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Fibromyalgia: HELP
Articles from Iowa
Based on 20 articles published since 2008
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These are the 20 published articles about Fibromyalgia that originated from Iowa during 2008-2019.
 
+ Citations + Abstracts
1 Review Neurobiology of fibromyalgia and chronic widespread pain. 2016

Sluka, Kathleen A / Clauw, Daniel J. ·Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, United States. Electronic address: kathleen-sluka@uiowa.edu. · Anesthesiology, Medicine (Rheumatology) and Psychiatry, University of Michigan, United States. ·Neuroscience · Pubmed #27291641.

ABSTRACT: Fibromyalgia is the current term for chronic widespread musculoskeletal pain for which no alternative cause can be identified. The underlying mechanisms, in both human and animal studies, for the continued pain in individuals with fibromyalgia will be explored in this review. There is a substantial amount of support for alterations of central nervous system nociceptive processing in people with fibromyalgia, and that psychological factors such as stress can enhance the pain experience. Emerging evidence has begun exploring other potential mechanisms including a peripheral nervous system component to the generation of pain and the role of systemic inflammation. We will explore the data and neurobiology related to the role of the CNS in nociceptive processing, followed by a short review of studies examining potential peripheral nervous system changes and cytokine involvement. We will not only explore the data from human subjects with fibromyalgia but will relate this to findings from animal models of fibromyalgia. We conclude that fibromyalgia and related disorders are heterogenous conditions with a complicated pathobiology with patients falling along a continuum with one end a purely peripherally driven painful condition and the other end of the continuum is when pain is purely centrally driven.

2 Review Implications of forgiveness enhancement in patients with fibromyalgia and chronic fatigue syndrome. 2010

Toussaint, Loren / Overvold-Ronningen, Mary / Vincent, Ann / Luedtke, Connie / Whipple, Mary / Schriever, Tina / Luskin, Frederic. ·Department of Psychology, Luther College, Decorah, Iowa 52101, USA. touslo01@luther.edu ·J Health Care Chaplain · Pubmed #20658426.

ABSTRACT: The purpose of this review is to examine forgiveness as a means to enhance coping with the emotional sequelae of two disorders, fibromyalgia and chronic fatigue. As with many chronic illnesses, fibromyalgia and chronic fatigue often result in a host of negative emotions including, anger, stress, fear, and depression. We contend that learning to become more forgiving may be a complementary treatment to cope with the ongoing stress, frustration, and negative emotions that result from these two conditions. Our review includes descriptive information on fibromyalgia and chronic fatigue, a brief review of the literature on anger and its influence on health, a review of the connections between forgiveness and well-being, and methods to enhance forgiveness in patients' lives. We conclude with a conceptual model that we hope will be useful to design and/or evaluate work on forgiveness in these patients.

3 Review Central mechanisms in the maintenance of chronic widespread noninflammatory muscle pain. 2008

DeSantana, Josimari M / Sluka, Kathleen A. ·Physical Therapy and Rehabilitation Science, 1-242 MEB, University of Iowa, Iowa City, IA 52252, USA. ·Curr Pain Headache Rep · Pubmed #18765138.

ABSTRACT: Chronic widespread pain (CWP) conditions such as fibromyalgia and myofascial syndromes are characterized by generalized pain, tenderness, morning stiffness, disturbed sleep, and pronounced fatigue. However, CWP pathophysiology is still unclear. A number of hypotheses have been proposed as the underlying pathophysiology of CWP: muscular dysfunction/ischemia, central sensitization, and a deficit in endogenous pain-modulating systems. This article reviews the current and emerging literature about the pathophysiology and neurobiology of chronic widespread -musculoskeletal pain. Widespread musculoskeletal pain results in changes in the central nervous system in human subjects and animal models. These changes likely reflect alterations in supraspinal modulation of nociception, and include increases in excitatory and decreases in inhibitory modulation pathways. These alterations in excitation and inhibition likely drive changes observed in the spinal cord to result in central sensitization, and the consequent pain and hyperalgesia.

