Volume 28, Issue 12 (3-2022)                   RJMS 2022, 28(12): 75-84 | Back to browse issues page

Research code: IR.MAZUMS..REC.13986458
Ethics code: IR.MAZUMS.REC.1398.1166
Clinical trials code: IR.MAZUMS..REC.13986458

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Behzad khamslo M, Ebrahimi M, Hosseini S H. A Comparison of Effect of Aerobic Exercise with Saffron Pills on CRP Levels and Quality of Life in Fibromyalgia Patients. RJMS 2022; 28 (12) :75-84
URL: http://rjms.iums.ac.ir/article-1-6649-en.html
Assistant Professor, Department of Sports Science, Faculty of Humanities, Semnan University, Semnan, Iran , mebrahimi@semnan.ac.ir
Abstract:   (1288 Views)
Background & Aims: Fibromyalgia syndrome is a chronic disorder characterized by widespread feelings of pain and stiffness in the muscles along with fatigue, sleep disturbance, mood swings, and cognitive impairment (1). This disease is very commonly in women at the ages of 20 to 55. Besides, it is 8 to 9 times in women more than men (2). In Iran, the prevalence rate of fibromyalgia is estimated to be about 4%. One of the most important consequences of this disease confirmed by many researches today is the increase of pain and inflammation and the decrease of quality of life in patients (1). Studies have demonstrated that high levels of CRP are significantly associated with BMI, IL-6 and IL-8 in fibromyalgia patients, and inflammation possibly helps to diagnose this disease especially in obese individuals. However, the value of hs-CRP in the screening of fibromyalgia is still in doubt (5). This disease affects the quality of life of patients (6). Numerous studies have been performed to identify risk factors affecting the quality of life in fibromyalgia patients (7). If the level of quality of their life decreases, it makes their life be disrupted, and also if the health of fibromyalgia patients decreases, it causes their life to be short. The consumption of drugs and supplements is another factor affecting inflammatory factors and quality of life in fibromyalgia patients. In terms of therapeutic properties, saffron plant is used for nerve pain, insomnia, seizures, asthma, inflammatory diseases such as rheumatism (15). With increasing physical problems like fibromyalgia that has reduced patients' quality of life, researchers are looking for ways to overcome it. Therefore, the use of various and complementary exercise programs that are desirable for all people has attracted many researchers' attention. As mentioned above and due to the lack of sufficient scientific knowledge in this field, the study researcher seeks to answer the question, "Do aerobic exercise and saffron tablets affect CRP levels and quality of life index in fibromyalgia patients?"
Methods: The research method was quasi-experimental with pre-test and post-test design in four groups. The statistical population of this study was all sick women who referred to Imam Khomeini Hospital located in Sari, Mazandaran in spring and summer 2017. Also, this study was approved by the ethics committee of Mazandaran University of Medical Sciences with the code (IR.MAZUMS.REC.1398.1166). After the individuals had been invited, they completed a health awareness questionnaire (in order to know the age and history of possible diseases). 32 Out of people were selected by purposive non-random sampling. After essential explanations about the study had been provided for the patients, written consent was received from them. Then information related to the subjects' age, height, weight, waist and hips were recorded before the research. Finally, subjects were randomly divided into 4 groups: aerobic exercise + placebo (n = 8), Saffrotin (n = 8), aerobic exercise + Saffrotin (n = 8) and placebo (n = 8). Afterward, the exercise groups did aerobic exercise for 6 weeks. The aerobic exercise + placebo and aerobic exercise + Saffrotin groups practiced aerobic exercise for 6 weeks with an intensity of 60 to 70% of the reserve heart rate, 3 sessions per week and 24 to 39 minutes per session.
Saffrotin group and aerobic exercise group + Saffrotin took two Saffrotin capsules containing 30 mg of saffron extract a day. This pill is produced by Green Plants Company and is available in our country in the form of 15 mg oral capsules with the official permission of the Ministry of Health. In addition to routine care, the placebo and aerobic exercise + placebo group took the placebo pill (made by the same company) twice a day (morning and evening) during the period of the study. Blood samples were taken to measure CRP by ELISA method at the beginning and end of the aerobic exercise program. The SF-36 questionnaire was also used to determine the quality of life index in the pre-test and post-test stages. Analysis of covariance (ANCOVA) and Bonferroni test were used to compare the differences between the groups.
