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Rev. colomb. anestesiol ; 49(4): e302, Oct.-Dec. 2021. tab
Article in English | LILACS, COLNAL | ID: biblio-1341241


Abstract Fibromyalgia is a chronic disease of unclear etiology, involving a neural oversensitization and impaired pain modulation, in addition to a clinical deficiency of the endocannabinoid system. Fibromyalgia is associated with a number of somatic and psychological disorders and hence multiple pharmacological approaches have been used, including opioids, antidepressants, antiepileptics, and more recently medical cannabis. This narrative review comprises a review of the current literature on the efficacy of cannabinoids in fibromyalgia. The studies describe a possible influence of cannabis on pain control in patients with fibromyalgia, with positive effects on quality of life and sleep. The use of cannabis seems to be beneficial in patients with fibromyalgia; however, more robust studies are still needed to establish is actual efficacy in pain management, quality of life and improvement of associated symptoms.

Resumen La fibromialgia es una enfermedad crónica, cuya etiología no es clara, en la que se involucra una sobresensibilización neural y disminución de la modulación del dolor, así como una deficiencia clínica del sistema endocannabinoide. Está asociada a una variedad de trastornos somáticos y psicológicos, por lo cual se han utilizado múltiples abordajes farmacológicos, entre ellos opioides, antidepresivos, antiepilépticos y, recientemente, cannabis medicinal. En esta revisión narrativa se hace una reseña de la literatura actual relacionada con la eficacia de los cannabinoides en la fibromialgia. Los estudios describen una posible influencia del cannabis sobre el control del dolor en pacientes con fibromialgia, con efectos positivos sobre la calidad de vida y el sueño. El uso del cannabis parece tener beneficios en los pacientes con fibromialgia; sin embargo, aún se requieren estudios más robustos para establecer su verdadera eficacia en el manejo del dolor, calidad de vida y mejoría de los síntomas asociados.

Humans , Female , Adult , Middle Aged , Cannabis , Fibromyalgia/therapy , Medical Marijuana , Dronabinol , Cannabinoids , Review Literature as Topic , Fibromyalgia
Adv Rheumatol ; 61: 3, 2021. tab, graf
Article in English | LILACS | ID: biblio-1152737


Abstract Introduction: Whole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM). There is cumulative evidence that cytokines play a crucial role in FM. It's unknown whether clinical effects of WBC can be demonstrated at the molecular level and how long the effects last. Methods: We compared effects of serial WBC (6 sessions (- 130 °C in 6 weeks) in FM patients and healthy controls (HC). Primary outcome was the change in pain level (visual analogue scale 0-100 mm) after 6 sessions. Secondary outcomes were a change in disease activity (revised Fibromyalgia Impact Questionnaire) and pain after 3 sessions and 3 months after discontinued therapy and in cytokine levels (interleukin (IL-)1, IL-6, tumor necrosis factor α (TNF-α) and IL-10). The patients' opinions on the satisfaction, effectiveness and significance of WBC were evaluated. Results: Twenty-three FM patients and 30 HC were enrolled. WBC resulted in a significant reduction in pain and disease activity after 3 and 6 sessions. No clinical benefit could be measured 3 months after discontinued treatment. Overall, probands were satisfied with WBC and considered WBC to be important and effective. FM patients had significantly different levels of IL-1, IL-6, TNF-α and IL-10 at each reading point compared to HC. Levels of IL-1, IL-6 and IL-10 were significantly altered over time in FM patients. Compared to HC FM patients showed a significantly different response of IL1, - 6 and - 10 to WBC. Conclusion: Serial WBC is a fast acting and effective treatment for FM. Proven effects of WBC may be explained by changes in cytokines.(AU)

Humans , Fibromyalgia/therapy , Cytokines , Cryotherapy/instrumentation , Surveys and Questionnaires
Adv Rheumatol ; 60: 34, 2020. tab, graf
Article in English | LILACS | ID: biblio-1130780


Abstract Objectives Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS. Methods Ninety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months). Results In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed. Conclusion Right DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation . Trial registration: Ref No: CTRI/2013/12/004228.(AU)

Humans , Fibromyalgia/therapy , Chronic Pain , Prefrontal Cortex , Oxidative Stress , Diffuse Noxious Inhibitory Control
Adv Rheumatol ; 60: 21, 2020. tab, graf
Article in English | LILACS | ID: biblio-1100888


Abstract Background: The mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia. Methods: A single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]). Results: There was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables. Conclusion: Significant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables. Trial registration: Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).(AU)

Humans , Female , Fibromyalgia/therapy , Exercise Movement Techniques/instrumentation , Quality of Life , Pain Measurement/instrumentation , Physical Therapy Modalities/instrumentation , Polysomnography/instrumentation
Adv Rheumatol ; 60: 09, 2020. tab, graf
Article in English | LILACS | ID: biblio-1088656


Abstract Background: EpiFibro (Brazilian Epidemiological Study of Fibromyalgia) was created to study patients with fibromyalgia (FM). Patients were included since 2011 according to the classification criteria for FM of the American College of Rheumatology of 1990 (ACR1990). Objective: To analyze the therapeutic measures prescribed by Brazilian physicians. Materials and methods: Cross-sectional study of a multicenter cohort. The therapeutic measures were described using descriptive statistics. Results: We analyzed 456 patients who had complete data in the registry. The mean age was 54.0 ± 11.9 years; 448 were women (98.2%). Almost all patients (98.4%) used medications, 62.7% received health education, and less than half reported practicing physical exercise; these modalities were often used in combination. Most patients who practiced exercises practiced aerobic exercise only, and a significant portion of patients combined it with flexibility exercises. The most commonly used medication was amitriptyline, followed by cyclobenzaprine, and a minority used medication specifically approved for FM, such as duloxetine and pregabalin, either alone or in combination. Combinations of two or three medications were observed, with the combination of fluoxetine and amitriptyline being the most frequent (18.8%). Conclusion: In this evaluation of the care of patients with FM in Brazil, it was found that the majority of patients are treated with a combination of pharmacological measures. Non-pharmacological methods are underused, with aerobic exercise being the most commonly practiced exercise type. The most commonly prescribed single drug was amitriptyline, and the most commonly prescribed combination was fluoxetine and amitriptyline. Drugs specifically approved for FM are seldom prescribed.(AU)

