Navegando por Palavras-chave "Fibromyalgia"

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    Anxiety and Fear-Avoidance in Musculoskeletal Pain
    (Current Medicine Group, 2012-10-01) Lucchetti, Giancarlo [UNIFESP]; Oliveira, Arao Belitardo [UNIFESP]; Peres Mercante, Juliane Prieto; Prieto Peres, Mario Fernando [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); São Paulo Med Spiritist Assoc; Albert Einstein Hosp
    Musculoskeletal pain (MP) is common in the general population and has been associated with anxiety in several ways: (a) muscle tension is included as a part of the diagnostic criteria for generalized anxiety disorder, (b) pain can be a common symptom and a good indicator of an anxiety disorder, (c) anxiety is an independent predictor of quality of life in patients with chronic MP, (d) anxiety leads to higher levels of pain chronification, and (e) fear, anxiety, and avoidance are related to MP. the objective of this article is to explore the mechanisms underlying the relation between anxiety disorders and musculoskeletal pain as well as its management. We have also highlighted the role of spirituality and religiosity in MP treatment. We found some similarities between proposed mechanisms and explicative models for both conditions as well as an overlapping between the treatments available. the recognition of this association is important for professionals who deal with chronic pain.
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    Apoio remoto à saúde: estudo com método netnográfico e análise de tendências para pacientes crônicos online. perspectivas interativas, de vínculos pessoais e um olhar para fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2018-08-28) Moretti, Felipe Azevedo [UNIFESP]; Barsottini, Claudia Galindo Novoa [UNIFESP]; http://lattes.cnpq.br/0921515386096454; http://lattes.cnpq.br/6185954649906310; Universidade Federal de São Paulo (UNIFESP)
    Objectives: The current research analyzes the personal profile, interests, interactive behaviors and interpersonal relationships of patients with chronic diseases in online health settings. It also investigate the forms of social support perceived by participants from virtual support groups, with a central focus on fibromyalgia. In addition, the study investigates new opportunities for remote support for chronic diseases that stimulate adherence to treatments. Methodology: Qualitative and quantitative research methods were combined. Initially, we analyzed specific responses on interactional patterns of behavior of 1,828 people attending online health platforms. Regarding the fibromyalgia research, a participatory netnography was conducted in which a Facebook community with 8,197 members was monitored for 6 months with weekly records of activities and behaviors. In addition, an electronic survey was distributed to the community members comprised of a validated social support satisfaction scale (ESSS) and questions about contentment with activities offered, criticisms, and suggestions for improvements to these groups. To identify new possibilities of remote support that stimulated adherence to treatments, 107 interviews were conducted with specialists in medical informatics and in the management of chronic patients. Other online questionnaires and patient interviews were used in some phases of the research. Results: Virtual health support platforms proved to be resources frequently used by chronic patients and such users usually see value in the possibility of exchanging experiences from the disease. Responses from the female gender predominated in the investigations. Variables such as schooling, age and income interfered in the way patients relate to health decision making (p <0.004). The behavior of searching health information for oneself or for family members, interaction with doctors or professionals after online searches, mutual help in virtual communities, and a broad sharing of personal data in discussion groups are frequent attitudes among the patients investigated. In the fibromyalgia group new treatments and patient rights are among the topics of greatest interest. The specific fibromyalgia community of the netnography has shown to have social relevance and impact on the life of its members, but presents difficulties of engagement and generation of interpersonal bond among the users. The electronic social support survey applied had 444 patients respondents and 72.1% (320) claimed to have made no significant friendships in the group. However, despite a few friendships created, most respondents (> 60%) miss a lot someone truly intimate to be able to talk, and approximately 70% misses a lot social activities. Conclusion: It is considered strategic to expand remote support initiatives that enhance interpersonal ties and social support in future online programs for chronic patients.
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    Assessment of Nutritional Status and Eating Disorders in Female Adolescents With Fibromyalgia
    (Elsevier B.V., 2012-11-01) Silva, Simone Guerra L. da [UNIFESP]; Sarni, Roseli O. S. [UNIFESP]; Souza, Fabiola I. S. de [UNIFESP]; Molina, Juliana [UNIFESP]; Terreri, Maria Teresa R. A. [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To assess eating disorders, nutritional status, body composition, and food intake in adolescents presenting with fibromyalgia.Methods: in a cross-sectional study, we evaluated the nutritional status (z score of body mass index [ZBMI]), waist circumference, body fat percentage by bioelectrical impedance analysis, symptoms of disordered eating, and possible eating disorders (Kids' Eating Disorders Survey [KEDS]) of 23 female adolescents with fibromyalgia and 23 matched healthy control subjects.Results: Median age for both groups was 15 years. in the fibromyalgia group, the median time for diagnosis was 13.5 months. We did not observe a statistically significant difference between the control and fibromyalgia groups in relation to ZBMI, fat mass percentage, food intake, and symptoms of disordered eating (KEDS). in the fibromyalgia group, there was a significant correlation between fat mass percentage and the total KEDS score (r = .587, p = .003); the same correlation was observed for ZBMI (r = .0778, p < .001).Conclusions: This study verified an absence of nutritional and eating disorders in adolescents recently diagnosed with fibromyalgia that, in addition to the correlation between adiposity indexes and KEDS total score, emphasizes the importance of nutritional and body composition assessment, allowing an early and adequate nutritional intervention. (C) 2012 Society for Adolescent Health and Medicine. All rights reserved.