Results: The results of analysis of covariance showed that after removing the effect of pretest, there was a significant difference between the groups in the variables of CRP (p = 0.001) and quality of life (p = 0.001). The results of Benferoni post hoc test (Table 3) showed that there was a significant difference between the training + Saffrotin group and the Saffrotin group and the placebo group in CRP values (p <0.05). Also, there was a significant difference between the exercise + placebo groups with exercise + Saffrotin and placebo, exercise + Saffrotin with Saffrotin and placebo, and also Saffrotin with placebo in the quality of life index (p <0.05).
Conclusion: Findings from cross-sectional studies showed that there is a significant positive relationship between fibromyalgia and CRP. Research has shown that regular exercise can reduce CRP and IL-6 in inactive individuals (22). The results of studies examining the effects of exercise on CRP are contradictory. Some studies confirmed the lack of change (24), some increased (25) and some (26) confirmed CRP. Studies showing simultaneous effects of exercise and saffron on CRP levels in fibromyalgia patients were not performed. Studies have shown that treatment with saffron can reduce pro-inflammatory cytokines and increase anti-inflammatory cytokines (27). In a study comparing the anti-inflammatory and analgesic effects of saffron and indomethacin in the prevention and treatment of delayed muscle contusion were compared. In this study, subjects consumed saffron for 10 days (300 mg) and participated in a short-term exercise session after the seventh day. The results of their research showed that saffron reduces pain and inflammation (28) which is consistent with the results of the present study.
The results of the present study also showed that aerobic exercise with the use of safrotin tablets increased the quality of life index in fibromyalgia patients. Also, in comparison between the groups, in the exercise + safrotin group, compared to the other groups, the highest increase in the quality of life index was observed. From the point of view of comparing the effect of aerobic exercise on quality of life with other researches, it can be said that the present study is in line with the results of Assumpcao et al. (29), Doletsky et al. (30) and Ulbrich et al. (31). Aerobic exercises are able to create physiological adaptations in the efficiency of the aerobic energy system, increase a person's functional ability, and even improve functional capacity in the conditions of disease progression. Aerobic exercise increases norepinephrine, serotonin synthesis and endorphins, all of which are effective in promoting vitality and preventing fatigue in a person with cardiovascular disease (30). In line with the results of the present study, Asompakov et al. (2017) in their study examined resistance and stretching exercises in fibromyalgia patients. In this study, 44 patients were randomly divided into three groups: stretching exercises, resistance exercises and control group. Quality of life was measured by SF-36 questionnaire. The stretching and resistance training groups performed two different training programs, 2 sessions per week for twelve weeks. The control group received only the necessary care and did not participate in any physical activity. The results of this study showed that the stretching exercises group had the highest quality of life score among fibromyalgia patients compared to the resistance and control groups (29).
Ulbrich et al. (2016) showed that following a period of intermittent exercise on the quality of life of patients with heart failure, the maximum level of oxygen consumption increased and the quality of life improved (31). Aerobic exercise increases flexibility and muscle strength, improves blood circulation and oxygen uptake and the function of the hormonal system, and ultimately improves physical function and role. (29). Although in the present study, we tried to prevent the effectiveness of some factors influencing the results of the research by selecting almost identical subjects, but considering that the subjects of the present study were fibromyalgia patients who were nutritionally They were under the supervision of a specialist physician, so to observe ethical considerations in the study, the diet of the subjects was not under the control of the researcher. Also, despite the researcher's recommendation, extracurricular activities were not controlled, and the possibility of controlling the energy expenditure of individuals and the amount of activity, rest and sleep of the subjects was beyond the control of the researcher, and these issues can be limited. future research should be considered by researchers who seek complete control of variables affecting research results.
In general, the results of this study indicated that 6 weeks of aerobic exercise and saffron consumption reduced CRP and increased quality of life in fibromyalgia patients. Therefore, it is mentioned that aerobic exercise and saffron consumption are able to improve the inflammatory factor of CRP, and increase the quality of life in patients. As a result, the combination of saffron consumption and exercise therapy increase life expectancy in fibromyalgia patients.
 
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Type of Study: Research | Subject: Clinical Psychiatry

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