Francisco J. Dominguez-Muñoz

Exergames for women with fibromyalgia: a randomised controlled trial to evaluate the effects on mobility skills, balance and fear of falling

Background Exergames are a new form of rehabilitation that combine the characteristics of physical exercise and the benefits of non-immersive virtual reality (VR). Effects of this novel therapy in women fibromyalgia are still unknown. The objective was to evaluate the effects of exergame-based intervention on mobility skills, balance and fear of falling in women with fibromyalgia. Methods This study was a randomized controlled trial with concealed allocation. Seventy-six women with fibromyalgia were divided into two groups: the exercise group received an eight week intervention based on exergames, while the control group continued their usual activities. Mobility skills were evaluated using the timed up and go test, while balance was assessed using the functional reach test, and the CTSIB protocol. Fear of falling was evaluated on a scale of 0–100 (0, no fear; 100, extreme fear). Measurements were performed before and after the intervention. A repeated-measures linear mixed model was used to compare the effects of the intervention between the two groups. Results The exercise group was significantly quicker than the control group in the timed up and go test (MD, −0.71; 95% CI [−1.09–0.32]; p < 0.001). There were also significant improvements in functional reach and a reduced fear of falling (MD, 4.34; 95% CI [1.39–7.30]; p = 0.005 and MD, −9.85; 95% CI [−0.19–−0.08]; p = 0.048, respectively). Discussion The improved TUG observed herein was better than the smallest real difference. Based on the results on mobility skills, balance and fear of falling, exergames may be an effective tool as a therapy for women with fibromyalgia.

Effects of Exergames on Quality of Life, Pain, and Disease Effect in Women With Fibromyalgia: A Randomized Controlled Trial

OBJECTIVE To evaluate the effects of an exergame-based intervention on a population sample of women with fibromyalgia. DESIGN Single-blinded, randomized controlled trial with 8-week intervention. SETTING Fibromyalgia center. PARTICIPANTS Participants (all women) (N=83) were divided into 2 groups: an exercise group (n=42; mean age ± SD, 52.52±9.73y) and a nonexercise group (n=41; mean age ± SD, 52.47±8.75y). INTERVENTIONS Women in the exercise group completed an 8-week exergame-based training program, which was focused on postural control and coordination of the upper and lower limbs, aerobic conditioning, strength, and mobility. Women (groups of 3) were encouraged to exercise for 120 minutes (over 2 sessions) per week. MAIN OUTCOME MEASURES Main outcome measures included pain and disease effect, which were assessed with the Fibromyalgia Impact Questionnaire (FIQ), a specific measure for fibromyalgia. Secondary outcome measure included quality of life, which was assessed with the EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) generic instrument. RESULTS The results showed that 97.62% of participants in the exercise group completed the 8-week intervention. The exercise group showed a significant improvement (P<.05) in the EQ-5D-5L utility index, and in 3 of 5 dimensions. For the FIQ, significant improvements were observed in the dimensions of pain, stiffness, anxiety, and feel good. The FIQ score was also reduced. The mean between-group improvement was 8.25 (95% confidence interval, 2.85-13.65). CONCLUSIONS The results and levels of compliance/adherence suggest this exergame-based training program is an effective intervention for reducing pain and increasing health-related quality of life in women with fibromyalgia.

Reliability of the Timed Up and Go Test in Fibromyalgia

Purpose: The aim of the study was to evaluate the test–retest reliability of the timed up and go test using manual and automatic chronometer (chronopic) in women with fibromyalgia. Design: Cross-sectional study with convenience sample. Method: A total of 49 women with fibromyalgia, aged 50.20 ± 10.01 participated in the study. Findings: The intraclass correlation coefficient was .935 with the manual stopwatch and .955 with the chronopic. The smallest real difference using manual stopwatch was 9.327%, whereas for the timed up and go using the chronopic it was 7.708%. Mean of the three repetitions was significantly different (p = .005) between both chronometers. Conclusion: Timed up and go is a reliable physical fitness test for assessing agility/dynamic balance in women with fibromyalgia. Clinical Relevance: The reliability is higher when the time is tracked using an automatic chronometer, which is easy to use and not expensive in terms of time and money, the use of this device is recommended in the nursing practice.

