Studied the effectiveness of an attention distracting and an attention focusing guided imagery as well as the effect of amitriptyline on fibromyalgia pain. 55 women with previously diagnosed fibromyalgia were monitored for daily pain (VAS) in a randomized, controlled clinical trial. 17 Ss received relaxation training and guided instruction in "pleasant imagery" (PI) in order to distract from the pain experience. 21 Ss received relaxation training and attention imagery upon the "active workings of the internal pain control systems", "attention imagery" (AI). a control group (CG) of 17 Ss received treatment as usual. Patients were also randomly assigned to 50-mg amitriptyline/day or placebo. Some psychological and sociodemographic variables were also measured initially. The slopes of diary pain ratings over 4 wks were used as the outcome measures. The authors found significant differences of the pain-slopes between the three psychological conditions. The pleasant imagery, but not the attention imagery group's slope, declined significantly when compared with the control group. There was neither a difference between the amitriptyline and placebo slopes nor a significant amitriptyline by psychological interaction. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
OBJECTIVE: To compare the therapeutic effects of physical fitness training or biofeedback training with the results of usual care in patients with fibromyalgia (FM). METHODS: One hundred forty-three female patients with FM (American College of Rheumatology criteria) were randomized into 3 groups: a fitness program (n = 58), biofeedback training (n = 56), or controls (n = 29). Half the patients in the active treatment groups also received an educational program aimed at improving compliance. Assessments were done at baseline and after 24 weeks. The primary outcome was pain [visual analog scale (VAS)]. Other endpoints were the number of tender points, total myalgic score (dolorimetry), physical fitness, functional ability (Arthritis Impact Measurement Scale and Sickness Impact Profile), psychological distress (Symptom Checklist-90-Revised), patient global assessment (5 point scale), and general fatigue (VAS). RESULTS: Baseline scores were similar in all 3 groups. Altogether 25 (17.5%) patients dropped out; they were similarly distributed over all groups: 14 patients after randomization and 11 (8%) during the study. A true high impact level for fitness training was not attained by any patient. After treatment, no significant differences in change scores of any outcome were found between the groups (ANOVA, p > 0.05). All outcome measures showed large variations intra- and interindividually. The educational program did not result in higher compliance with training sessions (62% vs 71%). Analysis of the subgroup of subjects with a high attendance rate (> 67%) also showed no improvement. CONCLUSION: In terms of training intensity and maximal heart rates, the high impact fitness intervention had a low impact benefit. Therefore effectiveness of high impact physical fitness training cannot be demonstrated. Thus compared to usual care, the fitness training (i.e., low impact) and biofeedback training had no clear beneficial effects on objective or subjective patient outcomes in patients with FM.
OBJECTIVE: To test effectiveness of static magnetic fields of two different configurations, produced by magnetic sleep pads, as adjunctive therapies in decreasing patient pain perception and improving functional status in individuals with fibromyalgia. DESIGN: Randomized, placebo-controlled, 6-month trial conducted from November 1997 through December 1998. SETTING AND SUBJECTS: Adults who met the 1990 American College of Rheumatology criteria for fibromyalgia were recruited through clinical referral and media announcements and evaluated at a university-based clinic. INTERVENTIONS: Subjects in Functional Pad A group used a pad for 6 months that provided whole-body exposure to a low, uniform static magnetic field of negative polarity. Subjects in the Functional Pad B group used a pad for 6 months that exposed them to a low static magnetic field that varied spatially and in polarity. Subjects in two Sham groups used pads that were identical in appearance and texture to the functional pads but contained inactive magnets; these groups were combined for analysis. Subjects in the Usual Care group continued with their established treatment regimens. OUTCOME MEASURES: Primary outcomes were the change scores at 6 months in the following measures: functional status (Fibromyalgia Impact Questionnaire), pain intensity ratings, tender point count, and a tender point pain intensity score. RESULTS: There was a significant difference among groups in pain intensity ratings (p = 0.03), with Functional Pad A group showing the greatest reduction from baseline at 6 months. All four groups showed a decline in number of tender points, but differences among the groups were not significant (p = 0.72). The functional pad groups showed the largest decline in total tender point pain intensity, but overall differences were not significant (p = 0.25). Improvement in functional status was greatest in the functional pad groups, but differences among groups were not significant (p = 0.23). CONCLUSIONS: Although the functional pad groups showed improvements in functional status, pain intensity level, tender point count, and tender point intensity after 6 months of treatment, with the exception of pain intensity level these improvements did not differ significantly from changes in the Sham group or in the Usual Care group.