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    Avaliação Da Capacidade Funcional, Qualidade De Vida E Nível Da Atividade Física De Pacientes Com Fibromialgia E Com Artrite Reumatoide Em Hospital Universitário De Atenção Terciária
    (Universidade Federal de São Paulo (UNIFESP), 2018-03-29) Azevedo, Carolina Bassoli De [UNIFESP]; Simoes, Martin Fabio Jennings [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Fibromyalgia (Fm) Is A Disease Characterized By Disturbances In Pain Control Mechanisms. Rheumatoid Arthritis (Ra) Presents Itself Erosive Synovitis In Small And Large Joints. Both Diseases Can Generate Functional Impairment To The Patient And Reduce Physical Fitness. Objective: The Objective Of The Study (Descriptive Transversal) Was To Evaluate The Functional Capacity, Level Of Physical Activity And Quality Of Life Of Patients With Fm And Ra And Compare To Control Individuals. Material And Methods: Three Groups Were Formed: Fm (N = 30) Ra (N = 42) And Control (N = 30) To Evaluate Clinical Characteristics And Functional Capacity By Questionnaires Haq (Health Assessment Questionnaire) And Fiq (Fibromyalgia Impact Questionnaire), Physical Activity Level By Ipaq (International Physical Activity Questionnaire) And General Quality Of Life (Sf-36 Questionnaire). Results: The Characteristics Of Gender, Age, Body Mass Index (Bmi) And Socioeconomic Between Groups Were Similar. Regarding Haq, The Ra 1.13
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    Avaliação da qualidade de vida em pacientes com fibromialgia submetidos a três tipos de tratamentos: medicamento e hidroterapia, medicamento e fisioterapia em solo, medicamento e placebo ensaio clínico randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2002) Vitorino, Débora Fernandes de Melo [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]
    Contexto A Sindrome da Fibromialgia e uma doenca reumatologica nao-articular, caracterizada pela ocorrencia de dor difusa e migratoria, acima e abaixo da cintura, a direita e a esquerda do corpo em pelo menos 11 dos 18 pontos dolorosos (tender points). Muitos pacientes apresentam fadiga, disturbio de sono e humor. O tratamento da SFM deve ser multiprofissional, incluindo medicamento e fisioterapia. Alguns autores mostram um impacto negativo na qualidade de vida das pessoas com esta sindrome, sendo portanto, a melhora ou manutencao da QV o objetivo fundamental na reabilitacao dos pacientes com Sindrome da Fibromialgia. Nao ha estudos atestando o valor da Hidroterapia como tratamento da SFM. Objetivo Comparar a Qualidade de Vida em pacientes com fibromialgia, submetidos a tres tipos de tratamento: medicamentoso e hidroterapia; medicamentoso e fisioterapia em solo; medicamentoso e placebo. Desenho Ensaio Clinico Randomizado Material e Metodo Serao avaliados 150 pacientes, de ambos os sexo, idade de 25 a 55 anos que preencham os criterios de diagnostico da ACR. Serao constituidos tres grupos de pacientes: medicamento e hidroterapia (Gl), medicamento e fisioterapia em solo ( G2), medicamento e aparelhos (placebo) (G3) que serao submetidos a avaliacao fisioterapeutica, preenchimento dos questionarios de Qualidade de Vida (SF36), Beck (ansiedade), Diario de sono, Escala de Dor, 1DATE (depressao), tratamento fisioterapeutico e novamente preenchimento dos questionarios. Resultados Conclusao
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    Avaliação da qualidade de vida, força muscular e capacidade funcional em mulheres com fibromialgia
    (Sociedade Brasileira de Reumatologia, 2011-08-01) Cardoso, Fábio de Souza; Curtolo, Murilo; Natour, Jamil [UNIFESP]; Lombardi Júnior, Imperio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To assess the quality of life, muscle strength and functional capacity in women with fibromyalgia (FM). PATIENTS AND METHODS: Cross-sectional study carried out with 31 female volunteers (age range, 35 to 60 years), paired in two groups (16 with FM, and 15 in the control group). Both groups underwent the following assessments: one-repetition maximum (1RM) of knee flexors and extensors; quality of life (application of the SF-36 questionnaire); 6-minute walk test (6MWT); pinch strengths (tripod, pulp-to-pulp, and key) and handgrip strength. RESULTS: A significant difference between the groups was observed in the following variables: handgrip strength; pulp-to-pulp and tripod pinch strength of both hands; and the 1RM test of knee flexors and extensors in both limbs (P < 0.05). Only the key pinch showed no statistical difference between groups for both limbs (P > 0.05). The 6MWT also showed a statistical difference between the groups (P < 0.01). The SF-36 showed that women with FM have reduced functional capacity, increased bodily pain, and worsened general health status (P < 0.05). CONCLUSION: The results revealed, in women with FM, a reduction in the following: muscle strength in the upper and lower limbs; the distance walked in the 6MWT; and quality of life
