RESUMO

OBJECTIVES: The aim of this study was to assess the relationship between variables of physical assessment - muscular strength, flexibility and dynamic balance - with pain, pain threshold, and fibromyalgia symptoms (FM). METHODS: Our sample consists of 55 women, with age ranging from 30 to 55 years (mean of 46.5, (standard deviation, SD=6.6)), mean body mass index (BMI) of 28.7 (3.8) and diagnosed for FM according to the American College of Rheumatology criteria. Pain intensity was measured using a visual analogue scale (VAS) and pain threshold (PT) using Fisher's dolorimeter. FM symptoms were assessed by the Fibromyalgia Impact Questionnaire (FIQ); flexibility by the third finger to floor test (3FF); the muscular strength index (MSI) by the maximum volunteer isometric contraction at flexion and extension of right knee and elbow using a force transducer, dynamic balance by the time to get up and go (TUG) test and the functional reach test (FRT). Data were analysed using Pearson's correlation, as well as simple and multivariate regression tests, with significance level of 5%. RESULTS: PT and FIQ were weakly but significantly correlated with the TUG, MSI and 3FF as well as VAS with the TUG and MSI (p<0.05). VAS, PT and FIQ was not correlated with FRT. Simple regression suggests that, alone, TUG, FR, MSI and 3FF are low predictors of VAS, PT and FIQ. For the VAS, the best predictive model includes TUG and MSI, explaining 12.6% of pain variability. For TP and total symptoms, as obtained by the FIQ, most predictive model includes 3FF and MSI, which respectively respond by 30% and 21% of the variability. CONCLUSIONS: Muscular strength, flexibility and balance are associated with pain, pain threshold, and symptoms in FM patients.

Assuntos

RESUMO

OBJETIVO: Verificar os efeitos de exercícios de alongamento muscular e condicionamento físico no tratamento fisioterápico da fibromialgia (FM). CASUÍSTICA E MÉTODOS: Foram avaliadas 15 mulheres com diagnóstico de FM, segundo os critérios do Colégio Americano de Reumatologia, divididas em dois grupos: Grupo 1 (G1) com oito pacientes, realizou tratamento por meio de alongamentos musculares e Grupo 2 (G2), sete pacientes, condicionamento físico. Foram avaliados qualidade do sono, fatores de piora e melhora da dor, sintomas associados e medicamentos utilizados. Além disso, foi aplicado o Fibromyalgia Impact Questionnaire (FIQ), para avaliar o impacto da FM. O tratamento durou oito semanas, sendo uma sessão semanal com duração de 40 a 45 minutos. As variáveis do FIQ antes e depois dos tratamentos foram comparadas pelo teste t para amostras dependentes (alfa< 0,05) e as demais foram analisadas descritivamente. RESULTADOS: A maioria das pacientes apresentava sono não reparador (86,67 por cento), piora da dor com serviços domésticos (40 por cento), nenhum fator de melhora da dor (28,57 por cento), distúrbios do sono como sintomas associados (100 por cento) e utilizava antidepressivos (69,23 por cento). Em relação às variáveis do FIQ, observaram-se diferenças estatisticamente significantes no sono (p= 0,0428) e rigidez matinal (p= 0,0130) nas pacientes do G1. Já no G2, não foram observadas diferenças significantes após o tratamento. CONCLUSÕES: Sugere-se que os alongamentos musculares realizados podem gerar impacto positivo na FM, promovendo melhora do sono e rigidez matinal das pacientes avaliadas.

OBJECTIVE: To investigate the effects of muscle stretching exercises and physical conditioning as physical therapy treatment for fibromyalgia. METHODS: Fifteen women with a diagnosis of fibromyalgia in accordance with the criteria of the American College of Rheumatology were evaluated and divided into two groups: Group 1 (G1, eight patients) underwent treatment consisting of muscle stretching and Group 2 (G2, seven patients), participated in a physical conditioning program. Sleep quality, pain-modulating factors, associated symptoms and medications used were evaluated. Furthermore, the Fibromyalgia Impact Questionnaire (FIQ) was applied to evaluate the impact of fibromyalgia. The treatment lasted for eight weeks, with one session per week of 40 to 45 minutes in duration. The FIQ data obtained before and after treatment were analyzed by means of Student's t test for dependent samples (alpha< 0.05) and other variables were analyzed descriptively. RESULTS: Most of the patients presented poor quality of sleep (86.67 percent). Many presented worsening of their pain when doing domestic tasks (40 percent) and there were no factors that relieved their pain (28.57 percent). All presented sleep disorders with associated symptoms (100 percent) and most used antidepressives (69.23 percent). For the FIQ data, statistically significant differences were observed in morning tiredness (p= 0.0428) and stiffness (p= 0.0130) among the G1 patients. Conversely, no difference was observed in G2 after the treatment. CONCLUSIONS: It is suggested that the muscle stretching may have had a positive impact on fibromyalgia, with reductions in morning tiredness and stiffness among the patients evaluated.