4 Clinical Trial Reliability and Construct Validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments in Women with Fibromyalgia. 2017

Merriwether, Ericka N / Rakel, Barbara A / Zimmerman, Miriam B / Dailey, Dana L / Vance, Carol G T / Darghosian, Leon / Golchha, Meenakshi / Geasland, Katherine M / Chimenti, Ruth / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science. · College of Nursing. · College of Public Health, University of Iowa, Iowa City, Iowa. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, Tennessee, USA. ·Pain Med · Pubmed #27561310.

ABSTRACT: Objective: The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to standardize measurement of clinically relevant patient-reported outcomes. This study evaluated the reliability and construct validity of select PROMIS static short-form (SF) instruments in women with fibromyalgia. Design: Analysis of baseline data from the Fibromyalgia Activity Study with TENS (FAST), a randomized controlled trial of the efficacy of transcutaneous electrical nerve stimulation. Setting: Dual site, university-based outpatient clinics. Subjects: Women aged 20 to 67 years diagnosed with fibromyalgia. Methods: Participants completed the Revised Fibromyalgia Impact Questionnaire (FIQR) and 10 PROMIS static SF instruments. Internal consistency was calculated using Cronbach alpha. Convergent validity was examined against the FIQR using Pearson correlation and multiple regression analysis. Results: PROMIS static SF instruments had fair to high internal consistency (Cronbach α = 0.58 to 0.94, P  < 0.05). PROMIS 'physical function' domain score was highly correlated with FIQR 'function' score (r = -0.73). The PROMIS 'total' score was highly correlated with the FIQR total score (r = -0.72). Correlations with FIQR total score of each of the three PROMIS domain scores were r = -0.65 for 'physical function,' r = -0.63 for 'global,' and r = -0.57 for 'symptom' domain. PROMIS 'physical function,' 'global,' and 'symptom' scores explained 58% of the FIQR total score variance. Conclusions: Select PROMIS static SF instruments demonstrate convergent validity with the FIQR, a legacy measure of fibromyalgia disease severity. These results highlight the potential utility of select PROMIS static SFs for assessment and tracking of patient-reported outcomes in fibromyalgia.

5 Clinical Trial Effect of transcutaneous electrical nerve stimulation on pain, function, and quality of life in fibromyalgia: a double-blind randomized clinical trial. 2015

Noehren, Brian / Dailey, Dana L / Rakel, Barbara A / Vance, Carol G T / Zimmerman, Miriam B / Crofford, Leslie J / Sluka, Kathleen A. ·B. Noehren, PT, PhD, Division of Physical Therapy, College of Health Sciences University of Kentucky, Lexington, Kentucky. · D.L. Dailey, PT, PhD, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, Iowa. · B.A. Rakel, RN, PhD, College of Nursing, University of Iowa. · C.G.T. Vance, PT, PhD, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa. · M.B. Zimmerman, PhD, Biostatistics, University of Iowa. · L.J. Crofford, MD, Department of Medicine, Vanderbilt University, Nashville, Tennessee. · K.A. Sluka, PT, PhD, FAPTA, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52422-1089 (USA). kathleen-sluka@uiowa.edu. ·Phys Ther · Pubmed #25212518.

ABSTRACT: BACKGROUND: Fibromyalgia is a common chronic pain condition that has a significant impact on quality of life and often leads to disability. To date, there have been few well-controlled trials assessing the utility of nonpharmacological treatment modalities such as transcutaneous electrical nerve stimulation (TENS) in the management of pain and improvement in function in individuals with fibromyalgia. OBJECTIVES: The purpose of this study will be to complete a long-term, multicenter study to assess the effects of TENS in women with fibromyalgia. DESIGN: This will be a phase II randomized, double-blind, placebo-controlled, multicenter clinical trial. PARTICIPANTS: Three hundred forty-three participants with fibromyalgia will be recruited for this study. INTERVENTION: Participants will be randomly assigned to 1 of 3 groups: the intervention (TENS), placebo, or no treatment. After completing the randomized period, all participants will receive the intervention for 1 month. The participants will be asked to use TENS at the highest tolerable level for at least 2 hours daily during physical activity. MEASUREMENTS: The primary outcome will be pain with movement, with secondary outcomes assessing functional abilities, patient-reported outcomes, and quantitative sensory testing. LIMITATIONS: Because having participants refrain from their typical medications is not practical, their usage and any change in medication use will be recorded. CONCLUSIONS: The results of this study will provide some of the first evidence from a large-scale, double-blind, placebo-controlled trial on the effectiveness of TENS on pain control and quality-of-life changes in patients with fibromyalgia.