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    Avaliação da relação entre funções cognitivas, ansiedade e depressão em mulheres com fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Goulart, Rubens [UNIFESP]; Panico, Rubens Goulart [UNIFESP]; Lombardi Júnior, Imperio [UNIFESP]; http://lattes.cnpq.br/6748923176828764; http://lattes.cnpq.br/5707670458484854; Universidade Federal de São Paulo (UNIFESP)
    Fibromyalgia is the second most common rheumatologic disease in Brazil. Its prevalence varies between 2.5 % and 4.4 % population, affecting predominantly woman. Several studies have demonstrated the occurrence of cognitive impairments in people with fibromyalgia, particularly in those patients who also have comorbidities such as depression and anxiety. The psychological aspects of fibromyalgia still require further investigation. Information regarding cognitive impairment in fib romyalgia are inconsistent. The volunteers in this study were women diagnosed with fibromyalgia according to the ACR criteria. After, we set up a control group of the same size, with individuals from the general population, in order to enable the pairing a ccording to age, level of education and income. Patients were assessed using the Rey Complex Figure Test, RAVLT, Stroop, Trail Making Test, Digit Test (Battery WAIS - III), Hospital Anxiety and Depression Scale, Visual Analog Pain Scale and Modified Wisconsin Card Sorting Test. The characteristics of the groups show no significant differences in the matching criteria (Age P= 0,744, scholarity P=0,504, Income P=0,498). The difference in Pain as measured by AEV was 4.17 points higher (P < 0.001) for the fibromyalgia group. The results of the Hospital Anxiety and Depression scale, was respectively 4.64 and 4.19 higher for fibromyalgia group (P < 0.001); show that this group has a tendency to have more symptoms of both anxiety as depression. Regarding the attentional characteristics of the groups, there seems to be a slower tendency in sustained attention (55.65 seconds longer in the TM-B, P=0.025), extrapolating 120 seconds cutoff. We also observed a general trend of poorer performance on pictorial memory, as measured by the REY Figure. Finally, the performance of the groups on executive functions, demonstrates a trend to poorer performance on the copy of the Rey figure (4.1 points lower, P = 0.002). Fibromyalgia patients suffer from deficits in executive functio ns, particularly in planning and inhibitory control components and such deficits are reflected in loss of memory.
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    Avaliação do estado nutricional e do comportamento alimentar de adolescentes com fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Silva, Simone Guerra Lopes da [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the eating behavior and nutritional status of adolescents with fibromyalgia; relating their eating behavior to socio-economic, anthropometric and other variables related to the illness. Methods: In a cross sectional, prospective and controlled study, the following data were evaluated in 23 adolescents with fibromyalgia, paired with a healthy control group (n=23): BMI and height to age z scores (OMS, 2005, 2007), waist circumference 2, body composition for bioelectric impedance analysis 6 (Mc Carthy, 2006), food intake (NutWin/Unifesp) and eating behavior and body image (questionnaire KEDS-Kids’ Eating Disorders Survey). Statistical analysis: chi-square, Mann-Whitney test and Spearman correlation. A significance level of p<0.05 was adopted. Results: Median of the two age groups was 15 years and the socio-economic level most widely encountered was B2. For the fibromyalgia group, it was verified that: the median of the time for illness diagnosis was 13.5 months, the number of painful points on the starting date of the study was 10.0 and that 26% made use of amitriptiline. In relation to the classification of nutritional condition via BMI z score, abdominal circumference, and body composition by BIA, no significant difference was observed between the groups, nor in relation to energy food consumption and macro and micro nutrients. In relation to a concern about excessive weight, body image, dissatisfaction with body image and final KEDS score, there was also no significant statistical difference between the fibromyalgia and control groups. For the adolescents with fibromyalgia the KEDS association and fat mass were stronger and statistically significant (r=0.713; p<0.001). By using the median final KEDS score of the control group (4) for stratifying the group with fibromyalgia and to evaluate which variables were associated to a higher KEDS score (> 4), it was verified that only overweight and obesity (BMI z score) showed an association. Conclusions: The adolescents with fibromyalgia did not demonstrate alterations in their nutritional status, in eating behavior and in body image when compared with an healthy control group. Taking into consideration the association, in adults, of fibromyalgia to obesity, eating disorders, metabolic syndrome and a worsening in their quality of life, the importance of nutritional guidance and of life style while still in the adolescent age group was emphasized.