Humans , Fibromyalgia/drug therapy , Fibromyalgia/therapy , Records , Fluoxetine/therapeutic use , Cross-Sectional Studies , Cohort Studies , Physical Therapy Modalities , Drug Combinations , Pregabalin/therapeutic use , Duloxetine Hydrochloride/therapeutic use , Amitriptyline/therapeutic use
Braz. arch. biol. technol ; 63: e20180734, 2020. tab, graf
Article in English | LILACS | ID: biblio-1132202


Abstract Fibromyalgia (FM) is a nonarticular rheumatic syndrome that leads to diffuse myalgia, sleep disturbances and morning stiffness. Balneotherapy has been shown an effective strategy to improve the health conditions of patients; however, the treatment follow-up is based on patient report due to the lack of biomarkers. Thus, this study evaluated the application of cytokines and phosphoglycerate mutase I (PGAM-I) to monitoring FM patient underwent to balneotherapy treatment. Eleven healthy and eleven women with FM were submitted to daily sessions of balneotherapy during 10 days. Clinical and quality of life parameters were assessed through a FIQ questionnaire. Blood levels of TNF-(, interleukins (IL-1, IL-2 and IL-10) and PGAM-I expression in patients' saliva were also evaluated. Patients with FM showed significant improvements in their clinical status after treatment. Also, FM patients has IL-10 levels lower than healthy women and the balneotherapy increased the expression of this cytokine in both groups, concomitantly to pain relief. Although inflammatory cytokines (IL-1, IL-2 and TNF-() were more expressed in FM patients than healthy patients their levels did not reduce after treatment. A slight increase of PGAM-I expression was observed. In conclusion, IL-10 levels could be a useful biomarker to balneotherapy follow-up of FM patients. However, these findings must be analyzed in a larger number of patients in order to validate IL-10 as an effective biomarker.

Humans , Female , Biomarkers , Fibromyalgia/diagnosis , Interleukin-10/blood , Quality of Life , Saliva , Balneology , Fibromyalgia/therapy , Case-Control Studies , Surveys and Questionnaires , Interleukin-1/blood , Interleukin-2/blood , Phosphoglycerate Mutase/blood
Brasília; Fiocruz Brasília;Instituto de Saúde de São Paulo; dez. 3, 2019. 34 p.
Non-conventional in Portuguese | LILACS, ColecionaSUS, MTYCI, PIE | ID: biblio-1118203


O yoga caracteriza-se como uma prática integrativa de origem oriental que combina posições corporais, técnicas de respiração, meditação e relaxamento. É indicada no tratamento de sistemas musculoesquelético, endócrino, respiratório, além de outros agravos à saúde, e estimula as funções cognitivas. Qual a eficácia/efetividade e a segurança do yoga para tratamento da dor aguda ou crônica em população adulta? As buscas foram realizadas nas bases de dados Pubmed, HSE-Health Systems Evidence, Epistemonikos, Portal Regional da BVS, HE-Health Evidence e Embase, em 27 de setembro de2019. Foram incluídas revisões sistemáticas (RS), com ou sem metanálises, publicadas em inglês, espanhol e português, e que que avaliavam o yoga no tratamento de dor crônica e aguda na população adulta e/ou idosa. Não houve restrição em relação ao ano de publicação. As estratégias de busca foram utilizadas com base na combinação de palavras-chave estruturadas a partir do acrônimo PICOS, usando os termos MeSH no Pubmed e DeCS na BVS, adaptando-os ao HSE, Epistemonikos, HE e Embase. A qualidade metodológica das revisões sistemáticas selecionadas foi avaliada segundo a ferramenta Assessing the Methodological Quality of Systematic Reviews(AMSTAR 2). De 693 artigos identificados, dez revisões sistemáticas foram selecionadas, oito delas com meta-análises. Com relação à qualidade metodológica, três revisões foram consideradas de qualidade moderada, duas de baixa qualidade e cinco de qualidade criticamente baixa. Na lombalgia crônica, a prática de yoga, quando comparada a atividades passivas, cuidado habitual, educação, atendimento médico padrão, controle de atenção, lista de espera, sem exercícios físicos, mostrou ser eficaz na diminuição da dor em curto, médio e longo prazos. Os resultados são mais consistentes com relação aos efeitos em curto e médio prazos. Na comparação de yoga com exercícios físicos as evidências resultam de poucos estudos e são controversas, mostrando benefício em curto e médio prazos no controle de lombalgia ou diferenças estatisticamente não significantes. Yoga, em comparação a intervenções passivas, sem exercícios físicos, mostrou ser benéfico também para melhorar quadros de incapacidade específica relacionada à lombalgia, em curto, médio e longo prazos. Além disso, houve melhora clínica dos casos de lombalgia a favor de yoga em curto e médio prazos. Na dor cervical crônica, as revisões mostraram evidências de efeitos benéficos de yoga para redução da dor quando comparado a cuidados habituais ou exercícios, entretanto não houve diferença com pilates ou medicina complementar e alternativa Da mesma forma, yoga mostrou-se superior a cuidados habituais e exercícios na redução da incapacidade relacionada dor cervical. A qualidade de vida e o humor melhoraram com yoga em relação a cuidados habituais. Yoga parece trazer benefícios também para pessoas com quadros de dor relacionados a osteoartrite e artrite reumatoide, fibromialgia, síndromes do túnel do carpo e do intestino irritável. No entanto, os resultados são menos consistentes. Com relação à segurança da prática de yoga, as evidências mostraram eventos adversos em geral sem gravidade. E quando comparado a exercícios não houve diferença no relato de eventos adversos. As revisões sistemáticas apresentaram resultados favoráveis à prática de yoga em relação aos cuidados habituais, particularmente nos casos de dor lombar e cervical. Há menos evidências acerca da superioridade do yoga em comparação a intervenções ativas. Em outras situações estudadas, como a dor associada a fibromialgia, osteoartrite, artrite reumatoide, síndromes do túnel do carpo e do intestino irritável, as evidências são menos consistentes. É importante ressaltar que as revisões sistemáticas incluídas nesta revisão rápida foram consideradas de baixa confiança na avaliação com a ferramenta AMSTAR 2. Além disso, os resultados têm como base estudos primários com amostras pequenas, com heterogeneidade na aplicação das intervenções, e considerável risco de viés. Isso remete à necessidade de se realizar ensaios clínicos, bem como revisões sistemáticas, com melhor qualidade metodológica

