Fibromyalgia Impact Questionnaire Scores Research Articles

Sex-Related Differences in Symptoms and Psychosocial Outcomes in Patients With Fibromyalgia: A Prospective Questionnaire Study.

ObjectiveTo investigate sex-related differences in patients with fibromyalgia (FM) in terms of demographic characteristics and clinical features, including tender point count (TPC), mood disorders, sleep problems, FM symptom severity, fatigue, cognitive dysfunction, and quality of life (QOL).Patients and MethodsWe studied 668 consecutive patients with FM (606 women) from May 1, 2012, to November 30, 2013. Validated questionnaires assessed outcomes of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), sleep problems (Medical Outcomes Study Sleep Scale), FM symptom severity (Revised Fibromyalgia Impact Questionnaire), fatigue (Multidimensional Fatigue Inventory), cognitive dysfunction (Multiple Ability Self-report Questionnaire), and QOL (36-Item Short Form Health Survey). Nonparametric Mann-Whitney U and Pearson χ2 tests were used to compare continuous and categorical outcome measures, respectively, between men and women. Linear regression models were performed for all continuous dependent variables, adjusting for age, body mass index, ethnicity, marital status, and highest education level completed. P<.05 was considered statistically significant. The Benjamini-Hochberg procedure was used to adjust for multiple comparisons.ResultsMultiple linear regression analysis revealed a significant association of female sex and greater TPC (P<.001), lower overall FM symptom severity (lower overall Revised Fibromyalgia Impact Questionnaire score; P=.03), and higher QOL subscale score for vitality (36-Item Short Form Health Survey vitality subscale score; P=.02). After adjustment for multiple comparisons, only the association between female sex and greater TPC remained significant. There were no sex-related differences in demographic characteristics, depression, anxiety, sleep problems, FM symptom severity, cognitive dysfunction, and QOL.ConclusionA higher TPC may be associated with female sex in patients with FM. The assumption of other sex-based differences in the clinical presentation of FM was not supported in our study.

Is fibromyalgia accompanying Behçet's disease more severe than primary fibromyalgia?

Objectives: Although there are studies in the literature about how Behçet's disease is affected in the presence of fibromyalgia, there is no information about how the severity of fibromyalgia is in the presence of Behçet's disease. This study aims to evaluate the severity of fibromyalgia by comparing the impact of fibromyalgia and pain thresholds between fibromyalgia patients with and without Behçet's disease. Methods: Twenty-five fibromyalgia patients with Behçet's disease and 34 primary fibromyalgia patients were included in this cross-sectional study. All participants completed the fibromyalgia impact questionnaire, and pain thresholds were measured at 18 tender points using algometry. Results: The mean fibromyalgia impact questionnaire scores in fibromyalgia patients with and without Behçet's disease were 66.6 ± 18.4 and 60.4 ± 14.5, respectively (p = 0.157). Pain thresholds were not different between the groups in 15 of the 18 tender points (TP). In fibromyalgia patients with Behçet's disease, pain thresholds in TP-15, TP-16 and TP-17 were 11.44 ± 4.84, 11.92 ± 5.00 and 15.16 ± 4.89 pounds, respectively, while in primary fibromyalgia patients those were 8.41 ± 2.68, 8.14 ± 2.76 and 12.14 ± 4.06 pounds respectively. Pain thresholds in TP-15, TP-16 and TP-17 were significantly different between the groups (p = 0.003, p = 0.003, p = 0.014, respectively). Conclusions: According to the literature data, although fibromyalgia has an effect on Behçet's disease, especially in cases associated with central sensitization syndromes, the severity of fibromyalgia was not found to be different in fibromyalgia patients with and without Behçet's disease in this study. There may be a relationship between Behçet's disease and fibromyalgia due to non-inflammatory causes such as central sensitization.

Assessment of sleep quality in fibromyalgia syndrome and its effect on postural balance and functional status.

