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Effects of a 12-week rehabilitation program on pressure pain threshold in individuals with fibromyalgia
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Conclusion(s): The present findings confirm the lower PPT values in patients with fibromyalgia compared to healthy controls. They further highlight a shift to the left of the dose–response curve, even under the PPT, in fibromyalgia patients. Thus, the full range of sensations pressure and which is characterized by a modified pressure hypersensitization. However, the ability of hierarchical levels of pressure is maintained. Implications: The completion of a dose-response curve could be used in monitoring patients with fibromyalgia. Keywords: Fibromyalgia; Pressure pain thresholds; Dose–response curve Funding acknowledgements: University Hospital Center of Grenoble. Ethics approval: This study was approved by local ethical committee. Informed consent was obtained from every participant. http://dx.doi.org/10.1016/j.physio.2015.03.1567 Research Report Poster Presentation Number: RR-PO-20-14-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 EFFECTS OF A 12-WEEK REHABILITATION PROGRAM ON PRESSURE PAIN THRESHOLD IN INDIVIDUALS WITH FIBROMYALGIA J. Vaillant 1,2 , S. Montjaux 2 , B. Wuyam 3,4 , M. Guinot 4 , R. Juvin 4 , A. Favre-Juvin 4 , N. Vuillerme 1,5 1 Grenoble-Alpes
University, AGIM Laboratory, Grenoble, France; 2 University Hospital Centre of Grenoble, School of Physiotherapy, Grenoble, France; 3 Grenoble-Alpes University, HP2 Laboratory, Grenoble, France; 4 University Hospital Centre of Grenoble, Clinic of Physiology and Rheumatology, Grenoble, France; 5 Institut Universitaire de France, Paris, France Background: Fibromyalgia is a chronic pain syndrome associated with sleep disorders, fatigue, physical deconditioning and psychological symptoms. Current evidence also indicates that fibromyalgia is a hyperalgesic state. There is well-documented evidence that exercise and aerobic program are beneficial for functional status, pain and physical condition for patients with fibromyalgia. Nevertheless, the impact on hyperalgesia status is still unknown. Purpose: The purpose of this study was to assess the effects of a 12-week rehabilitation program on algesic state in patients with fibromyalgia. Methods: Eleven patients with fibromyalgia participated to this study. They followed a 12-week rehabilitation program (3 sessions per week (3 hours per session)) based on a reentrainment program personalized effort.
eS1567
Pressure sensibility were determined with pressure algometry at two of the eighteen tender point sites defined by the American College of Rheumatology: (1) trapezius and (2) gluteus. Four level of pressure were randomly applied: 50, 100, 150, 200 kPa. Subjectively perceived pain was assessed using a visual analog scale (VAS). These measurement tools have enabled us to establish a dose (pressure)–response (pain). Pressure sensibility measurements were performed (1) at the start (baseline), (2) at the middle, and (3) at the end of the 12-week rehabilitation program intervention period. Results: At the end of the 12-week rehabilitation program, intent-to-treat analysis showed statistically significantly lower VAS score compared to the baseline. At the two points tested and all levels of pressure, decreased perceived pain was observed between the beginning and end of the program. A significant decrease in the pain caused to the gluteus is raised point 50 kPa and 100 kPa and the trapezius 200 to 150 kPa and the point (p < 0.05). Pressures of 50 kPa and 100 trapezius point approaching the threshold of significance at p < 0.06. Conclusion(s): The present results demonstrate that the positive impact of a 12-week rehabilitation program on pressure pain threshold in individuals with fibromyalgia. Our results hence suggest that the beneficial effect of such a rehabilitation program provide go beyond the musculoskeletal and cardiorespiratory systems, with clinically relevant impacts on the regulatory mechanisms of pain. Implications: A 12-week rehabilitation program appears effective to significantly reduce pressure pain sensitivity in to positively in fibromyalgia patients. Keywords: Fibromyalgia; Hyperalgesia; Exercise program Funding acknowledgements: University Hospital Centre of Grenoble. Ethics approval: This study was approved by local ethical committee. Informed consent was obtained from every participant. http://dx.doi.org/10.1016/j.physio.2015.03.1568