Humans , Adult , Middle Aged , Aged , Yoga , Acute Pain/therapy , Chronic Pain/therapy , Osteoarthritis/therapy , Arthritis, Rheumatoid/therapy , Carpal Tunnel Syndrome/therapy , Fibromyalgia/therapy , Treatment Outcome , Low Back Pain/therapy , Neck Pain/therapy , Irritable Bowel Syndrome/therapy
Rev. Assoc. Med. Bras. (1992) ; 65(10): 1265-1274, Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041035


SUMMARY OBJECTIVE We reported our multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our aim was to verify the effectiveness of a proprioceptive training program as a complementary therapy for a traditional protocol of education, mindfulness, and exercise training for the management of fibromyalgia associated with imbalance. METHODS Retrospective cohort study on 84 women, with primary fibromyalgia associated to imbalance. A group of patients performed traditional exercise training; in a second group the training was supplemented with proprioception exercises. Each session lasted from 40 to 60 minutes and was performed three times a week for 12 weeks. RESULTS After three months of training and eight months after the end of the training, the balance evaluation revealed significant differences in the comparison of the Timed Up and Go test, Berg Balance Scale, and Tinetti scale with the baseline, there was a better improvement in the proprioceptive training group (p<0.05). A reduction in pain and improvement in functional and muscular performance and quality of life were observed in both groups (p<0.05), but with no significant differences between them in the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, and Short Form Health Survey (p>0.05). Fifteen months after the end of the program, the effects of training were not maintained. CONCLUSION The present study revealed that training supplemented with proprioception exercises has beneficial effects on clinical findings and improves balance in patients with fibromyalgia, even if the positive results did not persist after the interruption of the rehabilitative program in the long term.

RESUMO OBJETIVO Relatamos nosso protocolo multidisciplinar para o manejo da fibromialgia associada ao desequilíbrio. Nosso objetivo foi verificar a eficácia do programa de treinamento proprioceptivo como terapia complementar de um protocolo tradicional (exercícios aeróbicos, de resistência e flexibilidade). MÉTODOS Estudo retrospectivo em 84 mulheres com fibromialgia primária associada a desequilíbrio. Um grupo de pacientes realizou o treinamento tradicional; em um segundo grupo o treinamento foi complementado com exercícios de propriocepção. Cada sessão durou de 40 a 60 minutos e foi realizada três vezes por semana durante 12 semanas. RESULTADOS Após três meses de treinamento e oito meses após o término do treinamento, a avaliação do equilíbrio revelou diferenças significativas nos testes Timed Up and Go, Escala de Equilíbrio de Berg e Escala de Tinetti em comparação com a linha de base, com uma melhora maior no grupo de treinamento proprioceptivo (p<0,05). Redução da dor e melhora do desempenho funcional e muscular e da qualidade de vida foram observadas em ambos os grupos (p<0,05), mas sem diferenças significativas entre eles na Escala Numérica de Dor, Fibromyalgia Impact Questionnaire e Short Form Health Survey (p>0,05). Quinze meses após o final do programa, os efeitos do treinamento não foram mantidos. CONCLUSÃO O presente estudo revelou que o treinamento suplementado com exercícios de propriocepção tem efeitos benéficos sobre os achados clínicos e melhora o equilíbrio em pacientes com fibromialgia, mesmo que os resultados positivos não tenham persistido após a interrupção do programa de reabilitação no longo prazo.

