Impact of fibromyalgia on sexual function in women.

BACKGROUND: The prevalence of sexual problems is very high among women with fibromyalgia. OBJECTIVE: To evaluate the prevalence of sexual problems in women with FM and the potential association among physical activity, quality of life and sexual function. We aimed to contribute in the understanding of the relationships between sexual function and the symptoms of FM. METHODS: The sample of this cross-sectional study comprised 113 women with FM and 116 age-matched women without FM. Sexual function was assessed using the 15D questionnaire. Health-related quality of life (using EQ-5D-5L and 15D questionnaires), impact of fibromyalgia and physical activity were also assessed. RESULTS: The prevalence of sexual problems among women with fibromyalgia was 76%, while it was 15% in healthy controls. This prevalence was even higher among those aged 50 or over. Sexual function was significantly associated with quality of life, distance walked, impact of fibromyalgia and four of the symptoms: depression, anxiety, tenderness and memory problems. CONCLUSION: More than three out of four women with fibromyalgia have any kind of sexual problem. Depression, anxiety and tenderness seems to be the most relevant symptoms associated with sexual function. Physical activity may be protective and reduce the risk of having sexual problems.

Application of EQ-5D-5L questionnaire in patients suffering from urinary incontinence. / Aplicación del cuestionario EQ-5D-5L en pacientes que padecen incontinencia urinaria.

BACKGROUND: Urinary incontinence is associated with reduced quality of life and given the high prevalence of people with this condition, it could be useful to know the impact of having urinary incontinence on physical, psychological and social aspects. The Spanish value set of EQ-5D was used to assign single scores to the EQ-5D-5L health states. EQ-5D-5L is a health-related quality of life questionnaire, which allows assessing health status. The aim of this study was to provide normative values of EQ-5D-5L in a population sample with urinary incontinence. STUDY DESIGN: Cross-sectional study. METHODS: A total of 965 people with urinary incontinence (297 men and 668 women) were included in this study. EQ-5D-5L index, VAS and health status are showed in the current study considering gender, age group, region, marital status, smoking status, net monthly incomes of household and educational level. RESULTS: Higher prevalence was observed in women (69.22%) compared with men (30.78%). Mean (SD) EQ-5D-5L utility index and VAS score were 0.58 (0.40) and 53.91 (22.16), respectively, for overall population. The 16.1% (155 people) reported perfect health status (11111). The utility equivalent to set values 55555 was not reported by anyone. CONCLUSION: This study provides normative values of EQ-5D-5L in a Spanish population sample with urinary incontinence.

Whole body vibration training improves vibration perception threshold in healthy young adults: A randomized clinical trial pilot study.

OBJECTIVES: Loss of foot sensitivity is a relevant parameter to assess and prevent in several diseases. It is crucial to determine the vibro-tactile sensitivity threshold response to acute conditions to explore innovative monitor tools and interventions to prevent and treat this challenge. The aims were: 1) to analyze the acute effects of a single whole body vibration session (4min-18Hz-4mm) on vibro-tactile perception threshold in healthy young adults. 2) to analyze the 48 hours effects of 3 whole body vibration sessions on vibro-tactile perception threshold in healthy young adults. METHODS: A randomized controlled clinical trial over 3 sessions of whole body vibration intervention or 3 sessions of placebo intervention. Twenty-eight healthy young adults were included: 11 experimental group and 12 placebo group. The experimental group performed 3 sessions of WBV while the placebo group performed 3 sessions of placebo intervention. RESULTS: The vibro-tactile threshold increased right after a single WBV session in comparison with placebo. Nevertheless, after 3 whole body vibration sessions and 48 hours, the threshold decreased to values lower than the initial. CONCLUSIONS: The acute response of the vibro-tactile threshold to one whole body vibration session increased, but the 48 hours short-term response of this threshold decreased in healthy young adults.

Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011.

