Effectiveness of dance in patients with fibromyalgia: a randomized, single-blind, controlled study

OBJECTIVES

The aim of the present study was to assess the effectiveness of belly dance as a treatment option for patients with fibromyalgia.

METHODS

Eighty female patients with fibromyalgia between 18 to 65 years were randomly allocated to a dance group (n=40) and control group (n=40). Patients in the dance group underwent 16 weeks of belly dance twice a week, while the patients in the control group remained on a waiting list. The patients were evaluated with regard to pain (VAS), function (6MWT), quality of life (FIQ and SF-36), depression (Beck Inventory), anxiety (STAI) and self-image (BDDE). Evaluations were carried out at baseline, 16 weeks and 32 weeks by a blinded assessor.

RESULTS

The dance group achieved significant improvements in VAS for pain (p<0.001), six-minute walk test (p<0.001), FIQ (p=0.003), BDDE (p<0.009) as well as the pain (p<0.001), emotional aspects (p<0.003) and mental health (p<0.021) subscales on the SF-36.

CONCLUSIONS

Belly dance can be used in the treatment of fibromyalgia to reduce pain and improve functional capacity, quality of life and self-image.

Assessment of different instruments used as outcome measures in patients with fibromyalgia

OBJECTIVE

To assess the different measure instruments used for patients with fibromyalgia.

PATIENTS AND METHODS

This study assessed 60 individuals participating in a clinical trial of cross-sectional cohort comparing the effects of exercises performed in water and on land. The following instruments were used: the Fibromyalgia Impact Questionnaire (FIQ) to assess the impact of the disease; the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) to assess quality of life; the Beck Depression Inventory to assess depression; and the Visual Analogue Scale (VAS) of pain. Those questionnaires were compared with the results obtained in a transitional Likert-type scale, the verbal scale for assessing change (VSAC), considered as a criterion of change in the assessment of other instruments.

RESULTS

The Spearman coefficient was used to study the correlation between the VSAC measure and the other instruments at two occasions (T1 and T2). At T1, a moderate correlation was observed between VSAC and VAS (r = 0.49), and between VSAC and FIQ (r = 0.41), and a negative correlation was observed between VSAC and the SF-36 domains pain (r = -0.49) and general health perception (r = -0.55), and the SF-36 physical component (r = -0.42). At T2, only the SF-36 domain vitality showed a weak negative correlation with VSAC (r = -0.27).

CONCLUSION

Considering VSAC as gold standard, none of the instruments assessed could optimally identify a change in the health status of patients with fibromyalgia.

Evaluation of immediate impact of cane use on energy expenditure during gait in patients with knee osteoarthritis

PURPOSE

The aim of the present study was to assess the immediate impact of cane use on energy expenditure during gait in patients with knee OA analyzing VO(2).

METHODS

An observational, cross-sectional study was carried out on 64 symptomatic patients with a diagnosis of knee OA. The assessment of energy expenditure was performed through an analysis of expired gases using the portable K4 apparatus (Cosmed, Model K4 b2, Italy) during the six-min walk test (6MWT). Two tests were performed with a cane and two without a cane on two different days within a seven-day period.

RESULTS

The patients walked farther on the test without the cane (p<0.001). Oxygen expenditure (VO(2)) and the O(2) cost of walking at the end of the 6MWT increased approximately 50% and 80% during cane-assisted gait when compared to gait without the use of a cane (p<0.001). Pain (Borg scale) decreased approximately 20% at the end of the 6MWT with cane-assisted gait in comparison to gait without a cane (p<0.001).

CONCLUSION

Cane use causes an immediate increase in energy expenditure (VO(2)) during gait and O(2) cost of walking and an immediate decrease of pain during gait. It is necessary to do a more prolonged follow up in order to assess the impact of daily cane use on energy expenditure among these patients and determine whether adaptation occurs. Furthermore, it is necessary to study whether daily cane use has a positive impact on important parameters in these patients, such as pain, function and quality of life.