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- Aspegren Kendall, Sally, 1950-, et al.
(författare)
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A pilot study of body awareness programs in the treatment of fibromyalgia syndrome
- 2000
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Ingår i: Arthritis Care and Research. - 0893-7524 .- 1529-0123. ; 13:5, s. 304-311
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To compare in a pilot study the effect of two physical therapies, the Mensendieck system (MS) and body awareness therapy (BAT) according to Roxendal, in fibromyalgia patients and to investigate differences in effect between the two interventions. Methods. Twenty female patients were randomized to either MS or BAT in a program lasting 20 weeks. Evaluations were tender point examination and questionnaires, including visual analog scales (pain intensity at worst site, muscular stiffness, evening fatigue, and global health), Fibromyalgia Impact Questionnaire (FIQ), Coping Strategies Questionnaire, Quality of Life Scales, Arthritis Self-Efficacy Scale (ASES), and disability before, immediately after, and at 6 and 18 months followup. Results. The BAT group had improved global health at 18 months followup, but lower results than the MS group. The MS group had improved FIQ, ASES other symptoms, and pain at worst site at 18 months followup. Conclusion. In the present pilot study, MS was associated with more positive changes than BAT.
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| 2. |
- Aspegren Kendall, Sally, 1950-, et al.
(författare)
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Differences in sensory thresholds in the skin of women with fibromyalgia syndrome : A comparison between ketamine responders and ketamine non-responders
- 2003
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Ingår i: Journal of Musculoskeletal Pain. - 1058-2452 .- 1540-7012. ; 11:2, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare detection and pain thresholds in the skin of female fibromyalgia patients who were either ketamine responders or ketamine nonresponders.Methods: Detection thresholds to innocuous warmth, of cold, heat or cold pain, and touch and dynamic touch sensation were determined in the skin. Pressure pain thresholds, local and widespread pain intensity, and pain duration were also registered.Results: Ketamine nonresponse was associated with more pronounced hypersensitivity for thermal pain [especially cold pain] than ketamine response.Conclusions: Blockade of N-metyl-D-aspartic acid receptors by ketamine and the recording of pain thresholds in the skin, especially for cold pain, might reveal different mechanisms of allodynia.
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| 3. |
- Aspegren Kendall, Sally, 1950-, et al.
(författare)
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Feldenkrais intervention in fibromyalgia patients : A pilot study
- 2001
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Ingår i: Journal of Musculoskeletal Pain. - 1058-2452 .- 1540-7012. ; 9:4, s. 25-35
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the effect of the Feldenkrais intervention, in fibromyalgia patients. Methods: Twenty fibromyalgia patients started Feldenkrais intervention done as one individual and two group sessions weekly for 15 weeks. Nineteen started a group-based pain education program followed by a pool program. Test and self-report questionnaires were administered at the start, at six month follow up, and at the end of intervention. Results: After the Feldenkrais intervention improvement in balance and trends to better lower extremity muscle function were shown, but the improvements were not maintained. Conclusions: No sustained benefit of the Feldenkrais intervention compared to a pool program was seen. Methodological problems are discussed. ⌐ 2001 by The Haworth Press, Inc. All rights reserved.
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| 4. |
- Aspegren Kendall, Sally, 1950-, et al.
(författare)
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The effect of a session of exercise of moderate intensity level on pressure pain thresholds in healthy women
- 2003
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 5:1, s. 15-20
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this investigation was to study in healthy women the effect of a moderately intensive physical exercise session on the pressure pain thresholds of tendon, bone and muscle. Twenty-four healthy women in the 7-14th day of the menstruation cycle took part in a 60-min exercise class. Pressure pain thresholds were measured by electronic algometer at four points before and after the class. Habitual exercise habits and perceived class exercise intensity were recorded. There was no change in pressure pain sensitivity at any site. Increased pressure pain thresholds tended to be linked to older age and later day in the follicular phase of the menstrual cycle. In conclusion, a single session of moderate exercise in an exercise setting outside the healthcare system or the laboratory did not increase pressure pain thresholds at group level in healthy women.
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| 5. |
- Elert, Jessica, 1954-, et al.
(författare)
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Chronic pain and difficulty in relaxing postural muscles in patients with fibromyalgia and chronic whiplash associated disorders
- 2001
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Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 28:6, s. 1361-1368
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate if muscle tension according to the surface electromyogram (EMG) of the shoulder flexors is increased in consecutive patients with fibromyalgia (FM) or chronic whiplash associated disorders (WAD). Methods. A total of 59 consecutive patients with FM (n = 36) or chronic WAD (n = 23) performed 100 maximal isokinetic contractions combined with surface electromyography of the trapezius and infraspinatus. A randomized group of pain-free female (n = 27) subjects served as control group. Peak torque initially (Pti) and absolute and relative peak torque at endurance level (PTe, PTer) were registered as output variables, together with the EMG level of unnecessary muscle tension, i.e., the signal amplitude ratio (SAR). Results. The patient groups had a higher level of unnecessary tension initially and at the endurance level. The patients had lower absolute output (PTi and PTe), but the relative levels (PTer) did not differ comparing all 3 groups. Subjects with FM had significantly higher body mass index (BMI) than the other groups. BMI did not influence the SAR but correlated positively with PTi. Conclusion. The results confirmed earlier findings that groups of patients with chronic pain have increased muscle tension and decreased output during dynamic activity compared to pain-free controls. However, the results indicated there is heterogeneity within groups of patients with the same chronic pain disorder and that not all patients with chronic pain have increased muscle tension.