Humans , Female , Fibromyalgia/therapy , Sensation Disorders/therapy , Postural Balance , Exercise Therapy/methods , Fibromyalgia/complications , Clinical Protocols , Surveys and Questionnaires , Retrospective Studies , Sensation Disorders/etiology
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 81-85, sept. 2019.
Article in Spanish | LILACS | ID: biblio-1048229


El dolor crónico constituye un reto terapéutico especial. Se presenta una revisión narrativa sobre el papel del tratamiento de oxigenación hiperbárica (TOHB) en el tratamiento del dolor neuropático, y sus aplicaciones en dolor crónico, síndromes neurosensitivos disfuncionales y oncodolor. El conocimiento de las indicaciones de TOHB en algiología y su aplicación en la práctica médica puede contribuir a mejorar la calidad de vida del paciente. (AU)

Chronic pain represents a special therapeutic challenge. We present a narrative review on the role of Hyperbaric Oxygen Therapy (HBOT) in the treatment of neuropathic pain, and its applications in chronic pain, dysfunctional neurosensitive syndromes and oncological pain. The knowledge of the indications of HBOT in algiology and its application in medical practice can contribute to improve the quality of life of the patient. (AU)

Chronic Pain/therapy , Hyperbaric Oxygenation/methods , Phantom Limb/therapy , Quality of Life , Reflex Sympathetic Dystrophy/therapy , Vascular Headaches/therapy , Brain Diseases/therapy , Facial Pain/therapy , Fibromyalgia/therapy , Causalgia/therapy , Diabetic Neuropathies/therapy , Edema/therapy , Neuralgia, Postherpetic/therapy , Chronic Pain/epidemiology , Cancer Pain/therapy , Hyperbaric Oxygenation/trends , Analgesia/methods , Inflammation/therapy , Neuralgia/therapy
Rev. cuba. reumatol ; 21(2): e93, mayo.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093821


Introducción: resulta de notable significación el hecho de enfatizar en la difusión de los avances en el tratamiento de la fibromialgia, ya que en décadas precedentes, ha ido alcanzando cada vez mayor magnitud hasta devenir hoy en una problemática de salud pública de atención prioritaria. Objetivo: reportar los avances en el tratamiento de la fibromialgia. Desarrollo: diversos factores pueden exponer esta situación: la elevada incidencia de la fibromialgia en la población general adulta; el escaso conocimiento de su origen y los componentes que la causan; así como el no hallazgo de tratamiento curativo, la inconformidad de los casos y los profesionales en el tratamiento actual del síndrome. Conclusiones: no existen evidencias de que el tratamiento farmacológico de la fibromialgia resulte más efectivo que el no farmacológico, de ahí la notable importancia de estudios como el presente(AU)

Introduction: it is of remarkable significance to emphasize the diffusion of advances in the treatment of fibromyalgia, since in previous decades, it has been reaching ever greater magnitude until becoming today a priority public health problem. Objective: To report the advances in the treatment of fibromyalgia. Development : Several factors can expose this situation: the high incidence of fibromyalgia in the general adult population; the limited knowledge of its origin and the components that cause it; as well as the non-discovery of curative treatment, the nonconformity of cases and professionals in the current treatment of the syndrome. Conclusions: There is no evidence that the pharmacological treatment of fibromyalgia is more effective than the non-pharmacological treatment, hence the remarkable importance of studies such as the present one(AU)

Humans , Fibromyalgia/therapy , Fibromyalgia/drug therapy , Ecuador
Rev. bras. anestesiol ; 69(3): 227-232, May-June 2019. tab
Article in English | LILACS | ID: biblio-1013410


Abstract Background and objectives: Pain is one of the most common reason for seeking medical care. This study aimed to analyze patients with chronic pain in Maricá, Rio de Janeiro State, Brazil. Methods: A transversal retrospective study with 200 patients, who were treated in ambulatory care in a public hospital from June 2014 to December 2015. The variables considered were: pain intensity, type of pain, anatomical location, diagnosis and treatment. The data were statistically analyzed, the Fisher's exact test was applied, and the probability p was significant when ≤0.05. Results: We analyzed 200 patients with chronic pain, most of them female (83%). Mean age was 58.6 ± 13.01 years old. The patients were classified in groups by age, six groups with ten years of difference between them. Main age range was the 50-59 years old group, with 49 females (32%) and 5 males (15%). About 65.5% of the total of patients (131) had severe pain (Numeric Rating Sacale was 9.01). Mixed pain was predominant, affecting 108 patients (92 females and 16 males, what represents 55% and 47% of the total of females and males, respectively, that participate in the study). The most prevalent anatomical pain (159 patients, 131 females and 28 males) was in the lower limbs. Lower back pain was present in 113 of the 200 patients (94 females and 19 males). In the 30-39, 50-59, 60-69 years old group, the results for pain locations were significant: p = 0.01, p = 0.0069, p = 0.0003, respectively. Conclusion: The prevalence of chronic pain was associated with females in 50-59 years old and severe mixed pain. Pain was located mainly in lower limbs and lumbar region. The most frequent diagnosis was low back pain followed by fibromyalgia. The patients were informed about their disease and treatment.

Resumo Justificativa e objetivos: A dor é um dos motivos mais comuns para procurar atendimento médico. Este estudo teve como objetivo analisar pacientes com dor crônica atendidos em Maricá, no Estado do Rio de Janeiro, Brasil. Métodos: Estudo transversal retrospectivo com 200 pacientes, atendidos em ambulatório de um hospital público no período de junho de 2014 a dezembro de 2015. As variáveis analisadas foram: intensidade da dor, tipo de dor, localização anatômica, diagnóstico e tratamento. Os dados foram submetidos à análise estatística, aplicou-se o teste exato de Fisher, e o valor p foi significativo quando ≤ 0,05. Resultados: Analisamos 200 pacientes com dor crônica, sendo a maioria mulheres (83%). A média de idade foi de 58,6 ± 13,01 anos. Os pacientes foram classificados em seis grupos de acordo com a faixa etária, com dez anos de diferença entre eles. O grupo principal foi entre 50-59 anos, com 49 mulheres (32%) e cinco homens (15%). Dos pacientes, 65,5% apresentaram dor intensa (Escala Visual Numérica 9,01). A dor mista foi prevalente, afetou 108 pacientes (92 mulheres e 16 homens, o que representa 55% e 47% do total de mulheres e homens, respectivamente). A dor anatômica mais prevalente (159 pacientes, 131 mulheres e 28 homens) foi nos membros inferiores. A dor na parte inferior das costas estava presente em 113 das 200 pessoas analisadas (94% mulheres e 19% homens). Nos grupos entre 30-39, 50-59 e 60-69 anos, os resultados para a localização da dor foram significativos: p = 0,01, p = 0,0069, p = 0,0003, respectivamente. Conclusão: A prevalência de dor crônica foi associada ao sexo feminino na faixa de 50-59 anos e à dor mista intensa. A dor foi localizada principalmente nos membros inferiores e na região lombar. O diagnóstico mais frequente foi de lombalgia seguida de fibromialgia. Os pacientes foram informados sobre suas doenças e tratamento.

