Effectiveness of Transcranial Direct Current Stimulation Combined With Exercising in People With Fibromyalgia: A Randomized Sham-Controlled Clinical Trial

Arroyo-Fernández, Rubén; Avendaño‐Coy, Juan; Velasco-Velasco, Rafael; Palomo-Carrión, Rocío; Bravo-Esteban, Elisabeth; Ferri-Morales, Asunción

doi:10.1016/j.apmr.2022.02.020

Cited by 12 publications

(12 citation statements)

References 20 publications

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“…We identified thirty-five studies reporting the use of tDCS to improve fibromyalgia symptoms (mainly pain intensity), and some of these studies correlated symptomatic improvements with changes in neurobiological measures. The specific protocols followed in each study and the respective results are shown in Table 3 [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ].…”

Section: Resultsmentioning

confidence: 99%

Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia

et al. 2023

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Although fibromyalgia is defined by its core muscular nociceptive component, it also includes multiple dysfunctions that involve the musculoskeletal, gastrointestinal, immune, endocrine, as well as the central and peripheral nervous systems, amongst others. The pathogenic involvement of the nervous system and the numerous neurological and neuroinflammatory symptoms of this disease may benefit from neuromodulatory stimulation techniques that have been shown to be effective and safe in diverse nervous system pathologies. In this systematic review, we outline current evidence showing the potential of non-invasive brain stimulation techniques, such as therapeutic strategies in fibromyalgia. In addition, we evaluate the contribution of these tools to the exploration of the neurophysiological characteristics of fibromyalgia. Considering that the pathogenesis of this disease is unknown, these approaches do not aim to causally treat this syndrome, but to significantly reduce a range of key symptoms and thus improve the quality of life of the patients.

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Section: Resultsmentioning

confidence: 99%

Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia

et al. 2023

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“…The mean methodological quality of the studies included was good (6.04 ± 1.26 points on the PEDro scale), and the risk of bias was medium. One study (1.4%) presented excellent methodological quality ( Arroyo-Fernández et al, 2022 ), 47 studies (69.1%) presented good quality ( Gowans et al, 2001 ; King et al, 2002 ; Schachter et al, 2003 ; Redondo et al, 2004 ; Da Costa et al, 2005 ; Kingsley et al, 2005 ; Hammond and Freeman, 2006 ; Munguía-Izquierdo and Legaz-Arrese, 2007 ; Rooks, 2007 ; Günendi et al, 2008 ; Mannerkorpi et al, 2009 ; Tomas-Carus et al, 2009 ; Tomas-Carus et al, 2018 ; Tomas-Carus et al, 2021 ; Carson et al, 2010 ; Sañudo Corrales et al, 2010 ; Núñez et al, 2011 ; Sañudo et al, 2011 ; Sañudo et al, 2015 ; Baptista et al, 2012 ; Jones et al, 2012 ; Kayo et al, 2012 ; Castel et al, 2013 ; Chan et al, 2014 ; 2017 ; Clarke-Jenssen et al, 2014 ; Larsson et al, 2015 ; Ericsson et al, 2016 ; Espí-López et al, 2016 ; Kurt, 2016 ; Kashikar-Zuck et al, 2018 ; Wong et al, 2018 ; Andrade et al, 2019 ; Silva et al, 2019 ; Atan and Karavelioğlu, 2020 ; Garrido-Ardila et al, 2020 ; Izquierdo-Alventosa et al, 2020 ; Izquierdo-Alventosa et al, 2021 ; Serrat et al, 2020 ; Serrat et al, 2021b ; Serrat et al, 2021a ; Serrat et al, 2022 ; Fonseca et al, 2021 ; Haugmark et al, 2021 ; Hernando-Garijo et al, 2021 ; de Lorena et al, 2022 ), 19 studies (27.9%) presented fair quality ( Mannerkorpi et al, 2000 ; Richards, 2002 ; Astin et al, 2003 ; Cedraschi, 2004 ...…”

