Objective: To investigate the effect of motion-controlled videogames on pain, functionality, cardiopulmonary capacity, and quality of life in women with fibromyalgia. Materials and Methods: Forty women with fibromyalgia were randomized into virtual reality group (VRG) and conventional training group (CTG). The CTG performed aerobic exercise (cycling, 3 days per week, 20 minutes per day) and conventional exercises (muscle strengthening, balance, and flexibility, 3 days per week, 15 minutes per day) for 4 weeks. The VRG performed virtual reality exercise (volleyball, Microsoft Xbox Kinect Ò , 3 days per week, 15 minutes per day) together with cycling exercise for 4 weeks. After the exercise program, both groups received the same home exercise program for 4 weeks. All patients were evaluated at baseline, fourth, and eighth weeks. Primary outcome measure was Fibromyalgia Impact Questionnaire. Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale, Fatigue Severity Scale (FSS), Symptom Severity Scale, EuroQol-Five Dimensions _ Index Scale/Visual Analogue Scale (EQ-5D-index/VAS) and Six Minute Walk Test (6MWT) were used as secondary outcome measures. Results: Thirty-four patients (17 VRG, 17 CTG) were evaluated at the eighth week. After 4 weeks, all outcome measures improved significantly in both groups (P < 0.05). However, there was no statistically significant difference in all outcome measures between fourth and eighth weeks. Group and time interactions for 6MWT (P = 0.043), FSS (P = 0.026), EQ-5D-_ Index Scale (P = 0.014), and EQ-5D-VAS (P = 0.049) were significant only for the VRG. In addition, median individual's satisfaction was significantly higher in the VRG (P < 0.001). Conclusion:Virtual reality exercises along with aerobic exercise increase cardiopulmonary capacity and quality of life in fibromyalgia syndrome. In addition, they increase patient satisfaction and may improve patient compliance to exercise.
This study aims to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the management of rheumatic diseases (RD). An online survey included 10 questions were designed to assess potential differences in rheumatology practice. The survey was conducted between March 2021 and June 2021. Marginal homogeneity test was used to compare frequencies of outpatient clinic patients between the pre-pandemic and pandemic. Other results were analyzed by descriptive statistics. One hundred three clinicians (75.7% in rheumatology practice for at least five years) responded to the survey. Almost 70% examined < 30 patients per day during the pandemic while nearly 70% examined ≥ 30 patients per day before the pandemic (p < 0.001). They indicated following reasons for decreasing outpatient clinic activity were concerns regarding COVID-19 transmission risk of the patients (95%) and the clinicians (53%), being able to supply chronic medications directly from the pharmacy (85%), lockdown (71%), limited outpatient appointments (64%) and using telemedicine (20%). The frequencies of rheumatology daily routine procedures were decreased as follows; patient hospitalization for diagnosing (80%) and treatment (78%), labial salivary gland biopsy (63%), Schirmer's test/salivary flow rate test (56%), nail bed video-capillaroscopy (52%), musculoskeletal ultrasonography (51%) and Pathergy test (50%). Clinicians hesitated to use rituximab (63%) mostly, followed by cyclophosphamide (53%), glucocorticoids (43%), tofacitinib (41%), mycophenolate mofetil (36%), and azathioprine (33%). In this first national survey, the prominent differences in the management of RD have decreased outpatient clinic activity, reduced rheumatology daily procedures, and hesitancy to use some rheumatic drugs.
