Objective: To investigate the effects of muscle stretching exercises and physical conditioning as physical therapy treatment for fi bromyalgia. Methods: Fifteen women with a diagnosis of fi bromyalgia in accordance with the criteria of the American College of Rheumatology were evaluated and divided into two groups: Group 1 (G1, eight patients) underwent treatment consisting of muscle stretching and Group 2 (G2, seven patients), participated in a physical conditioning program. Sleep quality, pain-modulating factors, associated symptoms and medications used were evaluated. Furthermore, the Fibromyalgia Impact Questionnaire (FIQ) was applied to evaluate the impact of fi bromyalgia. The treatment lasted for eight weeks, with one session per week of 40 to 45 minutes in duration. The FIQ data obtained before and after treatment were analyzed by means of Student's t test for dependent samples (α< 0.05) and other variables were analyzed descriptively. Results: Most of the patients presented poor quality of sleep (86.67%). Many presented worsening of their pain when doing domestic tasks (40%) and there were no factors that relieved their pain (28.57%). All presented sleep disorders with associated symptoms (100%) and most used antidepressives (69.23%). For the FIQ data, statistically signifi cant differences were observed in morning tiredness (p= 0.0428) and stiffness (p= 0.0130) among the G1 patients. Conversely, no difference was observed in G2 after the treatment. Conclusions: It is suggested that the muscle stretching may have had a positive impact on fi bromyalgia, with reductions in morning tiredness and stiffness among the patients evaluated.
Background:Health education is pointed out as the front line in non-pharmacological approaches in fibromyalgia.Objectives:To develop an interdisciplinary educational program to promote the health of individuals with fibromyalgia in Brazil.Methods:This is a qualitative study, through a focus group, carried out in a Basic Health Unit in the city of São Paulo, SP. The guiding questions were about the needs and demands exposed by patients with fibromyalgia and health professionals who work in primary health care. 12 individuals with fibromyalgia and 10 health professionals participated. The data were analyzed using the content analysis method proposed by Bardin, specifically the thematic content analysis.Results:Amigos de Fibro (Fibro Friends) should be conducted through lectures, dynamics and conversation circles. The educational program must include 15 meetings with weekly frequency. The meetings are: 1st to present the program and socialization activities. 2nd: Doctor presents the concepts of fibromyalgia. 3rd: Nurse informs about practices and environments that favor self-care. 4th: Social Worker shows the importance of support. 5th: Physiotherapist shows the main body practices and physical activity. 6th: Nutritionist presents an adequate and healthy diet. 7: Psychologist shows mental health practices. 8th: Pharmacist informs about medicines. 9, 11 and 13: participants perform activities at home. 10: Naturologist presents integrative and complementary practices. 12th: Occupational Therapist encourages methods to save energy. Day 14: Speech therapist helps in the quality of sleep. 15: closing activity.Conclusion:Amigos de Fibro is a program that presents interdisciplinary educational information for individuals with fibromyalgia, being considered a trend of care for the future. The next step is to conduct a clinical trial to verify the effect of this intervention and then implement it in the health service in Brazil. Fibro Friends was created from the conjunct action of patients and healthcare professionals, it can be an effective educational tool to be implemented at primary health attention centers, promoting the self-care, life quality and the promotion of health in individuals with Fibromyalgia. Fibro Friends is an excellent tool for patient education and counseling in Brazil.References:[1]Antunes M, Ferreira A, Oliveira D, Júnior JN, Bertolini S, Marques AP. There is association between the level of physical activity and quality of life of women with fibromyalgia?. Annals of rheumatic diseases. 2019;78(2)650-1. http://dx.doi.org/10.1136/annrheumdis-2019-eular.2835.