Humans , Male , Adult , Aged , Young Adult , Fibromyalgia/epidemiology , Low Back Pain/epidemiology , Chronic Pain/epidemiology , Ambulatory Care , Brazil , Fibromyalgia/therapy , Cross-Sectional Studies , Retrospective Studies , Low Back Pain/therapy , Chronic Pain/therapy , Middle Aged
Rev. medica electron ; 41(1): 196-202, ene.-feb. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1023610


Introducción: la fibromialgia es una enfermedad que no encuentra prueba orgánica aparente para explicar un dolor intenso y difuso, acompañado por una gran cantidad de síntomas como son: sueño no reparador, fatiga, síntomas de depresión y ansiedad, rigidez por las mañanas, síndrome de colon irritable. Desde el psico- ballet se trabaja con el cuerpo, con el movimiento, y con la expresión. Objetivo: evaluar los efectos a nivel psíquico y emocional del arte en movimiento. Materiales y métodos: se desarrolló un estudio preliminar con un grupo de 27 mujeres diagnosticadas de fibromialgia y en tratamiento farmacológico, de una media de edad de 41 años. Antes de empezar el proceso y al terminarlo se les hicieron varias entrevistas clínicas y se aplicaron diferentes pruebas de evaluación psicológica. Se les aplica el Test STAI de Spielberg, el de Autoestima de Rosenberg y el POMS. Recibieron veinte sesiones de 90 minutos de duración (60 minutos de psico ballet y 30 minutos de técnicas cognitivas), a razón de una sesión semanal durante 5 meses. Resultados: indican reducción de la fatiga, de la ansiedad, de la depresión y de la percepción del dolor y un aumento del vigor, mejora de la autoimagen y de la autoestima. Conclusiones: la actividad físico artística que aporta el psico-ballet mejora la calidad de vida de este tipo de pacientes, fortaleciendo su capacidad de comunicación, mejorando la autoestima y el vigor, reduciendo la fatiga y la percepción del dolor. (AU)

Introduction: fibromyalgia is a disease in which no apparent proof is found to explain an intense diffuse pain accompanied by a great quantity of symptoms like un-restful sleep, fatigue, depression and anxiety, stiffness in the morning, and irritable bowel syndrome. The body, movement and expression are trained using psycho-ballet. Objective: to assess the effects of the art of movement at the psychical and emotional level, paying attention to pain, with the pretension that the patient explore it through his body and his movement in a secure space and accompanied by people in the same situation, what facilitates communication. Material and methods: the study was carried out with a group of 27 women averagely aged 41 years, diagnosed with fibromyalgia under pharmacological treatment. Before the beginning of the treatment, and after finishing it, they answered to several clinical interviews and applied different tests of psychological evaluation: Spielberg´s State-Trait Anxiety Inventory (STAI), Rosenberg's self-steem scale, and mood states profile test. They underwent 20 sessions of 90 minutes (60 minutes of Psycho-ballet and 30 minutes of cognitive techniques), one session weekly during 5 months. Results: patients report the reduction of fatigue, anxiety, depression and pain perception, a vitality increase, and improvement of self-image and self-steem. Conclusions: physic-artistic activity provided by psycho-ballet improves life quality in this kind of patients, strengthens their communication ability, improves self-steem and vitality, and reduces fatigue and pain perception. (AU)

Humans , Fibromyalgia/diagnosis , Fibromyalgia/therapy , Dance Therapy/methods , Patient Health Questionnaire , Fibromyalgia/psychology , Fibromyalgia/drug therapy , Journal Article
Rev. gaúch. enferm ; 40: e20180411, 2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1043016


Resumo OBJETIVOS Descrever o cotidiano das mulheres que vivem com fibromialgia durante a intervenção do grupo interdisciplinar e analisar seus benefícios à saúde das mulheres após a intervenção. MÉTODO Trata-se de um estudo descritivo exploratório, de abordagem qualitativa, desenvolvido com 12 mulheres participantes do grupo interdisciplinar de educação em saúde, em uma Universidade Estadual do Rio de Janeiro. Os dados foram coletados em 2016 por meio de entrevista semiestruturada e, em seguida, organizados e submetidos à análise de conteúdo segundo Bardin. O presente estudo foi aprovado pelo comitê de ética recebendo o número do CAAE 16413013013100005259, em consonância aos aspectos éticos legais da resolução 466/2012. RESULTADOS Do corpus analítico, emergiram duas categorias intituladas: A expressão do cotidiano e Repercussões do grupo interdisciplinar. CONCLUSÃO As ações do grupo interdisciplinar proporcionaram inúmeros benefícios tanto físicos, quanto psicológicos e sociais para cada mulher.

