ResUMO Objetivo: Desenvolver uma versão transcultural do Fibromyalgia Impact Questionnaire (FIQ) para a população brasileira e analisar sua validade e eficácia quando aplicado em pacientes com fibromialgia. Pacientes e Métodos: Participaram do estudo 44 pacientes com fibromialgia (FM), diagnosticados segundo os critérios do American College of Rheumatology (ACR), 1990. Baseados nas orientações de Guillemin et al (22) , foram convidados quatro professores de língua inglesa, um reumatologista e dois fisioterapeutas. O procedimento seguiu as etapas: tradução inicial por dois professores de inglês, avaliação das duas traduções para uma versão única, versão para a língua inglesa por dois professores de inglês nativos, reunião de consenso com dois professores de inglês, reumatologista e fisioterapeutas para versão teste, avaliação da equivalência cultural, versão final, avaliação da confiabilidade e reprodutibilidade. A versão teste foi aplicada em 20 pacientes com FM, tendo em todas as questões o item "não-aplicável". Substituição de possíveis questões com mais de 15% de respostas "não-aplicável" por outras de mesmo conceito, resultando na versão final. Aplicação dessa versão em 24 pacientes com FM por dois avaliadores que fizeram a entrevista no mesmo dia com intervalo de uma hora e, após um período de sete dias da primeira avaliação, o questionário foi reaplicado pelo primeiro avaliador. Resultados: Na aplicação da versão teste não houve questões com mais de 15% de respostas "não-aplicável". Sendo assim, não foi mudado o texto para a versão final. Porém, houve dificuldade de compreensão das escalas visuais analógicas (questões 4 a 10). Com isso, foram acrescidas "carinhas" nos dois extremos: à esquerda uma "carinha" feliz e à direita, uma infeliz. Esse processo deu Validação da Versão Brasileira do Fibromyalgia Impact Questionnaire (FIQ) Validation of the Brazilian Version of the Fibromyalgia Impact Questionnaire (FIQ)
The trial included a control group and two intervention groups, both of which received exercise programs created specifically for patients with FM. In clinical practice, we suggest including both modalities in an exercise therapy program for FM.
Contexto: Fibromialgia é uma síndrome reumática caracterizada por dor musculoesquelética difusa e crônica, e sítios dolorosos específicos à palpação (tender points). Freqüentemente é associada à fadiga generalizada, distúrbios do sono, rigidez matinal, dispnéia, ansiedade, alterações no humor que podem evoluir para um quadro de depressão. Sendo assim, afeta negativamente a qualidade de vida das pessoas. No entanto, ainda não se sabe o poder de discriminação dos instrumentos de avaliação da depressão e qualidade de vida. O objetivo desse estudo foi avaliar a depressão e a qualidade de vida de pacientes com fibromialgia e avaliar o poder de discriminação de instrumentos relacionados a esses aspectos. Método: Para avaliar a qualidade de vida foram utilizados dois instrumentos: um específico, o Fibromyalgia Impact Questionnaire (FIQ) e outro genérico, o Medical Outcomes Study 36-item Short-Form Healthy Survey (SF-36); para avaliar a depressão, a Escala de Depressão de Beck (BDS). Participaram do estudo 40 mulheres sendo 20 com fibromialgia-Grupo teste e 20 saudáveis-Grupo controle. Os três protocolos foram aplicados aos indivíduos dos dois grupos em uma única sessão de avaliação. Toda a análise estatística foi realizada utilizando-se o teste "t" Student, com significância α = 0,05. Resultados: Houve diferença estatisticamente significante entre os grupos controle e teste em todos os questionários (p<0,05). Os três questionários têm bom poder discriminatório para diferenciar os dois grupos, porém o FIQ é o que tem maior poder de discriminação e o BDS o menor. Conclusão: O grupo de pacientes com fibromialgia tem pior qualidade de vida quando comparado com o grupo controle. Comparando os três questionários todos são eficientes não somente para avaliar a qualidade de vida mas também para avaliar a depressão. Entretanto, como o FIQ é um instrumento específico é o que melhor discrimina o grupo teste do grupo controle, fato este mostrado através dos valores estatisticamente significantes mais altos. Palavras-chave: fibromialgia, depressão, qualidade de vida.
BackgroundThe aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil.MethodsWe cross-sectionally sampled individuals assisted by the public primary health care system (n = 768, 35–60 years old). Participants were interviewed by phone and screened about pain. They were then invited to be clinically assessed (304 accepted). Pain was estimated using a Visual Analogue Scale (VAS). Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ), as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level = 5%).ResultsFrom the phone-interview screening, we divided participants (n = 768) in three groups: No Pain (NP) (n = 185); Regional Pain (RP) (n = 388) and Widespread Pain (WP) (n = 106). Among those participating in the clinical assessments, (304 subjects), the prevalence of fibromyalgia was 4.4% (95% confidence interval [2.6%; 6.3%]). Symptoms of pain (VAS and FIQ), feeling well, job ability, fatigue, morning tiredness, stiffness, anxiety and depression were statically different among the groups. In multivariate analyses we found that individuals with FM and WP had significantly higher impairment than those with RP and NP. FM and WP were similarly disabling. Similarly, RP was no significantly different than NP.ConclusionFibromyalgia is prevalent in the low socioeconomic status population assisted by the public primary health care system. Prevalence was similar to other studies (4.4%) in a more diverse socioeconomic population. Individuals with FM and WP have significant impact in their well being.
