration of 11.29 ± 2.62 months. The median monocyte, platelet, MPV, visual analog scale (VAS), FIQ, and HAQ values and the mean MHR of the FMS patients were significantly higher than the control group, while the mean HDL level was significantly lower (P < 0.05). There was a weak negative correlation between the MPV and HAQ score and the PDW and HAQ score (rs = -0.225, P = 0.042 and rs = -0.249, P = 0.024, respectively), whereas no correlation was detected between the MHR and the FIQ and HAQ scores in FMS patients. According to the receiver operating characteristic curve analysis, MHR had prediction of FMS (P = 0.002; sensitivity = 0.63, specificity = 0.50, cut-off point ≥8.4). Our results suggest that the monocyte, platelet, HDL, MHR, and MPV parameters can be used in the evaluation of inflammation in FMS patients.

Gender differences in the revised Fibromyalgia Impact Questionnaire: a pilot study.

Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with symptoms such as fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the application of the 2010/2011 and 2016 revision of the American College of Rheumatology (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if lately some studies have been conducted regarding FM gender differences, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed and validated through a predominantly female sample. The aim of this pilot study was to compare the 21 items of the FIQR among male and female patients in order to evaluate the possible existence of a gender bias. In this case-control study, consecutive patients with a diagnosis of FM (2016 ACR criteria) were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females, matched for age and disease duration, were consecutively enrolled in order to compare their FIQR scores. The univariate analysis showed that total FIQR scores and physical function domain scores were significantly higher in females and, among the 21 items of the FIQR, the female group obtained significantly higher scores in 6 of them. Our results showed that female patients obtain significantly higher scores in the FIQR total score and physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain. These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group.