Patients with fibromyalgia syndrome (FMS) often have sleep problems and balance disorders. The aim of the study was to examine sleep quality and balance disorders and the relationship between sleep quality and balance, functional status and the frequency of falls in patients with FMS. Fifty women with FMS and 50 healthy women were included in the study. Sleep quality was assessed with the numeric rating scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI) and balance and balance self-confidence were assessed with the Berg Balance Scale (BBS) and Activities-Specific Balance Confidence (ABC) Scale, respectively. Functional status and symptom severity of patients were assessed with the Fibromyalgia Impact Questionnaire (FIQ) and the Symptom Impact Questionnaire (SIQR). The number of falls in the last six months were recorded. In the patient group, sleep quality scores were significantly higher, and BBS and ABC scores were significantly lower than the control group. NRS scores were significantly correlated with the BBS, FIQ, and SIQR scores, and the PSQI scores were significantly correlated with the BBS and ABC scores and the number of falls in FMS. This study showed that the prevalence of sleep and balance disorders is higher in FMS patients. A relationship was reported between the sleep quality and balance and functional status and frequency of falls.

Overactive Bladder Symptoms in Patients with Fibromyalgia: A Systematic Case-Controlled Study.

A recent survey reported an association between fibromyalgia and overactive bladder. To carry out the first systematic case-controlled study to compare the level of overactive bladder symptoms in a group of fibromyalgia patients and a group of matched controls. The symptom-bother OAB-q8 questionnaire and Revised Fibromyalgia Impact Questionnaire (FIQR) were administered to 27 patients who fulfilled the revised diagnostic criteria for fibromyalgia of the American College of Rheumatology and to 26 healthy controls who had no history of suffering from fibromyalgia or any other rheumatological or neurological illness. The groups were matched in respect of age, sex and ethnicity. None of the 53 subjects was taking medication, which might cause urinary urgency, none was suffering from, or had recently suffered from, a urinary tract infection and none had undergone a previous operative procedure on the lower urinary tract. Twenty-five (93%) patients had evidence of an overactive bladder during the previous four weeks, compared with five (19%) of the control group (p < 0.001). In terms of symptom severity, the mean (standard error) OAB-q8 score was 24.4 (1.5) in the fibromyalgia patients and 10.8 (4.5) in the controls (p < 0.001). Furthermore, the total OAB-q8 and FIQR scores were positively correlated (rs = 0.727, p < 0.001). This systematic controlled study confirms that fibromyalgia is associated with overactive bladder symptoms. The relatively high prevalence of 93% indicates that overactive bladder is an important urological association of fibromyalgia and should be routinely assessed in these patients.

Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: ARandomized, Double-Blind, Placebo-Controlled Clinical Trial.

ObjectiveTo determine the benefit of a tetrahydrocannabinol (THC)-rich cannabis oil on symptoms and quality of life of fibromyalgia patients.MethodsA double-blind, randomized, placebo-controlled clinical trial was conducted for eight weeks to determine the benefit of a THC-rich cannabis oil (24.44 mg/mL of THC and 0.51 mg/mL of cannabidiol [CBD]) on symptoms and quality of life of 17 women with fibromyalgia, residents of a neighborhood with a low socioeconomic profile and a high incidence of violence in the city of Florianopolis, Brazil. The initial dose was one drop (∼1.22 mg of THC and 0.02 mg of CBD) a day with subsequent increases according to symptoms. The Fibromyalgia Impact Questionnaire (FIQ) was applied at pre- and postintervention moments and in five visits over eight weeks.ResultsThere were no significant differences on baseline FIQ score between groups. However, after the intervention, the cannabis group presented a significant decrease in FIQ score in comparison with the placebo group (P = 0.005) and in comparison with cannabis group baseline score. (P < 0.001). Analyzing isolated items on the FIQ, the cannabis group presented significant improvement on the “feel good,” “pain,” “do work,” and “fatigue” scores. The placebo group presented significant improvement on the “depression” score after intervention. There were no intolerable adverse effects.ConclusionsPhytocannabinoids can be a low-cost and well-tolerated therapy to reduce symptoms and increase the quality of life of patients with fibromyalgia. Future studies are still needed to assess long-term benefits, and studies with different varieties of cannabinoids associated with a washout period must be done to enhance our knowledge of cannabis action in this health condition.

