Life In Fibromyalgia Patients Research Articles

O PAPEL DO RECUPERO COMO RECURSO FISIOTERAPÊUTICO EM PACIENTES FIBROMIÁLGICOS AFETADOS PELA COVID-19

Introduction: Fibromyalgia is a complex chronic syndrome, characterized by diffuse pain, fatigue and sleep disturbances. The COVID-19 pandemic has aggravated symptoms, leading to the need for new therapeutic approaches, such as the use of Recupero, which can offer relief and improve patients' quality of life. Justification: This study is based on the need for integrated therapies in physical therapy for fibromyalgia, aggravated by COVID-19. The Recupero program combines photobiomodulation and ultrasound, promoting analgesia and tissue regeneration. Research is essential to fill gaps in knowledge and improve the quality of life of vulnerable patients. Objectives: To evaluate the efficacy of Recupero in the treatment of fibromyalgia and the management of post-COVID sequelae in patients affected by the infection. Methodology: This study reviewed the literature on fibromyalgia and COVID-19, analyzing articles from 2014 to 2024 in MedLine, SciELO, LILACS, and PEDro. Using the PICO strategy, six relevant studies were included, focusing on physiotherapy and the use of the Recupero device to improve symptoms in patients. Results and Discussion: COVID-19 infection intensified fibromyalgia symptoms, such as pain and anxiety, due to social isolation and treatment interruption. Studies have shown that the Recupero device improved pain and quality of life in fibromyalgia patients, showing efficacy in post-COVID rehabilitation and highlighting the importance of non-invasive therapies. Concluding Remarks: The COVID-19 pandemic has significantly impacted fibromyalgia patients, intensifying pain and anxiety due to isolation and treatment disruption. Interventions such as telerehabilitation and photosonic therapy have shown lasting benefits, underscoring the importance of a biopsychosocial approach. There is a need for rigorous studies to validate these therapies in the post-pandemic context.

Neuronutritional Approach to Fibromyalgia Management: A Narrative Review.

Fibromyalgia (FM) is a complex and common syndrome characterized by chronic widespread pain, fatigue, sleep disturbances, and various functional symptoms without clear structural or pathological causes. Affecting approximately 1-5% of the global population, with a higher prevalence in women, FM significantly impacts patients' quality of life, often leading to considerable healthcare costs and loss of productivity. Despite its prevalence, the etiology of FM remains elusive, with genetic, environmental, and psychological factors, including nutrition, being implicated. Currently, no universally accepted treatment guidelines exist, and management strategies are often symptomatic. This narrative review explores the potential of a neuronutritional approach to FM management. It synthesizes existing research on the relationship between FM and nutrition, suggesting that dietary interventions could be a promising complementary treatment strategy. Various nutritional interventions, including vitamin D, magnesium, iron, and probiotics supplementation, have shown potential in reducing FM symptoms, such as chronic pain, anxiety, depression, cognitive dysfunction, sleep disturbances, and gastrointestinal issues. Additionally, weight loss has been associated with reduced inflammation and improved quality of life in FM patients. The review highlights the anti-inflammatory benefits of plant-based diets and the low-FODMAPs diet, which have shown promise in managing FM symptoms and related gastrointestinal disorders. Supplements such as vitamin D, magnesium, vitamin B12, coenzyme Q10, probiotics, omega-3 fatty acids, melatonin, S-adenosylmethionine, and acetyl-L-carnitine are discussed for their potential benefits in FM management through various mechanisms, including anti-inflammatory effects, modulation of neurotransmitters, and improvement of mitochondrial function. In conclusion, this review underscores the importance of considering neuronutrition as a holistic approach to FM treatment, advocating for further research and clinical trials to establish comprehensive dietary guidelines and to optimize management strategies for FM patients.

