The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia, compared to passive muscle stretching and a control group: a randomized controlled clinical trial

To explore the potential effectiveness of myofascial release compared to passive muscle stretching and to a control group in modulating pain intensity and health status in adults diagnosed with fibromyalgia (FM). A preliminary randomized controlled clinical trial was conducted, consisting of eight weekly sessions. The participants were divided into three groups: myofascial release group (RG = 13), a muscle stretching group (SG = 13), and a control group (CG = 12), which received advice from a rheumatologist. The outcomes measured were the visual analogue pain scale (VAS), the fibromyalgia impact questionnaire (FIQ) (representing health status), and the number of painful areas. Univariate analyzes of covariance (ANCOVA) were performed at baseline, after 4 weeks (during treatment), after 8 weeks (post-treatment), and after 12 weeks (follow-up). The International Physical Activity Questionnaire (IPAQ), the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale (PCS) were included as covariates. Clinical trial registration number: NCT: 03408496. After eight weeks, the RG showed lower VAS scores compared to the CG (mean difference 95% CI: −5.10 to −1.26) and the SG (mean difference 95% CI: −4.9 to −0.23) with no difference between the SG and the CG. The total FIQ score for the RG was lower than the CG after 4 weeks (95% CI: −49.92 to −5.61), and 8 weeks (mean difference 95% CI: −52.72 to −15.73), although there was no difference between the RG and SG, as well as between the SG and CG, at both time points. The number of painful body areas was similar in all groups at the four time points. Preliminary results suggest that the RG possibly showed greater improvements in pain intensity and health status compared to the CG, and possibly greater improvements in pain intensity compared to the SG. Myofascial release in fibromyalgia may potentially have greater improvements on pain modulation and health status when compared to medical counseling.Myofascial release, when compared to stretching, may potentially offer greater improvement in pain modulation in fibromyalgia.Myofascial release was not effective in decreasing the number of painful body areas of patients with fibromyalgia. Myofascial release in fibromyalgia may potentially have greater improvements on pain modulation and health status when compared to medical counseling. Myofascial release, when compared to stretching, may potentially offer greater improvement in pain modulation in fibromyalgia. Myofascial release was not effective in decreasing the number of painful body areas of patients with fibromyalgia.</p

Cytokine Profile in Gout: Inflammation Driven by IL-6 and IL-18?

<p><b>Introduction</b>: Gout is considered to be an autoinflammatory disease and the presence of monosodium urate (MSU) crystals stimulates activation of NPRL3 inflammasome and subsequently caspase-1, generating production of active IL-1β and IL-18. However, the association between serum cytokines levels and clinical manifestations of the disease is not yet well understood. We evaluated the serum profile of proinflammatory cytokines (IL-1β, IL-6, IL-8, IL-17A, IL-18, IL-22, and IL-23) and described their relationship with clinical and laboratory data.</p> <p><b>Methodology</b>: Thirty-nine male patients with gout (GG) were assessed for clinical and laboratory variables and cytokine levels were measured by ELISA. For the purposes of comparison, 34 males with no previous history of arthritis were also included in the study (CG).</p> <p><b>Results</b>: Seventeen participants (43%) exhibited active arthritis on evaluation. Levels of IL-18 were significantly higher in patients in relation to the CG (<i>p</i> = 0.0013). No statistically significant differences were found between the GG and CG for the other measured cytokines. There was a moderate correlation between IL-18 and ESR (<i>R</i> = 0.43, <i>p</i> = 0.0073), CRP (<i>R</i> = 0.47, <i>p</i> = 0.0025), and serum levels of IL-6 (<i>R</i> = 0.36, <i>p</i> = 0.023). An association was observed between serum levels of IL-6 and the presence of tophi (<i>p</i> = 0.005) and deformities (<i>p</i> = 0.0008), as well as a correlation between this cytokine and ESR (<i>R</i> = 0.41, <i>p</i> = 0.011) and CRP (<i>R</i> = 0.48, <i>p</i> = 0.02).</p> <p><b>Conclusions</b>: IL-18 is associated with inflammatory activity in gout, as well as with IL-6 levels, while IL-6 is associated with clinical and laboratory activity, the presence of tophi and articular deformities, and may be a prognostic marker of this pathology.</p

Cytokine Profile in Gout: Inflammation Driven by IL-6 and IL-18?

<p><b>Introduction</b>: Gout is considered to be an autoinflammatory disease and the presence of monosodium urate (MSU) crystals stimulates activation of NPRL3 inflammasome and subsequently caspase-1, generating production of active IL-1β and IL-18. However, the association between serum cytokines levels and clinical manifestations of the disease is not yet well understood. We evaluated the serum profile of proinflammatory cytokines (IL-1β, IL-6, IL-8, IL-17A, IL-18, IL-22, and IL-23) and described their relationship with clinical and laboratory data.</p> <p><b>Methodology</b>: Thirty-nine male patients with gout (GG) were assessed for clinical and laboratory variables and cytokine levels were measured by ELISA. For the purposes of comparison, 34 males with no previous history of arthritis were also included in the study (CG).</p> <p><b>Results</b>: Seventeen participants (43%) exhibited active arthritis on evaluation. Levels of IL-18 were significantly higher in patients in relation to the CG (<i>p</i> = 0.0013). No statistically significant differences were found between the GG and CG for the other measured cytokines. There was a moderate correlation between IL-18 and ESR (<i>R</i> = 0.43, <i>p</i> = 0.0073), CRP (<i>R</i> = 0.47, <i>p</i> = 0.0025), and serum levels of IL-6 (<i>R</i> = 0.36, <i>p</i> = 0.023). An association was observed between serum levels of IL-6 and the presence of tophi (<i>p</i> = 0.005) and deformities (<i>p</i> = 0.0008), as well as a correlation between this cytokine and ESR (<i>R</i> = 0.41, <i>p</i> = 0.011) and CRP (<i>R</i> = 0.48, <i>p</i> = 0.02).</p> <p><b>Conclusions</b>: IL-18 is associated with inflammatory activity in gout, as well as with IL-6 levels, while IL-6 is associated with clinical and laboratory activity, the presence of tophi and articular deformities, and may be a prognostic marker of this pathology.</p