Association of patterns of moderate-to-vigorous physical activity bouts with pain, physical fatigue and disease severity in women with fibromyalgia: the al-Ándalus project

Publication date: Available online 5 January 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Víctor Segura-Jiménez, Fernando Estévez-López, José Castro-Piñero, Inmaculada C. Álvarez-Gallardo, Alberto Soriano-Maldonado, Milkana Borges-Cosic, Manuel Delgado-Fernández

Abstract

Objectives

i) To examine the associations of non-bouted moderate-to-vigorous physical activity (MVPA) and patterns of MVPA in bouts ≥ 10 min with pain, physical fatigue and disease severity in women with fibromyalgia, and test whether these associations are independent of sedentary time (ST) and physical fitness (PF).

Design

Cross-sectional study carried out from November 2011 to January 2013

Setting

University facilities and fibromyalgia associations.

Participants

439 (51.3±7.6 years old) women with fibromyalgia.

Interventions

Not applicable.

Main outcome measures

ST and MVPA were measured with triaxial accelerometry, and PF with the Senior Fitness test battery. We assessed pain, physical fatigue and disease severity with diverse questionnaires.

Results

Total time in non-bouted MVPA only was independently associated with lower physical fatigue (B=-0.012; P=0.010) and disease severity (B=-0.068; P=0.007) in women with fibromyalgia, regardless of PF but not of ST. Patterns of bouted MVPA were overall associated with symptoms independently of ST or PF. The strongest regressor was the maximum time in MVPA bout (min/bout), which was consistently and independently associated with pain, physical fatigue and disease severity after controlling for ST or PF (all, P≤0.002). Patients meeting bouted physical activity guidelines displayed lower disease severity than those not meeting guidelines (bouted or non-bouted) and those meeting non-bouted physical activity guidelines (all, P≤0.008).

Conclusions

Patterns of MVPA performed in bouts ≥ 10 min were overall consistently and independently associated with core symptoms (pain and fatigue) in fibromyalgia and the overall disease severity, regardless of ST or PF. The results suggest that longer bouts of continuous MVPA are associated with better symptoms profile in this population, which needs to be corroborated in longitudinal research.

from ScienceDirect Publication: Archives of Physical Medicine and Rehabilitation http://bit.ly/2TsLT6w
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Implanted device enables responsive bladder control

Implanted device enables responsive bladder control

Implanted device enables responsive bladder control, Published online: 02 January 2019; doi:10.1038/d41586-018-07811-1

Implants that electrically stimulate nerves continuously to treat disease can cause off-target effects and pain. An implant that uses light to modulate the activity of genetically modified nerve cells might offer a solution.

from Nature - Issue - nature.com science feeds https://go.nature.com/2AtT07F
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Effectiveness of opioids for chronic noncancer pain: a two-year multicenter, prospective cohort study with propensity score matching

Chronic pain (CP) is a major and debilitating health problem.9 It has an estimated prevalence of 20% in the European population and is an important cause of direct and indirect healthcare costs, quality of life impairment and has a significant impact on patients’ and their families’ lives.8,51

from The Journal of Pain http://bit.ly/2EWw44V
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Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain

Clinical studies indicate that cannabidiol (CBD), the primary nonaddictive component of cannabis that interacts with the serotonin (5-HT)1A receptor, may possess analgesic and anxiolytic effects. However, its effects on 5-HT neuronal activity, as well as its impact on models of neuropathic pain are unknown. First, using in vivo single-unit extracellular recordings in rats, we demonstrated that acute intravenous (i.v.) increasing doses of CBD (0.1-1.0 mg/kg) decreased the firing rate of 5-HT neurons in the dorsal raphe nucleus, which was prevented by administration of the 5-HT1A antagonist WAY 100635 (0.3 mg/kg, i.v.) and the TRPV1 antagonist capsazepine (1 mg/kg, i.v.) but not by the CB1 receptor antagonist AM 251 (1 mg/kg, i.v.). Repeated treatment with CBD (5 mg/kg/day, subcutaneously [s.c.], for 7 days) increased 5-HT firing through desensitization of 5-HT1A receptors. Rats subjected to the spared nerve injury model for 24 days showed decreased 5-HT firing activity, mechanical allodynia, and increased anxiety-like behavior in the elevated plus maze test, open-field test, and novelty-suppressed feeding test. Seven days of treatment with CBD reduced mechanical allodynia, decreased anxiety-like behavior, and normalized 5-HT activity. Antiallodynic effects of CBD were fully prevented by capsazepine (10 mg/kg/day, s.c., for 7 days) and partially prevented by WAY 100635 (2 mg/kg/day, s.c., for 7 days), whereas the anxiolytic effect was blocked only by WAY. Overall, repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.