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    Avaliação vestibulococlear na fibromialgia
    (CEFAC Saúde e Educação, 2011-02-01) Zeigelboim, Bianca Simone [UNIFESP]; Klagenberg, Karlin Fabianne; Liberalesso, Paulo Breno Noronha; Jurkiewicz, Ari Leon; Universidade Federal de São Paulo (UNIFESP); Universidade Tuiuti do Paraná
    BACKGROUND: fibromyalgia is a non-inflammatory musculoskeletal syndrome, with a chronic nature and unknown aetiology, characterized by widespread pain, increase in sensibility to palpation and by symptoms such as insomnia, stiffness, fatigue, psychological sickness, intolerance to cold and otologic complaints. PROCEDURES: two female patients diagnosed with fibromyalgia, aged 52 to 61 years, were evaluated in the Otoneurology sector of a institution, in September 2008, and consulted for: dizziness, paraesthesia, perception of movement of objects, imbalance on walking, falls, fatigue, depression, headaches, and difficulty in listening and moving the neck. They were submitted to the following procedures: anamnesis, otological inspection, audiologic evaluation and vestibular exam through vectoelectronystagmography. RESULTS: the following discoveries were noted: Patient 1 - hearing loss of the sensorineural type from 2 KHz in the left ear, normal hearing thresholds in the right ear and hypo-reflexia with an absolute value of 42ºC in the caloric test in the right ear. Patient 2 - normal hearing thresholds, bilaterally, and hyper-reflexia with an absolute value of 42ºC in the caloric test in the right ear with an intense neurovegetative manifestation. CONCLUSION: the submitted cases demonstrated the importance of audiologic evaluations and vestibular exams in the contribution to elaboration of strategies used in the therapeutic consolidation of fibromyalgia suggesting the performance of those exams as a clinical routine.
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    A Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR): a validation study
    (Springer, 2013-08-01) Paiva, Eduardo S.; Heymann, Roberto E. [UNIFESP]; Rezende, Marcelo C.; Helfenstein Junior, Milton [UNIFESP]; Martinez, Jose Eduardo; Provenza, Jose Roberto; Ranzolin, Aline; Assis, Marcos Renato de; Pasqualin, Vivian D.; Bennett, Robert M.; Univ Fed Parana; Universidade Federal de São Paulo (UNIFESP); Pontificia Univ Catolica São Paulo; Pontificia Univ Catolica Campinas; Universidade Federal de Pernambuco (UFPE); Fac Med Marilia; Pontificia Univ Catolica Parana; Oregon Hlth & Sci Univ
    The Fibromyalgia Impact Questionnaire (FIQ) was specifically developed to assess disease severity and functional ability in fibromyalgia patients. in 2009, a revised version of the FIQ was published, the FIQR; this version achieved a better balance among different domains (function, overall impact, symptoms). Here, we present the validity and reliability of the Brazilian version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Female fibromyalgia patients (n = 106) completed an online survey consisting of the Short Form 36 (SF-36) questionnaire, the original FIQ, and the Brazilian Portuguese FIQR, which was translated by a standard method. Validity was established with correlational analyses between the FIQR, FIQ, and SF-36 items. Three domains were established for the FIQR (function, overall impact, symptoms), and their contribution for the SF-36 subscales was also scrutinized. the Brazilian FIQR validation process showed that the questions performed in a very similar way to the original English FIQR. the new questions in the FIQR symptoms domain (memory, balance, tenderness, and environmental sensitivity) revealed a significant impact in fibromyalgia (FM) patients. the Brazilian Portuguese FIQR demonstrated excellent reliability, with a Cronbach's alpha of 0.96. There was a gain on weight of the function domain and a decrease of the symptom domain, leading to a better balance among domains. the FIQR predicted a great number of SF-36 subscales, showing good convergent validity. the Brazilian Portuguese version of the FIQR was validated and found to be a reliable, easy-to-use, and score FM-specific questionnaire that should prove useful in routine clinical practice and FM-related research.
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    Cognitive Impairment in Fibromyalgia
    (Springer, 2013-07-01) Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Oliveira, Fabricio Ferreira de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Cognitive and behavioral impairments are core manifestations of fibromyalgia and may be more disabling than pain itself. Involvement of the central nervous system is ascertained by the fact that frontoparietal and limbic cortices are often functionally and structurally affected along the course of this disease. Even though neuroimaging has brought some experimental evidence to support such network disruption, there are currently no clinically effective biomarkers that detect and quantify cognitive and behavioral disturbances in fibromyalgia; thus, traditional scales and tests of neuropsychiatric assessment remain the most important diagnostic tools. This review addresses the most common cognitive and behavioral impairments in people with fibromyalgia, while explaining their pathophysiological basis and currently available therapeutic options.