Resumen OBJETIVOS Describir el cotidiano de las mujeres que viven con fibromialgia durante la intervención del grupo interdisciplinario y analizar sus beneficios a la salud de las mujeres después de la intervención. MÉTODO Se trata de un estudio descriptivo exploratorio, de abordaje cualitativo, desarrollado con 12 mujeres participantes del grupo interdisciplinario de educación en salud, en una Universidad Estadual del Río de Janeiro. Los datos fueron recolectados en 2016 por medio de entrevistas semiestructuradas y luego organizados y sometidos al análisis de contenido según Bardin. El presente estudio fue aprobado en el comité de ética recibiendo la numeración del CAAE 16413013013100005259, en consonancia a los aspectos éticos legales de la resolución 466/2012. RESULTADOS Del corpus analítico, emergieron dos categorías tituladas: La expresión del cotidiano y Repercusiones del grupo interdisciplinario. CONCLUSIÓN Las acciones del grupo interdisciplinario proporcionaron innumerables beneficios tanto físicos, como psicológicos y sociales para cada mujer.

Abstract OBJECTIVE To describe the daily lives of women living with fibromyalgia through the implementation of an interdisciplinary group intervention and verify its benefits to the participants' health. METHOD This descriptive, exploratory, qualitative study was conducted with 12 women who participanted in an interdisciplinary health education group at the State University of Rio de Janeiro. Data were collected in 2016 through semi-structured interviews, which were organized and analyzed according to Bardin's content analysis. This study was approved by the Institutional Review Board (CAAE 16413013013100005259), in accordance with the legal and ethical guidelines estabished by Resolution 466/2012. RESULTS Two categories emerged from the analytical corpus, namely: Expression of everyday life and Repercussions of the interdisciplinary group. CONCLUSION The actions implemented by the interdisciplinary group resulted in numerous physical, psychological and social benefits for the women.

Humans , Female , Adult , Aged , Patient Care Team , Self Care/psychology , Activities of Daily Living , Fibromyalgia/psychology , Health Education , Psychotherapy, Group , Quality of Life , Social Support , Socioeconomic Factors , Stress, Psychological/etiology , Fibromyalgia/therapy , Qualitative Research , Exercise Therapy , Chronic Pain/psychology , Middle Aged
Rev. bras. med. fam. comunidade ; 13(40): 1-9, jan.-dez. 2018. ilus
Article in Portuguese | LILACS, ColecionaSUS | ID: biblio-969413


A síndrome da dor miofascial (SDM) é causa de dor e limitações, sendo bastante prevalente na população. Seu diagnóstico se dá pela apresentação clínica e exame físico, sendo a dor no local o principal sintoma, que conta com uma irradiação característica conforme o músculo acometido. Devido a esta irradiação, a condição pode mimetizar outras situações clínicas comuns e deve ser lembrada como diagnóstico diferencial. Sua identificação e tratamento podem ser feitos de forma simples e o profissional da atenção primária está apto a realizá-los, no entanto, ainda é muito negligenciada, por ser condição pouco estudada. Seu tratamento inclui fármacos, mudanças de estilo de vida, técnicas de fisioterapia e de agulhamento, sendo que este pode ser a seco ou com injeção de substâncias. O agulhamento com infiltração anestésica parece ser técnica eficaz na desativação de pontos-gatilho musculares e aparenta ser superior às demais em alguns estudos, com a vantagem de ser menos doloroso em sua realização. O objetivo deste estudo é realizar uma revisão da literatura sobre a SDM, levando em conta o quadro clínico, o diagnóstico e o tratamento, retratando resultados com diversas técnicas de agulhamento e comparando-as entre si e com demais técnicas.

Myofascial pain syndrome (MPS) causes pain and limitations, being quite prevalent in the population. The diagnosis is due to the clinical presentation and physical examination, being the local pain the main symptom, which counts with a characteristic irradiation according to the affected muscle. Due to this irradiation, the condition may mimic other common clinical situations and should be remembered as a differential diagnosis. Its identification and treatment can be done in a simple way and the primary care professional is able to perform them, however, it is still neglected, being a poorly studied condition. Treatment includes drugs, lifestyle changes, physiotherapy and needling techniques, which can be dry or injected. Needling with anesthetic infiltration seems to be an effective technique in the deactivation of muscle trigger points and seems to be superior to others in some studies, with the advantage of being less painful in its accomplishment. The objective of this study is to perform a literature review on MPS, taking into account the clinical presentation, diagnosis and treatment, portraying results with several needling techniques and comparing them with each other and with other techniques.

El síndrome del dolor miofascial (SDM) es causa de dolor y limitaciones, siendo bastante prevalente en la población. Su diagnóstico se da por la presentación clínica y examen físico, siendo el dolor en el lugar el principal síntoma, que cuenta con una irradiación característica conforme el músculo acometido. Debido a esta irradiación, la condición puede mimetizar otras situaciones clínicas comunes y se debe recordarla como diagnóstico diferencial. Su identificación y tratamiento se pueden hacer de forma sencilla y el profesional de la atención primaria es capaz de realizarlos, sin embargo, todavía es muy descuidada, por ser una condición poco estudiada. El tratamiento incluye fármacos, cambios de estilo de vida, técnicas de fisioterapia y de aguja, siendo que éste puede ser en seco o con inyección de sustancias. El punzonado con infiltración anestésica parece ser técnica eficaz en la desactivación de puntos-gatillo musculares y parece ser superior a las demás en algunos estudios, con la ventaja de ser menos doloroso en su realización. El objetivo de este estudio es realizar una revisión de la literatura sobre la SDM, teniendo en cuenta el cuadro clínico, el diagnóstico y el tratamiento, retratando resultados con diversas técnicas de punzonado y comparándolas entre sí y con otras técnicas.

