AB0957 IS AQUATIC THERAPY MORE EFFECTIVE THAN LAND-BASED THERAPY IN REDUCING PAIN OF WOMEN WITH FIBROMYALGIA?

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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Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0155 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Henrik Bjarke Vaegter ◽

Mette Terp Høybye ◽

Frederik Hjorth Bergen ◽

Christine E. Parsons

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Sleep Quality ◽

Pain Intensity ◽

Sleep Disturbances ◽

Pain Disability ◽

Pain Clinics ◽

Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

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EMDR Versus Treatment-as-Usual in Patients With Chronic Non-Malignant Pain: A Randomized Controlled Pilot Study

Journal of EMDR Practice and Research ◽

10.1891/emdr-d-20-00004 ◽

2020 ◽

Vol 14 (4) ◽

pp. 190-205 ◽

Cited By ~ 1

Author(s):

Nieves Arias Suárez ◽

Joana Moreno Pérez ◽

Diego Redolar-Ripoll ◽

Bridget M. Hogg ◽

Itxaso Gardoki-Souto ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Pilot Study ◽

Pain Intensity ◽

Psychological Intervention ◽

Psychological Trauma ◽

Post Treatment ◽

Treatment As Usual

In recent years, different studies have observed a strong association between chronic pain (CP) and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), could be an innovative treatment option. The aim of this pilot study was to assess whether a specific EMDR protocol for CP leads to (a) a reduction in pain intensity, (b) an improvement in anxiety and depressive symptoms, and (c) an improvement in quality of life. 28 CP patients were randomly assigned to EMDR + treatment as usual (TAU; n = 14) or to TAU alone (n = 14). Patients in the EMDR group received 12 psychotherapeutic sessions of 90 minutes over 3 months. Pain intensity was measured using the Visual Analog Scale and the Pain Disability index, quality of life using the EQ-5D-5L, and anxiety and depressive symptoms using the Hamilton Anxiety and Depression Scale. Measures were taken for both conditions at pre- and post-treatment, and a follow-up in the EMDR condition was taken at 3 months post-treatment. Patients in the EMDR group showed significantly reduced pain intensity and improved quality of life and anxiety and depressive symptoms compared to TAU alone at post-treatment. Improvements were largely maintained at 3-month follow-up. This study suggests that EMDR may be an effective and safe psychological intervention to be used within the multidisciplinary treatment plan of patients with CP.

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Role of Electro Acupuncture Therapy on Temporomandibular Joint Pain With Orofacial Myalgia Following Post Healed Unilateral Cervicofacial Burn

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16164310686789 ◽

2021 ◽

Vol 46 (2) ◽

pp. 123-134

Author(s):

Gopal Nambi ◽

Walid Kamal Abdelbasset ◽

Shereen H. Elsayed ◽

Anju Verma ◽

Shimaa Abd El-Hamid Abase ◽

...

Keyword(s):

Acupuncture Therapy ◽

Temporomandibular Joint ◽

Joint Pain ◽

Pain Threshold ◽

Mouth Opening ◽

Temporomandibular Joint Pain ◽

Pain Frequency ◽

Disability Level

Background: Temporomandibular Joint (TJ) pain and orofacial myalgia (OM) are the most significant problems in physiotherapy context to treat in Cervicofacial burn (CB). However, there is a lack of clinical studies in investigating the effects of electro acupuncture therapy on TJ pain with OM following post healed CB patients.<br/> Objective: To investigate the effects of clinical and functional efficacy of electro acupuncture therapy on temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn patients.<br/> Methods: Through two block random sampling method, the eligible participants were randomized and allocated into active EAT (Active-EAT; n = 15) and placebo EAT (Placebo-EAT; n = 15) groups. The Active-EAT group received electro acupuncture therapy and the Placebo-EAT group received placebo effect with regular physiotherapy care for 4 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the 4th week, 8th week and 6 month follow up.<br/> Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After 4 weeks of treatment, and at the end of 6 months follow up, the pain intensity, 3.0 (CI 95% 2.83 to 3.16), pain threshold 18.6 (CI 95% -35.0 to -2.1), pain frequency 2.9 (CI 95% 2.54 to 3.25), mouth opening, -13.4 (CI 95% -15.1 to -11.6), disability level 12.4 (CI 95% 12.16 to 12.63), and quality of life -25.8 (CI 95% -31.0 to -20.5) showed more improvement (p < 0.001) in Active-EAT group than Placebo-EAT group.<br/> Conclusion: The reports of this study proved that, 4 weeks active electro acupuncture therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of TJ rehabilitation.