6 Article Physical activity is related to function and fatigue but not pain in women with fibromyalgia: baseline analyses from the Fibromyalgia Activity Study with TENS (FAST). 2018

Merriwether, Ericka N / Frey-Law, Laura A / Rakel, Barbara A / Zimmerman, Miriam B / Dailey, Dana L / Vance, Carol G T / Golchha, Meenakshi / Geasland, Katherine M / Chimenti, Ruth / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA. · Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA. · College of Nursing, University of Iowa, Iowa City, IA, USA. · College of Public Health, University of Iowa, Iowa City, IA, USA. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, TN, USA. · Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA. kathleen-sluka@uiowa.edu. · College of Nursing, University of Iowa, Iowa City, IA, USA. kathleen-sluka@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, 1-242 MEB, University of Iowa Carver College of Medicine, Iowa City, IA, 52422-1089, USA. kathleen-sluka@uiowa.edu. ·Arthritis Res Ther · Pubmed #30157911.

ABSTRACT: BACKGROUND: Although exercise is an effective treatment for fibromyalgia, the relationships between lifestyle physical activity and multiple symptomology domains of fibromyalgia are not clear. Thus, the purpose of this study was to comprehensively examine the relationships between lifestyle physical activity with multiple outcome domains in women with fibromyalgia, including pain, fatigue, function, pain-related psychological constructs, and quality of life. METHODS: Women (N = 171), aged 20 to 70 years, diagnosed with fibromyalgia, recruited from an ongoing two-site clinical trial were included in this prespecified subgroup analysis of baseline data. Physical activity was assessed using self-report and accelerometry. Symptomology was assessed using questionnaires of perceived physical function, quality of life, fatigue, pain intensity and interference, disease impact, pain catastrophizing, and fear of movement. In addition, quantitative sensory testing of pain sensitivity and performance-based physical function were assessed. Correlation coefficients, regression analyses and between-group differences in symptomology by activity level were assessed, controlling for age and body mass index (BMI). RESULTS: Lifestyle physical activity was most closely associated with select measures of physical function and fatigue, regardless of age and BMI. Those who performed the lowest levels of lifestyle physical activity had poorer functional outcomes and greater fatigue than those with higher physical activity participation. No relationships between lifestyle physical activity and pain, pain sensitivity, or pain-related psychological constructs were observed. CONCLUSIONS: Lifestyle physical activity is not equally related to all aspects of fibromyalgia symptomology. Lifestyle physical activity levels have the strongest correlations with function, physical quality of life, and movement fatigue in women with fibromyalgia. No relationships between lifestyle physical activity and pain, pain sensitivity, or psychological constructs were observed. These data suggest that physical activity levels are more likely to affect function and fatigue, but have negligible relationships with pain and pain-related psychological constructs, in women with fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01888640 . Registered on 28 June 2013.

7 Article Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. 2017

Kutch, Jason J / Ichesco, Eric / Hampson, Johnson P / Labus, Jennifer S / Farmer, Melissa A / Martucci, Katherine T / Ness, Timothy J / Deutsch, Georg / Apkarian, A Vania / Mackey, Sean C / Klumpp, David J / Schaeffer, Anthony J / Rodriguez, Larissa V / Kreder, Karl J / Buchwald, Dedra / Andriole, Gerald L / Lai, H Henry / Mullins, Chris / Kusek, John W / Landis, J Richard / Mayer, Emeran A / Clemens, J Quentin / Clauw, Daniel J / Harris, Richard E / Anonymous3040912. ·aDivision of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USAbDepartment of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USAcOppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USAdDepartment of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAeDepartment of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University Medical Center, Stanford, CA, USAfDepartments of Radiology and Anesthesiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USAgDepartment of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAhDepartment of Urology, University of Southern California, Los Angeles, CA, USAiDepartment of Urology, University of Iowa, Iowa City, IA, USAjCollege of Medicine, Washington State University, Seattle, WA, USAkDepartment of Urology, Washington University, Saint Louis, MO, USAlNational Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USAmDepartment of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USAnDepartment of Urology, University of Michigan, Ann Arbor, MI, USA. ·Pain · Pubmed #28692006.

