Öz

Aim: The aim of this study was to investigate effect of balneotherapy (BT) on pain and quality of life in patients with fibromyalgia (FMS). 

Material and Methods: The study included 98 women without known metabolic or psychiatric disorder and history of new medication within prior month who were diagnosed as primary fibromyalgia according to 2010 American College of Rheumatology (ACR) criteria and accepted to participate to the study. The sociodemographic characteristics were recorded for all patients. All patients received 21 consecutive sessions of balneotherapy (20 minutes per day). The patients were assessed by Fibromyalgia Impact Questionnaire (FIQ) and Visual Analog Scale (VAS) before and after therapy. 

Results: The mean age of the all patients was 53.04 ± 10.3 years, the mean body mass index was 29.06 ± 5.9 kg/m2, and the mean disease duration was 54.91 ± 59.5 months. In patients with FMS, there were significant differences between VAS and FIQ scores assessed before and after BT (p=0.01). Also, the extent of decrease in FIQ score was greater in non-smokers than smoker FM patients (p<0.05). 

Conclusion: In patients with FM, there was a significant difference in VAS scores following BT. Moreover, there was also a significant difference in FIQ scores. However, the improvement in quality of life after BT was greater in non-smoker FM patients when compared to smoker FM patient.

Balneoterapinin fibromiyalji hastalarında ağrı ve yaşam kalitesine etkisi

Öz

Amaç: Bu çalışmanın amacı Balneoterapinin (BT) fibromiyalji sendromu (FMS) olan hastalarda ağrı ve yaşam kalitesi üzerine etkisini araştırmaktır.

Gereç ve Yöntem: Çalışmaya; 18-65 yaş arasında, 2010 American College of Rheumatology kriterlerine göre FMS tanısı alan ve çalışmayı kabul eden, bilinen metabolik ve psikiyatrik hastalığı olmayan ve son 1 ay içinde yeni bir ilaç kullanmamış 98 kadın hasta dahil edildi. Hastaların sosyodemografik özellikleri kaydedildi. Hastalar günde 1 defa olmak üzere her gün 20 dakika olacak şekilde toplam 21 seans BT aldı. Tüm hastalar tedavi öncesi ve sonrasında Fibromiyalji Etki Anketi (FEA) ve Görsel Analog Skala (GAS) ile değerlendirildi.

Bulgular: Çalışmaya alınan 98 FMS hastasının ortalama yaşı 53.04 ± 10.3 yıl, ortalama vücut kitle indeksi 29.06 ± 5.9 kg/m2 ve hastalık süresi ortalama 54.91 ± 59.5 ay olarak belirlendi. FMS’li hastaların tedavi öncesi ve tedavi sonrası değerlendirilen GAS ve FEA skorları arasındaki istatistiksel olarak anlamlı farklılık vardı (p=0.01). FEA skorlarındaki azalma sigara içmeyen hastalarda daha fazlaydı (p<0.05).

Sonuç: FMS’li hastalarda BT sonrasında GAS değerlerinde ve FEA skorlarında anlamlı derecede azalma vardı. Bununla birlikte yaşam kalitesindeki artış sigara içmeyen FM’li hastalarda sigara içen FM’li hastalara oranla daha fazladır.

Anahtar Kelimeler

• Balneoterapi,fibromiyalji,tedavi

Kaynakça

1. Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Research and Treatment 2012;426130.
2. Theoharides TC, Tsilioni I, Arbetman L, Panagiotidou S, Stewart JM, Gleason RM, et al. Fibromyalgia syndrome in need of effective treatments. J Pharmacol Exp Ther 2015;355:255-263.
3. Dadabhoy D, Clauw DJ. Therapy insight: fibromyalgia a different type of pain needing a different type of treatment. Nat Clin Pract Rheumatol 2006;2:364-72.
4. Albrecht PJ, Rice FL Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms. Rev Environ Health. 2016;31:281-94
5. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA: the Journal of the American Medical Association 2004; 292: 2388-95
6. Semiz EA, Hizmetli S, Semiz M, Karadağ A, Adalı M, Tuncay MS et al. Serum cortisol and dehydroepiandrosterone-sulfate levels after balneotherapy and physical therapy in patients with fibromyalgia. Saudi Med J. 2016;37:544-50
7. Bender T, Bariska J, Vághy R, Gomez R, Imre Kovács. Effect of balneotherapy on the antioxidant system--a controlled pilot study. Arch Med Res. 2007;38:86-9
8. Ablin JN, Häuser W, Buskila D. Spa treatment (balneotherapy) for fibromyalgia-a qualitative-narrative review and a historical perspective. Evid Based Complement Alternat Med. 2013;2013:63

9. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P et al. The American Collage of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research 2010; 62:600-610.
10. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20:9-12.
11. Falagas ME, Zarkadoulia E, Rafailidis PI. The therapeutic effect of balneotherapy: evaluation of the evidence from randomised controlled trials. Int J Clin Pract 2009;63:1068–84.
12. McVeigh JG, McGaughey H, Hall M, Kane P. The effectiveness of hydrotherapy in the management of fibromyalgia syndrome: a systematic review. Rheumatol Int 2008;2:119–30
13. Weingarten TN1, Podduturu VR, Hooten WM, Thompson JM, Luedtke CA, Oh TH. Impact of tobacco use in patients presenting to a multidisciplinary outpatient treatment program for fibromyalgia. Clin J Pain. 2009;25:39-3
14. Campos R, Vázquez M. Health-related quality of life in women with fibromyalgia: clinical and psychological factors associated. Clinical Rheumatology 2012;31:347-55
15. Ozkurt S, Dönmez A, Zeki Karagülle M, Uzunoğlu E, Turan M, Erdoğan N. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study. Rheumatol Int. 2012;32:1949-54
16. Buckhardt CS, Goldenberg D, Crofford L, Gerwin R, Gowens S, Jackson K, et al. Guideline for the management of fibromyalgia syndrome pain in adults and children. Glenview (IL): American Pain Society 4 th ; 2005. 109 p.
17. Carville SF, Arendt-Nielsen L, Bliddal H, Blotman F, Branco JC, Buskila D, et al. EULAR evidence based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 2008; 67:536–41.
18. Ha ¨user Winfried, Kati Thieme B, Dennis C, Turk C. Guidelines on the management of fibromyalgia syndrome–A systematic review. Eur J Pain 2010;14:5–10.
19. Bellometti S, Galzigna L. Function of the hypothalamic adrenal axis in patients with fibromyalgia syndrome undergoing mud-pack treatment. Int J Clin Pharmacol Res 1999;19:27–33.
20. Odabasi E, Turan M, Erdem H, Tekbas F. Does mud pack treatment have any chemical effect? A randomized controlled clinical study. J Altern Complement Med 2008;14:559–65.
21. Bender T, Bariska J, Vághy R, Gomez R, Imre Kovács. Effect of balneotherapy on the antioxidant system-a controlled pilot study. Arch Med Res 2007;38:86-9
22. Koçyiğit BF, Gür A, Altındağ Ö2, Akyol A, Gürsoy S. Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study. Agri 2016;28:72-8.
23. Evcik D, Kızılay B, Gökçen E. The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 2002;22:56–9.
24. Dönmez A, Karagülle MZ, Tercan N, Dinler M, Işsever H, Karagülle M, Turan M. SPA therapy in fibromyalgia: a randomised controlled clinic study. Rheumatol Int. 2005;26:168-72.
25. Ablin JN, Häuser W and Buskila D. Spa Treatment (Balneotherapy) for Fibromyalgia—A Qualitative-Narrative Review and a Historical Perspective. Evidence-Based Complementary and Alternative Medicine. 2013;2013:63805026.
26. Morf S, Amann-Vesti B, Forster A, Franzeck UK, Koppensteiner R, Uebelhart D, et al. Microcirculation abnormalities in patients with fibromyalgia - measured by capillary microscopy and laser fluxmetry. Arthritis Res Ther 2005;7:209-16.
27. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between smoking and low back pain: a meta-analysis. Am J Med 2010;123:7–35.
28. Orhurhu VJ, Pittelkow TP, Hooten WM. Prevalence of smoking in adults with chronic pain. Tob Induc Dis. 2015;17:13-7.
29. Goesling J, Brummett CM, Meraj TS, Moser SE, Hassett AL, Ditre JW. Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients. Pain Med 2015;16:1433–442
30. Ergin Ç, Yurdalan SU, Demirbüken İ, Zengin O. Fatigue and Physical Activity Levels of Smoking and Non-smoking Healthy Sedentary Individuals. Clin Exp Health Sci 2016;6:51-5.
31. Pineda JO, Oberman LM. What Goads Cigarette Smokers to Smoke? Neural Adaptation and Mirror Neuron System. Brain Research. 2006;1121:128-35.