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426. Post-chikungunya Chronic Disease and Its Impact on Quality of Life, Depression, Anxiety, Fatigue and Sleep Quality: Results From a 2-Year Follow-up Comparative Study of 62 Patients in La Virginia, Risaralda, Colombia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.437 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S161-S162

Author(s):

Alfonso J Rodriguez-Morales ◽

Julio Cesar Gutiérrez-Segura ◽

Sabina Ocampo-Serna ◽

Oscar Mauricio Meneses-Quintero ◽

Sergio Andrés Ochoa-Orozco ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Disease ◽

Sleep Quality ◽

Comparative Study

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A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

10.21203/rs.3.rs-33919/v1 ◽

2020 ◽

Author(s):

Pedro Otones ◽

Eva García ◽

Teresa Sanz ◽

Azucena Pedraz

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Usual Care ◽

Pain Intensity ◽

Physical Performance ◽

Frail Older Adults

Abstract Background Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details: This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study

Journal of Clinical Medicine ◽

10.3390/jcm11010272 ◽

2022 ◽

Vol 11 (1) ◽

pp. 272

Author(s):

Philippe Rigoard ◽

Amine Ounajim ◽

Lisa Goudman ◽

Tania Banor ◽

France Héroux ◽

...

Keyword(s):

Spinal Cord ◽

Pain Intensity ◽

Spinal Cord Stimulation ◽

Pulse Generator ◽

Clinical Success ◽

Real Life ◽

Intensity Rating ◽

Pain Mapping

While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of “Failed SCS Syndrome’ (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverage (LoC). Development of technologies associating new paresthesia-free stimulation waveforms and implanted pulse generator adapters provide opportunities to manage patients with LoE. The main goal of our study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing LoE. We retrospectively analyzed a cohort of patients who were offered new SCS programs/waveforms through an implanted adapter between 2018 and 2021. Patients were evaluated before and at 1-, 3-, 6- and 12-month follow-ups. Outcomes included pain intensity rating with a Visual Analog Scale (VAS), pain/coverage mappings and stimulation preferences. Last follow-up evaluations (N = 27) showed significant improvement in VAS (p = 0.0001), ODI (p = 0.021) and quality of life (p = 0.023). In the 11/27 patients with LoC, SCS efficacy on pain intensity (36.89%) was accompanied via paresthesia coverage recovery (55.57%) and pain surface decrease (47.01%). At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. SCS conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting. In light of these results, adapters could be integrated in SCS rescue algorithms or should be considered in SCS rescue.

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Sleep quality, daytime sleepiness and daytime functioning among Thai obstructive sleep apnea patients receiving continuous positive airway pressure therapy

Journal of Health Research ◽

10.1108/jhr-07-2020-0260 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Theerakorn Theerakittikul ◽

Jindarat Chaiard ◽

Jirawan Deeluea

Keyword(s):

Sleep Quality ◽

Daytime Sleepiness ◽

Positive Airway Pressure ◽

Quality Of Sleep ◽

Daytime Functioning ◽

Content Type ◽

Cpap Treatment ◽

Obstructive Sleep

PurposeThe purpose is to assess the effectiveness of continuous positive airway pressure (CPAP) treatment on sleep quality, daytime sleepiness and daytime functioning among Thai obstructive sleep apnea (OSA) patients.Design/methodology/approachA repeated measures clinical intervention design was implemented. Participants were 50 patients first time diagnosed with OSA and prescribed CPAP treatment. The intervention composed of CPAP health education, and follow-up evaluation. Data on CPAP adherence were downloaded from Smartcards of the CPAP device. The Thai PSQI, ESS and FSAQ-10 questionnaires were administered at baseline, 1-month, and 3-months. Descriptive statistics and repeated measure analysis with multilevel mixed-effects modeling approach were used.FindingsThirty-nine participants completed the study. Approximately 53% (n = 25) and 71.1% (n = 27) of the patients adhered to CPAP treatment by the end of the 1- and 3-months, respectively. After controlling for patients’ adherence, at 1-month follow-up, the intervention improved quality of sleep (β = −2.65, 95% CI = −1.60, −4.13), daytime functioning (β = 3.24, 95% CI = 1.87, 4.61) and decreased daytime sleepiness (β = −3.29, 95% CI = −1.85, −4.73). At 3 months, the intervention still improved quality of sleep (β = −3.53, 95% CI = −2.05, −5.01), and daytime functioning (β = 4.34, 95% CI = 2.76, 5.92), and decreased daytime sleepiness (β = −4.82, 95% CI = −3.16, −6.49).Originality/valueAdherence to CPAP treatment is effective in improving sleep quality, daytime functioning and reducing daytime sleepiness. Patient-oriented strategies for enhancing CPAP adherence should be developed and implemented as a standard care in sleep clinics.

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Effect of a Sleep Hygiene Education Program Using Telephone Follow-up Method on the Sleep Quality of the Elderly

Salmand ◽

10.32598/sija.15.4.2895.1 ◽

2021 ◽

Vol 15 (4) ◽

pp. 484-495

Author(s):

Maryam Moradi ◽

◽

Hamideh Mohammadzadeh ◽

Reza Noori ◽

Kokab Basiri Moghadam ◽

...