The journey of pain management for fibromyalgia patients: A ten year experience from Tunisia

IntroductionFibromyalgia often deteriorates the quality of life of patients on physical, emotional, socio-familial, and professional levels. Aim of the workTo describe the characteristics of fibromyalgia patients and to assess the impact of fibromyalgia on their quality of life. Patients and methodsA questionnaire was provided to the fibromyalgia patients at the pain management center of Tunis, during the last ten years and the sociodemographic data, journey characteristics and satisfaction regarding the quality of their care were recorded and the impact of fibromyalgia on the quality of life was assessed using the Fibromyalgia Impact Questionnaire (FIQ). ResultsThe work included 110 patients, 93 females and 13 males (F:M 7.2:1) and a mean age of 52 ± 12 years. 65 % reported an initial pain visual analog scale (VAS) ≥ 7. The mean consultation and diagnostic delays were 75 ± 30 and 44 ± 28 months, respectively. 94 % of patients were initially misdiagnosed, despite consulting more than two different physicians. The mean FIQ total was 77.5 ± 13.Age, female gender, and manual professions were related to a more impaired physical impact of fibromyalgia (p = 0.02; p = 0.01; p = 0.03, respectively). Patients whose fibromyalgia trigger was persistent stress (n = 50) reported more impaired FIQ (p = 0.001). Patients with shorter consultation and diagnostic delays reported more improvement (p = 0.001 and p = 0.01, respectively). Patients treated with tricyclic antidepressants and vitamins felt significantly improved (p = 0.02 and p = 0.002). Non-pharmacological treatments included physical therapy, yoga, acupuncture, and thermal baths. ConclusionsThe quality of life in fibromyalgia patients is frequently impaired, and the journey is complex and ambivalent.

A Fixed Combination of Palmitoylethanolamide and Melatonin (PEATONIDE) for the Management of Pain, Sleep, and Disability in Patients with Fibromyalgia: A Pilot Study.

Fibromyalgia is characterized by chronic widespread pain, fatigue, and sleep disturbances. Recent theories attribute fibromyalgia to central sensitization syndromes, suggesting altered nociceptive processing leads to hyperalgesia and allodynia. Standardized effective treatments are currently lacking. Palmitoylethanolamide and melatonin have shown pain-relieving effects in chronic pain conditions, including fibromyalgia, with excellent safety. Our open-label study assessed the impact of a daily combination of 1200 mg of palmitoylethanolamide and 0.2 mg of melatonin on pain, sleep, and quality of life in fibromyalgia patients. Between June 2023 and March 2024, 50 patients (2016 ACR criteria) were treated and evaluated at baseline, 1 month, 3 months, and 4 months (1 month discontinuation). The assessments included VAS for pain, ISI for insomnia, HAQ for health assessments, and a tender points evaluation. The patients, averaging 54.12 years old with a 3:1 female-to-male ratio, showed significant improvements in VAS, ISI, and HAQ scores relative to their own baselines and a reduction in tender points at 1 and 3 months, which was maintained at 4 months. No adverse events were reported. This study is the first to demonstrate the efficacy of a palmitoylethanolamide and melatonin combination as an adjunct therapy in fibromyalgia, highlighting its potential to reduce pain and improve sleep and quality of life.

Psychological factors and health-related quality of life in fibromyalgia patients

BackgroundFibromyalgia (FM) has been associated with decreased health-related quality of life (HRQoL), which has been linked to psychological variables such as anxiety, depression, coping, and social support. This study aimed to simultaneously analyse the association of these variables with HRQoL in FM patients and explore their mediating role in the relationship between somatic symptoms and HRQoL.Participants and procedureA cross-sectional sample of 134 FM patients (97% women) with no other rheumatologic diseases followed in specialized healthcare services completed self-report questionnaires to evaluate pain, fatigue, sleep, anxiety, depression, coping, social support, and HRQoL.ResultsThe results indicated that FM patients experienced a negative impact on all dimensions of HRQoL, with anxiety primarily affecting the mental dimensions, and depression and social support affecting both physical and mental dimensions. Anxiety, depression, dysfunctional coping, and low social support were independent predictors of HRQoL and mediated the effect of somatic symptoms in the mental component of HRQoL.ConclusionsFM patients experience a negative impact on HRQoL, and anxiety, depression, coping and social support play an important role as independent predictors of this decrease, and as mediators of the effect of somatic symptoms in the mental dimen-sions of HRQoL. This underscores the importance of considering these psychological variables in the therapeutic approach to FM and suggests the need for interventions targeting anxiety, depression, dysfunctional coping, and low social support to improve HRQoL in FM patients.

