Chronic widespread pain and fibromyalgia: Should reports of increased mortality influence management?

ArticleinCurrent Rheumatology Reports 7(5):339-41 · November 2005with5 Reads
DOI: 10.1007/s11926-005-0017-8 · Source: PubMed
Abstract
There have been few studies examining whether persons with chronic widespread pain or fibromyalgia are at increased risk for dying prematurely. Among the studies conducted there is little consistency in results. If there is an increased mortality risk, it is of the order of a 30% excess and it may be related to the lifestyle of patients with these symptoms, including lack of exercise. Skilled judgment is required in determining whether reports of new symptoms are likely to indicate underlying new pathology. Studies are currently underway which will determine whether initial observations of an increased mortality risk can be replicated.
    • "Diminished aerobic fitness in FM has been documented for almost three decades, and recent studies report that the average 40-year-old with FM has fitness findings expected for a healthy 70 to 80-year-old, and FM has now also been associated with increased mortality.2,3,11–14 Tailoring exercise to patients with FM requires an understanding of the relevant pathophysiology. "
    [Show abstract] [Hide abstract] ABSTRACT: Complementary and alternative medicine includes a number of exercise modalities, such as tai chi, qigong, yoga, and a variety of lesser-known movement therapies. A meta-analysis of the current literature was conducted estimating the effect size of the different modalities, study quality and bias, and adverse events. The level of research has been moderately weak to date, but most studies report a medium-to-high effect size in pain reduction. Given the lack of adverse events, there is little risk in recommending these modalities as a critical component in a multimodal treatment plan, which is often required for fibromyalgia management.
    Full-text · Article · Mar 2013
    • "In the last 5 years, reports have emerged suggesting an association between chronic widespread pain and increased mortality [3,4] . The increased mortality risk has been hypothesized to be related to a patient's lifestyle, including physical inactivity [4]. The current standard of care for FMS is a combination of pharmacological and non-pharmacological therapies, including recommendations for increased physical activity (PA) and exercise [5]. "
    [Show abstract] [Hide abstract] ABSTRACT: There currently is a paucity of well-validated instruments to quantitatively measure physical activity (PA) levels in patients with fibromyalgia syndrome (FMS). This study aims to determine the construct validity and test-retest reliability of two self-report physical activity questionnaires [short-form international physical activity questionnaire (s-IPAQ) and community health activities model program for seniors (CHAMPS)] in a fibromyalgia population. Thirty subjects (mean age 49.1 +/- 9.6 years; 90% females) who met the American College of Rheumatology criteria for FMS were invited to participate in the study. Two-week test-retest reliability was evaluated for the CHAMPS and s-IPAQ. Construct validity was evaluated by comparing PA reported from these questionnaires with data obtained from accelerometry (steps/week, counts/week) and the 6-minute walk test (6-MWT). CHAMPS showed greater test-retest reliability (r = 0.58; p < 0.001) compared with s-IPAQ (r = 0.18; p = 0.15). No significant correlations were observed between the self-report PA questionnaires and the 6-MWT or accelerometry data (p > 0.05). In a fibromyalgia population, the s-IPAQ does not appear to be a reliable and valid PA assessment tool. CHAMPS displayed moderate test-retest reliability; however, no associations were found between CHAMPS and objectives measures of PA. In view of the known benefits of exercise in patients with FMS, there is a need to develop new measures or validate other existing well-established PA questionnaires.
    Full-text · Article · Dec 2009
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