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    A comparison of quality of life, demographic and clinical characteristics of Brazilian men with fibromyalgia syndrome with male patients with depression
    (Springer, 2010-02-01) Yoshikawa, Gilberto Toshimitsu [UNIFESP]; Heymann, Roberto Ezequiel [UNIFESP]; Helfenstein Junior, Milton [UNIFESP]; Pollak, Daniel Feldman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The primary aim of this study was to assess the quality of life (Qol) in men with fibromyalgia (FM) as compared to the Qol of depressive patients, using the SF-36 questionnaire. the secondary objectives were as follows: to describe demographic and clinical characteristics of male patients with FM; to evaluate basal levels of dehydroepiandrosterone sulfate (DHEAS) and total testosterone in both groups; and to investigate the relationship among pain, tender points, anxiety, and depression in these patients. Fifty men with FM and 20 depressed males, matched by age and body mass index entered the study. All participants answered the SF-36, the Beck Depression Inventory and the State-Trait Anxiety Inventory questionnaire. Radioimmunoassay was used to determine serum concentration of DHEAS and total testosterone. Patients and controls had similar demographic characteristics. the scores were significantly lower in all domains of the SF-36 in patients with FM as compared with the depressive controls. No significant differences were observed among patient and control in the mean concentration of either DHEAS or total testosterone. Male patients with FM experience worse Qol than depressive men. Depression was influential on mental health, whereas FM impacted on both physical and mental health.
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    A compreensão do residente médico em reumatologia no atendimento aos pacientes com fibromialgia
    (Associação Brasileira de Educação Médica, 2009-09-01) Canzonieri, Ana Maria [UNIFESP]; Pollak, Daniel Feldman [UNIFESP]; Martins, Maria Anita Viviani; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica de São Paulo
    This study focuses on the understanding of rheumatology residents in caring for fibromyalgia patients. The syndrome is difficult to diagnose, and pain is the most important symptom. OBJECTIVES: Understand how residents understand the care, and discover what this care leads to. METHODS: Qualitative study based on hermeneutic phenomenology, with taped individual interviews answering the key question: What does it mean to you to treat fibromyalgia patients? The study analyzed the meanings provided by the residents. The research was performed in three public university hospitals, with second-year medical residents. RESULTS: Care for fibromyalgia patients proved to be a source of frustration, bringing a feeling of powerlessness and indignation; patients suffer from prejudice due to idiosyncrasies, social components, and non-adherence to treatment; the physician needs to be emotionally prepared to provide care - requirements include knowing how to listen and understand the patient-illness relationship; the diagnosis is marked by lack of laboratory confirmation and subjectivity in the work-up; the physician needs support from psychology, and the treatment requires a multidisciplinary team. CONCLUSION: Care is frustrating and generates a feeling of powerlessness. It requires greater psychological preparation during medical training and a more integrated approach between medicine, psychology, and physical therapy.
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    Contribuição para a avaliação e utilização do condicionamento aeróbio em pacientes com fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2004) Natour, Jamil [UNIFESP]
    Objetivos: Avaliar a aptidão cardiorrespiratória de pacientes com fibromialgia, avaliar os efeitos do condicionamento aeróbio e do alongamento na melhora da dor e qualidade de vida na fibromialgia e analisar os efeitos do exercício aeróbio no meio aquático comparativamente ao exercício em solo em mulheres com fibromialgia. Material e métodos: No primeiro estudo 50 mulheres fibromialgicas sedentárias e 50 mulheres sedentárias sadias foram estudadas e comparadas quanto a sua capacidade aeróbia. No segundo estudo 76 mulheres fibromialgicas sedentárias foram randomizadas em 2 grupos iguais. Um grupo foi submetido a caminhadas regulares, outro grupo á sessões de alongamento. Nos dois grupos as pacientes realizavam a atividade física três vezes por semana, por uma hora durante 20 semanas. No terceiro estudo 60 mulheres fibromialgicas sedentárias foram randomizadas em dois grupos iguais. Um grupo fez caminhado em solo e o outro caminhada na água três vezes por semana por 15 semanas. Escala visual analógica de dor (EVA), Questionário de Impacto da Fibromialgia (FIQ), Inventário Beck de Depressão, Questionário de qualidade de vida SF-36 e teste espiroergométrico foram aplicados à entrada, no meio e ao final dos estudos. Resultados: As pacientes fibromialgicas apresentaram piores resultados nos testes espiroergométricos que as não fibromialgicas. Tanto o V02 max quanto o limiar anaeróbio foram piores nas fibromialgicas. Estas pacientes realizaram testes submáximos. Na comparação entre caminhada e alongamento, as pacientes fibromialgicas melhoraram mais quando submetidas à caminhada no que se refere a dor e qualidade de vida, mesmo as que não se condicionaram. O tratamento de fibromialgia com a técnica de corrida dentro d'água foi efetivo e mostrou-se superior ao treinamento por caminhada ou corrida em solo, pelo FIQ total e por alguns itens de avaliação psicoafetiva. A melhora da dor e o ganho de condicionamento físico foram semelhantes nos dois grupos. Conclusões: Pacientes fibromiálgicas tem capacidade física reduzida. O limiar anaeróbio é o melhor parâmetro para avaliar a capacidade física destas pacientes. O treinamento aeróbio pela caminhada em solo é superior ao alongamento. A comparação entre caminhar na água e no solo, mostrou resultados semelhantes, com exceção de alguns aspectos que foram superiores na caminhada na água. A corrida dentro d'água com cinto flutuador mostrou-se uma opção segura para o tratamento de pacientes com fibromialgia.
