Juliana Ferreira Sauer

Prevalence of fibromyalgia in a low socioeconomic status population

BackgroundThe aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil.MethodsWe cross-sectionally sampled individuals assisted by the public primary health care system (n = 768, 35–60 years old). Participants were interviewed by phone and screened about pain. They were then invited to be clinically assessed (304 accepted). Pain was estimated using a Visual Analogue Scale (VAS). Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ), as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level = 5%).ResultsFrom the phone-interview screening, we divided participants (n = 768) in three groups: No Pain (NP) (n = 185); Regional Pain (RP) (n = 388) and Widespread Pain (WP) (n = 106). Among those participating in the clinical assessments, (304 subjects), the prevalence of fibromyalgia was 4.4% (95% confidence interval [2.6%; 6.3%]). Symptoms of pain (VAS and FIQ), feeling well, job ability, fatigue, morning tiredness, stiffness, anxiety and depression were statically different among the groups. In multivariate analyses we found that individuals with FM and WP had significantly higher impairment than those with RP and NP. FM and WP were similarly disabling. Similarly, RP was no significantly different than NP.ConclusionFibromyalgia is prevalent in the low socioeconomic status population assisted by the public primary health care system. Prevalence was similar to other studies (4.4%) in a more diverse socioeconomic population. Individuals with FM and WP have significant impact in their well being.

Associação da qualidade de vida com dor, ansiedade e depressão

O objetivo deste estudo foi verificar associacao entre qualidade de vida relacionada a saude e dor, ansiedade e depressao em individuos de 35 a 60 anos. Foram avaliados 304 individuos (244 mulheres, 60 homens) com queixa de dor, divididos em tres grupos segundo a caracteristica da dor: dor difusa e cronica (DDC), dor regional (DR) e dor esporadica (DE). A intensidade da dor foi avaliada por uma escala visual analogica, ansiedade pelo Inventario de Ansiedade Traco-Estado, depressao pela escala de depressao de Beck e a qualidade de vida (QV), pelo questionario Short-Form Health Survey - SF-36. A media de idade foi 49,1±6,8 anos; 80,3% eram do sexo feminino; e 35% da amostra referiu dor difusa e cronica. Os resultados mostram que o grupo DDC apresentou os sintomas mais intensos de dor, ansiedade, depressao e pior qualidade de vida, seguido pelos grupos DR e DE, com diferenca estatisticamente significante (p<0,001). A correlacao entre qualidade de vida e depressao foi forte (r=-0,73) e moderada entre qualidade de vida e dor (r=-0,41), entre QV e ansiedade-traco (r=-0,65), e entre QV e ansiedade-estado (r=-0,58) (p<0,0001). Os individuos com dor difusa e cronica foram pois os que apresentaram os sintomas mais intensos e pior qualidade de vida; e esta mostrou-se correlacionada negativamente a depressao, dor e ansiedade.

Efeito da acupuntura na melhora da dor, sono e qualidade de vida em pacientes fibromiálgicos: estudo preliminar

Fibromyalgia is a syndrome defined by chronic widespread pain and sensitivity to pressure at at least 11 of 18 tender points. The aim of this random blind clinical trial was to assess the effectiveness of acupuncture on pain relief, on quality of sleep and life in fibromyalgia patients. From 20 female fibromyalgic patients (diagnosed according to the American College of Rheumatology), mean aged 44 years, 12 completed the study, randomly assigned into two groups: group A (GA, n=5) received acupuncture according to the traditional Chinese medicine; and group B (GB, n=7) received acupuncture at eight tender points: at the occiput, trapezius muscle, supraspinatus muscle, and lateral epicondyle. Pain was assessed by a visual analogue scale and by dolorimetry; quality of life, by the Fibromyalgia Impact Questionnaire (FIQ); and sleep, by the Post Sleep Inventory. Both groups received acupuncture once a week for eight weeks, with insertion of eight needles for 25 minutes. Data were statistically analysed and significance level set at α=0.05. Results show significant sleep improvement in GA; and, in GB, lesser pain as detected by VAS, higher pain threshold on tender points, better sleep and improvement in FIQ items pain, morning tiredness, anxiety, and depression (p<0.05). These data suggest that acupuncture, especially that with tender point needle insertion, provides pain relief, better quality of life and of sleep in fibromyalgic patients.

Fibromyalgia: is there association between balance and pain? a pilot study

Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group.