Assuntos

RESUMO

OBJECTIVE: To assess the efficiency of a treatment composed of muscle stretching exercises, associated or not to laser therapy at tender points, for patients with fibromyalgia (FM), in view of bettering their quality of life. METHODS: Twenty FM patients were randomly assigned to two groups: one submitted to laser therapy and stretching (LSG, n=10), and the other only to stretching exercises (SG, n=10). The visual analog scale of pain (VAS) and dolorimetry at tender points were used to assess pain; life quality was evaluated by means of the Fibromyalgia Impact Questionnaire (FIQ) and the 36-item Short-Form Health Survey (SF-36). RESULTS: After the treatment program, both in LSG and SG were detected pain reduction, higher pain threshold at tender points (all p<0.01), lower mean FIQ scores, and higher SF-36 mean scores (all p<0.05). No significant differences were found between both groups. CONCLUSION: The stretching exercises program proposed is efficient to reduce pain and painful sensibility at tender points, thus enhancing patients' quality of life. Laser therapy has not shown advantages when added to muscle stretching exercises.

Assuntos

RESUMO

CONTEXTO: Fibromialgia é uma síndrome reumática caracterizada por dor musculoesquelética difusa e crônica, e sítios dolorosos específicos à palpação (tender points). Freqüentemente é associada à fadiga generalizada, distúrbios do sono, rigidez matinal, dispnéia, ansiedade, alterações no humor que podem evoluir para um quadro de depressão. Sendo assim, afeta negativamente a qualidade de vida das pessoas. No entanto, ainda não se sabe o poder de discriminação dos instrumentos de avaliação da depressão e qualidade de vida. O objetivo desse estudo foi avaliar a depressão e a qualidade de vida de pacientes com fibromialgia e avaliar o poder de discriminação de instrumentos relacionados a esses aspectos. MÉTODO: Para avaliar a qualidade de vida foram utilizados dois instrumentos: um específico, o Fibromyalgia Impact Questionnaire (FIQ) e outro genérico, o Medical Outcomes Study 36-item Short-Form Healthy Survey (SF-36); para avaliar a depressão, a Escala de Depressão de Beck (BDS). Participaram do estudo 40 mulheres sendo 20 com fibromialgia - Grupo teste e 20 saudáveis - Grupo controle. Os três protocolos foram aplicados aos indivíduos dos dois grupos em uma única sessão de avaliação. Toda a análise estatística foi realizada utilizando-se o teste "t" Student, com significância alfa = 0,05. RESULTADOS: Houve diferença estatisticamente significante entre os grupos controle e teste em todos os questionários (p<0,05). Os três questionários têm bom poder discriminatório para diferenciar os dois grupos, porém o FIQ é o que tem maior poder de discriminação e o BDS o menor. CONCLUSÃO: O grupo de pacientes com fibromialgia tem pior qualidade de vida quando comparado com o grupo controle. Comparando os três questionários todos são eficientes não somente para avaliar a qualidade de vida mas também para avaliar a depressão. Entretanto, como o FIQ é um instrumento específico é o que melhor discrimina o grupo teste do grupo controle, fato este mostrado...

BACKGROUND: Fibromyalgia is a rheumatic syndrome characterized by widespread chronic musculoskeletal pain and specific palpable tender points. It is often associated with generalized fatigue, sleep disturbances, morning stiffness, dyspnea, anxiety and mood disturbances that may evolve into depression. Thus, such individuals' quality of life is negatively affected. However, the discriminating power of quality-of-life and depression assessment instruments is still unknown. OBJECTIVE: To assess depression and quality of life among patients with fibromyalgia, and the discriminating power of such instruments. METHOD: Quality of life was assessed by one specific instrument, the Fibromyalgia Impact Questionnaire (FIQ), and another generic one, the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The Beck Depression Scale (BDS) was used to assess depression. Forty women participated: 20 with fibromyalgia (test group) and 20 healthy women (control group). The three protocols were applied to all individuals in both groups in a single evaluation session. All statistical analyses were performed using Student's t-test, with alpha = 0.05. RESULTS: Statistically significant differences between test and control groups were found via all questionnaires (p<0.05). The three questionnaires had good discriminatory power for differentiating between the two groups, but FIQ had the greatest and BDS least. CONCLUSION: Patients with fibromyalgia presented poor quality of life, compared with the control group. Comparing the three questionnaires, they were all efficient for both quality-of-life and depression assessments. However, since FIQ is a specific instrument, this gave the best discrimination between test and control groups, and this was shown through higher, statistically significant values.

Assuntos

RESUMO

Fibromialgia (FM) é uma síndrome reumática caracterizada por dor musculoesquelética cr6onica e difusa assim como baixo limiar de dor em pontos anatômicos específicos chamados tender points

Assuntos

RESUMO

Respiring Saccharomyces cerevisiae cells grown on a non-fermentable carbon source are intrinsically more resistant to several stresses, including oxidative stress. The mechanisms leading to increased stress resistance are not yet well understood. Active mitochondria are the major source of intracellular reactive oxygen species (ROS), which could cause the up-regulation of the antioxidant defense systems. We investigated the role of mitochondria in the intrinsic stress resistance against the hydroperoxides H2O2 and tert-butylhydroperoxide 4 h after a shift in carbon source. We found that, independently of functional mitochondria, the yeast acquired the intrinsic resistance of respiring cells against hydroperoxides solely as a response to a change of carbon source in the growth medium. Furthermore, utilizing reporter gene fusion constructs, we monitored the expression of the gamma-glutamylcysteinyl synthetase (encoded by GSH1) and the two superoxide dismutases (encoded by SOD1 and SOD2) during the metabolic transition from fermentation to respiration; and we detected an up-regulation of all three genes during the diauxic shift. Overall available data allowed us to propose that the antioxidant system of S. cerevisiae could be considered as a class of genes under glucose/carbon catabolite regulation. This control system is different from the well-known adaptive response to oxidative stress.

Assuntos