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    Descrição de um quadro músculo-esquelético fibromialgias-simile em atletas
    (Universidade Federal de São Paulo (UNIFESP), 2003) Vaisberg, Mauro Walter [UNIFESP]; Rosa, Luis Fernando Bicudo Pereira Costa [UNIFESP]
    O atleta competitivo, sempre em busca da melhora do seu desempenho, muitas vezes apresenta lesoes musculo - esqueleticas de natureza nao traumatica. Habitualmente tais lesoes sao atribuidas a fatores mecanicos. O exame clinico de atletas que apresentavam este tipo de lesao sugeria que muitos deles apresentavam um quadro que em varios aspectos lembrava fibromialgia, condicao que nao e descrita em atletas. A presente pesquisa tem como objetivo estudar um grupo composto por 55 atletas competitivos para verificar a possibilidade de ocorrencia da associacao entre lesao nao traumatica e fibromialgia. A avaliacao clinica dos sujeitos foi realizada segundo os criterios do Colegio Americano de Reumatologia e, num segundo momento, procedeu-se a obtencao de parametros laboratorias abrangendo hormonios, neurotransmissores, creatinina urinaria, citocinas e prostaglandina - e de testes fisiologicos. Os resultados permitem afirmar que em 27 por cento dos atletas estudados e possivel a caracterizacao de um quadro fibromialgiasimile. Foram encontradas algumas diferencas estatisticamente significantes. Verificou-se maior numero de queixas relativas ao sono e incidencia aumentada de lesoes musculo-esqueleticas nos atletas portadores de fibromialgia-simile. Estes mesmos atletas apresentaram aumento da producao de citocinas dosadas em cultura de celulas de sangue periferico, com concentracoes mais elevadas de IL-1, IL-2, TNF- e IFN-. Nesta mesmas culturas, foi possivel demonstrar aumento da concentracao de prostaglandina E2. A avaliacao de parametros fisiologicos por teste ergo- espirometrico revelou uma queda do V02 max e do V02 LA no grupo fibromialgia- simile
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    Development and validation of Fibromyalgia Knowledge Questionnaire: FKQ
    (Springer, 2012-03-01) Suda, Alina L. [UNIFESP]; Jennings, Fabio [UNIFESP]; Bueno, Vanessa C. [UNIFESP]; Natour, Jamil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The objective of this study is to develop and validate a questionnaire for evaluating patients' specific knowledge regarding fibromyalgia. the development of items and questions of the questionnaire was done using four focus group that included physicians, physical therapists, a nurse, and patients with fibromyalgia. Other 30 consecutive patients were recruited to evaluate the questionnaire's reproducibility (intra- and inter-observer). in order to construct validity, the questionnaire was applied to healthcare professionals with knowledge on fibromyalgia and 20 other patients. To investigate sensitivity to change, the questionnaire was applied to 56 patients before and after an educational program (intervention group) or a waiting list (control group). Eighteen questions fulfilled the inclusion criteria and were understandable for more than 90% of the participants. the intraclass correlation coefficients for inter-observer and intra-observer reproducibility ranged from 0.65 to 0.90 and from 0.86 to 0.96, respectively (P < 0.01). for construct validation, healthcare professionals obtained significant higher scores than the patients (P < 0.01). On the sensitivity to change evaluation, the intervention group obtained higher scores than the control group after the educational program (P < 0.01). Conclusion: the Fibromyalgia Knowledge Questionnaire was developed and it is reliable, valid, and sensitive to changes, for evaluating disease-specific knowledge in patients with fibromyalgia.