Tai Chi as a method of improving pain management in patients with fibromyalgia

AbstractIntroductionFibromyalgia (FM) is a chronic pain condition defined by widespread body pain and hyperalgesia, lasting over 3 months. Pharmacotherapy is the usual initial management; however, this is frequently insufficient, resulting in persistent symptoms. Tai Chi is considered a meditative movement, combining deep breathing with gentle movements to foster a healthy relationship of body and mind. This research aims to investigate the impact of Tai Chi on pain management in patients with FM, with the aim of producing an educational resource.MethodsA literature review was conducted on online databases for research papers, using the keywords ‘Fibromyalgia’, ‘Tai Chi’, ‘meditative movement’ and ‘Pain’. The results were critically analysed; research papers that were relevant and carried adequate validity were selected.ResultsEfficacy of Tai Chi compared to aerobic exercise was investigated in one randomized controlled trial (RCT), using the revised fibromyalgia impact questionnaire (FIQR) to quantify outcomes. FIQR scores improved significantly in the Tai Chi group (P = .03). A supporting meta‐analysis suggests that Tai Chi expresses significant positive effects on improving FIQR, whereas another RCT indicates that Tai Chi reduced symptoms and improved quality of life (P = .001).ConclusionsOverall, research indicates that Tai Chi can significantly improve pain management in FM. However, it fails to consider the challenges of implementing Tai Chi within the community. Currently there is insufficient funding within the National Health Service (NHS), which compromises Tai Chi interventions. Nevertheless, Tai Chi has been shown to empower patients to adopt behaviours that facilitate a bio‐psycho‐social wellbeing, which improves symptom management. An intervention such as an educational resource may benefit patients with FM by improving access to Tai Chi.

Fibromyalgia in patients with psoriatic arthritis: Relationship with enthesopathy, sleep, fatigue and quality of life.

To evaluate the relationship of fibromyalgia with enthesopathy, sleep, fatigue and quality of life in patients with psoriatic arthritis. The psoriatic arthritis patients according to CASPAR criteria were included in the study. The diagnosis of fibromyalgia was based on 2016 ACR criteria. Demographic and clinical parameters were noted. Disease activity and enthesopathy were evaluated with Disease Activity Score-28 (DAS-28) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), respectively. Functional assessment scales in this study were Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF). Fibromyalgia Impact Questionnaire (FIQ) was used to assess the functional status of fibromyalgia. The Mann-Whitney U test and Spearman correlation coefficient (ρ) were used. Hierarchical multiple regression analysis used to examine the differential contributions to FIQ score. P<.05 was accepted as significant. We enrolled 50 PsA patients (31 female, 19 male) with a mean age of 49.5years (SD: 10.2) and mean disease duration 7.5years (SD: 7.5). Thirty-two patients (64% of PsA patients) fulfilled ACR criteria for fibromyalgia. The mean scores of MASES, PSQI, MAF and PsAQoL were significantly higher in patients with fibromyalgia (P<.05). The correlations between FIQ and other functional parameters were as follows; MASES (ρ=0.71, P<.0005), PSQI (ρ=0.62, P<.0005), MAF (ρ=0.60, P<.0005), PsAQoL (ρ=0.61, P<.0005). A moderate correlation was existing between FIQ and DAS-28 (ρ=0.42, P=.03). Coexistence of fibromyalgia in PsA patients is associated with the presence of enthesopathy, poor quality of life, sleep disturbance and fatigue.