artigo dE rEvisão rEviEw articlE RESUMO Introdução e Objetivo: este trabalho teve como objetivo realizar uma revisão da literatura sobre a prevalência da fibromialgia (FM) na população a partir dos critérios propostos pelo American College of Rheumatology (ACR). Métodos: foi realizado levantamento bibliográfico do período de 1990 a 2005 nas bases de dados MedLine, Lilacs, Embase e ISI. Foram utilizadas as palavras-chave "fibromialgia" e "prevalência" e as correspondentes em inglês, "fibromyalgia" e "prevalence". Foram selecionados 97 artigos e, após leitura dos resumos, foram excluídos os que se referiam à prevalência em doenças. Somente 30 abordavam o tema prevalência da fibromialgia na população. Os artigos selecionados foram agrupados em cinco categorias: a) prevalência da FM em populações adultas; b) prevalência da FM em mulheres; c) prevalência da FM em crianças e adolescentes; d) prevalência da FM em populações específicas; e) prevalência de dor crônica e difusa na população, segundo os critérios do ACR. Resultados: a literatura aponta a prevalência da FM na população com valores entre 0,66 e 4,4%, sendo mais prevalente em mulheres do que em homens, especialmente na faixa etária entre 35 e 60 anos. Os estudos com crianças e adolescentes e em grupos especiais são escassos e pouco conclusivos. A prevalência de dor crônica difusa na população em geral também tem poucos estudos, com valores entre 11 e 13%. Conclusão: mais estudos sobre prevalência de dor crônica e difusa devem ser estimulados, assim como os de prevalência na população adulta, crianças e jovens.Palavras-chave: fibromialgia, prevalência, população. A Prevalência de Fibromialgia: uma Revisão de LiteraturaThe Prevalence of Fibromyalgia: a Literature Review Alane B. Cavalcante (1) , Juliana F. Sauer (1) , Suellen D. Chalot (1) , Ana Assumpção (2) , Lais V. Lage (3) , Luciana Akemi Matsutani (4) , Amélia Pasqual Marques AbStRActIntroduction and Objective: The aim of this study was to review the literature concerning of the prevalence of fibromyalgia in general population using the criteria from the American College of Rheumatology (ACR). Methods: The literature envolved the period of 1990 to 2005, in the databases Medline, Lilacs, Embase and ISI. The keywords "fibromialgia" and "prevalência" and the correspondents in English "fibromyalgia" and "prevalence" had been used. It was selected 97 articles and after reading the summaries, the ones related to the fibromyalgia prevalence with oher diseases were excluded. Only 30 articles evoked the subject prevalence of the fibromyalgia in the population. The selected articles were grouped in five items: a) the prevalence of fibromyalgia in adult populations; b) prevalence of fibromyalgia in women; c) prevalence of fibromyalgia in children and adolescents; d) prevalence of fibromyalgia in specific populations; e) prevalence of chronic and diffuse pain in the population according to the ACR criteria. Results: Literature points that the prevalence of fibromyalgia in the general population has values between 0...
The most typical symptom of fibromyalgia (FM) is diffuse pain, and pain at specific points-tender points-is crucial for its diagnosis. By comparing healthy individuals and FM patients, this study was aimed at assessing pain and quality of life of Brazilian females with FM, while seeking for a correlation between pain threshold and quality of life. A total of 178 women were evaluated: 124 were FM patients and 54 were healthy women. Pain threshold at tender points was quantified by dolorimetry, and diffuse pain by means of the visual analogue scale (VAS); the Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate quality of life. Statistical treatment of the data allowed for proposing two indexes: a pain threshold index (PT) and a quality of life one (QOL). PT is the lowest value among all pain thresholds measured at the 18 tender points; QOL is the mean of responses to the FIQ and VAS. Both indexes were tested and showed significant differences between the test and control groups. By pairing pain threshold values of each tender point in the test and control groups, it was found that the most sensitive points matched between the two groups, that is, the most sensitive anatomic spots in a healthy individual are also likely to be the most sensitive points in a person with FM. This suggests that a stimulus that provokes slight discomfort to a healthy person may produce more pain in FM patients--which may bear implications for FM clinical treatment. In this sample of Brazilian women, FM patients had both lower pain threshold and worse quality of life than healthy women.
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: The Activities-specific Balance Confidence (ABC) scale was developed to quantify the selfperceived level of confidence in performing specific activities without losing balance or becoming unsteady. The ABC scale has been adopted in clinical practice and in research, although cross-cultural differences may impose difficulties in its use. Objective: To translate, cross-culturally adapt and verify the intra-and inter-rater reliability of the BrazilianPortuguese version of the ABC scale and describe the self-perceived balance confidence of elderly Brazilian people. Method: The ABC scale was translated and culturally adapted. To verify the intra-and inter-rater reliability, 40 elderly individuals with ages ranging from 60 to 88 years were interviewed. The scale was administered by two raters on the same day and readministered after seven days by rater 1. To test the reliability, we used the intraclass correlation coefficient (ICC). Results: Six items from the ABC scale were considered culturally, semantically or regionally inappropriate and were modified. The intra-rater reproducibility was excellent (ICC=0.94), and the inter-rater reproducibility was very good (ICC=0.80). The self-perception of balance in specific activities of the elderly was considered very good, with an average of 81.7 and scores ranging from 61.2 to 96.7. Conclusion: The ABC scale was translated and culturally adapted for the Brazilian population and presents good intra-and inter-rater reliability. The self-perceived balance confidence in elderly Brazilian people evaluated with the ABC scale is moderate.Keywords: physical therapy; reproducibility; balance; fear; elderly. HOW TO CITE THIS ARTICLEMarques AP, Mendes YC, Taddei U, Pereira CAB, Assumpção A. Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence (ABC) scale. Braz J Phys Ther.
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