Repetitive Transcranial Magnetic Stimulation in Fibromyalgia: Exploring the Necessity of Neuronavigation for Targeting New Brain Regions.

Fibromyalgia and osteoarthritis are among the most prevalent rheumatic conditions worldwide. Nonpharmacological interventions have gained scientific endorsements as the preferred initial treatments before resorting to pharmacological modalities. Repetitive transcranial magnetic stimulation (rTMS) is among the most widely researched neuromodulation techniques, though it has not yet been officially recommended for fibromyalgia. This review aims to summarize the current evidence supporting rTMS for treating various fibromyalgia symptoms. Recent findings: High-frequency rTMS directed at the primary motor cortex (M1) has the strongest support in the literature for reducing pain intensity, with new research examining its long-term effectiveness. Nonetheless, some individuals may not respond to M1-targeted rTMS, and symptoms beyond pain can be prominent. Ongoing research aims to improve the efficacy of rTMS by exploring new brain targets, using innovative stimulation parameters, incorporating neuronavigation, and better identifying patients likely to benefit from this treatment. Summary: Noninvasive brain stimulation with rTMS over M1 is a well-tolerated treatment that can improve chronic pain and overall quality of life in fibromyalgia patients. However, the data are highly heterogeneous, with a limited level of evidence, posing a significant challenge to the inclusion of rTMS in official treatment guidelines. Research is ongoing to enhance its effectiveness, with future perspectives exploring its impact by targeting additional areas of the brain such as the medial prefrontal cortex, anterior cingulate cortex, and inferior parietal lobe, as well as selecting the right patients who could benefit from this treatment.

Psychological Outcomes and Quality of Life of Fibromyalgia Patients with Vitamin D Supplementation-A Meta-Analysis.

The efficacy of current pharmaceutical treatments for fibromyalgia are limited. Vitamin D has shown promise in relieving pain. However, there is a lack of comprehensive analysis of psychological outcomes with vitamin D supplementation in fibromyalgia. This study aimed to investigate the impact of vitamin D supplementation on psychological outcomes and quality of life in fibromyalgia patients, given the unmet clinical need for effective treatment options. A meta-analysis of randomized controlled trials comparing vitamin D to placebo and prospective studies examining changes before and after vitamin D supplementation for patients with fibromyalgia was conducted to evaluate the effects of vitamin D on psychological outcomes, quality of life, and pain scores in patients with fibromyalgia. Databases were searched for relevant articles published from earliest available date to October 31, 2022. (PROSPERO number, CRD42022369889). We included 8 trials with a total of 694 participants and found that vitamin D supplementation had significant positive effects on physical function (standard mean differences (SMD) = 0.44, 95% CI = [0.10, 0.77 ]), role limitations due to emotional health (SMD = 0.57, 95% CI = [0.32, 0.82]), social function (SMD = 0.50, 95% CI = [0.08, 0.93]), and general health (SMD = 0.36, 95% CI = [0.11, 0.61]). Improvement of the Fibromyalgia Impact Questionnaire (FIQ) scores was noted (SMD = -0.414, 95% CI = [-0.808, -0.021]), but not on the Visual Analog Scale (VAS) (SMD = -0.15, 95% CI = [-0.771, 0.471]) and the Beck's Depression Inventory (BDI) scores (SMD = -0.456, 95% CI = [-1.27, 0.30]). In conclusion, vitamin D supplementation might be an alternative option for improvement of psychological outcomes and quality of life in patients with fibromyalgia.

Assessment of balance and functional capacity in fibromyalgia patients with and without migraine

ObjectiveTo evaluate the balance and functional capacity of fibromyalgia patients’ with and without migraine.MethodsObservational study with 60 women, between 20 and 60 years old (47±9 years), who were allocated into the following groups: 1. fibromyalgia and migraine (n=49); 2. only fibromyalgia (n=11). The following were used: Migraine Disability Assessment Test (MIDAS) to analyze the impact of migraine on quality of life; Revised Fibromyalgia Impact Questionnaire (FIQ-R) to assess the impact of fibromyalgia; six-minute walk test (6MWT)to assess functional capacity and Berg Balance Scale (BBE) for balance analysis.ResultsThere was no difference between groups 1 and 2 regarding functional capacity (TC6M: 308.7 m ±107.33 vs. 298.8 m ±153.54; p=0.55) and balance (BBE: 48± 14 vs. 47±16; p=0.68) as well as the impact on quality of life (FIQ: 78.8±14.77 vs. 74.4±13.99; p=0.28 and MIDAS: 31 ±24).ConclusionsOur study showed that there was no difference in functional capacity, balance and quality of life in fibromyalgia patients compared to patients with fibromyalgia associated with migraine.

