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Resumo O presente estudo teve como objetivo atualizar a revisao de literatura sobre a prevalencia da fibromialgia (FM) publicada em 2006. Foi feito levantamento bibliografico do periodo de 2005 a 2014 nas bases de dados Medline, Web of Science, Embase, Lilacs e SciELO e identificaram‐se 3.274 registros. Cinco pesquisadores selecionaram os estudos, de acordo com os criterios de inclusao: estudos que obtiveram a prevalencia da FM. Foram excluidos estudos da FM em doencas. Na triagem pelo titulo e resumo, foram excluidos 2.073 artigos irrelevantes. Foram avaliados quanto a elegibilidade os textos completos de 210 artigos, incluiram‐se nesta revisao 39 estudos, descritos em 41 artigos. Os estudos selecionados foram agrupados em quatro categorias: a) prevalencia da FM na populacao em geral; b) prevalencia da FM em mulheres; c) prevalencia da FM em areas rurais e urbanas; d) prevalencia da FM em populacoes especiais. A literatura aponta valores de prevalencia da FM na populacao em geral entre 0,2 e 6,6%, em mulheres entre 2,4 e 6,8%, nas areas urbanas entre 0,7 e 11,4%, nas rurais entre 0,1 e 5,2% e em populacoes especiais entre 0,6 e 15%. Esta atualizacao de revisao de literatura mostra um aumento expressivo de estudos de prevalencia da FM ao redor do mundo. Os novos criterios do Colegio Americano de Reumatologia de 2010 foram ainda pouco usados e a metodologia Copcord (Programa Orientado para a Comunidade para Controle de Doencas Reumaticas) aumentou a qualidade dos estudos de prevalencia de doencas reumaticas em geral.

The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.

Background Exercise therapy is an effective component of fibromyalgia (FM) treatment. However, it is important to know the effects and specificities of the different types of exercise: muscle stretching and resistance training. Aim To verify and compare the effectiveness of muscle stretching exercise and resistance training for symptoms and quality of life in FM patients. Design Randomized controlled trial. Setting Physical therapy service, FM outpatient clinic. Population Forty-four women with FM (79 screened). Methods Patients were randomly allocated into a stretching group (N.=14), resistance group (N.=16), and control group (N.=14). Pain was assessed using the visual analog scale, pain threshold using a Fischer dolorimeter, FM symptoms using the Fibromyalgia Impact Questionnaire (FIQ), and quality of life using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The three intervention groups continued with usual medical treatment. In addition, the stretching and resistance groups performed two different exercise programs twice a week for 12 weeks. Results After treatment, the stretching group showed the highest SF-36 physical functioning score (P=0.01) and the lowest bodily pain score (P=0.01). The resistance group had the lowest FIQ depression score (P=0.02). The control group had the highest score for FIQ morning tiredness and stiffness, and the lowest score for SF-36 vitality. In clinical analyses, the stretching group had significant improvement in quality of life for all SF-36 domains, and the resistance group had significant improvement in FM symptoms and in quality of life for SF-36 domains of physical functioning, vitality, social function, emotional role, and mental health. Conclusions Muscle stretching exercise was the most effective modality in improving quality of life, especially with regard to physical functioning and pain, and resistance training was the most effective modality in reducing depression. Clinical rehabilitation impact The trial included a control group and two intervention groups, both of which received exercise programs created specifically for patients with FM. In clinical practice, we suggest including both modalities in an exercise therapy program for FM.

The present study aimed to update the literature review on the prevalence of fibromyalgia published in 2006. A bibliographical survey was carried out from 2005 to 2014 in the MEDLINE, Web of Science, Embase, LILACS and SciELO databases and 3274 records were identified. Five researchers selected the studies, following the inclusion criteria: studies that obtained the prevalence of fibromyalgia. Fibromyalgia studies in associated diseases were excluded. When screening by title and abstract, 2073 irrelevant articles were excluded. The full texts of 210 articles were evaluated for eligibility and this review included 39 studies, described in 41 articles. The selected studies were grouped into four categories: (A) prevalence of fibromyalgia in the general population; (B) prevalence of fibromyalgia in women; (C) prevalence of fibromyalgia in rural and urban areas; (D) prevalence of fibromyalgia in special populations. The literature shows values of fibromyalgia prevalence in the general population between 0.2 and 6.6%, in women between 2.4 and 6.8%, in urban areas between 0.7 and 11.4%, in rural areas between 0.1 and 5.2%, and in special populations values between 0.6 and 15%. This literature review update shows a significant increase in fibromyalgia prevalence studies in the world. The new 2010 American College of Rheumatology criteria have not been widely used yet and the COPCORD (Community-oriented program for control of Rheumatic Diseases) methodology has increased the quality of studies on the prevalence of rheumatic diseases in general. RESUMO O presente estudo teve como objetivo atualizar a revisão de literatura sobre a prevalência da fibromialgia (FM) publicada em 2006. Foi feito levantamento bibliográfico do período de 2005 a 2014 nas bases de dados Medline, Web of Science, Embase, Lilacs e SciELO e identificaram-se 3.274 registros. Cinco pesquisadores selecionaram os estudos, de acordo com os critérios de inclusão: estudos que obtiveram a prevalência da FM. Foram excluídos estudos da FM em doenças. Na triagem pelo título e resumo, foram excluídos 2.073 artigos irrelevantes. Foram avaliados quanto à elegibilidade os textos completos de 210 artigos, incluíram-se nesta revisão 39 estudos, descritos em 41 artigos. Os estudos selecionados foram agrupados em quatro categorias: a) prevalência da FM na população em geral; b) prevalência da FM em mulheres; c) prevalência da FM em áreas rurais e urbanas; d) prevalência da FM em populações especiais. A literatura aponta valores de prevalência da FM na população em geral entre 0,2 e 6,6%, em mulheres entre 2,4 e 6,8%, nas áreas urbanas entre 0,7 e 11,4%, nas rurais entre 0,1 e 5,2% e em populações especiais entre 0,6 e 15%. Esta atualização de revisão de literatura mostra um aumento expressivo de estudos de prevalência da FM ao redor do mundo. Os novos critérios do Colégio Americano de Reumatologia de 2010 foram ainda pouco usados e a metodologia Copcord (Programa Orientado para a Comunidade para Controle de Doenças Reumáticas) aumentou a qualidade dos estudos de prevalência de doenças reumáticas em geral.