Isokinetic evaluation of the trunk muscle strength in housewives with fibromyalgia: a cross-sectional study

BackgroundIt is known that physical activity and muscular performance are reduced in fibromyalgia (FM) syndrome. This study aims to compare the performance of trunk muscles in women with FM and healthy controls and evaluate the correlation between trunk muscle strength and FM severity.MethodsForty-six patients with FM and 42 age- and body mass index-matched healthy housewives without FM were included in the FM and control groups, respectively. The Fibromyalgia Impact Questionnaire (FIQ) was used for the assessment of FM severity. The pain intensity was evaluated using the visual analogical scale (VAS). An isokinetic dynamometer was used to measure the isokinetic trunk muscle strength. The peak torque (PT) values were recorded. The psychological status of the patients was evaluated using the Beck Depression Inventory.ResultsThere was no statistically significant difference in terms of age, BMI, and BDI scores in two groups (p > 0.05, for all). The isokinetic trunk extensor PT values were significantly lower in the FM group (p = 0.002 for 60°/s, and p < 0.001 for 90°/s and 120°/s) than control group. There was a statistically significant negative correlation between FIQ score and isokinetic extensor muscle parameters.ConclusionThe results indicate that trunk extensor muscles were significantly weaker in FM patients. Trunk extensor muscle strength decreased as FM severity increased in FM patients.

Pain acceptance and its impact on function and symptoms in fibromyalgia

Objectives Fibromyalgia is a chronic widespread pain (CWP) syndrome of unknown etiology with substantial burden of illness and functional impairment. Pain acceptance has emerged as an interesting target of therapy in chronic pain populations, but few studies have yet been done on the effect of pain acceptance on patients with fibromyalgia. The aim of the present study was to examine the relationship between pain acceptance and its impact on function and symptoms in fibromyalgia with both a cross-sectional and longitudinal design. Methods Three hundred and sixty five participants aged 22-70 with fibromyalgia were recruited from the Norwegian Fibromyalgia Association (NFA). They filled out a questionnaire containing the Fibromyalgia Impact Questionnaire (FIQ), measurement of function and symptoms, and Chronic Pain Acceptance Questionnaire (CPAQ), measurement of pain acceptance, in addition to sociodemographic and clinical variables such as degree of fibromyalgia, depression and pain duration (T1 measures). One year after, 87 of the participants filled out the FIQ and clinical measures once again (T2 measures). Unadjusted and adjusted linear regression analyses were performed both for cross-sectional measures at T1 and for longitudinal measures from T1 to T2, with FIQ score as the outcome variable and CPAQ score at T1 as one of the main independent variables. Results Higher CPAQ score was significantly associated with a lower FIQ score at T1, also when adjusting for age, education, work, depression and Fibromyalgianess Score (p<0.01). Lower FIQ score indicate less impact of fibromyalgia on functioning. In addition, two adjusted linear regression models found higher pain acceptance (CPAQ score) at T1 to be associated with lower negative impact of fibromyalgia on function and symptoms (FIQ score) at T2 (p<0.01). Conclusions Higher pain acceptance is associated with better functional level and less symptoms in fibromyalgia, both cross-sectionally and when measurements are separated in time. Further research should include experimental studies with acceptance-based interventions for this patient group.

Feasibility and Acceptability of Heart Rate Variability Biofeedback in a Group of Veterans with Fibromyalgia.

Objectives: To determine the feasibility and acceptability of a heart rate variability biofeedback (HRVB) protocol in a focus group of Veterans with fibromyalgia (FM). Design: A multimethod feasibility and acceptability study. Settings/location: A Veterans Health outpatient pain medicine clinic in the southern United States. Subjects: The researcher enrolled seven women and three men between the ages of 33 and 68 years with a diagnosis of FM. Interventions: Participants practiced HRVB on the emWave2 at home for 20 min twice daily for 7 weeks. Outcome measures: Feasibility to adhere to the HRVB protocol was measured using the practice frequency and time (minutes) data collected from the emWave2. The author compared the individual reports from participants with the Credibility/Expectancy Questionnaire to measure the acceptability of the intervention. In addition, the principal investigator evaluated data from the Short-form McGill Pain Questionnaire (SFMQ) and the Revised Fibromyalgia Impact Questionnaire (FIQR) at the baseline and weekly study visits for a signal of efficacy for pain control, functional status, and quality of life (QOL). Results: The majority of participants (80%) expected 50% or more improvement in their pain, and (70%) felt HRVB would reduce their FM-related pain by 50%-80%. The mean daily practice frequency rate was 0.80. The mean practice duration was 19.36 min. Pain score differences from the SFMQ were insignificant preintervention and postintervention. The mean total FIQR scores postintervention improved by 18.1 points. Conclusions: Findings suggest twice-daily HRVB practice protocol is not feasible. However, 20-min HRVB sessions were feasible and acceptable. Improved FIQR scores post-treatment suggest HRVB may be an effective strategy to improve functional status and QOL for Veterans with FM. ClinicalTrials.gov ID: Pro00079144.

