Fibromyalgia and Soft Tissue Disorders: Late Morning Poster Tour Recap

Among the numerous posters on display under the "Fibromyalgia and Soft Tissue Disorders" heading on day 4 at the American College of Rheumatology/Association of Rheumatology Health Professionals 2009 Annual Scientific Sessions were posters focused on the development of a fibromyalgia (FM) responder index, anxiety and depression among patients with FM, tai chi as an effective treatment of FM, and sex differences in predictors of increased symptoms after exercise and sleep restriction in patients with such chronic pain disorders as fibromyalgia.

Towards Development of Fibromyalgia Responder Index: Identifying Responders Using Patients Global AssessmentPresentation Number: 1424

Poster Board Number: 157

Researchers: Arnold L, Zlateva G, Sadosky A, et al.

Purpose: To analyze pooled data from FM trials in order "to determine what FM domains drive patients' perception of improvement," with the intention of helping the Fibromyalgia Working Group of OMERACT in developing an FM responder index.

Results: Improvement in Multiple domains drove patients' response to treatment for FM, with pain, fatigue, and sleeps associated most strongly with improvement in PGIC and physical and work-related function also correlating "with patients overall assessment of improvement." The researchers concluded that these "domains and their respective outcome measures can be used in the development of a responder index."

Anxiety and Depression Subselects Fibromyalgia Patients: A Cluster Analysis with Treatment ImplicationsPresentation Number: 1403

Poster Board Number: 136

Researchers: Barcellos de Souza J, Marchand S, Ware M, et al.

Purpose: To report the validation of previously identified FM patient subgroups-with or without comorbid depression and anxiety-"on a large population of FM patients in a tertiary care setting."

Results: The research team feels they "have shown that the clustering of FM patients remained valid in a tertiary care setting, often considered to represent patients with more severe symptoms. There is therefore little doubt that different FM profiles exist, and may be identified by a single, comprehensive instrument, the [fibromyalgia impact questionnaire]. These clusters groups have implications regarding treatment approaches. Future studies should take these different patient groups into consideration in order to focus treatment interventions applicable to distinct patient groups."

Tai Chi Is Effective in Treating Fibromyalgia: A Randomized Controlled TrialPresentation Number: 1406

Poster Board Number: 139

Researchers: Wang C, Schmid C, Kalish R, et al.

Purpose: To compare Tai Chi-which the authors hypothesized might be especially suited to the therapy of FM-to stretching and wellness education on change in FM impact questionnaire score at 12 weeks and "tender point count, patient and physician global assessments, sleep quality (PSQI), timed chair stand, 6-minute walk, grip strength, depression, self-efficacy and quality of life." Results: Tai Chi "appears highly efficacious for treatment of both physical and psychological components of FM. [Tai Chi] may be a useful adjunctive treatment in the multidisciplinary management of this difficult disorder."

Sex Differences in Predictors of Increased Symptoms After Exercise and Sleep RestrictionPresentation Number: 1428

Poster Board Number: 161

Researchers: Glass J, Ablin J, Lyden A, et al.

Purpose: To test the hypothesis "We hypothesize that sleep restriction and exercise deprivation can act as stressors, and that neurobiological factors can predict if an otherwise healthy individual will respond to such stress with an acute increase in symptoms of pain, fatigue, cognitive problems and negative mood," as chronic pain disorders, such as fibromyalgia, "are often precipitated by an event that prevents normal sleep and exercise."

Results: Consistent with "previous research on heart rate reactivity and variability to painful stimuli that suggest dramatically different sympathetic regulation of pain in men and women," Glass and colleagues found that increased symptoms of pain, fatigue, mood, cognition, and somatic complaints result from sleep restriction, especially among women. Increases in these symptoms were associated with neurobiological measures of autonomic nervous system function only in men.