IL-10 Cytokine as Potential Biomarkers in Women with Fibromyalgia Who Underwent to a Short Balneotherapy Treatment

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.

Tratamento de restrição e indução do movimento na reabilitação funcional de pacientes pós acidente vascular encefálico: uma revisão bibliográfica / A review about the effectiveness of the constraint induced movement therapy in rehabilitation of patients after stroke

INTRODUÇÃO: O Acidente Vascular Encefálico (AVE) é uma das doenças mais incidentes da hipermodernidade, que resulta em múltiplas sequelas. Uma das mais importantes refere-se à função motora do membro superior afetado que, em geral, é mais lenta que a do membro inferior e não acontece de forma adequada. A Terapia de Restrição e Indução do Movimento (TRIM) tem sido considerada uma técnica de reabilitação da função motora da extremidade hemiparética, capaz de promover melhora funcional deste membro. OBJETIVO: O objetivo deste estudo é realizar uma pesquisa bibliográfica para avaliar a eficácia da TRIM em pacientes acometidos por AVE. Material e Método: o presente estudo é uma revisão bibliográfica de artigos indexados na base de dados PubMed, publicados de janeiro de 2000 a dezembro de 2007, em inglês e português. Na estratégia de busca foram utilizados os unitermos: "cerebrovascular accident", "stroke", "CIMT", "constraint induced movement therapy". RESULTADOS E DISCUSSÃO: de modo geral, as pesquisas demonstram que a TRIM é uma técnica alternativa no campo de reabilitação funcional do membro superior parético, promovendo reorganização cortical, superação do "não uso aprendido" e melhora na quantidade e qualidade de movimentos, e que este efeito é transferido para o dia-a-dia do paciente durante suas atividades de rotina. CONCLUSÃO: a TRIM é um produto do advento científico da fisioterapia que traz benefícios funcionais para os pacientes que se submetem a ela. Porém, faz-se necessário investigar mais detalhadamente essa técnica a fim de reduzir as complicações psicológicas advindas deste tratamento, maximizando, assim, a funcionalidade do membro superior acometido.

INTRODUCTION: The cerebrovascular accident is one of the most incident disease of the modernity, that results in multiple sequels. One of the most important sequel is the impairment of the motor function of the affected upper limb and, usually, the rehabilitation is slower than the lower limb and, often, it does not happen in adequate form. The Constraint Induced Movement Therapy (CIMT) have been considered a rehabilitation technique for the affected upper limb and it’s able to promote the functional recovery of the hemiparetic arm. OBJECTIVE: the aim of this study is conducting a literature search to assess the effectiveness of the CIMT in patients after stroke. Materials and Method: this study is a literature review of articles indexed in the database PubMed, published from 2000 to 2007, in English and Portuguese. In the search strategy was used the following key-words: “cerebrovascular accident”, “stroke”, “constraint induced movement therapy” and “CIMT”. RESULTS AND DISCUSSION: in general, the researches shows that the CIMT is an alternative technique in the field of functional rehabilitation of the paretic arm, promoting cortical reorganization, overcoming of the “learned non-use”, improving the quality of movement and increasing amount of use and, these improvements are transferred to the daily life activities of the patient. CONCLUSION: CIMT is a product of the scientific advent of the physiotherapy that brings functional benefits for the patients after stroke. However, it’s necessary more investigation about this technique to reduce the psychological complications resulting from the treatment, thus maximizing the functionality of the affected upper limb.