AB0951 THE ITALIAN FIBROMYALGIA REGISTRY: A NEW WAY OF USING ROUTINE REAL-WORLD DATA CONCERNING PATIENT-REPORTED DISEASE STATUS IN HEALTHCARE RESEARCH AND CLINICAL PRACTICE

Background:Fibromyalgia (FM), the most frequently encountered cause of widespread musculoskeletal pain, affects an estimated 2% of the general Italian population. However, it is not a homogeneous clinical entity, and a number of interacting factors can influence patient prognosis and the outcomes of standardised treatment programmes. Registries are a source of high-quality data for clinical research, but relating this information to individual patients is technically challenging.Objectives:The aim of this article is to describe the structure and objectives of the first Italian Fibromyalgia Registry (IFR), a new web-based registry of patients with FM.Methods:The IFR was developed to collect, store, and share information electronically entered by physicians throughout Italy who are members of the Italian Society of Rheumatology and have a particular interest in FM. It has a web-based architecture that uses two separate servers and an encryption algorithm to ensure the confidentiality and integrity of the exchanged data. The questionnaires included on the platform are the Revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status (ModFAS), and the Polysymptomatic Distress Scale (PDS).Results:The registry includes data relating to 2,339 patients (93.2% female) who satisfied the 1990 or 2010/2011 American College of Rheumatology Classification Criteria for Fibromyalgia at the time of diagnosis. At the time of this analysis, the patients had a mean age of 51.9 years (SD 11.5) and a mean disease duration of 7.3 years (SD 6.9). The majority were married (71.3%), and generally well educated. The overall median FIQR, ModFAS and PDS scores and 25th-75thpercentiles were respectively 61.16 (41.16-77.00), 8.91 (41.16-77.00), and 19.0 (13.00-24.00). The six highest scoring items indicating the greatest impact of the disease on the patients related to fatigue/energy (7.18), sleep quality (6.87), tenderness (6.69), pain (6.68), stiffness (6.66), and environmental sensitivity (6.35). A high proportion of the responding patients reported experiencing pain in the neck (80.46%), upper back (68.36%), and lower back (75.05%).Conclusion:The IFR is the most comprehensive FM registry in Italy, and provides healthcare professionals with a secure, reliable, and easy-to-use means of monitoring the patients’ clinical progression, treatment history and treatment responses. This can help clinicians to plan patient management, facilitates research study patient recruitment, and provides the participating pain clinics with statistics based on real-world data. It also helps address the Italian Ministry of Health long-term goal of using precision medicine for chronic pain prevention and treatment. It is hoped that the IFR will enhance both scientific research and clinical practice.

Fibromyalgia in a rheumatology clinic in north-central Nigeria: An audit of the characteristics of the syndrome and the sensitivities of 4 sets of American College of Rheumatology criteria.

