Cervical Canal Microbiota Features in Second Trimester of Pregnancy in Insuficiencia Istmicocervical with Clinical Signs of Vulvovaginitis Depending on Vaginal Discharge рH

Study Objective: To study the microbiological composition of cervical canal in insuficiencia istmicocervical (IIC) in patients with vulvovaginitis depending on vaginal discharge рH. Study Design: perspective study. Materials and Methods. The study included 67 patients of reproductive age with clinical signs of vulvovaginitis and IIC. Where vaginal discharge рН was > 4.5, patients were prescribed empirical Metrogil Plus; these women comprised the study group (n = 40). Where vaginal discharge рН was ≤ 4.5, patients were prescribed empirical Tergynan; these women were controls (n = 27). Baseline anthropometric, social, clinical and anamnestic data, pregnancy characteristics and parity were recorded; then women underwent examination, and samples were collected for analysis (bacterioscopy, vaginal discharge рН measurement, bacteriological test). On day 9–11 of hospitalisation, patients had another speculum examination; clinical symptoms dynamics, pH and bacterioscopic test results were evaluated. Satisfaction with therapy, compliance and therapy-related arverse events were recorded. Study Results. Various Staphylococcus spp. were the most prevalent cause of the conditions in the study group (n = 17; 42.5%). In controls this value was 12 (44.4%). Staphylococcus spp. were mostly opportunistic saprophytic flora and usually were not pathogens, except for Staphylococcus haemolyticus, which was found in 11 (27.5%) patients in the study group and in 3 (11.1%) controls. Lactobacillus spp. Was diagnosed more often in controls than in the study group: 12 (44.4%) vs. 9 (22.5%) (р = 0.05). The control group was diagnosed only with Lactobacillus crispatus, Lactobacillus jensenii; they also prevailed in the study group, together with Lactobacillus gasseri, Lactobacillus paracasei. At рН > 4.5, cervical canal culture was characterised with a variety of opportunistic pathogens and normal flora. After the therapy, patients in both groups did not complain of vaginal discharges. Physical examination demonstrated normal vaginal wall colour and moderate discharges. Vaginal discharge pH was significantly lower in the study group and was normal in controls. Conclusion. The majority of patients with vulvovaginitis and IIC in the second trimester of pregnancy had lower prevalence as well as lower absolute and relative amount of Lactobacillus spp. in their cervical canal discharge. At the same time, increase in vaginal рН is associated with changes in the quality ratio of lactic acid bacilli. Keywords: cervical canal microbiota, insuficiencia istmicocervical, vaginal discharge рH, vulvovaginitis

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Hemostasis in Infertile Patients Participating in Assisted Reproduction Programmes

Doctor Ru ◽

10.31550/1727-2378-2021-20-6-6-11 ◽

2021 ◽

Vol 20 (6) ◽

pp. 6-11

Author(s):

A.O. Godzoeva ◽

◽

I.E. Zazerskaya ◽

V.S. Vlasov ◽

T.V. Vavilova ◽

...

Keyword(s):

Reproductive Technologies ◽

Control Group ◽

Study Group ◽

Study Objective ◽

Hemostasis System ◽

Fibrin Monomer ◽

Study Results ◽

Venous Thromboembolic Events ◽

The Impact ◽

Infertile Patients

Study Objective: To evaluate the impact of multifollicular ovarian stimulation in in vitro fertilisation (IVF) programmes on hemostasis. Study Design: perspective comparative study. Materials and Methods. The study included 68 patients divided into two groups: study group (n = 36) — infertile patients; control group (n = 32) — healthy non-pregnant women of reproductive age. The protocol with gonadotrophin releasing hormone antagonists was used for ovulation stimulation. Hemostasis system in study patients was evaluated in 2 weeks after embryos were transferred to uterus; in control group — on day 20–22 of menstrual period. For the study group, we evaluated clotting test parameters of hemostasis system, D-dimers (D-d) and fibrin monomer (FM). Study Results. We have not found statistically significant differences between hemostasis screening results of study groups. We have identified increase in pro-coagulatory properties of blood in the study group patients: increase in FM and D-d (р < 0.0001 in both cases). There is an association between study parameters and pregnancy (p < 0.001) and no association with obesity, age and infertility. Conclusion. In IVF programme, FM and D-d levels rise, evidencing hypercoagulation development. An increase in FM levels was even more significant and can be used as an early and specific fibrogenesis marker. Keywords: assisted reproductive technologies, fibrin monomer, D-dimer, hypercoagulation, venous thromboembolic events.