OBJECTIVE:To study the clinical effectiveness of Swedish massage in fibromyalgia syndrome [FMS].METHODS:: Swedish massage [SM] was compared with standard physician care [SC] without or with interim follow-up telephone calls [SCPC] in 37 subjects. RESULTS:Baseline Arthritis Impact Measurement Scales [AIMS] of physical activity, depression, anxiety, and pain for all patients indicated poor status. Baseline Quality of Well Being [QWB] scores showed impaired quality of life; the Rheumatology Attitudes Index [RAI] scores indicated helplessness. All but five subjects had a Center for Epidemiologic Studies Depression score above 15. At four weeks [7-SM/8-SC/9-SCPC], the SM group improved in RAI [P = 0.06] and AIMS mobility [P = 0.05]. At 28 weeks [4-SM/6-SC/6-SCPC], there were no significant intergroup differences. The 16 study completers had significantly lower baseline QWB scores [P = 0.025] than dropouts.CONCLUSIONS: Although our study showed some effect of SM in FMS at four weeks, benefits were modest and not significant at later time-points, perhaps attributable to low subject retention. The subject warrants further exploration.
CONTEXT: It has been suggested that the consumption of natural "whole foods" rich in macronutrients has many healthful benefits for those who otherwise ingest a normal, nonvegetarian diet. One example is dietary supplements derived from Chlorella pyrenoidosa, a unicellular fresh water green alga rich in proteins, vitamins, and minerals.
OBJECTIVE: To find evidence of the potential of chlorella dietary supplements to relieve signs and symptoms, improve quality of life, and normalize body functions in people with chronic illnesses, specifically fibromyalgia, hypertension, and ulcerative colitis.
DESIGN: Double-blind, placebo-controlled, randomized clinical trials.
SETTING: Virginia Commonwealth University's Medical College of Virginia.
PATIENTS: Fifty-five subjects with fibromyalgia, 33 with hypertension, and 9 with ulcerative colitis.
INTERVENTION: Subjects consumed 10 g of pure chlorella in tablet form and 100 mL of a liquid containing an extract of chlorella each day for 2 or 3 months.
MAIN OUTCOME MEASURES: For fibromyalgia patients, assessments of pain and overall quality of life. For hypertensive patients, measurements of sitting diastolic blood pressure and serum lipid levels. For patients with ulcerative colitis, determination of state of disease using the Disease Activity Index.
RESULTS: Daily dietary supplementation with chlorella may reduce high blood pressure, lower serum cholesterol levels, accelerate wound healing, and enhance immune functions.
CONCLUSIONS: The potential of chlorella to relieve symptoms, improve quality of life, and normalize body functions in patients with fibromyalgia, hypertension, or ulcerative colitis suggests that larger, more comprehensive clinical trials of chlorella are warranted.
The aim of this study was to evaluate the effectiveness of balneotherapy on patients with fibromyalgia (FM) at the Dead Sea. Forty-eight patients with FM were randomly assigned to a treatment group receiving sulfur baths and a control group. All participants stayed for 10 days at a Dead Sea spa. Physical functioning, FM-related symptoms, and tenderness measurements (point count and dolorimetry) were assessed at four time points: prior to arrival at the Dead Sea, after 10 days of treatment, and 1 and 3 months after leaving the spa. Physical functioning and tenderness moderately improved in both groups. With the exception of tenderness threshold, the improvement was especially notable in the treatment group and it persisted even after 3 months. Relief in the severity of FM-related symptoms (pain, fatigue, stiffness, and anxiety) and reduced frequency of symptoms (headache, sleep problems, and subjective joint swelling) were reported in both groups but lasted longer in the treatment group. In conclusion, treatment of FM at the Dead Sea is effective and safe and may become an additional therapeutic modality in FM. Future studies should address the outcome and possible mechanisms of this treatment in FM patients.
Brain tryptophan is low in fibromyalgia. Intake of protein rich in large neutral amino acids is reported to lower brain tryptophan. This study was undertaken to assess whether any reduction of such proteins by exclusion of animal protein from the diet reduced pain and morbidity in fibromyalgia patients. It was an open, randomized controlled trial. 37 subjects with fibromyalgia were enrolled in the vegetarian diet and 41 in the amitriptyline groups. The outcome was assessed with the help of frequencies of fatigue, insomnia & non-restorative sleep, pain score on a 10-point VAS and tender point count. Fatigue, insomnia and non-restorative sleep were present in 41, 26 and 32 subjects before and in 3, 0 and 0 subjects respectively at six weeks of treatment in the amitriptyline group. The pain score and tender point count were 6.2 +/- 1.9 & 16.1 +/- 2.3 before and 2.3 +/- 1.3 & 6.4 +/- 3.0 after treatment. All these differences were significant (P < 0.001). In the vegetarian diet group, fatigue, insomnia and non-restorative sleep were present in 36, 24 and 27 subjects before and in 34, 29 and 29 subjects at six weeks of treatment. The pain score and tender point count were 5.7 +/- 1.8 and 15.7 +/- 2.4 before and 5.0 +/- 1.8 & 14.7 +/- 3.6 after treatment. All these differences were insignificant except that in the pain score. The decrease in the pain score, though significant, was much smaller than that in the amitriptyline group. So, it may be concluded that vegetarian diet is a poor option in the treatment of fibromyalgia.