Quantitative Postural Analysis of Children With Congenital Visual Impairment

Objectives: The aim of this study was to compare the postural alignment of children with visual impairment with that of children without visual impairment. Methods: The sample studied was 74 children of both sexes ages 5 to 12 years. Of these, 34 had visual impairment and 40 were control children. Digital photos from the standing position were used to analyze posture. Postural variables, such as tilt of the head, shoulder position, scapula position, lateral deviation of the spine, ankle position in the frontal plane and head posture, angle of thoracic kyphosis, angle of lumbar lordosis, pelvis position, and knee position in the frontal and sagittal planes, were measured with the Postural Assessment Software 0.63, version 36 (SAPO, São Paulo, Brazil), with markers placed in predetermined bony landmarks. Results: The main results of this study showed that children with visual impairment have increased head tilt (P < .001), shoulder deviation in frontal plane (P = .004), lateral deviation of the spine (P < .001), changes in scapula position (P = .012), higher thoracic kyphosis (P = .004), and lower lumbar lordosis (P < .001). Conclusions: Visual impairment influences postural alignment. Children with visual impairment had increased head tilt, uneven shoulders, greater lateral deviation of the spine, thoracic kyphosis, lower lumbar lordosis, and more severe valgus deformities on knees.

Crianças com deficiência visual podem ter a amplitude de movimento articular alterada: um estudo observacional tipo caso-controle

To assess the articular range of motion in children with congenital visual impairment. Were evaluated 75 children between five and twelve years old, 49 with normal visual acuity and 26 visually impaired. Two evaluators performed the measure of active and passive range of motion by goniometry of shoulder and hip in all axes of motion. All examiners made a test of correlation between data obtained, to determine the inter-rater reliability, using the intraclass correlation coefficient (ICC). In individuals with visual impairments was statistically significant difference, with higher range of motion in individuals with visual impairments to medial and lateral rotation of shoulder and hip lateral rotation. Were found: high correlation in the inter-rater reliability (ICC>0.70) for 9 (22.5%) groups of articular range of motion, moderate correlation (0.7>ICC>0.5) for 25 (62.5%) groups and low correlation to 6 (15%) groups ranges of motion. Sampled children with congenital visual impairment showed greater joint mobility for rotational range of motion of the shoulder and hip than children with normal visual acuity, although they have also shown lower values for articular range of motion in abduction and extension in shoulders.Se evaluo la amplitud de movimiento articular en ninos con deficiencias visuales congenitas. Se evaluaron a 75 ninos con edades entre 5 y 12 anos, siendo 49 con acuidad visual normal y 26 con deficiencia visual. Dos evaluadores realizaron la medicion de la amplitud de movimiento articular activa y pasiva mediante goniometria del hombro y de la cadera, en todos los ejes de movimiento. Todos los evaluadores realizaron un test de correlacion entre los datos obtenidos para la determinacion de la fiabilidad interevaluador, por medio del coeficiente de correlacion intraclase (ICC). En los individuos con deficiencia visual hubo diferencia estadisticamente significativa, con mayores valores de amplitud de movimiento para la rotacion medial y lateral del hombro y rotacion lateral de la cadera. Fueron encontradas: alta correlacion de fiabilidad interevaluadores (ICC>0,70) para 9 (22,5%) grupos de amplitud de movimiento articular, correlacion moderada (0,7>ICC>0,5) para 25 (62,5%) grupos y baja correlacion para 6 (15%) grupos de amplitudes de movimiento. Los ninos incluidos en la muestra con deficiencia visual congenita presentaron mayor movilidad articular para las amplitudes de movimiento de rotacion del hombro y de la cadera que los ninos sin deficiencias visuales, aunque tambien presentaron valores mas bajos para la amplitud de movimiento articular de abduccion y extension de hombros.

Children with visual impairments may have altered joint movement: an observational case-control study