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Microbiota of Bronchial Tree in Children with Bronchial Asthma: today and 20 years ago

Doctor Ru ◽

10.31550/1727-2378-2021-20-10-25-30 ◽

2021 ◽

Vol 20 (10) ◽

pp. 25-30

Author(s):

I.A. Fedorov ◽

◽

O.G. Rybakova ◽

E.A. Goreva ◽

◽

...

Keyword(s):

Respiratory Tract ◽

Bronchial Asthma ◽

Lower Respiratory Tract ◽

Bronchial Tree ◽

Induced Sputum ◽

Cross Sectional ◽

Study Objective ◽

Study Results ◽

Inflammatory Phenotype ◽

Staphylococcus Spp

Study Objective: To analyze the microbiota of the lower respiratory tract in children with bronchial asthma, depending on the severity, period of the disease and inflammatory phenotype, as well as to compare the obtained data on the microbiota with the data obtained two decades ago. Study Design: The study is organized in a cross-sectional manner. Materials and Methods. The study involved 66 children with bronchial asthma aged 6 to 18 years old. All participants had their microbiota of the bronchial tree studied by bacteriological examination of induced sputum samples; in some children, the cytology of induced sputum was analyzed (n = 36). Statistical analysis was performed using Statistica 10.0. Intergroup differences in qualitative parameters were evaluated using χ2 and Fisher’s exact test. Statistically significant changes were are p < 0.05. Study Results. The predominant flora of the lower respiratory tract in children with bronchial asthma was Streptococcus spp. (66.7%), Staphylococcus spp. (33.3%) and Neisseria spp. (30.3%). There were no significant differences in the spectrum of the microflora of the bronchial tree depending on the period (exacerbation/remission) and the severity of the disease. When analysing the spectrum of the microbiota depending on the inflammatory phenotype, it was found that all sputum samples from patients with neutrophilic inflammatory phenotype were inoculated with Streptococcus spp., and in 25% of cases it was Streptococcus pneumonia. In patients with an eosinophilic inflammatory phenotype, most common was Staphylococcus spp. (75.0%), in particular Staphylococcus aureus (62.5%). When analysing the spectrum of microflora in a temporal aspect, it turned out that 20 years ago 41.2% of sputum samples did no demonstrate microflora growth. The growth of Streptococcus spp. and, in particular, Streptococcus pneumoniae, was significantly less frequent, Staphylococcus spp. were shown with the same frequency as now. Conclusion. The relationship between bronchial asthma and airway microbiota is complex and controversial. The revealed patterns show that the severity of bronchial asthma and the period of the disease do not affect the spectrum of microflora; however, statistically significant differences were found depending on the inflammatory phenotype. Since asthma phenotypes are immunological and physical-chemical characteristics of the mucous membrane of lower respiratory tract, this may be the reason for their selective impact of the microbial growth in respiratory tract, and on their biogeography, thus impacting the course and management of bronchial asthma. Keywords: bronchial asthma, respiratory tract microbiota, inflammatory phenotype, children.

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Neuro-Orthopedic Criteria of Dorsopathy in Pregnant Women

Doctor Ru ◽

10.31550/1727-2378-2021-20-5-43-48 ◽

2021 ◽

Vol 20 (5) ◽

pp. 43-48

Author(s):

E.V. Radzinskaya ◽

◽

I.V. Damulin ◽

◽

Keyword(s):