Fear of COVID-19: reflections on disease severity, sleep and anxiety in fibromyalgia patients

Aim: This study aimed to assess the effects of COVID- 19 fear and anxiety on disease severity, pain, sleep quality and health-related quality of life in fibromyalgia patients.
 Material and Method: Sixty-four patients with diagnosis fibromyalgia and sixty-five healthy volunteers over 18 years of age were enrolled in the study. Sociodemographic features were evaluated. Fibromyalgia Impact Questionnaire (FIQ), Short Form 36 (SF-36), Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale(OCS), and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants.
 Results: The mean values of CAS, FIQ, PSQI, and BDI were found to be higher in the fibromyalgia group than the control group (p

Catastrophisation, chronic pain and sexuality: a cross-sectional investigation in fibromyalgia and rheumatoid arthritis.

In the present study we investigate the putative differences in pain catastrophising (PC), pain perception (PP), sexual functioning (SF), satisfaction (SS), and overall quality of life between fibromyalgia (FM) and rheumatoid arthritis (RA) patients as compared to healthy controls (HC). Fifty-seven native Italian-speaking female individuals suffering either from FM or RA and thirty-eight healthy female controls (FM = 40; RA = 17; HC = 38) were submitted to a semi-structured interview aimed at assessing PP intensity (Visual Analog Scale; VAS), general health conditions (36-items Short-Form Health Survey; SF-36), PC (Pain Catastrophising Scale; PCS), SF and SS (Index of Sexual Satisfaction; ISS/ Female Sexual Function Index; FSFI). FM patients had a significantly higher PP both as compared to RA and HC (p<0.002 for both), and higher PC as compared to HC but not as compared to RA patients (p<0.03 and p<0.64). When compared to RA patients and HC, they showed a lower quality of life (p<0.002 for both comparisons), a compromised SF (p<0.003 and p<0.002, respectively) and a lower index of SS with respect to HC (p<0.002). RA patients had higher PP (VAS; p<0.002), lower quality of life and SF as compared to HC (p<0.002 and p<0.003, respectively). FM and RA patients showed a significantly lower quality of life, SF and SS as compared to HC. PC was significantly related to PP and low quality of life in FM patients while in RA patients it negatively affected quality of life and especially the sexual sphere both when considering SF and SS.

Physiotherapeutic performance in improving quality of life in patients with fibromyalgia: an integrative literature review

Fibromyalgia (FM) is a painful syndrome characterized by generalized chronic pain, fatigue, morning stiffness, headache, and sleep disorders. Comorbidities such as anxiety and depression are also associated. This syndrome has etiology and pathogenesis not fully clarified, and the basis of its pathophysiology is an increase in the transmission of painful stimulus, thus altering the perception of pain. Physiotherapy acts in this syndrome, mainly aiming at improving symptoms and quality of life. The main objective of this study is to present the possibilities of therapeutic treatment to improve quality of life in fibromyalgia patients. The work consists of an integrative literature review, carried out between September and December 2020. A search was carried out in the electronic databases PEDro, BVS and PubMed, using the descriptors: physiotherapy and fibromyalgia. 10 articles from 2015 to 2020 were selected. As results, the benefits of hydrotherapy, electrothermophototherapy, aerobic exercises, manual therapy, acupuncture, Kinesio taping, balneotherapy, stretching and strength training were obtained. These generated effects such as: pain reduction, anxiety and depression. In addition to decreased fatigue, improvement in sleep, muscle strength, balance and flexibility. This led to physical and mental well-being, as well as improvement in quality of life. Therefore, it can be considered that this research has scientific relevance, since it provides significant contributions on the physiotherapeutic performance in the treatment of patients diagnosed with Fibromyalgia. Thus, this study may contribute to future research on the theme presented. &#x0D; Keywords: Fibromyalgia. Physical therapy. Pain. Quality of life.