To describe the characteristics of fibromyalgia among Nigerian patients and assess the sensitivities of the American College of Rheumatology (ACR) criteria of 1990, 2010, 2011, and 2016 for making the diagnosis of fibromyalgia. Consecutive patients diagnosed clinically with fibromyalgia by a rheumatologist were assessed. ACR criteria for fibromyalgia of 1990, 2010, 2011, and 2016 were applied to each patient. Polysymptomatic distress scores (PSD) were calculated from the Widespread Pain Index and Symptom Severity Scores. Sleep was assessed using the Pittsburgh Sleep Quality Index; fatigue by the Fatigue Severity Scale and the severity of fibromyalgia was determined using the Revised Fibromyalgia Impact Questionnaire (FIQR). A total of 660 new patients were seen out of which a diagnosis of fibromyalgia was made in 114 (17.3%). The mean age of the patients was 44.6±15.6years and females accounted for 84.2%. Twenty-one (18.4%) patients had changed or quit their jobs due to fibromyalgia. Problematic fatigue was present in 80 (70.2%), and sleep disturbance was reported in 83 (72.8%) patients. The severity of fibromyalgia, poor sleep, severe or very severe PSD, and male gender were associated with problematic fatigue, but only moderate/severe fibromyalgia independently predicted problematic fatigue (P=.004). The number of tender points (P=.001) and FIQR score (P=.038) were associated with changing or quitting jobs. The sensitivities of the ACR1990, ACR2010, ACR2011 and ACR2016 were 38.5%, 68.2%, 76.7% and 76.7%, respectively. The ACR1990 had low sensitivity when used to diagnose fibromyalgia in this population and the ACR2010 encounters problems while applying the somatic symptom list.

THE RELATIONSHIP BETWEEN INSULIN RESISTANCE AND FA-TIGUE SYMPTOM IN FIBROMYALGIA SYNDROME

The aim of this study is to examine the relationship between insulin resistance and fatigue in fi-bromyalgia. A total of 72 patients (4 males, 68 females) with fibromyalgia (FM) was investigated. Patients were divided into two groups by insulin resistance (IR), group 1; IR- (n=49), and group 2; IR+ (n=23). IR was determined using homeostasis model assessment (HOMA) formula. All subjects were evaluated with serum 25 (OH) D vitamin levels. The severity of the disease was measured with the Fibromyalgia Impact Questionnaire (FIQ); the level of fatigue was evaluated with Fatigue Severity Scale (FSS); and the pain level was evaluated with Visual Analog Scale (VAS). There were significant differences between the FIQ and FSS mean scores of two groups (IR+ and IR-), (p=0.031, p=0.005). There were no significant differences between two groups in respect to VAS and serum 25 (OH) D vitamin levels (p=0.789, p=0.875). There was no significant correlation be-tween vitamin D and FSS (IR+, r=-0.263, p=0.225; IR-, r=0.112, p=0.443), and also vitamin D and FIQ (IR+, r=-0.103, p=0.641; IR-, r=0.050, p=0.733) in both groups. There was no relationship be-tween insulin resistance and fatigue symptom in fibromyalgia patients, but it was observed that the severity of fatigue was higher in the group with insulin resistance.

Fibromyalgia Impact Reduction Using Online Personal Health Informatics: Longitudinal Observational Study.

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

Effectiveness of Hydro-Galvanic Bath Therapy on Global Health Status, Quality of Life, Depression, and Pain in Individuals with Fibromyalgia – A Quasi-Experimental Study

Abstract Purpose Although a number of treatments are widely prescribed for fibromyalgia (FM), many are not fully effective. In clinical practice, the effectiveness of electrotherapy is limited in particular to hydro-galvanic bath therapy in the management of FM. This experiment aims to evaluate whether hydro-galvanic bath therapy can be beneficial in decreasing pain and increasing quality of life for individuals with FM. Material and Methods This quasi-experimental study recruited 92 individuals diagnosed with FM who were then divided equally either into a galvanic group or control group. The galvanic group received both hydro-galvanic bath therapy and a 12-week supervised aerobic exercise program, whereas the control group only received the exercise program. Outcomes were assessed at baseline and post-intervention using the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), SF-36 Health Survey, and Visual Analog Scale (VAS). Results and discussion Individuals in both groups showed excellent compliance with interventions by attending more than 85% of sessions. Both groups showed a significant change in all outcome measures evaluated (p&lt;0.001), but the galvanic group showed greater improvements when compared with the control group (p&lt;0.001). The galvanic group showed a 16.6% of FIQ score, 8.2% of SF-36 score, 25.0% of BDI score, and 53.2% of VAS score from baseline. In turn, the control group demonstrated a reduction of 6.8% of FIQ score, 11.8% of SF-36 score, 22.0% of BDI score, and 41.6% of VAS score. Conclusion The galvanic group who received galvanic bath therapy along with aerobic exercise for 12 weeks evoked greater change in FIQ, BDI, and SF-36 Health Survey scores compared with results of aerobic exercise alone in control group.