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| 6. |
- Graven-Nilsen, T, et al.
(författare)
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Ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients
- 2000
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Ingår i: Pain. - 0304-3959 .- 1872-6623. ; 85:3, s. 483-491
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Tidskriftsartikel (refereegranskat)abstract
- Central mechanisms related to referred muscle pain and temporal summation of muscular nociceptive activity are facilitated in fibromyalgia syndrome (FMS) patients. The present study assessed the effects of an NMDA-antagonist (ketamine) on these central mechanisms. FMS patients received either i.v. placebo or ketamine (0.3 mg/kg, Ketalar(«)) given over 30 min on two separate occasions. Habitual pain intensity was assessed on a visual analogue scale (VAS). Initially, 29 FMS patients received ketamine or isotonic saline to determine which patients were ketamine responders (>50% decrease in pain intensity at rest by active drug on two consecutive VAS assessments). Fifteen out of 17 ketamine-responders were included in the second part of the study. Before and after ketamine or placebo, experimental local and referred pain was induced by intramuscular (i.m.) infusion of hypertonic saline (0.7 ml, 5%) into the tibialis anterior (TA) muscle. The saline-induced pain intensity was assessed on an electronic VAS, and the distribution of pain drawn by the subject. In addition, the pain threshold (PT) to i.m. electrical stimulation was determined for single stimulus and five repeated (2 Hz, temporal summation) stimuli. The pressure PT of the TA muscle was determined, and the pressure PT and pressure pain tolerance threshold were determined at three bilaterally located tenderpoints (knee, epicondyle, and mid upper trapezius). VAS scores of pain at rest were progressively reduced during ketamine infusion compared with placebo infusion. Pain intensity (area under the VAS curve) to the post-drug infusion of hypertonic saline was reduced by ketamine (-18.4▒0.3% of pre-drug VAS area) compared with placebo (29.9▒18.8%, P<0.02). Local and referred pain areas were reduced by ketamine (-12.0▒14.6% of pre-drug pain areas) compared with placebo (126.3▒83.2%, P<0.03). Ketamine had no significant effect on the PT to single i.m. electrical stimulation. However, the span between the PT to single and repeated i.m. stimuli was significantly decreased by the ketamine (-42.3▒15.0% of pre-drug PT) compared with placebo (50.5▒49.2%, P<0.03) indicating a predominant effect on temporal summation. Mean pressure pain tolerance from the three paired tenderpoints was increased by ketamine (16.6▒6.2% of pre-drug thresholds) compared with placebo (-2.3▒4.9%, P<0.009). The pressure PT at the TA muscle was increased after ketamine (42.4▒9.2% of pre-drug PT) compared with placebo (7.0▒6.6%, P<0.011). The present study showed that mechanisms involved in referred pain, temporal summation, muscular hyperalgesia, and muscle pain at rest were attenuated by the NMDA-antagonist in FMS patients. It suggested a link between central hyperexcitability and the mechanisms for facilitated referred pain and temporal summation in a sub-group of the fibromyalgia syndrome patients. Whether this is specific for FMS patients or a general phenomena in painful musculoskeletal disorders is not known. Copyright (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.
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| 7. |
- Hurtig, Ingrid, 1947-, et al.
(författare)
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Quantitative sensory testing in fibromyalgia patients and in healthy subjects : identification of subgroups
- 2001
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 17:4, s. 316-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine perception and pain thresholds in patients with fibromyalgia syndrome and in healthy controls, and to investigate whether patients with fibromyalgia syndrome can be grouped with respect to thermal hyperalgesia and whether these subgroups differ from healthy controls and in clinical appearance. Design: The authors conducted a quasi-experimental clinical study. Subjects: Twenty-nine women patients with fibromyalgia syndrome and 21 healthy pain-free age-matched women participated in the study. Methods: Quantitative sensory testing using a Thermotest instrument was performed on the dorsum of the left hand. Sleep and pain intensity were rated using visual analog scales. Results: Cold and heat pain but not perception thresholds differed significantly between patients with fibromyalgia syndrome and healthy subjects. Based on thermal pain thresholds, two subgroups could be identified in fibromyalgia syndrome using cluster analysis. Conclusion: Patients with fibromyalgia syndrome were subgrouped by quantitative sensory testing (i.e., thermal pain thresholds). Subgroups show clinical differences in pain intensities, number of tender points, and sleep quality. Cold pain threshold was especially linked to these clinical aspects.
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