Pregnant Women ◽

Pelvic Ring ◽

Pubic Symphysis ◽

Study Group ◽

Study Objective ◽

Study Materials ◽

Lower Back ◽

Study Results ◽

Atlantooccipital Joint ◽

The Right

Study Objective: To improve the diagnostic and therapeutic efficiency of dorsopathy in pregnant women by introducing a neuro-orthopedic examination algorithm. Study Design: prospective cohort study. Materials and Methods. The study enrolled 171 pregnant women: 87 dorsopathy patients (study group) and 84 healty women (controls). Inclusion criteria in both groups were progressive single uterine pregnancy, while the inclusion criterion for the study group was lower back pain (LBP) or pelvic ring pain (PRP). Neuro-orthopedic examination complied with the Russian clinical recommendations. Study Results. Neuro-orthopedic criteria to differentiate between pregnant women with or without dorsopathy were lower craniosacral rhythm (7.37 ± 1.53 vs. 8.14 ± 1.46 cycle/min, р = 0.002); sacral counternutation (odds ratio (OR) = 2.66); somatic dysfunctions (SD) in the lower and/or middle third of the right shank, right knee, Th11 NSRL, right clavicle, atlantooccipital joint, cuniform bone (left torsion), dura mater. SD in the right hip and pubic symphysis was included into gestation-associated changes which were unrelated to dorsopathy (LBP and PRP). A probability of LBP and PRP during pregnancy is higher in right sacroiliac joint SD (OR = 13.28; 95% CI: 1.69-104.59). Conclusion. It is reasonable to use osteopathic methods in dorsopathy (LBP and PRP) during pregnancy. Neuro-orthopedic differential diagnosis of lower back and pelvic ring pain reduces the risk of unjustified therapy to prolong pregnancy. Keywords: dorsalgia, somatic dysfunction, pregnancy, neuro-orthopedic examination.

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Renal Dysfunction in Pre-eclampsia Patients: Prediction and Differential Diagnosis. Part 2

Doctor Ru ◽

10.31550/1727-2378-2020-19-8-7-13 ◽

2020 ◽

Vol 19 (8) ◽

pp. 7-13

Author(s):

V.F. Bezhenar ◽

◽

A.V. Smirnov ◽

R.R. Temirbulatov ◽

K.A. Gabelova ◽

...

Keyword(s):

Cystatin C ◽

Prognostic Value ◽

Perinatal Outcomes ◽

Angiogenic Factors ◽

Second Trimester ◽

Diagnostic Significance ◽

Study Objective ◽

Hypertensive Disorders ◽

Group I ◽

Study Results

Study Objective: To assess the prognostic value, sensitivity, and specificity of biomarkers of acute renal injury (ARI), and of angiogenic factors, in the development of pre-eclampsia (PE) in the second trimester of pregnancy, and determine their diagnostic significance for PE, as well as to compare obstetric and perinatal outcomes experienced by patients. Study Design: This was a comparative, group, prospective and retrospective study. Materials and Methods: The patient groups studied in the first, second, and third phases are described in Part 1 of this article. Based on the distinguishing diagnostic criterion and the outcomes of pregnancy, the 138 patients were divided into three groups. Group I (main) consisted of 66 (47.8%) patients who developed hypertensive disorders during pregnancy, 30 (21.7%) of whom were included in subgroup 1 (CKD) and 36 (26.1%) in subgroup 2 (no CKD). Group II (comparison) was made up of 32 patients with CKD who did not have hypertensive disorders. Group III (control) comprised 40 women with normal pregnancies and no history of reproductive disorders. The fourth phase involved a retrospective analysis of biomarker levels and assessment of their prognostic value for the development of PE. All participants underwent clinical and laboratory examinations and had measurements taken for sFlt-1, PlGF, S-endoglin, cystatin C, uKIM-1, podocalyxin, and α1- and β2-microglobulins. Obstetric and perinatal outcomes were traced. Study Results: Levels of the following parameters had the greatest prognostic value in the second trimester of pregnancy: PlGF (94%), sFlt-1 (92%), sFlt-1/PlGF (94%), ΔPlGF (93.3%), ΔsFlt-1 (92%), ΔsFlt-1/PlGF (94%), S-endoglin (94%), and sNGAL (94%). The sensitivity of the sFlt-1/PlGF ratio at this stage of pregnancy was 89.1%, making this parameter a promising predictive marker of PE. Logistic regression analysis showed that it is most reasonable to measure sFlt-1/PlGF and sNGAL levels in the first trimester; and in the second trimester, ΔsFlt-1/PlGF (between the first and second trimesters) and sFlt-1/PlGF as well as levels of PlGF, S-endoglin, uKIM-1, urinary podocalyxin, and sNGAL. In both subgroups of patients with PE, there were critical hemodynamic disruptions in the fetal-placental-maternal system: six (20%) and eight (22.2%) cases in subgroups 1 and 2, respectively. Pre-term delivery in patients with pre-existing intrauterine growth retardation led to the necessity of putting 22 (73.3%) newborns from the first subgroup and seven (19.4%) newborns from the second subgroup on mechanical ventilation (p<0.0001). Conclusion: Some weeks before the clinical onset of PE, at weeks 16-24 of pregnancy, patients develop placental dysfunction, decreases or slight increases in PlGF levels, and elevation of sFlt-1 levels, reflecting an imbalance between pro-angiogenic and anti-angiogenic factors; there is also an increase in the levels of markers of ARI (sNGAL, uKIM-1, β2- and α1-microglobulins, and urinary podocalyxin). The clinical information obtained about perinatal outcomes indirectly confirms the role of the cascade of pathogenic events in chronic placental insufficiency, in the development of generalized endothelial dysfunction. Keywords: pre-eclampsia, predictive diagnosis, chronic kidney disease, sFlt-1, PlGF, S-endoglin, cystatin C, KIM-1, podocalyxin, α1-microglobulin, β2-microglobulin.