Section: Resultsmentioning

confidence: 99%

Optimal dose and type of exercise to reduce pain, anxiety and increase quality of life in patients with fibromyalgia. A systematic review with meta-analysis

et al. 2023

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The aim of our meta-analysis was to compile the available evidence to evaluate the effect of physical exercise-based therapy (PEBT) on pain, impact of the disease, quality of life (QoL) and anxiety in patients with fibromyalgia syndrome (FMS), to determine the effect of different modes of physical exercise-based therapy, and the most effective dose of physical exercise-based therapy for improving each outcome. A systematic review and meta-analysis was carried out. The PubMed (MEDLINE), SCOPUS, Web of Science, CINAHL Complete and Physiotherapy Evidence Database (PEDro) databases were searched up to November 2022. Randomized controlled trials (RCTs) comparing the effects of physical exercise-based therapy and other treatments on pain, the impact of the disease, QoL and/or anxiety in patients with FMS were included. The standardized mean difference (SMD) and a 95% CI were estimated for all the outcome measures using random effect models. Three reviewers independently extracted data and assessed the risk of bias using the PEDro scale. Sixty-eight RCTs involving 5,474 participants were included. Selection, detection and performance biases were the most identified. In comparison to other therapies, at immediate assessment, physical exercise-based therapy was effective at improving pain [SMD-0.62 (95%CI, −0.78 to −0.46)], the impact of the disease [SMD-0.52 (95%CI, −0.67 to −0.36)], the physical [SMD 0.51 (95%CI, 0.33 to 0.69)] and mental dimensions of QoL [SMD 0.48 (95%CI, 0.29 to 0.67)], and the anxiety [SMD-0.36 (95%CI, −0.49 to −0.25)]. The most effective dose of physical exercise-based therapy for reducing pain was 21–40 sessions [SMD-0.83 (95%CI, 1.1–−0.56)], 3 sessions/week [SMD-0.82 (95%CI, −1.2–−0.48)] and 61–90 min per session [SMD-1.08 (95%CI, −1.55–−0.62)]. The effect of PEBT on pain reduction was maintained up to 12 weeks [SMD-0.74 (95%CI, −1.03–−0.45)]. Among patients with FMS, PEBT (including circuit-based exercises or exercise movement techniques) is effective at reducing pain, the impact of the disease and anxiety as well as increasing QoL.Systematic Review Registration: PROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021232013.

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“…Os resultados do estudo demonstraram reduções significativas da intensidade da dor nesses casos, além de uma melhora no estado de saúde, da catastrofização da dor e da depressão dos pacientes. No entanto, pesquisas futuras devem fornecer métodos de intervenção capazes de investigar possíveis alterações no sistema nervoso que possam vir a ocorrer (Arroyo-Fernández et al, 2022).…”

Section: Terapêutica Intervencionistaunclassified

Avanços na abordagem terapêutica da fibromialgia: uma revisão integrativa

Souza

Silva

Pereira

et al. 2022

RSD

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A fibromialgia (FM) é uma síndrome caracterizada como um distúrbio sistêmico complexo, a qual afeta milhões de pessoas em todo o mundo, levando ao aumento do uso de terapias não farmacológicas, como medidas terapêuticas com menos efeitos colaterais e com o intuito de uma abordagem mais efetiva da FM. O presente estudo de revisão buscou avaliar novos avanços na abordagem terapêutica da fibromialgia, documentados por meio de estudos clínicos e randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: ensaios clínicos e testes controlados e aleatórios; artigos publicados no último ano que possuíam texto completo disponível e que abordassem o tratamento da fibromialgia. Foi observado que a prática de fortalecimento muscular central, alongamento e de vibração do corpo inteiro se mostrou benéfica na melhora da qualidade de vida, assim como intervenções em grupo que possuem enfoque no autocuidado e na educação em neurociência da dor. Terapias intervencionistas como a estimulação transcraniana por corrente contínua demonstraram divergências quanto à eficácia do método, e uma dieta de substituição com o trigo Khorasan resultou em melhora geral dos sintomas gastrointestinais vistos em pacientes com fibromialgia. Espironolactona e alopurinol se mostraram ineficazes, diferente da suplementação de vitamina B6 e magnésio, ambas relacionadas com melhora da dor e redução do estresse, respectivamente, em pacientes com fibromialgia. Dessa forma, novos estudos que possibilitem a compreensão efetiva de tais modalidades terapêuticas no manejo da fibromialgia são sugeridos pelos autores.

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Effectiveness of Transcranial Direct Current Stimulation Combined With Exercising in People With Fibromyalgia: A Randomized Sham-Controlled Clinical Trial

Cited by 12 publications

References 20 publications

Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia

Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia

Optimal dose and type of exercise to reduce pain, anxiety and increase quality of life in patients with fibromyalgia. A systematic review with meta-analysis

Avanços na abordagem terapêutica da fibromialgia: uma revisão integrativa

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