Fibromyalgia/diagnosis , Fibromyalgia/therapy , Trigger Points , Pain Management , Injections , Acupuncture , Physical Therapy Specialty , Saline Solution , Lidocaine
Bogotá; s.n; 2018. 1-54 p. tab.
Thesis in Spanish | LILACS, MTYCI | ID: biblio-1140555


La fibromialgia (FM), es un síndrome clínico común y complejo, de origen neurológico y psicosomático, crónico, insidioso, caracterizado por dolor de diseminación musculoesquelética de predomino en cuello, espalda, hombros, cintura pélvica y extremidades, asociado a otros síntomas. Esta patología afecta del 2-4% de la población mundial, con una proporción 4 mujeres por 1 hombre, siendo incapacitante en 1/3 de los pacientes que la padecen, en Colombia el 90% de la población es subdiagnósticada y por lo tanto recibe una atención deficiente y no integral. Esta monografía como objetivo estudiar la etiología, fisiopatología, diagnóstico y tratamiento desde la medicina occidental, así mismo dar un abordaje desde el sistema medico complejo de la medicina tradicional china, haciendo énfasis en los principios de tratamiento y los múltiples procedimientos terapéuticos con se podría tratar los pacientes con fibromialgia, siendo esta una herramienta útil, integral, económicamente accesible y valiosa en nuestro medio. Se realizó una búsqueda exhaustiva de información bibliográfica en bases de datos reconocidas y revistas indexadas, en donde se incluyeron diferentes tipos de estudios clínicos y revisiones sistemáticas, adicionalmente se consultaron libros, trabajos de grado, consensos médicos y opinión de expertos. Se describen terapéuticas utilizadas en la Escuela Nacional de Homeopatía Humana del Instituto Politécnico Nacional (IPN) y el consultorio particular del Dr. Roberto González, sitios donde se realizó la pasantía de la Maestría, observando excelentes resultados y evolución de los pacientes quienes padecen fibromialgia.

Humans , Fibromyalgia/therapy , Acupuncture , Complementary Therapies , Medicine, Chinese Traditional
Braz. j. med. biol. res ; 51(4): e6775, 2018. tab, graf
Article in English | LILACS | ID: biblio-889055


The aims of this study were 1) to characterize the intensity of the vibration stimulation in women diagnosed with fibromyalgia (FM) compared to a control group of healthy women (HW) matched by age and anthropometric parameters, and 2) to investigate the effect of a single session of whole body vibration (WBV) on inflammatory responses. Levels of adipokines, soluble tumor necrosis factor receptors (sTNFr1, sTNFr2), and brain-derived neurotrophic factor (BDNF) were determined by enzyme-linked immunosorbent assay. Oxygen consumption (VO2) was estimated by a portable gas analysis system, heart rate (HR) was measured using a HR monitor, and perceived exertion (RPE) was evaluated using the Borg scale of perceived exertion. Acutely mild WBV increased VO2 and HR similarly in both groups. There was an interaction (disease vs vibration) in RPE (P=0.0078), showing a higher RPE in FM compared to HW at rest, which further increased in FM after acute WBV, whereas it remained unchanged in HW. In addition, there was an interaction (disease vs vibration) in plasma levels of adiponectin (P=0.0001), sTNFR1 (P=0.000001), sTNFR2 (P=0.0052), leptin (P=0.0007), resistin (P=0.0166), and BDNF (P=0.0179). In conclusion, a single acute session of mild and short WBV can improve the inflammatory status in patients with FM, reaching values close to those of matched HW at their basal status. The neuroendocrine mechanism seems to be an exercise-induced modulation towards greater adaptation to stress response in these patients.

Humans , Female , Middle Aged , Vibration , Exercise , Fibromyalgia/blood , Fibromyalgia/therapy , Inflammation Mediators/blood , Oxygen Consumption/physiology , Enzyme-Linked Immunosorbent Assay , Biomarkers/blood , Case-Control Studies , Interleukin-8/blood , Receptors, Tumor Necrosis Factor/blood , Brain-Derived Neurotrophic Factor/blood , Leptin/blood , Resistin/blood , Adipokines/blood , Heart Rate/physiology , Inflammation/blood , Inflammation/therapy
Rev. bras. enferm ; 69(6): 1115-1123, nov.-dez. 2016.
Article in Portuguese | LILACS, BDENF | ID: biblio-829840


RESUMO Objetivos: analisar o modelo da terapia comunitária integrativa para o empoderamento de pessoas que vivem com fibromialgia e discutir a repercussão dessa intervenção interdisciplinar no processo saúde-doença e autocuidado. Método: estudo qualitativo de abordagem participativa, desenvolvido em 2015 com 11 participantes, no Laboratório de Fisiologia aplicada à Educação Física da Universidade do Estado do Rio de Janeiro, RJ. A produção de dados abrangeu o World Café, a observação participante e entrevista semiestruturada. A análise foi realizada segundo Bardin, pela triangulação de dados em diálogo com a literatura pertinente. Resultados: o grupo de terapia comunitária integrativa é um dinamizador na construção e ampliação do conhecimento sobre a fibromialgia e no empoderamento para o autocuidado. Conclusão: esta estratégia de grupo revelou-se um instrumento de práxis interdisciplinar que permite construir redes solidárias de cuidado. Desse modo, gerou-se o conhecimento compartilhado, transformado em ambiente de escuta e reflexão para gerir os obstáculos pessoais e familiares.

