Understanding Fibromyalgia Study Module

The following questions relate to the paperFibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment“Fibromyalgia is a syndrome characterised by chronic widespread pain at multiple tender points, joint stiffness, and systemic symptoms…….This paper is based on a systematic search of the PubMed database to identify articles related to fibromyalgia.”  What today is defined as Fibromyalgia (meaning Pain Syndrome in the absence of specific organic disease) was already known since 1904 by which name?Please use the correct spelling

Fibromyalgia is not a well-defined organic disease, and can not be diagnosed with a simple blood test, or scan. It has however been associated with which diseases?Please only select the diseases mentioned in the papers. You can choose more than 1 if you need.

• A.

  Diabetes

• B.

  Rheumatic Pathologies

• C.

  Psychiatric

• D.

  Infections

While an individual's symptoms can vary, there are three main symptoms of fibromyalgia referred to, by almost all patients.Please tick the three mentioned in the papers provided. You can choose more than one.

• A.

  Pain

• B.

  Fatigue

• C.

  Sleep Disturbance

• D.

  Headache

The aetiology and pathogenesis of fibromyalgia are still not fully understood. Several factors such as dysfunction of the central and autonomic nervous systems, neurotransmitters, hormones, immune system, external stressors, psychiatric aspects, and others seem to be involved.Is the above statement True or False?

• A.

  True

• B.

  False

Is the following statement True or False?  Serotonin (5-HT) has a significant role in the modulation of pain, is involved also in the regulation, of mood and sleep, and this could explain the association between fibromyalgia, sleep and mental disorders.

• A.

  True

• B.

  False

Choose whether the statement is True or False. While many people suffering from fibromyalgia also regularly have, elevated levels of anxiety and depression, fibromyalgia is not considered a stress-related disorder.

• A.

  True

• B.

  False

Fibromyalgia affects many processes of the body, including sleeping patterns, resulting in sufferers waking up sore and tired.Please select the sleep stage shown to be affected by fibromyalgia

• A.

  REM Rapid Eye Movement

• B.

  Stage 1

• C.

  Stage 2

• D.

  Stage 3-4

GH is involved in micro trauma muscle repair.While GH levels in people with fibromyalgia have been shown to be normal during the day, they are at reduced levels during sleep. This might be caused by sleep disturbance experienced by people with fibromyalgia.What does GH stand for?Please use the correct spelling.

A genetic predisposition is likely to play a part of a person developing fibromyalgia, as well as trigger factors, such as infections.Is fibromyalgia common in patients with autoimmune disease?

• A.

  Yes

• B.

  No

There seems to be a psychiatric aspect to the development of fibromyalgia. Is the prevalence of psychiatric conditions among patients affected by fibromyalgia Higher or Lower than among subjects complaining of other rheumatic diseases?

• A.

  Higher

• B.

  Lower

Please answer Yes or No When testing the 18 tender points, as explained by the American College of Rheumatology, is a response of "irritating" sufficient, to confirm a positive finding of fibromyalgia?

• A.

  Yes

• B.

  No

Because pain, depression, and other symptoms of fibromyalgia, are linked to inherited and environmental causes, a multifaceted treatment approach is often required, including both non-pharmacological pain management strategies, and medication.Is the above statement True or False 

• A.

  True

• B.

  False

As described in one of the three papers.The goals of fibromyalgia treatment are to achieve, what outcome?Please select the correct answers, you can choose more than one

• A.

  Alleviate pain

• B.

  Increase restorative sleep

• C.

  Improve physical function

• D.

  Increase Range of Motion in all 4 quadrants of the body

A nociceptor is a sensory neuron, that responds to potentially damaging stimuli, by sending signals to the spinal cord and brain. Various studies suggest that suffers of fibromyalgia have, What? amplification/depression of nociceptive impulses.Please tick the appropriate answer

• A.

  Amplification

• B.

  Depression

The most widely accepted hypothesis is that chronic pain in fibromyalgia, is of muscle origin, although, plasma muscle enzyme levels, electromyographic studies, and muscle biopsies have proven completely normal.Is this statement True or False?

• A.

  True

• B.

  False

In this randomised clinical controlled trial. The control group received a sham protocol therapy. What was the sham therapy used?

• A.

  Disconnected magnotherapy

• B.

  Functional magnetic resonance

• C.