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Bacterial Lysate in the Therapy of Acute and Recurrent Respiratory Infections in Children

Doctor Ru ◽

10.31550/1727-2378-2021-11-16 ◽

2021 ◽

Vol 20 (3) ◽

pp. 11-16

Author(s):

O.I. Pikuza ◽

◽

R.A. Faizullina ◽

A.M. Zakirova ◽

T.B. Moroz ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Control Group ◽

Study Group ◽

Bacterial Lysate ◽

Local Immunity ◽

Study Objective ◽

Recurrent Respiratory Infections ◽

Study Results

Study Objective: To study the clinical efficacy of adding the novel mechanical bacterial lysate to the therapy and its effect for the local immunity in children with acute and recurrent respiratory infections in children. Study Design: comparative study. Materials and Methods. The study included 97 children hospitalised with uneventful moderate bronchitis. The subjects were divided into two groups comparable on all selection parameters. Study group: 54 patients, 3 to 10 years old, who had a microbial immunomodulatory (bacterial lysate) added to the standard therapy, 1 sublingual tablet once daily: 25 children with acute bronchitis — for 10 days; 29 children with recurrent bronchitis — 3 x 10 days with 20-day intervals. Control group included 43 children of the same age (22 subjects with acute disease and 21 — with recurrent disease) who were prescribed general therapy only. Clinical examination results and local immunity were assessed using rhinocytogram and cytokine status. Study Results. The clinical effect of the bacterial lysate was 2.4-fold reduction in acute respiratory infection rate. Acute respiratory infection duration reduced by 1.3 times. Arrest of the respiratory syndrome with the help of bacterial lysate was recorded in 10.3 ± 0.2 days, while in control group it was 13.5 ± 0.4 days (р = 0.041). The study group demonstrated statistically significant reduction in the neutrophil and epithelial cell court (rhinocytogram), interleukin-8 and tumour necrosis factor α, markers of a system respiratory inflammation. Conclusion. Prescription of the product for prevention and therapy ensures reduction in morbidity rates; it is well-tolerated, easy-to-use and has no adverse drug reactions, facilitating compliance in children and their parents. Keywords: children, acute and recurrent infections, bacterial lysate.

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Search for Markers in HPV-Associated Cervical Lesions Using the Chromatography-Mass Spectrometry

Doctor Ru ◽

10.31550/1727-2378-2021-20-8-48-58 ◽

2021 ◽

Vol 20 (8) ◽

pp. 48-58

Author(s):

D.I. Attoeva ◽

◽

N.L. Starodubtseva ◽

N.M. Nazarova ◽

A.O. Tokareva ◽

...