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    Dor, qualidade de vida, autopercepção de saúde e depressão de pacientes com fibromialgia, tratados com hidrocinesioterapia
    (Sociedade Brasileira de Reumatologia, 2013-12-01) Letieri, Rubens Vinícius; Furtado, Guilherme E.; Letieri, Miriangrei; Góes, Suelen M.; Borba-Pinheiro, Cláudio Joaquim; Veronez, Suellen de Oliveira [UNIFESP]; Magri, Angela Maria Paiva [UNIFESP]; Dantas, Estélio Henrique Martin; Faculdade Católica Rainha do Sertão; Universidade de Coimbra Faculdade de Ciências do Desporto e Educação Física; Centro Universitário da Fundação Educacional Guaxupé; Universidade Federal do Paraná; Federal do Estado do Rio de Janeiro; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: The aim of this study was to analyze the effects of treatment by hydrotherapy on quality of life, perception of pain and the severity of depression in a group of patients with fibromyalgia. MATERIALS AND METHODS: We evaluated 64 females divided into two groups: hydrocinesiotherapy (n = 33, 58.2 ± 10.6 years) and control group (n = 31 with 59.6 ± 9.4 years) with clinical diagnosis of fibromyalgia. Individuals were assessed by Visual Analog Scale of Pain (VAS), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory. Participants underwent a treatment in a hydrotherapy pool heated to 33ºC over a period of 15 weeks, two sessions per week of 45 minutes, a total of 30 sessions. The exercises were underwater: cardiovascular conditioning, strength training, mobility, coordination, balance and still, stretching exercises and muscle relaxation. The ANOVA 2×2 and Kruskall-Wallis was used for statistical analysis RESULTS: There were statistically significant improvements in the perception of pain intensity (Δ% = -28.2%, p < 0, 01), quality of life (Δ% = -32.4%, p < 0, 05) and depression symptoms (Δ% = -35.4%, p < 0, 05) in favor of the Hydrotherapy group compared to the control group. CONCLUSIONS: The study suggests that hydrocinesiotherapy was effective as an alternative therapy for fibromyalgia, however further studies are recommended to test the associations between the variables and intervention programs and using the water activities, and the modifiability of the parameters of physical and mental health when these individuals undergo programs of short, medium and long duration.
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    Efeito da lidocaína por via venosa no alívio da dor e nas concentrações plasmáticas de serotonina, noradrenalina e dopamina em pacientes com fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2012) Vlainich, Roberto [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]
    Introdução e Objetivos: A fibromialgia e complexa, com alteracoes centrais e perifericas, envolvendo neurotransmissores. O objetivo do estudo foi avaliar o efeito da lidocaina venosa associada a amitriptilina sobre a dor e niveis plasmaticos de serotonina, noradrenalina e dopamina, em paciente com fibromialgia. Metodos: Foi realizado estudo prospectivo, aleatorio, comparativo, e duplo encoberto. Todos os pacientes receberam amitriptilina na dose de 12,5 mg, na primeira semana e 25 mg, nas quatro semanas subsequentes. Os pacientes do G1 (n= 15) receberam 125 ml de solucao salina a 0,9%; os do G2 (n= 15) receberam 240 mg de lidocaina em 125 ml de solucao salina a 0,9%. As solucoes foram infundidas em 1 h, uma vez por semana, nas quatro semanas subsequentes (T1, T2, T3 e T4) ao inicio do estudo (T0). Foram colhidas amostras de sangue para as dosagens de serotonina, noradrenalina e dopamina, em T0 e T4. A avaliacao da intensidade da dor foi feita pela escala numerica de zero a 10, em T0, T1, T2, T3, e T4. Os efeitos adversos foram registrados. Resultados: Todos eram do sexo feminino em ambos os grupos e a media de idade foi de 44,7 ± 10,5 anos no G1 e 40,9 ± 11,6 anos no G2. Nao houve diferenca entre os grupos em nenhum dos tempos em relacao a intensidade da dor. A intensidade da dor diminuiu apos o tratamento no G1 (T0: 7,0 ± 1,2 e T4: 4 ± 2,1) e G2 (T0: 7,6 ± 0,8 e T4: 4,1 ± 2,3). Os valores plasmaticos de serotonina e noradrenalina foram semelhantes em ambos os grupos e entre o inicio e o final do tratamento. Foi observado aumento dos valores plasmaticos de dopamina entre o inicio e o final do tratamento no G1. Conclusoes: A associacao de 240 mg de lidocaina por via venosa (1 vez por semana) a 25 mg de amitriptilina durante 4 sem nao modificou a intensidade de dor e as concentracoes plasmaticas de serotonina, noradrenalina e dopamina em pacientes com fibromialgia
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    Efeitos da fotobiomodulação com dosagem progressiva associada a um protocolo de exercício aeróbio no nível de dor e qualidade de vida de mulheres com fibromialgia: controlado, randomizado e cego
    (Universidade Federal de São Paulo, 2022-01-25) Credidio, Beatriz Mendes [UNIFESP]; Renno, Ana Claudia Muniz [UNIFESP]; Vassão, Patricia Gabrielli [UNIFESP]; Balão, Ana Beatriz [UNIFESP]; http://lattes.cnpq.br/8746855238862798; http://lattes.cnpq.br/2381613310217783; http://lattes.cnpq.br/4106611304688552; http://lattes.cnpq.br/8765685906733380; Universidade Federal de São Paulo (UNIFESP)