The relationship between disease severity and defense mechanisms in fibromyalgia syndrome.

The aim of the present study was to investigate the possible relationship between the disease severity and defense mechanisms in fibromyalgia syndrome (FMS) and to contribute to the clarification of the etiopathogenesis of FMS. A total of 103 female patients (mean age: 42.6±10.0 years; range, 20 to 67 years) diagnosed with primary FMS based on the 2016 revised American College of Rheumatology (ACR) diagnostic criteria and without any psychiatric diagnosis were included in the study. A semi-structured sociodemographic and clinical data form was used. The Fibromyalgia Impact Questionnaire (FIQ), Defense Style Questionnaire-40 (DSQ-40), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to all patients. Based on the FIQ scores, the patients were divided into two groups as mild-moderate (<70) and severe (≥70) FMS groups. There were 56 patients in the mild-moderate FMS group and 47 patients in the severe FMS group. As FIQ scores increased, sublimation (r=-0.204, p=0.030) and mature factor (r=-0.229, p=0.020) scores decreased, and projection (r=0.210, p=0.033) and somatization (r=0.287, p=0.003) scores increased. Pseudoaltruism (p=0.043), displacement (p=0.026), and somatization (p=0.021) scores were higher in the severe FMS group. The BDI and BAI scores were also higher in the severe FMS group, compared to the mild-moderate FMS group (p=0.001 and p=0.002, respectively). Our study results show that there is a significant correlation between the increased disease severity, decreased mature defense mechanisms, and increased immature defense mechanisms in FMS patients.

Serum paraoxonase enzyme activity after balneotherapy in patients with fibromyalgia

Objective: The aim of this study was to compare the serum paraoxonase (PON 1) levels between patients with fibromyalgia syndrome (FMS) and healthy control subjects, and to investigate the possible effect of balneotherapy (BT) on PON 1 enzyme activity in FMS patients.&#x0D; Methods: The study included 45 female patients with FMS, and 35 healthy female volunteers. To measure PON 1 enzyme activity, venous blood samples were taken twice from the FMS group, before and after BT, and once from the control group. The Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scales were applied to the FMS patients before and after BT.&#x0D; Results: There was no difference between the FMS group and healthy control group in terms of serum PON1 activity (p&gt;0.05). The comparison of the serum PON 1 activity of the FMS group before and after BT revealed a statistically significant increase after BT (p=0.001). A statistically significant decrease was determined in the VAS and FIQ scores of the FMS group after BT compared to the pre-treatment values (p=0.002, p=0.001, respectively).&#x0D; Conclusion: BT is an effective non-pharmacologic method in the treatment of FMS. There was an increase in serum PON 1 activity in patients with FMS after BT. BT may have a regulatory effect on the antioxidant system of patients with FMS.

Comparison of Beta-2 Adrenergic Receptor Gene Polymorphisms Between Patients with Fibromyalgia Syndrome and Healthy Controls.