Keyword(s):

Mass Spectrometry ◽

Cervical Cancer ◽

Negative Ions ◽

Negative Ion ◽

Cervical Canal ◽

Low Grade ◽

Model Accuracy ◽

Study Objective ◽

Chromatography Mass Spectrometry ◽

Study Results

Study Objective: To study the lipid composition of cervical epithelium in HPV-associated lesions in order to search for markers for early noninvasive diagnosis of squamous intraepithelial lesions (SIL) of the cervix. Study Design: cross-sectional prospective cohort study. Materials and Methods. The study included 124 patients aged 21 to 45 years old. For scraping of the epithelium in the cervix and cervical canal, a cervical brush was used. The lipidic extract from a scraping sample was analysed with the use of chromatography-mass spectrometry (positive and negative ions). Possible markers were searched for with the help of the Mann-Whitney test and analysis of views for hidden structures; logistic regression variables were selected based on the Akaike information criterion. The models were tested with cross validation of a separate item. Study Results. We have identified lipids belonging to cholesterol esters, phosphatidylcholines, ceramides and sphingomyelins, which allow differentiating between normal conditions, cervicitis, high- and low-grade SIL, and cervical cancer. The model accuracy for positive and negative ion modes was 70% and 71%, respectively. The final model accuracy was 79% and demonstrated high predicative value for cervicitis and cervical cancer and moderate predicative value for low-grade SIL vs. norm. Conclusion. The potential for non-invasive cervical SIL differentiation using lipid markers has been demonstrated. Keywords: neoplastic lesions, cervical cancer, lipids, diagnosis.

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Parasitic GIT Damage in School Children Diagnosed with Clinical Tests and Ultrasound Imaging

Doctor Ru ◽

10.31550/1727-2378-2021-20-3-29-32 ◽

2021 ◽

Vol 20 (3) ◽

pp. 29-32

Author(s):

D.S. Aleksashina ◽

◽

R.S. Arakelyan ◽

M.V. Bogdanyants ◽

E.I. Okunskaya ◽

...

Keyword(s):

Ultrasound Imaging ◽

School Children ◽

Clinical Signs ◽

Biliary Dyskinesia ◽

Primary School Children ◽

Personal Hygiene ◽

Study Objective ◽

Imaging Results ◽

Study Results ◽

Liver Changes

Study Objective: To analyse parasitic GIT damage in children in Astrakhan Region as exemplified by Lamblia intestinalis invasion. Study Design: real-time epidemiological analysis. Materials and Methods. Follow-up enrolled 131 children aged 2.5 to 17 years with lambliosis, including 55 (42.0%) school children. Parasitic GIT damage was diagnosed in 33 (60.0%) school children. The highest percentage of subjects with GIT damage and lambliosis was recorded in children aged 7 to 14 years — 21 out of 33 (63.6%) children. Study Results. All children came from organised groups (school children). All followed up children had clinical signs of GIT damage (ultrasound imaging results): reactive pancreas changes — 2 (6.1%), reactive liver changes — 5 (15.2%), signs of biliary dyskinesia — 12 (36.3%), a combination of liver and pancreas damage — 4 (12.1%), a combination of liver, pancreas damage and signs of biliary dyskinesia — 5 (15.2%), liver damage and signs of biliary dyskinesia — 3 (9%), and pancreas damage and signs of biliary dyskinesia — 2 (6.1%). In the majority of cases (n = 25; 75.8%), children were treated with Nifuratel 15 mg/kg twice daily for 7 days. Albendazole 12 mg/kg once daily for 5-7 days was prescribed to 8 (24.2%) children. Conclusion. Lambliosis was more common in primary school children; it can be indicative of inadequate knowledge of personal hygiene routine. The main causes of disease are poor personal hygiene and contact with pets, mostly with cats. Key complaints are abdominal pain, nausea, loss of appetite, loose stool and skin allergies. Keywords: lambliosis, geography, onychophagy, personal hygiene, reactive liver changes, reactive pancreas changes.

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Modern approaches to the treatment of mastitis in women of reproductive age

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.101 ◽

2016 ◽

pp. 191-108

Author(s):

A.A. Sukhanova ◽

◽

Yu.M. Melnik ◽

O.O. Karlova ◽

◽

...