PURPOSE: To derive EQ-5D-5L Spanish population norms based on a national representative sample adjusted by age, gender and region. METHODS: A representative sample of the Spanish general population (n = 21,007) was used in a cross-sectional study. The source of data was the Spanish National Health Survey 2011-2012. All socio-demographic factors and clinical characteristics were carried to a descriptive analysis. All variables were stratified by region, gender and age-group. RESULTS: The utility value 1 is the most repeated (62%) in this representative population sample. This study showed a deterioration of health states as age increases. Overall, men reported better health status than women. In relation to ceiling effect by regions, there was little difference with the highest scores. Conversely, the lowest score corresponds to Galicia. CONCLUSIONS: The paper reports EQ-5D-5L normative data for Spanish general population, based on a national representative sample adjusted by region, gender and age-group. These results may serve as reference data of the population health status. A regional difference in health status could be observed, which might suggest that policies aiming to reduce regional inequalities are important.

VALIDATION AND COMPARISON OF EQ-5D-3L AND SF-6D INSTRUMENTS IN A SPANISH PARKINSON´S DISEASE POPULATION SAMPLE.

INTRODUCTION: generic, preference-based Health- Related Quality of Life instruments are receiving growing attention in health-care decision-making process. In spite of this, to our knowledge, EQ-5D and SF-6D have never been compared in a Parkinson´s disease population sample. OBJECTIVE: the aim of this paper was to assess the psychometric properties of both instruments in a Spanish PD population sample. METHODS: a total sample of 133 patients were interviewed using EQ-5D-3L and SF-6D. The validity, level of agreement and sensitivity of both instruments were computed and then compared. The Spanish tariff has been used in both instruments. RESULTS: utilities of EQ-5D-3L and SF-6D have shown a strong correlation (r >0.50 and p<0.001) with the summary score of the PDQ-8 and the EQ-VAS score. Significant differences were observed in the stages III-IV of the Hoehn & Yahr stage. SF-6D had 51% higher efficiency than EQ-5D at detecting differences in symptoms severity. DISCUSSION: both EQ-5D-3L and SF-6D seem to be adequate generic Health-Related Quality of Life measures in terms of validity and sensitivity. CONCLUSION: EQ-5D-3L presents greater ceiling and floor effects than the SF-6D instrument in this sample. Besides, the instrument SF-6D was better at detecting changes in symptoms severity compared with EQ-5D-3L.

Introducción: el uso de cuestionarios de calidad de vida basados en preferencias poblacionales están recibiendo cada vez más atención en el proceso de toma de decisiones en el ámbito sanitario. Sin embargo, a nuestro entender, EQ-5D y SF-6D nunca han sido comparados en una muestra de población con la enfermedad de Parkinson. Objetivo: el objetivo de este trabajo fue evaluar las propiedades psicométricas de ambos instrumentos en una muestra de población española con enfermos de Parkinson. Métodos: un total de 133 pacientes fueron entrevistados utilizando EQ-5D y SF-6D. La validez, el grado de acuerdo y la sensibilidad de ambos instrumentos fueron calculados para su posterior comparación. Las preferencias de la población española fueron utilizadas en ambos instrumentos. Resultados: las utilidades de EQ-5D y SF-6D han mostrado una fuerte correlación (r> 0,50 y p.

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance.

OBJECTIVE: To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. METHODS: A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. RESULTS: Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. CONCLUSION: FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.

A web-based intervention to improve and prevent low back pain among office workers: a randomized controlled trial.