    A fibromialgia (FM) é caracterizada pela dor muscular generalizada crônica, que acomete principalmente mulheres. Vários estudos já demonstraram que exercícios aeróbicos se mostram efetivos para a melhora da dor e da qualidade de vida desta população; outros estudos que a fotobiomodulação (FBM) também é efetiva neste sentido. No entanto, não há consenso na literatura a respeito dos melhores parâmetros da FBM do tipo cluster para tratar pacientes com FM, bem como, o uso em dosagem progressiva ao longo do tratamento. Assim, o objetivo deste estudo foi verificar o efeito da associação de um protocolo de exercício aeróbio e a FBM, com dosagem progressiva, no nível de dor e na qualidade de vida relacionado a saúde de mulheres com FM. As mulheres foram randomizadas e divididas em dois grupos: GEFA: grupo exercício e FBM ativa (n=4), ou GEFP: grupo exercício e FBM placebo (n=8). Antes da primeira sessão e após a última sessão de tratamento foi avaliado como desfecho primário o nível de dor através da Escala Visual Analógica (EVA), e como desfechos secundários o Questionário do Impacto de Fibromialgia Revisado (FIQR-Br, do inglês Fibromyalgia Impact Questionnaire), qualidade de vida pelo Medical Outcomes Study 36-item Short Form Health Survey (SF-36), e qualidade do sono pelo Pittsburgh Sleep Quality Index (PSQI) e Epworth Sleepiness Scale (ESS). As intervenções tiveram duração de 12 semanas, 2 vezes por semana com a realização do exercício aeróbio em bicicleta estacionária com progressão de carga associado a aplicação da FBM do tipo cluster (808nm, 100mW, de 20 a 40J por aplicação) ativo ou placebo. Os resultados demonstraram que o tratamento proposto foi capaz de melhorar significativamente o nível de dor para o domínio EVA da menor dor sentida na semana anterior, GEPA (p= 0,007) e GEFP (p= 0,002), a qualidade de vida, GEPA (p<0,0001) e GEFP (p= 0,005), o impacto da doença, GEPA (p=0,01) e GEFP (p= 0,003), e a qualidade do sono, GEFA (p= 0,001) e GEFP (p= 0,0001), em ambos os grupos. Ainda, o GEFP melhorou significativamente o nível de dor em movimento pela EVA (p=0,004), da qualidade de vida nos domínios limitação por aspectos emocionais (p= 0,0002) e dor (p= 0,019), e a qualidade do sono (p= 0,043) pelo PSQI. E o GEFA apresentou melhora significativa nos domínios função física (p= 0,033) e vitalidade (p=0,004). E por fim, a qualidade de vida para o domínio limitação por aspectos emocionais foi significativamente maior para o GEFP (p<0,0001), sendo que o GEFP apresentou valor superior ao GEFA. Assim, podemos concluir que os dados parciais deste estudo demonstram que um programa de treino aeróbico em bicicleta ergométrica foi capaz de demonstrar benefícios na dor, qualidade de vida e sono em mulheres com FM, mas a associação da FBM com o exercício não produziu o efeito extra na maioria das variáveis analisadas. Com isso, torna-se de suma importância a continuidade do estudo para conclusões mais definitivas.
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    Efeitos das intervenções baseadas em Mindfulness em indivíduos com fibromialgia
    (Universidade Federal de São Paulo (UNIFESP), 2020) Sakai, Bianca Yuri [UNIFESP]; Cicuto, Karen Messas [UNIFESP]; http://lattes.cnpq.br/9905267940193868; http://lattes.cnpq.br/7406876026019499; Universidade Federal de São Paulo (UNIFESP)
    Considered one of the most common rheumatological clinical conditions, fibromyalgia is characterized by generalized musculoskeletal pain and symptoms such as fatigue, cognitive dysfunction, sleep disorders, anxiety, depression, gastrointestinal discomfort and stiffness, in addition to generalized hypervigilance. However, as it is a heterogeneous condition, diagnosis and treatment are complex for health professionals, considering that exercise is the only recommendation with effective scientific evidence. Despite this, patient education and non-pharmacological therapies are also suggested, and in case of no improvement, psychological therapies, pharmacotherapy and / or a multidisciplinary rehabilitation program. By the way, the interest in Mindfulness-based interventions (IBMs), as one of the possible therapeutic resources, has increased in the last 3 decades, which has Mindfulness as its main component. Thus, the objective of the study was to evaluate what are the effects of IBMs in individuals with fibromyalgia, through an integrative review. The literature search was carried out through the databases of Pubmed / Medline, Lilacs, Cochrane Library and Scielo, resulting in a total of 14 studies. Of these, 57.14% were classified with level of evidence II, 21.43% of studies with level of evidence III, in the same way as level IV (21.43%). The majority (71.42%) consisted of clinical trials, 80% of which were randomized clinical trials. Among the research in this group, 30% of the studies had an active control group, 50% a passive control group and 20% presented both types of control group. The variables that showed effective results were reduction and coping with stress; reduced symptoms of depression, anxiety, sleep disorders and the impact of fibromyalgia; increase in positive affects; improvement in psychological well-being, social functioning, family performance and loneliness; disengagement from the "me"; relationship between the symptoms of fibromyalgia and the practices of Mindfulness and catastrophizing with Mindfulness; improvement of pain and dealing with it. However, no significant changes were found to improve physical functioning or cortisol; cardiac autonomic benefits or changes in the daily activity of fibromyalgia. However, due to the scarcity of studies, more research is essential for there to be consolidated scientific evidence of these effects in people with such a clinical condition.