ABSTRACT: Chronic pain is often measured with a severity score that overlooks its spatial distribution across the body. This widespread pain is believed to be a marker of centralization, a central nervous system process that decouples pain perception from nociceptive input. Here, we investigated whether centralization is manifested at the level of the brain using data from 1079 participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network (MAPP) study. Participants with a clinical diagnosis of urological chronic pelvic pain syndrome (UCPPS) were compared to pain-free controls and patients with fibromyalgia, the prototypical centralized pain disorder. Participants completed questionnaires capturing pain severity, function, and a body map of pain. A subset (UCPPS N = 110; fibromyalgia N = 23; healthy control N = 49) underwent functional and structural magnetic resonance imaging. Patients with UCPPS reported pain ranging from localized (pelvic) to widespread (throughout the body). Patients with widespread UCPPS displayed increased brain gray matter volume and functional connectivity involving sensorimotor and insular cortices (P < 0.05 corrected). These changes translated across disease diagnoses as identical outcomes were present in patients with fibromyalgia but not pain-free controls. Widespread pain was also associated with reduced physical and mental function independent of pain severity. Brain pathology in patients with centralized pain is related to pain distribution throughout the body. These patients may benefit from interventions targeting the central nervous system.

8 Article Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls. 2017

Toussaint, Loren / Sirois, Fuschia / Hirsch, Jameson / Weber, Annemarie / Vajda, Christian / Schelling, Jorg / Kohls, Niko / Offenbacher, Martin. ·Luther College, Decorah, Iowa, USA. touslo01@luther.edu. · University of Sheffield, Sheffield, UK. · East Tennessee State University, Johnson City, Tennessee, USA. · Coburg University, Coburg, Germany. · Medical University of Graz, Graz, Austria. · University of Munich, Munich, Germany. ·Qual Life Res · Pubmed #28584891.

ABSTRACT: PURPOSE: Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls. METHODS: Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics. RESULTS: Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables. CONCLUSIONS: Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.

9 Article Struggling With Adversities of Life: The Role of Forgiveness in Patients Suffering from Fibromyalgia. 2017

Offenbaecher, Martin / Dezutter, Jessie / Kohls, Niko / Sigl, Claudia / Vallejo, Miguel A / Rivera, Javier / Bauerdorf, Felix / Schelling, Jörg / Vincent, Ann / Hirsch, Jameson K / Sirois, Fuschia M / Webb, Jon R / Toussaint, Loren L. ·*Institute of General Medicine, University Clinic, Munich ‡Division of Integrative Health Promotion, University of Applied Science and Arts, Coburg, Germany †Faculty of Psychology and Educational Sciences, KU Leuven University of Leuven, Leuven, Belgium §Psychology Faculty, UNED ∥Rheumatology Unit, Rehabilitation Provincial Institute, "Gregorio Marañón" General Hospital, Madrid, Spain ¶Division of General Internal Medicine, Mayo Clinic, Rochester, MN #Department of Psychology, East Tennessee State University, Johnson City, TN **Department of Psychology, University of Sheffield, Sheffield, UK ††Department of Psychology, Luther College, Decorah, IA. ·Clin J Pain · Pubmed #27584816.

ABSTRACT: OBJECTIVES: We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. MATERIALS AND METHODS: A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. RESULTS: Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. DISCUSSION: Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being.

10 Article Perceived function and physical performance are associated with pain and fatigue in women with fibromyalgia. 2016

Dailey, Dana L / Frey Law, Laura A / Vance, Carol G T / Rakel, Barbara A / Merriwether, Ericka N / Darghosian, Leon / Golchha, Meenakshi / Geasland, Katharine M / Spitz, Rebecca / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 1-252 MEB, 500 Newton Road, Iowa City, IA, 52242, USA. dana-dailey@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, 1-242 MEB, Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA, 52422, USA. dana-dailey@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 1-252 MEB, 500 Newton Road, Iowa City, IA, 52242, USA. · College of Nursing, University of Iowa, 50 Newton Road, Iowa City, IA, 52242, USA. · Department of Medicine, Division of Rheumatology & Immunology, Vanderbilt University, 1161 21st Avenue South, Nashville, TN, 37232, USA. ·Arthritis Res Ther · Pubmed #26979999.