Keyword(s):

Ultrasound Examination ◽

Clinical Signs ◽

Reproductive Age ◽

Herbal Remedies ◽

Control Group ◽

Women Of Reproductive Age ◽

Clinical Method ◽

Gynecological Examination ◽

Study Results ◽

Observation Period

The aim of the study: to study the efficacy and safety of use Mastofemin in the treatment of various forms of mastitis in women of reproductive age. Materials and methods. The study included 62 women of reproductive age (mean age of 33.5±2.3 years) who were screened in the Kiev city center reproductive and perinatal medicine. Women were divided into 2 groups. The first (main) group consisted of 32 patients who received the proposed treatment using herbal remedies Mastofemin 1 capsule 2 times per day for 3 months; 30 patients of the second (control) group were under observation and received no treatment. These groups were representative and homogeneous on age, clinical symptoms and sonographic characteristics. The clinical method included evaluation of complaints of patients, anamnesis, presence of concomitant gynecologic pathology, inspection, palpation of the lymph nodes and the breast and obtaining a discharge from the nipples to conduct cytological examination, which allowed excluding from the study women with suspected malignancy of the process. All the patients were performed ultrasound examination of the breast. The review was supplemented with vaginal gynecological examination and ultrasound examination of small pelvis organs to assess the condition of the uterus and its appendages, the diagnosis of gynecological diseases. Results. Summarizing obtained in this study results one should stress the positive long-term effect of applying Mastofemin for the treatment of proliferative changes of the breast in women of reproductive age. This is manifested by a decrease in the intensity of clinical signs of mastitis, consistent with the results of sonographic control. Established positive dynamics in the treatment of cystic mastitis, dectective and when combined cystic mastopathy with dectective. In the control group of patients for a given observation period (6 months) no significant changes in clinical signs of mastitis and sonographic characteristics. Regression of disease has not occurred in any of the patients, in 2 patients increased sensitivity of the breast after 6 months moved to the soreness. Sonographic characteristics of mastitis during the observation period did not change. Thus, the use of Mastofemin aimed at pathogenetic treatment of mastitis and prevention of breast cancer. Conclusion. Application of Mastofemin during the treatment of mastitis in women of reproductive age significantly improves the clinical condition of patients; reduce the subjective and objective symptoms of the disease. The positive effect of the treatment with Mastofemin proved in the case of the treatment of sonographic following forms of mastitis: cystic mastopathy, cystic mastopathy with dectectasy. Mastofemin may be the drug of choice for complex conservative monotherapy in women of reproductive age with proliferative changes in the breast, and can also be used as part of complex treatment in patients with diffuse changes of the breast when combined with hyperplastic processes of the myometrium and endometrium. Keywords: mastopathy, breast gland, herbal medicine, herbal remedies, Mastofemin.

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Efficacy of intrauterine administration of autologous peripheral blood mononuclear cells prior to embryo transfer in patients with recurrent implantation failures in assisted reproductive technology programmes

GYNECOLOGY ◽

10.26442/2079-5696_2018.2.28-33 ◽

2018 ◽

Vol 20 (2) ◽

pp. 28-33

Author(s):

T S Amyan ◽

S G Perminova ◽

L V Krechetova ◽

V V Vtorushina

Keyword(s):

Embryo Transfer ◽

Peripheral Blood Mononuclear Cells ◽

Peripheral Blood ◽

Mononuclear Cells ◽

Peripheral Blood Mononuclear ◽

Study Objective ◽

Study Results ◽

Blood Mononuclear Cells ◽

History Of ◽

Group 2

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

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Effects of a physical self-care support program for patients with fibromyalgia: A randomized controlled trial

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191820 ◽

2021 ◽

pp. 1-10

Author(s):

Suélem B. de Lorena ◽

Angela L.B.P. Duarte ◽

Markus Bredemeier ◽

Vanessa M. Fernandes ◽

Eduardo A.S. Pimentel ◽

...

Keyword(s):

Controlled Trial ◽

Fibromyalgia Impact Questionnaire ◽

Self Care ◽

Support Program ◽

Control Group ◽

Study Objective ◽

Study Results ◽

Significant Difference ◽

Stretching Exercises ◽

Care Support

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the CONTROL group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.

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