To assess the articular range of motion in children with congenital visual impairment. Were evaluated 75 children between five and twelve years old, 49 with normal visual acuity and 26 visually impaired. Two evaluators performed the measure of active and passive range of motion by goniometry of shoulder and hip in all axes of motion. All examiners made a test of correlation between data obtained, to determine the inter-rater reliability, using the intraclass correlation coefficient (ICC). In individuals with visual impairments was statistically significant difference, with higher range of motion in individuals with visual impairments to medial and lateral rotation of shoulder and hip lateral rotation. Were found: high correlation in the inter-rater reliability (ICC>0.70) for 9 (22.5%) groups of articular range of motion, moderate correlation (0.7>ICC>0.5) for 25 (62.5%) groups and low correlation to 6 (15%) groups ranges of motion. Sampled children with congenital visual impairment showed greater joint mobility for rotational range of motion of the shoulder and hip than children with normal visual acuity, although they have also shown lower values for articular range of motion in abduction and extension in shoulders.Se evaluo la amplitud de movimiento articular en ninos con deficiencias visuales congenitas. Se evaluaron a 75 ninos con edades entre 5 y 12 anos, siendo 49 con acuidad visual normal y 26 con deficiencia visual. Dos evaluadores realizaron la medicion de la amplitud de movimiento articular activa y pasiva mediante goniometria del hombro y de la cadera, en todos los ejes de movimiento. Todos los evaluadores realizaron un test de correlacion entre los datos obtenidos para la determinacion de la fiabilidad interevaluador, por medio del coeficiente de correlacion intraclase (ICC). En los individuos con deficiencia visual hubo diferencia estadisticamente significativa, con mayores valores de amplitud de movimiento para la rotacion medial y lateral del hombro y rotacion lateral de la cadera. Fueron encontradas: alta correlacion de fiabilidad interevaluadores (ICC>0,70) para 9 (22,5%) grupos de amplitud de movimiento articular, correlacion moderada (0,7>ICC>0,5) para 25 (62,5%) grupos y baja correlacion para 6 (15%) grupos de amplitudes de movimiento. Los ninos incluidos en la muestra con deficiencia visual congenita presentaron mayor movilidad articular para las amplitudes de movimiento de rotacion del hombro y de la cadera que los ninos sin deficiencias visuales, aunque tambien presentaron valores mas bajos para la amplitud de movimiento articular de abduccion y extension de hombros.

Niños con deficiencia visual pueden tener la amplitud de movimiento articular alterada: un estudio observacional tipo caso-control

To assess the articular range of motion in children with congenital visual impairment. Were evaluated 75 children between five and twelve years old, 49 with normal visual acuity and 26 visually impaired. Two evaluators performed the measure of active and passive range of motion by goniometry of shoulder and hip in all axes of motion. All examiners made a test of correlation between data obtained, to determine the inter-rater reliability, using the intraclass correlation coefficient (ICC). In individuals with visual impairments was statistically significant difference, with higher range of motion in individuals with visual impairments to medial and lateral rotation of shoulder and hip lateral rotation. Were found: high correlation in the inter-rater reliability (ICC>0.70) for 9 (22.5%) groups of articular range of motion, moderate correlation (0.7>ICC>0.5) for 25 (62.5%) groups and low correlation to 6 (15%) groups ranges of motion. Sampled children with congenital visual impairment showed greater joint mobility for rotational range of motion of the shoulder and hip than children with normal visual acuity, although they have also shown lower values for articular range of motion in abduction and extension in shoulders.Se evaluo la amplitud de movimiento articular en ninos con deficiencias visuales congenitas. Se evaluaron a 75 ninos con edades entre 5 y 12 anos, siendo 49 con acuidad visual normal y 26 con deficiencia visual. Dos evaluadores realizaron la medicion de la amplitud de movimiento articular activa y pasiva mediante goniometria del hombro y de la cadera, en todos los ejes de movimiento. Todos los evaluadores realizaron un test de correlacion entre los datos obtenidos para la determinacion de la fiabilidad interevaluador, por medio del coeficiente de correlacion intraclase (ICC). En los individuos con deficiencia visual hubo diferencia estadisticamente significativa, con mayores valores de amplitud de movimiento para la rotacion medial y lateral del hombro y rotacion lateral de la cadera. Fueron encontradas: alta correlacion de fiabilidad interevaluadores (ICC>0,70) para 9 (22,5%) grupos de amplitud de movimiento articular, correlacion moderada (0,7>ICC>0,5) para 25 (62,5%) grupos y baja correlacion para 6 (15%) grupos de amplitudes de movimiento. Los ninos incluidos en la muestra con deficiencia visual congenita presentaron mayor movilidad articular para las amplitudes de movimiento de rotacion del hombro y de la cadera que los ninos sin deficiencias visuales, aunque tambien presentaron valores mas bajos para la amplitud de movimiento articular de abduccion y extension de hombros.

Fibromialgia: ¿hay una asociación entre el equilibrio y el dolor? un estudio piloto

Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group.

Fibromialgia: existe associação entre equilíbrio e dor? um estudo piloto

Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group.