Music-based interventions to improve fibromyalgia syndrome: A meta-analysis

ObjectiveWe evaluated the effects of music therapy on pain, depression and quality of life in patients with fibromyalgia. MethodsTen online databases were searched to identify randomized controlled trials that investigated the effects of music therapy on fibromyalgia patients, published up to 1st January 2019. The results were filtered and independently extracted. Statistical heterogeneity was assessed using the chi-square test. According to the outcome of the heterogeneity indices, either a fixed effect or a random effect model was used. ResultsIn total, seven randomized controlled trials were included. The Pain Visual Analog Scale, the McGill Pain Scale, the Beck Depression Scale and the Fibromyalgia Impact Questionnaire were used as outcome measures. Our evidence indicated that patient intervention with music therapy had lower scores on the Pain Visual Analog Scale (95% confidence interval [CI] -2.22 to -1.18, Z = 6.44, P < 0.00001, four studies) and Beck Depression Scale (95% CI -0.65 to -0.03, Z = 2.17, P = 0.03, two studies). No significant differences were observed on the McGill Pain Scale between the music intervention and control groups (95% CI -0.83 to -0.09, Z = 1.59, P = 0.11). A general qualitative description of the Fibromyalgia Impact Questionnaire results was given due to high heterogeneity (I2 = 96%, P < 0.00001). ConclusionsThe music therapy is superior to non-music therapy in the treatment of pain, depression, and improvement of quality of life in fibromyalgia patients. However, due to the low quantity and quality of the included studies, a larger number and high-quality of RCTs are needed to confirm the beneficial effects of music therapy.

A training program for fibromyalgia management: A 5-year pilot study.

We studied the effects of a specific cardio training program lasting 5 years on pain and quality of life in fibromyalgia patients.Method:An observational longitudinal pilot study was conducted in 138 fibromyalgia women. Fibromyalgia women recruited were asked to carry out three sessions per week, each lasting 45 min, of moderate-intensity continuous training (64%–75% Maximal Heart rate [HRmax]). During the first year, the patients progressively increased their training intensity. During the last 2 years, the patients were asked to associate moderate-intensity continuous training and high-intensity interval training (85%–90% HRmax). Pain on a visual analog scale, anxiety and depression state on the Hospital Anxiety and Depression Scale, impact of fibromyalgia on daily life using the Fibromyalgia Impact Questionnaire, heart rate and sleep quality (visual analog scale) were assessed at baseline and each year for 5 years.Results:Forty-nine patients dropped out in the first year. Depending on their training status, the remaining 89 patients were retrospectively assigned to one of the three groups: Active (moderate-intensity continuous training), Semi-Active (one or two sessions, low-intensity continuous training <60% HRmax) and Passive (non-completion of training), based on their ability to comply with the program. Alleviation of all symptoms (p < 0.0001) was observed in the Active group. Increasing exercise intensity enhanced the effects obtained with moderate-intensity continuous training. Significant change in the Fibromyalgia Impact Questionnaire (p < 0.0001) and depression (Hospital Anxiety and Depression Scale; p < 0.0001), and no significant decrease in pain were noted in the Semi-Active group. No effect of the training was observed in the Passive group.Conclusion:The study intervention associated with multidisciplinary care alleviated pain, anxiety and depression, and improved both quality of life and quality of sleep, in fibromyalgia patients.

Mindfulness is associated with psychological health and moderates the impact of fibromyalgia.