OBJECTIVES: To test the feasibility, safety, and efficacy of a web-based multidisciplinary intervention for office workers with subacute, nonspecific low back pain. METHODS: The randomized controlled trial included 100 office workers with subacute low back pain. The intervention group had access to both the study intervention and standard care. The control group had access to standard care only. Standard care was defined as all existing non-web-based interventions offered by the University of Extremadura's Preventive Medicine Service. The web-based program was offered via the Preventive Medicine Service website. The participants in the intervention group were asked to engage in the web-based program at their work site for 11 minutes each day, 5 days a week. Primary outcomes were functional disability, as measured by the Roland-Morris Disability Questionnarie, and health-related quality of life, as measured by the European Quality of Life-5 Dimensions-3 Levels. Secondary outcomes were the number of episodes of low back pain and trunk muscles endurance. Outcomes were measured before and after the 9-month intervention period. RESULTS: Over the 9-month study, the score on the Roland-Morris Disability Questionnaire for the participants in the web-based intervention group improved by a mean of -7.36 points (95% confidence interval [CI]:-8.41, -6.31) compared to a worsening of 1.89 points (95% CI: 0.71, 2.65) in the control group. The between-group difference in change on the Roland-Morris Disability Questionnarie over the study period was -9.25 points (95% CI:-10.57, -7.89). Similarly, over the compared to the control group. CONCLUSIONS: A 9 month web-based intervention is feasible and effective to improve function and health-related quality of life and to decrease episodes of low back pain among office workers with a history of subacute, nonspecific low back pain.

Musculoskeletal fitness and health-related quality of life characteristics among sedentary office workers affected by sub-acute, non-specific low back pain: a cross-sectional study.

OBJECTIVES: To establish the level of musculoskeletal fitness and health-related quality of life (HRQoL) in sedentary office workers with sub-acute, non-specific low back pain, and compare the results with reference data for healthy sedentary office workers. DESIGN: Cross-sectional study. SETTING: Occupational secondary prevention setting. PARTICIPANTS: One-hundred and ninety sedentary office workers: 118 suffering from sub-acute, non-specific low back pain (47 men and 71 women) and 72 age-matched healthy controls (30 men and 42 women). MAIN OUTCOME MEASURES: Participants were assessed using a musculoskeletal fitness battery (sit-and-reach test, hand grip strength, lumbar and abdominal trunk muscle endurance, and back scratch test), the EuroQol-5D-3L, Oswestry Disability Questionnaire, and Roland Morris Disability Questionnaire. Data for both genders and conditions were compared. RESULTS: Subjects with low back pain achieved lower scores in most of the fitness tests compared with healthy, age-matched controls. Trunk flexor and extensor endurance demonstrated the greatest difference in both men {flexion: median difference 59 [95% confidence interval (CI) 26 to 90]seconds; extension: median difference 24 [95% CI 20 to 68]} and women [flexion: median difference 59 (95% CI 5 to 85.50)seconds; extension: median difference 41 (95% CI 30 to 55)seconds]. Differences in HRQoL were also demonstrated between groups for both men and women, with the exception of the pain/discomfort dimension in women. CONCLUSIONS: Sedentary office workers with sub-acute, non-specific low back pain had lower musculoskeletal fitness than healthy, age-matched controls, with the main difference found in endurance of the trunk muscles. HRQoL was also lower in workers with low back pain.

Whole body vibration improves the single-leg stance static balance in women with fibromyalgia: a randomized controlled trial.

AIM: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain. Fibromyalgia is associated with balance problems and increased fall frequency. Whole-body vibration therapy had been used for improve balance in special populations but not in fibromyalgia. The main objective of this study was to analyze the effects of 12 weeks of tilting whole-body vibration therapy on static balance in fibromyalgia patients. METHODS: Women with FM were randomly and sequentially assigned to either the vibration group (N.=21) or the control group (N.=20) based on a randomly generated number table, and a code number was assigned to each participant. All participants received standard care that included medical care through the public health system (hospital and outpatient clinic, including primary care) and social support through the local fibromyalgia association. Participants in the exercise group received whole-body vibration therapy (12 weeks, 12.5 Hz frequency and 3 mm amplitude). Outcome measure was determined using postural stability indices (overall, anterior-posterior and medial-lateral) assessed by the Biodex Balance System in a single dominant limb stance. RESULTS: Treatment effect after 12-weeks of tilting whole body vibration therapy were 57.1% on overall stability and 66.6% on anterior-posterior stability. CONCLUSION: Tilting whole-body vibration therapy effectively improves static balance in patients with FM.