Fibromyalgia with severe forms of progression in a multidisciplinary therapy setting with emphasis on hyperthermia therapy – a prospective controlled study

Figures & data

Figure 1 Assumed physiological effects of systemic whole-body hyperthermia.

Table 1 Excerpt of evidence-based treatment regime in a multimodal setting

Hydrotherapeutic methods^Citation65,Citation66: application of water through various methods (Kneipp treatments), eg, baths with added substances, mud baths, steam baths, water with whirlpool, bandages, or compresses

Thermotherapeutic methods^Citation70: eg, infrared radiation only for hyperthermia group, heating pad, hot water bath

Psychotherapy^Citation62,Citation63: eg, CBT, mind–body therapy

Practical therapies^Citation67: eg, movement therapy, occupational therapy

Pain therapy^Citation68,Citation69: eg, infiltration, cupping, cupping massage, acupuncture

Physiotherapy/physical therapy^Citation67: eg, massage, transcutaneous electrical nerve stimulation, reflexology

Phytotherapy and dietary^Citation58^–^Citation61: eg, use of herbal extracts in tea and medication, arnica pad, herbs, dietary consultations according to indication

Homeopathy^Citation64: eg, substances that come from minerals, plants, or animals, such as arnica, or crushed whole bees

Abbreviation: CBT, cognitive behavioral therapy.

Figure 2 Hyperthermia indications and contraindications.

Notes: (A) Indications for systemic whole-body hyperthermia. (B) Contraindications for systemic whole-body hyperthermia.

Figure 3 von Zerssen symptom list.

Table 2 Sociodemographic details of CG versus HG

	CG	HG
Female/male	47/1	55/1
Age (mean)	57	55.1
Age (median)	56.0	54.5
Age (range in years) 16–38	2	3
Age (range in years) 39–49	6	11
Age (range in years) 50–55	11	18
Age (range in years) 56–65	17	16
Age (range in years) 65 and older	12	8
Total (N)	48	56

Abbreviations: CG, control group; HG, hyperthermia group.

Figure 4 Functional capacity on discharge in patients with versus without hyper thermia.

Table 3 von Zerssen on admission with versus without hyperthermia

	von Zerssen on admission
	Hyperthermia
	CG	HG
Mean	41.8	41.8
Standard deviation	12.2	9.4
Standard error of mean	1.8	1.3
Percentile 25	34.0	35.5
Median	41.0	42.0
Percentile 75	48.5	48.0
Minimum	13	21
Maximum	67	60
Count	48	56
Total (N)	48	56

Abbreviations: CG, control group; HG, hyperthermia group.

Table 4 von Zerssen on discharge with versus without hyperthermia

	von Zerssen on discharge
	Hyperthermia
	CG	HG
Mean	36.6	30.6
Standard deviation	14.6	12.0
Standard error of mean	2.1	1.6
Percentile 25	28.0	21.5
Median	37.5	29.0
Percentile 75	45.5	39.5
Minimum	5	9
Maximum	65	55
Count	48	56
Total (N)	48	56

Abbreviations: CG, control group; HG, hyperthermia group.

Figure 5 von Zerssen on discharge in patients with versus without hyperthermia.

Table 5 Physical therapy/thermotherapy, physiotherapy, movement therapy, and homeopathy in patients with versus without hyperthermia (intervention in minutes)

	Physical therapy/thermotherapy		Physiotherapy		Movement therapy		Homeopathy
	Hyperthermia		Hyperthermia		Hyperthermia		Hyperthermia
	CG	HG	CG	HG	CG	HG	CG	HG
Mean	330.8	693.7	492.4	284.2	476.4	307.0	46.9	31.6
Standard deviation	138.8	321.5	239.6	222.8	229.2	202.3	62.5	55.6
Percentile 25	267.5	397.5	335.0	115.0	33.1	27.0	0.0	0.0
Median	340.0	785.0	437.5	222.5	320.0	167.5	0.0	0.0
Percentile 75	412.5	917.5	640.0	352.5	470.0	315.0	120.0	30.0
Minimum	0	30	120	0	40	0	0	0
Maximum	695	1,240	1,080	840	950	850	180	150
Count	48	56	48	56	48	56	48	56
Total (N)	48	56	48	56	48	56	48	56

Abbreviations: CG, control group; HG, hyperthermia group.

Figure 6 Applications for clinical practice (fibromyalgia syndrome).

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