ABSTRACT: BACKGROUND: Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue and associated with significant impairment in perceived function and reduced physical performance. The purpose of this study was to determine the degree to which pain and fatigue are associated with perceived function and physical performance in women with fibromyalgia. METHODS: Hierarchical linear regression determined the contribution of pain and fatigue (Numeric Rating Scale (NRS) for resting, movement and combined) to perceived function (Fibromyalgia Impact Questionnaire Revised - Function Subscale, FIQR-Function), Multidimensional Assessment of Fatigue - Activities of Daily Living (MAF-ADL) and SF-36 Physical Function Subscale (SF-36-PF) and physical performance (6-Minute Walk Test, 6MWT and Five Time Sit To Stand, 5TSTS) while controlling for age, body mass index, pain catastrophizing, fear of movement, anxiety, and depression in women with fibromyalgia (N = 94). RESULTS: For perceived function, movement pain and movement fatigue together better predicted FIQR-function (adjusted R(2) = 0.42, p ≤ 0.001); MAF-ADL (adjusted R(2) = 0.41, p ≤ 0.001); and SF-36-PF function (adjusted R(2) = 0.34, p ≤ 0.001). For physical performance measures, movement pain and fatigue together predicted 6MWT distance (adjusted R(2) = 0.42, p ≤ 0.001) and movement fatigue alone predicted performance time on the 5TSTS (adjusted R(2) = 0.20, p ≤ 0.001). CONCLUSIONS: Pain and fatigue are significantly associated with and explain more than one-third of the variance in perceived function and physical performance in women with fibromyalgia. TRIAL REGISTRATION: NIH Clinicaltrials.gov REGISTRATION: NCT01888640 . Registered 13 June 2013.

11 Article Perceived dyscognition reported by patients with fibromyalgia. 2016

McAllister, Samantha J / Toussaint, Loren L / Williams, David A / Hoskin, Tanya L / Whipple, Mary O / Vincent, Ann. ·Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. · Department of Psychology, Luther College, Decorah, Iowa, USA. · Chronic Pain and Fatigue Research Center, University of Michigan Health System, Ann Arbor, Michigan, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA. · Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. vincent.ann@mayo.edu. ·Clin Exp Rheumatol · Pubmed #26941074.

ABSTRACT: OBJECTIVES: Patients with fibromyalgia often report dyscognition as a symptom; however, the literature on this symptom is sparse. Our objective for this cross-sectional study was to characterize dyscognition among patients with fibromyalgia, identify comorbid symptoms associated with dyscognition, and evaluate its relation with fibromyalgia severity. METHODS: Dyscognition was assessed with the Multiple Abilities Self-report Questionnaire (MASQ) for 681 patients with fibromyalgia. Other assessed comorbid symptoms were pain, fatigue, sleep problems, mood, physical and mental health, and autonomic function. Correlation and regression modeling were used to identify relations between the MASQ subscales and other fibromyalgia symptoms. Mixed analysis of variance was used to examine the profile of dyscognition in different levels of fibromyalgia. MASQ subscale scores from a previously described healthy normal control population were used for comparison. RESULTS: The mean (SD) age of the study patients was 55.8 (12.6) years, and most patients were female (93%) and white (91%). Perceived dyscognition was most related to depression, anxiety, and autonomic function. Across all fibromyalgia severity levels, patients had significantly higher levels of perceived dyscognition than the healthy controls. Significant differences existed for the MASQ total and most MASQ subscales among patients with mild, moderate, and severe fibromyalgia. CONCLUSIONS: Our study results provide further evidence that perceived dyscognition in fibromyalgia is influenced by various comorbid symptoms. In treating patients with fibromyalgia who have dyscognition, clinicians should consider the multiple types of dyscognition and the effects of other fibromyalgia symptoms.