[2]García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, Toledano-Moreno S, Casas-Barragán A, Correa-Rodríguez M et al. Effectiveness of health education in patients with fibromyalgia: a systematic review. European Journal of Physical and Rehabilitation Medicine. 2019;55(2):301-13. https://doi.org/10.23736/S1973-9087.19.05524-2.[3]Oliveira DV, Ferreira AAM, Oliveira DCD, Leme DEDC, Antunes MD, Nascimento Júnior JRAD. Association of the practice of physical activity and of health status on the quality of life of women with fibromyalgia. Journal of Physical Education. 2019;30(1): e3027. https://doi.org/10.4025/jphyseduc.v30i1.3027.[4]Stuifbergen AK, Blozis SA, Becker H, Phillips L, Timmerman G, Kullberg V, et al. A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome. Clinical Rehabilitation. 2010;24(4):305-18. https://doi.org/10.1177/0269215509343247.Acknowledgements:This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.Disclosure of Interests:None declared
Background:Fibromyalgia is a rheumatic disorder characterized by chronic widespread pain often associated with fatigue, unrefreshed sleep and cognitive problems with an increasing prevalence. Aquatic therapy has already been used for managing the symptoms of this syndrome. However, it is not clear whether there is a superiority of aquatic therapy over land-based therapy in improving the symptoms of fibromyalgia patients.Objectives:Determine the effectiveness of two physiotherapy protocols: aquatic therapy versus land-based therapy, for decreasing pain in women with fibromyalgia.Methods:The study protocol was a single-blind randomized controlled trial. Forty women diagnosed with fibromyalgia were randomly assigned into two groups: Aquatic Therapy (n = 20) or Land-based Therapy (n = 20). Both interventions include 60-min therapy sessions, structured into four sections: Warm-up, Proprioceptive Exercises, Stretching and Relaxation. These sessions were carried out three times a week for three months. The variables analyzed were: pain intensity (Visual Analogue Scale [VAS]), pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire [FIQR]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), fatigue (Multidimensional Fatigue Inventory [MFI]) and physical ability (6-minute Walk Test [6MWT]). Outcome measures were evaluated at baseline, at the end of the 3-month intervention period, and 6-weeks post-treatment. Statistical analysis will be carried out using the SPSS 21.0 program for Windows and a significance level of p ≤ 0.05 was used for all tests.Results:At the end of intervention period, both therapies were effective in improving pain intensity (p<0.05), pain threshold (p<0.05), quality of life (p<0.05), fatigue (p<0.05) and physical ability (p<0.05). For sleep quality, only the aquatic therapy group experienced a significant improvement (p=0.033). No differences were observed between the groups in post-treatment, but they were found at the follow-up, in favor of aquatic therapy for pain intensity (p=0.023) and sleep quality (p=0.030).Conclusion:Both physiotherapy interventions showed to be effective in reducing pain in patients with fibromyalgia. However, aquatic therapy was more effective in improving quality of sleep and decreasing pain intensity at six weeks of follow-up than land-based therapy. It seems that the therapeutic effects achieved in post-treatment were maintained for a longer time in the aquatic therapy group. Even so, in order to maintain the benefits obtained with the interventions, continuous physiotherapy treatment seems to be necessary.References:[1]Salgueiro M, García-Leiva JM, Ballesteros J, Hidalgo J, Molina R, Calandre EP. Validation of a Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Health Qual Life Outcomes. 2013; doi: 10.1186/1477- 7525-11-132.[2]Macías JA, Royuela A. La versión española del índice de calidad de sueño de Pittsburgh. Informaciones psiquiátricas. 1996;146:465-72.[3]Munguía-Izquierdo D, Segura-Jiménez V, Camiletti-Moirón D, Pulido-Martos M, Alvarez-Gallardo IC, Romero A, et al. Multidimensional Fatigue Inventory: Spanish adaptation and psychometric properties for fibromyalgia patients. The Al-Andalus study Clin Exp Rheumatol. 2012;30(6):94-102.[4]Gutiérrez-Clavería M, Beroíza T, Cartagena C, Caviedes I, Céspedez J, Gutiérrez-Navas M, et al. Prueba de caminata de seis minutos. Rev Chil Enf Respir. 2009;25:15-24.Disclosure of Interests:None declared
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