  Tramadol

• D.

  Balneotherapy

This study's purpose was to determine the benefits of massage-myofascial release therapy on patients with fibromyalgia. The authors were looking into the results of which specific symptoms.Please tick the symptoms mentioned in the paper. You can choose more than one.

• A.

  Quality of sleep

• B.

  Pain

• C.

  Depression

• D.

  Quality of life

• E.

  Fibro-fog

• F.

  Muscle energy

To take part in this trial, participants had to pass several inclusion criteria.Please tick the correct criteria. 

• A.

  Be younger than 65

• B.

  Be older than 18

• C.

  No regular physical activity

• D.

  Be diagnosed with fibromyalgia

• E.

  Be younger than 50

• F.

  Regular physical activity

• G.

  Not be diagnosed with fibromyalgia

• H.

  Be older than 16

One of the two criteria for the diagnosis of fibromyalgia is the presence of tender points. How many of the 18 tender points, as explained by the American College of Rheumatology (ACR) , should be tender, to consider a positive diagnosis of fibromyalgia? Select the correct answer from the choices below. 

• A.

  At least 11

• B.

  At least 8

• C.

  At least 14

• D.

  At least 6

Fill in the blank field below You must use the same wording and spelling as the textOut of the 231 accessible patients, how many were unable to participate, due to incompatibility with their work schedule?

The intervention group received treatment to assess if massage therapy can improve the symptoms of fibromyalgia. Which were the areas of the body massage?Please choose the correct answer

• A.

  The 18 painful points as described by the American College of Rheumatology.

• B.

  Cervical and Lumber regions with the patient laying prone

• C.

  Myofascial trigger points found in the peripheral muscles.

• D.

  The 3 areas of most concern to the subject at the time of starting the trial.

Is the following statement True or False?Testing of the 18 painful sensitive points, as described by the American College of Rheumatology, were assessed by means of a pressure algometer (Wagner FPI 10-USA),  exerting a pressure of 6 kg. ​

• A.

  True

• B.

  False

Select the correct answer from the choices below How many of the 18 painful sensitive points, described by the American College of Rheumatology were evaluated with the pressure algometer?

• A.

  18

• B.

  16

• C.

  14

• D.

  20

The experimental group underwent a protocol of massage therapy with a duration of....Please tick the appropriate boxes with the correct session duration and number of weeks that massage was used for.You can choose more than one

• A.

  30-minute session

• B.

  60-minute session

• C.

  90-minute session

• D.

  5 Weeks

• E.

  10 Weeks

• F.

  20 Weeks

Select the correct answer from the choices below.What type of massage technique was applied to the experimental group in this trial?

• A.

  Myofascial release

• B.

  Trigger point therapy

• C.

  Deep tissue

• D.

  Remedial massage therapy

One month post intervention, the experimental group showed a significant improvement in V.A.S. scores versus baseline and in comparison to the control group.What was V.A.S measuring?Hint Your answer should be 1 word

Immediately after the intervention, the experimental group showed a significant improvement in pain versus baseline, and in comparison to the control group. There were significant reductions in sensitive points as measured by the pressure algometer. Please tick the regions that showed improvement. You can choose more than one

• A.

  Left lower cervical

• B.

  Right lower cervical

• C.

  Right gluteal muscle

• D.

  Left gluteal muscle

• E.

  Right greater trochanter

• F.

  Left greater trochanter

Is the statement below also true or false?One month post intervention, the experimental group still showed a significant reduction in pain

• A.

  True

• B.

  False

People suffering from fibromyalgia have a high incident of depression.Is the statement below true or false?One month post intervention, the experimental group showed a significant improvement in their state of depression.

• A.

  True

• B.

  False

Sleep quality is one of the body processes affected by fibromyalgia. Testing has shown that G.H levels are normal during the day but altered at night. Is the statement below True or False. At one-month post intervention, the experimental group showed a significant improvement in Quality of Sleep._

• A.

  True

• B.

  False

The following questions are from the paper Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsThis paper evaluated the evidence of massage therapy for patients with fibromyalgia. This was done by searching electronic databases, for relevant research that fitted within criteria.Choose whether the statement is true or falseWhile only research trials where massage therapy was not combined with other manual treatments were included in this meta-analysis. The authors did allow any type of control intervention

• A.

  True

• B.