12 Article Intra- and Inter-Patient Symptom Variability in Fibromyalgia: Results of a 90-Day Assessment. 2015

Toussaint, Loren / Vincent, Ann / McAllister, Samantha J / Whipple, Mary. ·Luther College, Decorah, IA, USA. · Mayo Clinic, Rochester, MN, USA. ·Musculoskeletal Care · Pubmed #25408116.

ABSTRACT: Symptoms of fibromyalgia (FM)--chronic widespread pain, fatigue, unrefreshing sleep, dyscognition etcetera--present with varying degrees of severity in different individuals; however, studies reporting daily estimates of variability of symptoms are sparse. Given the limited literature on the stability and variability of FM symptoms, the purpose of the present study was to determine the feasibility of daily visual analogue, self-report measures to assess daily variability and time trends in core FM symptoms. Ten female patients completed daily assessments of common FM symptoms (pain, fatigue, anxiety, depression, stress, cognitive dysfunction, unrefreshing sleep and lightheadedness) for approximately 90 days. The completion rate was excellent (89.6%). The results demonstrated that average symptom intensity differs markedly across the different symptoms that were measured. Unrefreshing sleep, fatigue and pain are clearly higher in intensity than other symptoms and are followed by memory problems, stress, anxiety and depression. There is also notable average intra-individual change across time (10-15 points on a 100-point scale). Average symptom intensity does not appear to be related to the amount of symptom change within individuals. The results of the present study confirm that intensive longitudinal study, using comprehensive symptom assessment in patients with FM, is both possible and informative, in the sense that a rich description of the daily experience of living with FM can be obtained. Future work, utilizing larger samples, will offer the opportunity to investigate better the causes, consequences and correlates of the daily ups and downs of key symptoms that compromise quality of life in patients with FM.

13 Article Do cognitive and physical fatigue tasks enhance pain, cognitive fatigue, and physical fatigue in people with fibromyalgia? 2015

Dailey, Dana L / Keffala, Valerie J / Sluka, Kathleen A. ·University of Iowa, Iowa City. ·Arthritis Care Res (Hoboken) · Pubmed #25074583.

ABSTRACT: OBJECTIVE: Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue. The primary objective of this study was to determine if pain, perceived cognitive fatigue, and perceived physical fatigue were enhanced in participants with fibromyalgia compared to healthy controls during a cognitive fatigue task, a physical fatigue task, and a dual fatigue task. METHODS: In total, 24 people with fibromyalgia and 33 healthy controls completed pain, fatigue, and function measures. A cognitive fatigue task (Controlled Oral Word Association Test) and physical fatigue task (Valpar peg test) were done individually and combined for a dual fatigue task. Resting pain, perceived cognitive fatigue, and perceived physical fatigue were assessed during each task using visual analog scales. Function was assessed with shoulder range of motion and grip. RESULTS: People with fibromyalgia had significantly higher increases in pain, cognitive fatigue, and physical fatigue when compared to healthy controls after completion of a cognitive fatigue task, a physical fatigue task, or a dual fatigue task (P < 0.01) with the exception of perceived cognitive fatigue during the cognitive fatigue task. People with fibromyalgia performed equivalently on measures of physical performance and cognitive performance on the physical and cognitive fatigue tasks, respectively. CONCLUSION: These data show that people with fibromyalgia show larger increases in pain, perceived cognitive fatigue, and perceived physical fatigue to both cognitive and physical fatigue tasks compared to healthy controls. The increases in pain and fatigue during cognitive and physical fatigue tasks could influence subject participation in daily activities and rehabilitation.

14 Article Psychological Resilience, Affective Mechanisms and Symptom Burden in a Tertiary-care Sample of Patients with Fibromyalgia. 2015

McAllister, Samantha J / Vincent, Ann / Hassett, Afton L / Whipple, Mary O / Oh, Terry H / Benzo, Roberto P / Toussaint, Loren L. ·Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA. · Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA. · Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Psychology, Luther College, Decorah, IA, USA. ·Stress Health · Pubmed #24376184.