Previous studies suggest mindfulness is associated with pain and depression. However, its impact in individuals with fibromyalgia remains unclear. We examined associations between mindfulness and physical and psychological symptoms, pain interference, and quality of life in fibromyalgia patients. We performed a cross-sectional analysis on baseline data from a fibromyalgia clinical trial. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Pearson's correlations and multivariable linear regression models were used to evaluate associations between mindfulness and fibromyalgia impact, pain interference, physical function, depression, anxiety, stress, self-efficacy, and health-related quality of life. We also examined whether mindfulness moderated associations between fibromyalgia impact and psychological outcomes. A total of 177 participants (age 52.0 ± 12.2 (SD) years; 93.2% women; 58.8% white; body mass index 30.1 ± 6.7kg/m2; FFMQ score 131.3 ± 20.7; Revised Fibromyalgia Impact Questionnaire score 57.0 ± 19.4) were included. Higher total mindfulness was significantly associated with lower fibromyalgia impact (r = - 0.25), pain interference (r = - 0.31), stress (r = - 0.56), anxiety (r = - 0.58), depression (r = - 0.54), and better mental health-related quality of life (r = 0.57). Describing, Acting-with-awareness, and Non-judging facets of mindfulness were also associated with these outcomes. Mindfulness moderated the effect of fibromyalgia impact on anxiety (interaction P = 0.01). Higher mindfulness is associated with less pain interference, lower impact of fibromyalgia, and better psychological health and quality of life in people with fibromyalgia. Mindfulness moderates the influence of fibromyalgia impact on anxiety, suggesting mindfulness may alter how patients cope with fibromyalgia. Future studies should assess how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with fibromyalgia. • Higher mindfulness was associated with better psychological health and lower overall impact of fibromyalgia. • Mindfulness moderated the relationship between overall fibromyalgia impact and anxiety.

Somatosensory temporal discrimination is impaired in fibromyalgia

ObjectiveFibromyalgia is the prototypical central sensitivity syndrome which is associated with increased sensitivity to pain and other stimuli. In this study, we aimed to evaluate whether somatosensory temporal discrimination ability, which provides information about central processing of sensory stimuli, was impaired in patients with fibromyalgia. MethodsFifteen patients with fibromyalgia and 15 healthy subjects participated in the study. Demographic characteristics of participants and severity for fatigue, sleep quality, cognitive symptoms, somatic symptoms and health-related quality of life in fibromyalgia patients were recorded. Somatosensory temporal discrimination thresholds were measured from the dorsum of the dominant hands of the participants by using a constant current stimulator (Medtronic, Keypoint). ResultsPatients with fibromyalgia had higher somatosensory temporal discrimination thresholds than healthy subjects (p < 0.001). There were significant correlations between STDTs and pain intensity, FIQ scores and symptom severity scale scores in fibromyalgia group (p = 0.006, r = 0.68; p = 0.037, r = 0.54; p = 0.017, r = 0.61 respectively). ConclusionSomatosensory temporal discrimination ability is impaired in fibromyalgia patients compared to healthy subjects. Disrupted somatosensory temporal discrimination ability correlates with increased widespread pain and severity of other symptoms including fatigue, sleep quality, cognitive symptoms, somatic symptoms and decreased functional status. The impaired somatosensory temporal discrimination ability indicates an alteration in higher cognitive sensory processing in fibromyalgia patients.

Rehabilitation program improves quality of life in fibromyalgia patients up to one year: Preliminary results

Cognitive behaviour therapy (CBT) and graded activity (GA) have a beneficial effect on the Quality of life (QoL) of patients with fibromyalgia. However the question remains how long this effect will last. Patients with fibromyalgia meeting the 1990 ACR classification criteria are well informed about the problem of fibromyalgia and checked on motivation before starting the program. They were evaluated by the SF36v2 questionnaire at the beginning (T0) of an 8-week multidisciplinary (psychologist, occupational therapist and physical therapist) rehabilitation program, at the end of the 8 week program (T1), at 6 months (T2) and 1 year (T3). So far, of the 88 patients that were included, 71 were evaluated after 8 weeks, 55 after 6 months and 30 had a final evaluation after 1 year. Dropout at 1 year is 5/35 (14%). At 8 weeks, a substantial improvement compared to baseline was noticed in all subscales of the SF-36v2. At 6 months, the effect was slightly reduced, but both Physical Component Summary score and Mental Component Summary score were still significantly improved when compared to baseline ( P < 0.001). At 1 year, a persistent improvement ( P < 0.001) in Role Limitation (physical), General Health Perception, Energy and Vitality scores was observed. One year after starting the rehabilitation program with CBT and GA, QoL has consistently improved. The effect was most explicit in the domain of Role Limitations (physical), General Health, Energy and Vitality and weakest in the domain of Physical Functioning.

Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial.