  False

The following questions relate to the paper "Benefits of Massage Myofascial release Therapy on Pain, Anxiety, Quality of Sleep, Depression and Life in Patients with Fibromyalgia" Choose whether the statement is True or False.Fibromyalgia is still not fully understood, but the decrease in serotonin levels, reported in some people with fibromyalgia, may suggest that there is some form, of Peripheral Nervous System involvement in Fibromyalgia

• A.

  True

• B.

  False

Massage therapy is a very safe therapy for people with fibromyalgia to receive. Keeping that fact in mind, after reading the paper. Is the following statement True or False?No adverse events were reported in all eligible Random Control Trials of massage therapy for fibromyalgia. 

• A.

  True

• B.

  False

Please choose the correct answers, you can choose more than one.According to the authors of this paper, massage therapy may improve pain, anxiety, depression, and sleep disturbance by a complex interplay of which 2 modes of action?  ​

• A.

  Physical

• B.

  Mental

• C.

  Emotional

• D.

  Neurological

Choose whether the statement is true or false.Massage therapy with a duration greater than or equal to 5 weeks, had beneficial immediate effects on improving pain, anxiety, and depression in patients with fibromyalgia

• A.

  True

• B.

  False

Fill in the blank field below. You must use the same wording and spelling as the text.When the publishers of this paper searched the database for relevant records, they found 433, of this 20 randomised controlled trials had their full text screened. How many randomised controlled trials, made it into the final meta-analyses of this paper?

The authors of this paper, due to the evidence presented, believe that.  Massage therapy should or should not be one of the viable complementary and alternative treatments for fibromyalgia.Please select the correct choice

• A.

  Should

• B.

  Should not

As mentioned in this paper. Some studies have found that massage therapy, improved pain by modulating What? levels in patients with fibromyalgia.Please write your answer below.Hint your answer should be 1 word

There was no evidence that massage therapy showed superior effects on improving symptoms associated with sleep. Is the above comment an accurate reflection, on the finding of the paper presented?

• A.

  True, this is an accurate reflection of the finding in the paper.

• B.

  False, this is not an accurate reflection of the finding in the paper.

In Castro-Sa´nchez study, the experimental group showed significant improvements, on symptoms of fibromyalgia,  versus baseline levels after the 4 follow-up weeks.Please select the improved symptoms, you can choose more than one.

• A.

  Anxiety

• B.

  Depression

• C.

  Pain

• D.

  Sleep

Select the correct answer from the choices belowIn Castro-Sa´nchez study, at the end of 24 follow-up weeks, the experimental group only showed a significant improvement on which symptom, versus baseline.

• A.

  Anxiety

• B.

  Depression

• C.

  Pain

• D.

  Sleep

Choose whether the statement is true or falseThe purpose of this systematic review was to evaluate the evidence of massage therapy in improving symptoms in patients with fibromyalgia.  The meta-analyses suggested that massage therapy, with a duration greater than or equal to 5 weeks, significantly improved pain, anxiety, and depression in patients with fibromyalgia.

• A.

  True

• B.

  False

Please select the correct answer. Would you say that according to the meta-analysis, the 8 included studies into massage therapy effects on anxiety, showed better results, for less than or greater than, the 5 weeks duration?​​ 

• A.

  Greater than 5 weeks

• B.

  Less than 5 weeks

As you have seen, people with fibromyalgia often benefit from, some form of complementary and alternative treatments.According to the paper, "The research reported that around, what % of individuals with fibromyalgia, have used at least one form of complementary and alternative treatments to manage their symptoms.Please tick the correct answer.

• A.

  33%

• B.

  55%

• C.

  70%

• D.

  90%

Final Three Questions These questions relates to all papers People suffering from fibromyalgia have disturbed sleeping patterns. Across all papers, was there a consistency in the results of massage, on sleep disturbance experienced by, people with fibromyalgia?Please choose the correct answer from the list below.​ 

• A.

  Yes massage was shown to ​have benefit in helping with sleeping patterns in all papers 

• B.

  No while one paper showed no improvement the other showed improvement and more research needs to done.

• C.

  Both papers showed massage had no effect on the sleeping patterns of clients with fibromyalgia.

With all, you have covered with this workshop. Do you believe that soft tissue therapy (massage) is a beneficial therapy for people suffering from fibromyalgia to receive?

• A.

  Yes

• B.

  No