ABSTRACT: Research demonstrates that patients with fibromyalgia who have higher positive and lower negative affect have lower symptom burden. Affect has been shown to be associated with resilience. This study examined the relationship between affect, resilience and fibromyalgia symptom burden in a clinical sample of patients with fibromyalgia. We hypothesized that (a) positive and negative affect would be associated with fibromyalgia symptom burden; (b) resilience would be associated with positive and negative affect; (c) resilience would be associated with fibromyalgia symptom burden; and (d) the connection between resilience and fibromyalgia symptom burden would be mediated by both positive and negative affect. A sample of 858 patients with fibromyalgia completed questionnaires. Mediation modelling revealed statistically significant direct effects of resilience on fibromyalgia symptom burden (β = -0.10, P < 0.001) and statistically significant indirect effects of resilience on fibromyalgia symptom burden through affect (β = -0.36, P < 0.001), suggesting that both resilience and affect influence fibromyalgia symptom burden. Our results suggest that improving affect through resiliency training could be studied as a modality for improving fibromyalgia symptom burden.

15 Article Nutcracker esophagus: demographic, clinical features, and esophageal tests in 115 patients. 2015

Lufrano, R / Heckman, M G / Diehl, N / DeVault, K R / Achem, S R. ·Medical School, Univerisity of Iowa, Iowa City, Iowa, USA. ·Dis Esophagus · Pubmed #24251375.

ABSTRACT: Nutcracker esophagus (NE) is a common esophageal motility disorder chacterized by high amplitude peristaltic contractions in the distal esophagus. While previous studies have examined selected aspects of this condition (e.g. pathogenesis and treatment), there is a paucity of data regarding demographic and clinical features in large cohorts of patients. The aim of this study was to describe demographics, clinical features, comorbidities, time to diagnosis, source of patient referral by specialty, and medication use in a large cohort of patients with NE. We retrospectively analyzed consecutive cases of NE diagnosed from 2008-2010. The electronic medical records of these patients were reviewed, and relevant information was extracted. We identified 115 patients with NE. The median age was 62 years (range 25-87 years), and 63% were female. The median time patients experienced symptoms prior to diagnosis was 24 months (0-480 months). Most patients presented to an internal medicine consultant (42%) or to a gastroenterologist (35%). Presenting symptoms were chest pain (31%) and dysphagia (21%). Gastroesophageal reflux disease (GERD) symptoms were common: heartburn occurred in 51% of patients, 77% had a prior history of GERD, and 78% were receiving acid suppressive medications. GERD was confirmed by testing in at least 35%. Psychiatric comorbidity occurred in 24% with half the patients receiving psychotropic medications. Irritable bowel syndrome (IBS) and fibromyalgia co-existed in 15% and 12% of patients, respectively. Surprisingly, opioids were prescribed to 26% of patients. No statistically significant correlation was found between esophageal motility parameters and symptoms. In this study, NE patients were more commonly middle-aged females experiencing a considerable amount of time between symptom onset and diagnosis. Many were initially evaluated by internists for dysphagia or chest pain and had a history of GERD. Medication prescribed prior to diagnoses frequently involved acid suppression, but narcotic and psychotropic prescriptions were also commonly used. Central sensitization syndromes (fibromyalgia and IBS), psychiatric comorbidity, and reflux commonly coexisted. Our study suggests that future investigations should address the role and interaction of GERD and psychiatric disorders in NE.

16 Article A report of the autonomic symptom profile in patients with fibromyalgia. 2014

Vincent, Ann / McAllister, Samantha J / Singer, Wolfgang / Toussaint, Loren L / Sletten, David M / Whipple, Mary O / Low, Phillip A. ·From *Mayo Clinic, Rochester, MN; and †Department of Psychology, Luther College, Decorah, IA. ·J Clin Rheumatol · Pubmed #24561417.

ABSTRACT: -- No abstract --

17 Article Decreased physical activity attributable to higher body mass index influences fibromyalgia symptoms. 2014

Vincent, Ann / Clauw, Daniel / Oh, Terry H / Whipple, Mary O / Toussaint, Loren L. ·Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, 200 First Street SW, Rochester, MN 55902(∗). Electronic address: vincent.ann@mayo.edu. · Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI(†). · Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN(‡). · Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN(§). · Department of Psychology, Luther College, Decorah, IA(¶). ·PM R · Pubmed #24534101.