RESUMEN Objetivos: analizar el modelo de terapia comunitaria integradora para el empoderamiento de las personas que viven con fibromialgia y discutir el impacto de esta intervención interdisciplinaria en el proceso de salud-enfermedad y autocuidado. Método: estudio cualitativo de enfoque participativo, desarrollado en 2015 con 11 participantes en el Laboratorio de Fisiología aplicada a la Educación Física de la Universidade do Estado do Rio de Janeiro, RJ. La producción de datos incluyó el World Café, la observación participante y la entrevista semi-estructurada. El análisis se realizó de acuerdo con Bardin por la triangulación de los datos en diálogo con la literatura relevante. Resultados: el grupo de terapia comunitaria integradora es una fuerza impulsora en la construcción y ampliación de conocimientos sobre la fibromialgia y el empoderamiento para el autocuidado. Conclusión: esta estrategia de grupo ha demostrado ser una herramienta de praxis interdisciplinaria que permite la construcción de redes de solidaridad de la atención. Así, se ha generado conocimiento compartido, transformado en un ambiente de escucha y reflexión para manejar los obstáculos personales y familiares.

ABSTRACT Objectives: to analyze the integrated community therapy model for the empowerment of people living with fibromyalgia and discuss the impact of this interdisciplinary intervention in the health-disease process and self-care. Method: a participatory-approach qualitative study, developed in 2015 with 11 participants at the Laboratory of Physiology Applied to Physical Education of the Rio de Janeiro State University, RJ. Data production comprised World Café, participant observation and semi-structured interview. The analysis was performed according to Bardin, through data triangulation in dialogue with the relevant literature. Results: the integrated community therapy group is a driving force in building and expanding knowledge about fibromyalgia and in self-care empowerment. Conclusion: this group strategy proved to be an interdisciplinary praxis tool that enables the development of solidary care networks. Thus, shared knowledge was generated, transformed into a listening and reflection environment to manage personal and family obstacles.

Humans , Male , Female , Adult , Fibromyalgia/therapy , Patient Care Team , Self Care , Brazil , Community Health Nursing , Delivery of Health Care, Integrated , Fibromyalgia/nursing , Interviews as Topic , Patient Education as Topic , Psychotherapy, Group , Surveys and Questionnaires
Rev. bras. reumatol ; 55(3): 209-215, May-Jun/2015. tab
Article in Portuguese | LILACS | ID: lil-752082


Objetivo: Avaliar e comparar o efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres climatéricas com e sem fibromialgia. Métodos: Participaram 90 mulheres climatéricas, divididas em dois grupos: fibromialgia (47) e controle (43). As pacientes foram avaliadas nas variáveis: qualidade de vida (Utian Quality of Life [UQOL]), função sexual (questionário do quociente sexual/versão feminina [QS-F]) e intensidade dos sintomas climatérios (Índice Menopausal de Blatt-Kupperman [IMBK]). Os grupos fizeram cinesioterapia para o assoalho pélvico, composto de 20 sessões, duas vezes por semana. Análise estatística foi feita por meio dos testes t de Student pareado, análise de variância de delineamento misto e Kappa de Cohen. Resultados: Na qualidade de vida, foi observada melhoria em ambos os grupos para todos os domínios avaliados. Na análise intergrupo foi evidenciada diferença nos domínios emocional (p = 0,01), saúde (0,03) e sexual (p = 0,001) com ganhos mais expressivos para o grupo controle. Na função sexual, foi verificada melhoria nos grupos, após a intervenção; na análise intergrupo as fibromiálgicas apresentaram escores inferiores ao grupo controle (p < 0,001). Em relação aos sintomas climatéricos não houve diferença na análise intergrupo pós-intervenção (p = 0,73). Entretanto, ambos os grupos apresentaram redução significativa da sintomatologia após a intervenção (p < 0,001). Conclusões: A cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e sem fibromialgia na fase do climatério. Entretanto, a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados .

Objective: To evaluate the effect of the kinesiotherapy in the quality of life, sexual function and menopause-related symptoms and compare in climacteric women with and without fibromyalgia (FM). Methodology: The group was composed of 90 climacteric women divided in 2 groups: FM (47) and control (43). The patients were analyzed on their quality of life (Utian Quality of Life [UQoL]), sexual function (Sexual Quotient-Female Version [SQ-F] questionnaire) and intensity of the climacteric symptoms (Blatt–Kupperman menopausal index [BKMI]). Both groups performed pelvic floor kinesiotherapy, composed of 20 sessions, twice a week. Statistical analysis was performed using Student's t-test, mixed-design analysis of variance (ANOVA) and Cohen's Kappa. Results: In the quality of life, an improvement was noticed in both groups for all domains analyzed. In the comparison between groups it was noticed a difference in the emotional (p = 0.01), health (p = 0.03) and sexual (p = 0.001) domains with considerable gains verified in the control group. Improvement was also noticed in the sexual function. In the analysis between groups, FM group showed a lower score compared to the control group (p < 0.001). With respect to the climacteric symptoms, there was no difference in the analysis between groups after the intervention (p < 0.001). Conclusions: The pelvic floor kinesiotherapy promotes a positive effect in the domains of quality of life, sexual function and climacteric symptoms in women with and without fibromyalgia in the climacteric period; however, fibromyalgia seems to be a limiting factor to achieve better results in some of the aspects evaluated. .

Humans , Female , Middle Aged , Aged , Fibromyalgia/therapy , Physical Therapy Modalities , Quality of Life , Fibromyalgia/physiopathology , Menopause , Sexuality/physiology