Conclusion(s): The present findings confirm the lower PPT values in patients with fibromyalgia compared to healthy controls. They further highlight a shift to the left of the dose–response curve, even under the PPT, in fibromyalgia patients. Thus, the full range of sensations pressure and which is characterized by a modified pressure hypersensitization. However, the ability of hierarchical levels of pressure is maintained. Implications: The completion of a dose-response curve could be used in monitoring patients with fibromyalgia. Keywords: Fibromyalgia; Pressure pain thresholds; Dose–response curve Funding acknowledgements: University Hospital Center of Grenoble. Ethics approval: This study was approved by local ethical committee. Informed consent was obtained from every participant. http://dx.doi.org/10.1016/j.physio.2015.03.1567 Research Report Poster Presentation Number: RR-PO-20-14-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 EFFECTS OF A 12-WEEK REHABILITATION PROGRAM ON PRESSURE PAIN THRESHOLD IN INDIVIDUALS WITH FIBROMYALGIA J. Vaillant 1,2 , S. Montjaux 2 , B. Wuyam 3,4 , M. Guinot 4 , R. Juvin 4 , A. Favre-Juvin 4 , N. Vuillerme 1,5 1 Grenoble-Alpes
University, AGIM Laboratory, Grenoble, France; 2 University Hospital Centre of Grenoble, School of Physiotherapy, Grenoble, France; 3 Grenoble-Alpes University, HP2 Laboratory, Grenoble, France; 4 University Hospital Centre of Grenoble, Clinic of Physiology and Rheumatology, Grenoble, France; 5 Institut Universitaire de France, Paris, France Background: Fibromyalgia is a chronic pain syndrome associated with sleep disorders, fatigue, physical deconditioning and psychological symptoms. Current evidence also indicates that fibromyalgia is a hyperalgesic state. There is well-documented evidence that exercise and aerobic program are beneficial for functional status, pain and physical condition for patients with fibromyalgia. Nevertheless, the impact on hyperalgesia status is still unknown. Purpose: The purpose of this study was to assess the effects of a 12-week rehabilitation program on algesic state in patients with fibromyalgia. Methods: Eleven patients with fibromyalgia participated to this study. They followed a 12-week rehabilitation program (3 sessions per week (3 hours per session)) based on a reentrainment program personalized effort.
eS1567
Pressure sensibility were determined with pressure algometry at two of the eighteen tender point sites defined by the American College of Rheumatology: (1) trapezius and (2) gluteus. Four level of pressure were randomly applied: 50, 100, 150, 200 kPa. Subjectively perceived pain was assessed using a visual analog scale (VAS). These measurement tools have enabled us to establish a dose (pressure)–response (pain). Pressure sensibility measurements were performed (1) at the start (baseline), (2) at the middle, and (3) at the end of the 12-week rehabilitation program intervention period. Results: At the end of the 12-week rehabilitation program, intent-to-treat analysis showed statistically significantly lower VAS score compared to the baseline. At the two points tested and all levels of pressure, decreased perceived pain was observed between the beginning and end of the program. A significant decrease in the pain caused to the gluteus is raised point 50 kPa and 100 kPa and the trapezius 200 to 150 kPa and the point (p < 0.05). Pressures of 50 kPa and 100 trapezius point approaching the threshold of significance at p < 0.06. Conclusion(s): The present results demonstrate that the positive impact of a 12-week rehabilitation program on pressure pain threshold in individuals with fibromyalgia. Our results hence suggest that the beneficial effect of such a rehabilitation program provide go beyond the musculoskeletal and cardiorespiratory systems, with clinically relevant impacts on the regulatory mechanisms of pain. Implications: A 12-week rehabilitation program appears effective to significantly reduce pressure pain sensitivity in to positively in fibromyalgia patients. Keywords: Fibromyalgia; Hyperalgesia; Exercise program Funding acknowledgements: University Hospital Centre of Grenoble. Ethics approval: This study was approved by local ethical committee. Informed consent was obtained from every participant. http://dx.doi.org/10.1016/j.physio.2015.03.1568