title: The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia.
abstract: Multidisciplinary treatment has proven to be the best therapeutic option to fibromyalgia (FM) and physiotherapy has an important role in this approach. Considering the controversial results of electrotherapy in this condition, the aim of this study was to assess the effects of combined therapy with pulsed ultrasound and interferential current (CTPI) on pain and sleep in FM. Seventeen patients fulfilling FM criteria were divided into two groups, CTPI and SHAM, and submitted to pain and sleep evaluations. Pain was evaluated by body map (BM) of the painful areas; quantification of pain intensity by visual analog scale (VAS); tender point (TP) count and tenderness threshold (TT). Sleep was assessed by inventory and polysomnography (PSG). After 12 sessions of CTPI or SHAM procedure, patients were evaluated by the same initial protocol. After treatment, CTPI group showed, before and after sleep, subjective improvement of pain in terms of number (BM) and intensity (VAS) of painful areas (P<0.001, both); as well as objective improvement, with decrease in TP count and increase in TT (P<0.001, both). Subjective sleep improvements observed after CTPI treatment included decrease in morning fatigue and in non-refreshing sleep complaint (P<0.001, both). Objectively, PSG in this group showed decrease in sleep latency (P<0.001) and in the percentage of stage 1 (P<0.001), increase in the percentage of slow wave sleep (P<0.001) and in sleep cycle count (P<0.001). Decrease in arousal index (P<0.001), number of sleep stage changes (P<0.05) and wake time after sleep onset (P<0.05), were also observed and no difference regarding pain or sleep parameters were verified after SHAM procedure. This study shows that CTPI can be an effective therapeutic approach for pain and sleep manifestations in FM.
authors.affiliation: Department of Psychobiology, Universidade Federal de São Paulo, Rua Napoleão de Barros 925, Vila Clementino, 04024-002 São Paulo, SP, Brazil.
authors.forename: Tatiana F
authors.initials: TF
authors.lastname: Almeida
authors.forename: Suely
authors.initials: S
authors.lastname: Roizenblatt
authors.forename: Ana Amelia
authors.initials: AA
authors.lastname: Benedito-Silva
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
mesh_terms: D000704:Analysis of Variance; D004599:Electric Stimulation Therapy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000150:complications; D059408:Pain Management; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000150:complications / Q000628:therapy*; D014464:Ultrasonic Therapy / Q000379:methods* / Q000706:statistics & numerical data