Exercise therapy is an effective component of fibromyalgia (FM) treatment. However, it is important to know the effects and specificities of the different types of exercise: muscle stretching and resistance training. To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients. Randomized controlled trial. Physical therapy service, FM outpatient clinic. Forty-four women with FM (79 screened). Patients were randomly allocated into a stretching group (N.=14), resistance group (N.=16), and control group (N.=14). Pain was assessed using the visual analog scale, pain threshold using a Fischer dolorimeter, FM symptoms using the Fibromyalgia Impact Questionnaire (FIQ), and quality of life using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The three intervention groups continued with usual medical treatment. In addition, the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks. After treatment, the stretching group showed the highest SF-36 physical functioning score (P=0.01) and the lowest bodily pain score (P=0.01). The resistance group had the lowest FIQ depression score (P=0.02). The control group had the highest score for FIQ morning tiredness and stiffness, and the lowest score for SF-36 vitality. In clinical analyses, the stretching group had significant improvement in quality of life for all SF-36 domains, and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning, vitality, social function, emotional role, and mental health. Muscle stretching exercise was the most effective modality in improving quality of life, especially with regard to physical functioning and pain, and resistance training was the most effective modality in reducing depression. The trial included a control group and two intervention groups, both of which received exercise programs created specifically for patients with FM. In clinical practice, we suggest including both modalities in an exercise therapy program for FM.

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

IntroductionAlthough fibromyalgia syndrome (SFM) affects 2–4 percent of adults, research has not identified a preferred therapeutic option for patients worldwide yet. Based on recent findings, it can be expected that whole body cryotherapy can improve health-reported quality of life by alleviating the symptoms of musculoskeletal pain and fatigue. ObjectiveOur aim was to determine whether whole body cryotherapy only can result in improved perceived health and quality of life in fibromyalgia patients. Methods24 patients with fibromyalgia diagnosis were randomized into 2 groups (n=11 in the whole body cryotherapy group, n=13 in the control group). In the whole body cryotherapy group, 10 sessions of whole body cryotherapy were performed (in addition to usual care) in a standard cryotherapy room over a duration of 8days. Subjects in the control group did not change anything in their everyday activities. Quality of life was assessed just before and one month after treatment. ResultsCompared with the control group, patients in the whole body cryotherapy group reported significantly improved for health-reported quality of life. These effects lasted for at least one month following intervention. ConclusionBased on these findings, whole body cryotherapy can be recommended as an effective clinically adjuvant approach in the improvement of health-related quality of life in fibromyalgia patients.

The degree of cardiac baroreflex involvement during active standing is associated with the quality of life in fibromyalgia patients.

Fibromyalgia syndrome (FMS) is a rheumatologic disorder characterized by chronic widespread pain, fatigue and other symptoms. Baroreflex dysfunction has been observed in women with FMS. However, it is unknown whether the limited involvement of the baroreflex control during an orthostatic stimulus has some impact on the quality of life of the FMS patient. Therefore, the aim of the study is evaluate the relationship between the quality of life of the FMS patient and indexes of the cardiovascular autonomic control as estimated from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP). We enrolled 35 women with FMS (age: 48.8±8.9 years; body mass index: 29.3±4.3 Kg/m2). The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded during 15 minutes at rest in supine position (REST) and in orthostatic position during active standing (STAND). Traditional cardiovascular autonomic control markers were assessed along with a Granger causality index assessing the strength of the causal relation from SAP to HP (CRSAP→HP) and measuring the degree of involvement of the cardiac baroreflex. The impact of FMS on quality of life was quantified by the fibromyalgia impact questionnaire (FIQ) and visual analog score for pain (VAS pain). No significant linear association was found between FIQ scores and the traditional cardiovascular indexes both at REST and during STAND (p>0.05). However, a negative relationship between CRSAP→HP during STAND and FIQ score was found (r = -0.56, p<0.01). Similar results were found with VAS pain. In conclusion, the lower the degree of cardiac baroreflex involvement during STAND in women with FMS, the higher the impact of FMS on the quality of life, thus suggesting that Granger causality analysis might be clinically helpful in assessing the state of the FMS patient.

Gratitude mediates quality of life differencesbetween fibromyalgia patients and healthy controls.

Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls. Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics. Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables. Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.