Keyword(s):

Sleep Quality ◽

Education Program ◽

Intervention Group ◽

The Elderly ◽

Sleep Hygiene ◽

Control Group ◽

Hygiene Education ◽

And Control

Objectives: Low quality sleep is one of the most common problems in old age. The present study aims to determine the effect of a sleep hygiene education program using Telephone Follow-Up (TFU) method on the sleep quality of the elderly. Methods & Materials: This quasi-experimental study was conducted on 80 eligible elderly people aged 60-74 years who were selected using a systematic random sampling method and were randomly assigned into intervention and control groups. The intervention group received a one-hour face-to-face education session on sleep hygiene. The TFU were carried out two times per week in the first month and once a week in the second month after intervention. The control group received routine care. The data collection tools were a demographic form and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI was completed for both groups immediately after the second month. Results: There was no statistically significant difference in the mean PSQI score before intervention in the intervention (8.02) and control (7.47) groups (P=0.32), but after the intervention, the mean PSQI score in the intervention group (5.42) was significantly reduced compared to the control group (7.67) (P<0.001). Conclusion: Sleep hygiene education program based on TFU improves the sleep quality of the elderly. It is recommended that health care providers use this method to improve the sleep quality of the elderly.

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Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty

Ciência & Saúde Coletiva ◽

10.1590/1413-81232014196.04632013 ◽

2014 ◽

Vol 19 (6) ◽

pp. 1881-1888 ◽

Cited By ~ 9

Author(s):

María Dolores Herrero-Sánchez ◽

María del Carmen García-Iñigo ◽

Blanca Soledad Nuño-Beato-Redondo ◽

César Fernández-de-las-Peñas ◽

Francisco Alburquerque-Sendín

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Sleep Quality ◽

Pain Intensity ◽

Social Role ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Total Knee

The scope of this paper was to study the relationship between pain intensity, health-related quality of life, disability, sleep quality and demographic data in elderly people with total knee arthroplasty (TKA). 24 subjects who had been subjected to TKA the previous month (4 females; 66 ± 9years) and 21 comparable controls (8 male; 70 ± 9years) participated in the study. Intensity of pain, and highest and lowest pain intensity experienced in the preceding week were collected. The Western Ontario and McMaster Universities index function, quality of life (Medical Outcomes Study Short Form 36), and Pittsburgh Sleep Quality Index were assessed. Age, gender, weight, height, body mass index were also collected. Individuals with TKA presented worse physical function (P < 0.01), social role (P = 0.01), physical performance (P < 0.01), pain (P = 0.04), disability (P = 0.04) and sleep quality (P = 0.03) than the controls. Higher intensity of pain was associated with lower physical function, social role, mental health, vitality and general health, and with higher disability and sleep quality. Disability and sleep quality were negatively associated with several quality of life domains. The associations between the intensity of pain, disability, quality of life and sleep reveal the multidimensional experience of TKA.

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Sleep Pattern and Predictors of Sleep Disturbance Among Family Caregivers of Terminal Ill Patients With Cancer in Taiwan: A Longitudinal Study

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118755453 ◽

2018 ◽

Vol 35 (8) ◽

pp. 1109-1117 ◽

Cited By ~ 4

Author(s):

Kwo-Chen Lee ◽

Ya-Ling Hsieh ◽

Pi-Chu Lin ◽

Yun-Ping Lin

Keyword(s):

Longitudinal Study ◽

Sleep Quality ◽

Sleep Disturbance ◽

Family Caregivers ◽

Terminally Ill ◽

Patients With Cancer ◽

Terminally Ill Patients ◽

Prospective Longitudinal

Background: Sleep disturbance commonly has a negative impact on the well-being of family caregivers (FCs) of terminally ill patients with cancer. The effect of sleep disturbance on FCs has not been explored through long-term follow-up studies in Taiwan. Objective: The purposes of this study were to (1) identify the trajectory of sleep quality of FCs of terminally ill patients with cancer in Taiwan and (2) examine the determinants of sleep disturbance through a longitudinal follow-up until patient death. Methods: A prospective, longitudinal study was conducted among 95 FCs of terminally ill patients with cancer. The FCs’ sleep quality was measured subjectively by using the Pittsburgh Sleep Quality Index and objectively by wearing a wrist actigraphy for 48 hours each month during the 6-month follow-up assessments. The trajectory and determinants of sleep quality were identified using a generalized estimation equation approach. Results: The FCs’ sleep quality significantly decreased as the patient’s death approached. Family caregivers who were women or older, had a relative with a longer survival period after diagnosis, reported higher levels of depression and fatigue, and provided lower levels of assistance to their relatives experienced more sleep disturbance. Conclusion: The sleep quality of Taiwanese FCs significantly deteriorated as the death of the terminally ill patients with cancer approached. Early detection of the FCs’ sleep disturbance, increasing their self-awareness of sleep problems, and providing nonpharmacological interventions and psychosocial support may be helpful for FCs to improve their quantity and quality of sleep.

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