Background:Fibromyalgia Syndrome (FMS) is a clinical condition with many symptoms such as chronic generalized pain, fatigue, sleep disorder, cognitive dysfunction and depressive mood. Management of FMS is difficult and the most important component is regular exercise.1 In this syndrome, patients generally have compliance and motivation problems in maintenance of exercises. In recent years, exercises, with fun and game components, have been prescribed to increase patient compliance.2 Motion-controlled video games targeting virtual reality are examples of these exercises.3 Objectives:To investigate the effect of motion controlled video games on pain, functionality, cardiopulmonary capacity and quality of life in fibromyalgic women.Methods:Forty women (> 18 years) who have FMS were included in study. Patients were randomized into study and control groups. Control group performed aerobic exercise (cycling, 3 days/week, 20 minutes/day) for 4 weeks. Study group performed virtual reality exercise (Volleyball, Microsoft Xbox Kinect®, 3 days/week, 15 minutes/day) together with cycling exercise. After the four week supervised exercise program, both groups received the same home exercise program for four weeks. All patients were evaluated at baseline, 4th and 8th weeks. Primary outcome measure was Fibromyalgia Impact Questionnaire. Visual Analog Scale (VAS), Hospital Anxiety and Depression Scale, Fatigue Severity Scale (FSS), Symptom Severity Scale, EuroQol-Quality of Life/Visual Analogue Scale (EQ5D-QoL/VAS) and 6 Minute Walk Test (6MWT) were used as secondary outcome measures. Positive and Negative Affect Schedule (PANAS) was used for patient satisfaction. T-test was used to compare demographic data between two groups. Repeated measures ANOVA was used in evaluation of intra-group efficiency of treatment. Treatment group and time interaction was evaluated by two-way analysis of variance. We calculated 20 patients per group, in order to find 14% minimal clinical difference in Fibromyalgia Impact Questionnaire with 80% power and 0.05 error rate (Tip 1 error).4 Results:All patients completed supervised exercise program (4 weeks). 34 patients (17 study group, 17 control group) were evaluated at the 8th week. Age, body mass index, education status, comorbidities and drug use were similar in both groups (p> 0.05). After four weeks, all outcome measures improved significantly in both groups (p<0.05). However, there was no statistically significant difference in all outcome measures between 4th and 8th weeks. Group and time interactions for 6MWT (F (1.21, 46.33) = 4.04, p = 0.043), FSS (F (1.61, 61.24) = 4.21, p = 0.026), EQ5D-QoL Scale (F (2, 76) = 4.55, p = 0.014) and EQ5D-VAS Scale (F (1.4, 53.55) = 3.59, p = 0.049) were significant only for the study group. In addition, PANAS score was significantly higher in study group (p <0.001).Conclusion:Virtual reality exercises along with aerobic exercise increase cardiopulmonary capacity and quality of life in FMS. In addition, they increase patient satisfaction and may improve patient ...
Objectives: This study aimed to analyze the research, publication activities, and perspectives on clinical practices of rheumatology practitioners during the coronavirus disease 2019 (COVID-19) pandemic. Materials and methods: The survey-based cross-sectional study was designed online and included 24 closed-ended questions. After performing a pilot test and validation of survey, it was conducted among clinicians between September 2021 and December 2021. Results: One-hundred fifteen clinicians (54 males, 61 females; 78.1% in rheumatology practice for at least five years) responded to the survey. The respondents indicated that they worked in coronavirus-related departments, comprising inpatient service (50.4%), consultancy (42.6%), and outpatient clinic (27.8%). Around 40% of clinicians stated they spent less time on scientific research (43.1%) and clinical learning activities (43.2%), while almost the same proportion of them spent more (41.1% and 45.0%, respectively). This study revealed that 53.5% published at least one paper covering mostly COVID-19 in the scientific citation index (SCI) or SCI-expanded (SCI-E) indexed journals. However, nearly half of them did not have any papers published in the SCI/SCI-E (46.5%) or non-SCI/SCI-E indexed (44.6%) journals. Regarding the perspectives of clinicians about clinical practices, they considered fewer biological (57.0%) and nonbiological (55.0%) drug usage, reported fewer outpatient clinic visits (88.2%), more newly diagnosed rheumatic diseases (62.5%), and more disease exacerbations (31.2%). Most of the clinicians (range, 76.2 to 86.3%) thought they accurately managed their patients during the COVID-19 pandemic. Conclusion: Clinicians published mostly coronavirus-related papers in the pandemic era, and in the self-assessment, clinicians thought that they correctly manage their patients. In addition, this study reflected the frequency of academic publications and clinicians’ work routines during the pandemic.
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