from PAIN - Featured Articles - Current Issue Highlights http://bit.ly/2EOBBte
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Do pain measurement instruments detect the effect of pain-reducing interventions in neonates? A systematic review on responsiveness

Worldwide, more than 15 million children a year are born prematurely and this number is rising.43 In the NICU setting they are at risk of acute pain; one study reported a mean number of 11.4 painful procedures per day during the first 14 day.35 They are also at risk of prolonged or chronic pain from, for example, skin conditions, gastro-intestinal conditions, inflammation and the aftermath of surgery.2,3

from The Journal of Pain http://bit.ly/2T8SKC6
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Effectiveness of Exercise Interventions for Pain Reduction in People With Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Publication date: January 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 1

Author(s): Thibaut Demaneuf, Zoe Aitken, Amalia Karahalios, Teng Ieng Leong, Alysha M. De Livera, George A. Jelinek, Tracey J. Weiland, Claudia H. Marck

Abstract

Objective

To systematically review the evidence of the effect of exercise compared with passive control on pain in people with multiple sclerosis.

Data Source and Study Selection

Five electronic databases were searched for randomized controlled trials published up to March 2017 that recruited people with multiple sclerosis where exercise was the intervention and pain was an outcome (PROSPERO registration number CRD42017060489).

Statistical Analysis

A random-effects meta-analysis was conducted to estimate the standardized mean difference of the effect of exercise on pain between treatment and control groups. We assessed risk of bias, fitted meta-regression models to explore heterogeneity between studies, and assessed small study effects.

Data Synthesis

Ten studies met the inclusion criteria (total sample size=389), and all studies were at high risk of bias. We found that exercise interventions were associated with less pain compared with passive control groups (standardized mean difference=−.46; 95% CI, −.92 to .00). There was high between-study heterogeneity (I²=77.0%), which was not explained by the prespecified study characteristics. There was also some evidence of small study effects.

Conclusion

This is the first systematic review of the effect of exercise interventions on pain in people with multiple sclerosis, a chronic neurological disorder that affects 2.5 million people. We found some evidence that exercise compared with passive control alleviates pain in this population, but there were limitations in reporting and study quality with high risk of bias of individual studies and heterogeneity between studies.

from ScienceDirect Publication: Archives of Physical Medicine and Rehabilitation http://bit.ly/2EJcoRd
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Ability of Patient-Reported Outcomes to Characterize Patient Acceptable Symptom State (PASS) After Attending a Primary Care Physical Therapist and Medical Doctor Collaborative Service: A Cross-Sectional Study

Publication date: January 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 1

Author(s): Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Abstract

Objectives

To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).

Design

A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.

Setting

Phone survey after primary care.

Participants

Patients (N=94) attending primary care for musculoskeletal problems.

Interventions

Not applicable.

Main Outcomes Measures

Accuracy and proportion of patients classified as PASS Yes or No.

Results

Receiver operator curve analysis showed significant area under the curve (AUC) values for each PROMIS scale (AUC>.72) and the GRNF rating (AUC=.74). Identified PROMIS thresholds suggested PASS was achieved when scores were at or slightly worse than the US population average. A score of ≥7 and ≤4 characterized patients that were PASS Yes and No, respectively, on the GRNF rating. A moderate (80%) specificity/sensitivity criteria yielded 72.3%-73.5% accuracy for a majority of participants (>69.9%).

Conclusion

This analysis suggests the PROMIS and GRNF scales are able to characterize PASS status with moderate accuracy (∼70%) for a large portion of patients (∼70%). New to this study is the association of self-efficacy with PASS status. PROMIS scales at or slightly worse than the US population average characterized PASS status.

from ScienceDirect Publication: Archives of Physical Medicine and Rehabilitation http://bit.ly/2EJ5vQt
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