ABSTRACT: BACKGROUND: Although previous studies report associations between increased body mass index (BMI) and fibromyalgia symptoms, there is uncertainty as to whether this relationship is driven by physical factors, psychological factors, or both. OBJECTIVE: To assess these relationships in a clinical sample of patients with fibromyalgia. DESIGN: Cross-sectional study. SETTING: Tertiary care facility. PATIENTS: A total of 686 patients from an existing national fibromyalgia registry. METHODS: Patients completed a demographic form and self-report questionnaires including the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the Medical Outcomes Study Short Form-36 (SF-36), the Brief Pain Inventory (BPI), and the 30-item Profile of Mood States (30-item POMS). MAIN OUTCOME MEASUREMENTS: FIQ-R overall impact subscale. RESULTS: BMI was significantly correlated with fibromyalgia impact (P < .001). The relationship between BMI and fibromyalgia impact was almost fully accounted for by physical factors and not by psychological factors. CONCLUSIONS: Despite patient report that pain hinders physical activity, clinicians who encounter patients with fibromyalgia, particularly patients with increased BMI, should be cognizant of the need to invest time and resources to counsel patients on physical factors (ie, physical activity) that could improve the patients' symptom experience.

18 Article Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia. 2013

Dailey, Dana L / Rakel, Barbara A / Vance, Carol G T / Liebano, Richard E / Amrit, Anand S / Bush, Heather M / Lee, Kyoung S / Lee, Jennifer E / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA. ·Pain · Pubmed #23900134.

ABSTRACT: Because transcutaneous electrical nerve stimulation (TENS) works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo-controlled cross-over design to test the effects of a single treatment of TENS with people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS and no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and in movement; pressure pain thresholds, 6-m walk test, range of motion; 5-time sit-to-stand test, and single-leg stance. Conditioned pain modulation was completed at the end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. Pressure pain thresholds increased at the site of TENS (spine) and outside the site of TENS (leg) when compared to placebo TENS or no TENS. During active TENS, conditioned pain modulation was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to the way in which TENS is used clinically on pain, fatigue, function, and quality of life in individuals with fibromyalgia.

19 Article A mind-body technique for symptoms related to fibromyalgia and chronic fatigue. 2012

Toussaint, Loren L / Whipple, Mary O / Abboud, Lana L / Vincent, Ann / Wahner-Roedler, Dietlind L. ·Department of Psychology, Luther College, Decorah, IA 52101, USA. touslo01@luther.edu ·Explore (NY) · Pubmed #22385563.

ABSTRACT: CONTEXT: A novel mind-body approach (amygdala retraining) is hypothesized to improve symptoms related to fibromyalgia and chronic fatigue. OBJECTIVE: To examine the use of a mind-body approach for improving symptoms related to fibromyalgia and chronic fatigue. DESIGN: This was a single-blind, randomized controlled trial. SETTING: The study was conducted in a tertiary-care fibromyalgia and chronic fatigue clinic. PATIENTS: Patients with fibromyalgia, chronic fatigue, or both were included. INTERVENTIONS: Patients were randomly assigned to receive amygdala retraining along with standard care or standard care alone. Standard care involved attending a 1.5-day multidisciplinary program. The amygdala retraining group received an additional 2.5-hour training course in which the key tools and techniques adapted from an existing program were taught to the patient. A home-study video course and associated text were provided to supplement the on-site program. Both groups received telephone calls twice a month to answer questions related to technique and to provide support. MAIN OUTCOME MEASURES: Validated self-report questionnaires related to general health, well-being, and symptoms, including Short Form-36, Measure Yourself Medical Outcome Profile, Multidimensional Fatigue Inventory, Epworth Sleepiness Scale, and Fibromyalgia Impact Questionnaire. RESULTS: Of the 44 patients randomly assigned who completed baseline assessments, 21 patients completed the study (14 in the standard care group and 7 in the study group). Median age was 48 years (range, 27-56 years), and female subjects comprised 91% of the group. Analyses demonstrated statistically significant improvements in scores for physical health, energy, pain, symptom distress, and fatigue in patients who received the amygdala retraining compared with standard care.

20 Article Is it possible to develop an animal model of fibromyalgia? 2009

Sluka, Kathleen A. ·Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA 52242, USA. kathleen-sluka@uiowa.edu ·Pain · Pubmed #19695780.

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