Performance of women with fibromyalgia in walking up stairs while carrying a load

Background. Fibromyalgia is a chronic disease characterized by widespread pain and other associated symptoms. It has a relevant impact on physical fitness and the ability to perform daily living tasks. The objective of the study was to analyze the step-by-step-performance and the trunk tilt of women with fibromyalgia in the 10-step stair climbing test compared with healthy controls. Methods. A cross-sectional study was carried out. Twelve women suffering from fibromyalgia and eight healthy controls were recruited from a local association. Participants were asked to climb 10 stairs without carrying a load and 10 stairs carrying a load of 5 kg in each hand. Mediolateral trunk tilt was assessed using the “Functional Assessment of Biomechanics (FAB)” wireless motion capture device, and the time between steps was assessed via weight-bearing insoles. Results. Trunk tilt in the stair-climbing task carrying a load was significantly higher in women with fibromyalgia when compared to the healthy controls (2.31 (0.63) vs. 1.69 (0.51) respectively). The effect of carrying a load was significantly higher for women with fibromyalgia compared with healthy controls at the intermediate and final part of the task. Discussion. Trunk tilt during stair climbing while carrying a load was higher in women with FM, which could increase the risk of falling. Additionally, women with FM experienced a higher pace slowdown as a consequence of the load, which supports the need of including specific strength and resistance training to physical therapies for this population.

Impact of Fibromyalgia in the Sit-to-Stand-to-Sit Performance Compared With Healthy Controls.

Fibromyalgia is associated with a reduction in the ability to perform activities of daily living. Sit‐to‐stand‐to‐sit performance is one of the most common activities of daily living and often is evaluated by counting the number of repetitions of the 30‐second chair‐stand test. No study, however, has examined the performance over the 30 seconds of this test of female patients with fibromyalgia on a phase‐by‐phase basis.

Stair negotiation in women with fibromyalgia: A descriptive correlational study.

Abstract Walking up and down stairs is a common and important activity of daily living. Women with fibromyalgia often show a reduced ability to perform this task. The objective of this study was to evaluate the test–retest reliability of stair negotiation tasks and to assess the impact of fibromyalgia symptoms on the ability to negotiate stairs. Forty-two women with fibromyalgia participated in this descriptive correlational study. The relevance of the stair negotiation (both walking up and down) was evaluated by assessing its association with the revised version of the fibromyalgia impact questionnaire (FIQ-R) and other health-related variables. Test–retest reliability was also analyzed. The main outcome measures were time spent walking up and down stairs and impact of fibromyalgia, quality of life, number of falls, weight, and lower limb strength and endurance. The intraclass correlation coefficient (ICC) for stair descent was 0.929 whereas that for ascent was 0.972. The score in these tests correlated significantly with the total score for the FIQ-R and the score for many of dimensions and symptoms: that is, physical function, overall impact of fibromyalgia, pain, energy, stiffness, restorative sleep, tenderness, self-perceived balance problems, and sensitivity. Given the importance of the stair negotiation as activity of daily living and the high reliability, both stair ascent and descent tasks may be useful as outcome measures in studies on patients with fibromyalgia.

Cost-Utility Analysis of a Six-Weeks Ganoderma Lucidum-Based Treatment for Women with Fibromyalgia: A Randomized Double-Blind, Active Placebo-Controlled Trial

Abstract Purpose: To determine the effectiveness of adding Ganoderma lucidum (GL) to standard care for patients with fibromyalgia (FM), and to examine the costs per quality-adjusted life year (QALY) gained from this nutritional supplementation. Materials and methods: This was a randomised controlled trial with a random allocation of participants to two groups; experimental group and active-placebo controlled group. A total of 26 women with FM participated in the experimental group. These participants were instructed to take 3 g of micromilled GL twice a day for six weeks. EQ-5D-5L was used to obtain the utilities and a non-parametric bootstrap was used to plot the acceptability curve. Results: Of the women initially recruited, over 81% completed the experimental treatment. The incremental QALY in the GL group was 0.177, and the incremental QALY in the active placebo group was 0.101. Therefore, the difference in terms of QALYs was 0.076 and the incremental cost-utility ratio was €1348.55/QALYs. The cost-utility acceptability curve showed 90% probability that the addition of GL to the standard care as a nutritional supplement is cost-effective. Conclusions: The GL as nutritional supplementation in patients with FM is cost-effective in women with FM. To authors’ knowledge, the current study reports the first cost-utility analysis of GL as a nutritional supplement.