The structure of MTH538, a previously uncharacterized hypothetical protein from Methanobacterium thermoautotrophicum, has been determined by NMR spectroscopy. MTH538 is one of numerous structural genomics targets selected in a genome-wide survey of uncharacterized sequences from this organism. MTH538 is a so-called singleton, a sequence not closely related to any other (known) sequences. The structure of MTH538 closely resembles the known structures of receiver domains from two component response regulator systems, such as CheY, and is similar to the structures of flavodoxins and GTP-binding proteins. Tests on MTH538 for characteristic activities of CheY and flavodoxin were negative. MTH538 did not become phosphorylated in the presence of acetyl phosphate and Mg(2+), although it appeared to bind Mg(2+). MTH538 also did not bind flavin mononucleotide (FMN) or coenzyme F(420). Nevertheless, sequence and structure parallels between MTH538/CheY and two families of ATPase/phosphatase proteins suggest that MTH538 may have a role in a phosphorylation-independent two-component response regulator system.
Objective: To determine if the chronic pain and sleep disturbances experienced by patients with fibromyalgia can be improved by sleeping on a magnetic mattress pad. Design: A double-blind randomized controlled trial. Setting: Patients' homes and the private practice office of the principal investigator. Patients: Thirty-five female subjects diagnosed with fibromyalgia syndrome were recruited. Thirty met inclusion/exclusion criteria and entered the study. Twenty-five completed it. One was lost to follow-up. Three were withdrawn for protocol violations and one because of an intercurrent hospitalization. Intervention: Sleeping on an experimental (magnetized at a magnet surface field strength of 1100 ± 50 Gauss and delivering 200-600 Gauss to the skin surface) or a sham (non-magnetized) mattress pad over a 16 week period. Main Outcome Measures: Visual Analog Scales (VAS) for global wellbeing, pain, sleep, fatigue and tiredness on awakening; Total Myalgic Score; Pain Distribution Drawings; and a modified Fibromyalgia Impact Questionnaire. Results: Subjects sleeping on the experimental mattress pad experienced a significant decrease in pain (p < .05), fatigue (p < .006), total myalgic score (p < .03), and pain distribution drawing (p < .02). Additionally, these subjects showed significant improvement in reported sleep (p < .01) and physical functioning as evidenced from the modified Fibromyalgia Impact Questionnaire (p < .04). Subjects sleeping on the sham mattress pad experienced no significant change in these same outcome measures. Subjects in both the control and experimental groups showed improvement in tiredness on wakening, demonstrating a placebo effect in this parameter. Neither group showed any effect on global wellbeing. Conclusions: Sleeping on a magnetic mattress pad, with a magnet surface field strength of 1100 ± 50 Gauss, delivering 200-600 Gauss at the skin surface provides statistically significant and clinically relevant pain relief and sleep improvement in subjects with fibromyalgia. No adverse reactions were noted during the 16-week trial period.
Studied the effectiveness of an attention distracting and an attention focusing guided imagery as well as the effect of amitriptyline on fibromyalgia pain. 55 women with previously diagnosed fibromyalgia were monitored for daily pain (VAS) in a randomized, controlled clinical trial. 17 Ss received relaxation training and guided instruction in "pleasant imagery" (PI) in order to distract from the pain experience. 21 Ss received relaxation training and attention imagery upon the "active workings of the internal pain control systems", "attention imagery" (AI). a control group (CG) of 17 Ss received treatment as usual. Patients were also randomly assigned to 50-mg amitriptyline/day or placebo. Some psychological and sociodemographic variables were also measured initially. The slopes of diary pain ratings over 4 wks were used as the outcome measures. The authors found significant differences of the pain-slopes between the three psychological conditions. The pleasant imagery, but not the attention imagery group's slope, declined significantly when compared with the control group. There was neither a difference between the amitriptyline and placebo slopes nor a significant amitriptyline by psychological interaction. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