Objectives This study aims to compare the beta-2 adrenergic receptor (ADRB2) gene polymorphisms of patients with fibromyalgia syndrome (FMS) with those of healthy control subjects, and to investigate the possible relationship between symptoms of FMS and polymorphisms of the ADRB2 gene.Patients and methods The study included 170 females (mean age 47.8±10.3 years; range, 21 to 75 years) diagnosed with FMS according to the 2010 American College of Rheumatology criteria and 170 healthy females (mean age 47.2±8.8 years; range, 20 to 72 years) as the control group. Several clinical symptoms of the participants related to FMS were questioned and recorded. The visual analog scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scores of the fibromyalgia group were recorded. In both groups, the ADRB2 (rs1042717) single-nucleotide polymorphism was detected by way of a real-time polymerase chain reaction. The wild-type (Guanine/Guanine), the mutant type (Adenine/Adenine) and heterozygous type (Adenine/Guanine) were detected. The sample power was calculated considering the minor allele frequency.Results The comparison of the ADRB2 gene polymorphism between patients with FMS and the control subjects showed that the groups were similar in terms of ADBR2 gene polymorphism and genotype (p>0.05). There was no significant difference in terms of genotype when the ADRB2 gene polymorphisms in patients with FMS were compared in terms of clinical symptoms, VAS and FIQ scores (p>0.05).Conclusion Beta-2 adrenergic receptor (rs1042717) gene polymorphisms and genotype distribution are no different between patients with FMS and healthy individuals. ADRB2 gene polymorphisms in patients with FMS have no effect on clinical symptoms and VAS and FIQ scores. The results of the present study will light the way for future research into ADRB2 gene polymorphisms in the pathogenesis of FMS.

Kinesiophobia Levels in Fibromyalgia Syndrome and the Relationship Between Pain, Disease Activity, Depression.

This study aims to compare kinesiophobia levels between patients with fibromyalgia syndrome (FMS) and healthy volunteers and to investigate the factors associated with kinesiophobia in FMS. This case-control study included 88 female patients with FMS (mean age 41.61 years; range 21 to 61 years) and 67 female healthy volunteers (mean age 41.34 years; range 19 to 59 years). The participants' age, body mass index (BMI), and educational status were recorded. Patients were evaluated using a visual analog scale for pain, the Fibromyalgia Impact Questionnaire (FIQ) for disease activity, the Hamilton Depression Scale (HAM-D) for depression level, and the Tampa Scale for Kinesiophobia (TSK) for kinesiophobia. Additionally, the patients' serum 25-hydroxyvitamin D levels were measured. No significant differences were found between the patient and control groups in terms of age, BMI, and educational status (p>0.05). The mean TSK scores were 42.0±7.6 in the patient group and 37.2±8.8 in the control group. TSK score was significantly higher in the patient group (p<0.001). BMI levels, FIQ scores, and vitamin D concentrations were significantly associated with TSK scores according to the linear regression analysis (p<0.05). However, age, symptom duration, and HAM-D scores were not found to be associated with TSK scores (p>0.05). Kinesiophobia scores were significantly higher in patients with FMS. Physicians should focus on kinesiophobia when evaluating patients with FMS and inform patients about the importance and treatment strategies of kinesiophobia.

The Comparison of the Biological Rhythms of Patients with Fibromyalgia Syndrome with Biological Rhythms of Healthy Controls.

BackgroundFibromyalgia syndrome (FMS) is a rheumatic disease characterized by diffuse body pain and decreased muscle function. The aim of the present study was to compare the biological rhythms of patients with fibromyalgia syndrome with the biological rhythms of healthy controls.Material/MethodsThis was a cross-sectional, single blind, and single center case-control study. The patients with fibromyalgia were evaluated using a Fibromyalgia Impact Questionnaire (FIQ), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) Scale, Visual Analog Scale (VAS), Pittsburg Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI).ResultsThe study included 77 female patients with FMS, and 32 healthy female individuals as the control group. We found that the patients in the FMS group achieved higher scores in VAS, BDI, PSQI, and the BRIAN scale than the patients in the control group (P<0.001). An evaluation of the relationship between FMS evaluation parameters and biological rhythm scores in patients with FMS revealed a significant positive correlation between total BRAIN and VAS, FIQ, BDI, and PSQI scores. When the relationship between FMS evaluation parameters and biological rhythm scores was evaluated in patients with FMS, a significant positive correlation was found between total BRAIN and VAS, FIQ, BDI, and PSQI scores (r=0.555, P<0.001; r=0.461, P<0.001; r=0.630, P<0.001; and r=0.551, P<0.001 respectively).ConclusionsWe consider that an evaluation of the biological rhythm of female patients with FMS, and appropriate treatment when required, would contribute significantly to the treatment and follow-up process of the patients.