INTRODUÇÃO: Os exercícios físicos têm sido benéficos para o controle dos sintomas da fibromialgia (FM). OBJETIVOS: Comparar os efeitos de exercícios de alongamento muscular com os exercícios aeróbicos na dor, número de tender points, sono, ansiedade e depressão de pacientes com FM. MATERIAIS E MÉTODOS: Participaram do estudo 19 pacientes com diagnóstico de FM, segundo critérios do Colégio Americano de Reumatologia, divididos em dois grupos: grupo alongamento, com 12 pacientes, que realizou um programa de 8 sessões de 45 minutos de exercícios de alongamento, uma vez a cada semana; grupo aeróbico com 7 pacientes, que realizou caminhada em esteira ergométrica por 30 minutos. Ambos foram orientados a realizarem exercícios em casa nos demais dias. A dor foi avaliada pela escala analógica visual; o limiar de dor dos tender points com o dolorímetro; sono pelo Post Sleep Inventory; ansiedade pelo Inventário de Ansiedade Traço-Estado e depressão pela Escala de Depressão de Beck. RESULTADOS: Os dados mostram que o ganho clínico foi maior no grupo alongamento em relação à dor (25%), número de tender points (15%), sono (38%) e depressão (22%) ao se comparar com o grupo aeróbico (ganho clínico de 2% na dor e 4% no sono; piora de 3% no número de tender points e 18% na depressão). O ganho clínico da ansiedade foi mais importante no grupo aeróbico (8% no traço de ansiedade e 10% no estado de ansiedade) em comparação ao grupo alongamento (piora de 3% no traço de ansiedade e melhora de 2% no estado de ansiedade). CONCLUSÃO: Este estudo sugere que os exercícios de alongamento são mais eficazes que os exercícios aeróbicos na dor, número de tender points, sono e depressão da FM. Os exercícios aeróbicos parecem produzir um efeito mais importante na diminuição da ansiedade em comparação aos exercícios de alongamento. INTRODUCTION: The physical exercises have been beneficial for the control of the fibromyalgia (FM) symptoms. OBJECTIVES: To compare the effects of stretching exercises to aerobic exercises on pain, number of tender points, sleep, anxiety and depression of patients with FM. MATERIALS AND METHODS: Nineteen patients with diagnosis of FM according to the American College of Rheumatology criteria were divided into two groups: the stretching group, with 12 patients, performed a program composed by 45 minutes eight sessions of stretching exercises once a week, and the aerobic group, with seven patients, carried out walking on a treadmill for 30 minutes. Both groups received orientation to exercise at home on the other days. Pain intensity, tenderness threshold at the tender points, sleep, anxiety and depression were evaluated by, respectively, visual analogic scale, dolorimeter, Post Sleep Inventory (PSI), Trait-State Anxiety Inventory (IDATE) and Beck Depression Scale (BDS). RESULTS: The data show that the clinical improvement was higher in the stretching group in relation to pain (25%), number of tender points (15%), sleep (38%) and depression (22%), compared to aerobic group (clinical improvement in pain was 2% and in sleep, 4%; the number of tender points and depression became worse, respectively 3% and 18%). The anxiety clinical improvement was more important in the aerobic group (8% in the trait anxiety and 10% in the state anxiety) compared to stretching group (the trait anxiety become worse at 3% and the state anxiety clinical improvement was 2%). CONCLUSION: This study suggests that the stretching exercises are more effective than the aerobic exercises on pain, number of tender points, sleep and depression in FM. On the other hand, the aerobic exercises seem to produce a more important effect on anxiety reduction compared to stretching exercises.

BACKGROUND: Fibromyalgia is a rheumatic syndrome characterized by widespread chronic musculoskeletal pain and specific palpable tender points. It is often associated with generalized fatigue, sleep disturbances, morning stiffness, dyspnea, anxiety and mood disturbances that may evolve into depression. Thus, such individuals' quality of life is negatively affected. However, the discriminating power of quality-of-life and depression assessment instruments is still unknown. OBJECTIVE: To assess depression and quality of life among patients with fibromyalgia, and the discriminating power of such instruments. METHOD: Quality of life was assessed by one specific instrument, the Fibromyalgia Impact Questionnaire (FIQ), and another generic one, the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The Beck Depression Scale (BDS) was used to assess depression. Forty women participated: 20 with fibromyalgia (test group) and 20 healthy women (control group). The three protocols were applied to all individuals in both groups in a single evaluation session. All statistical analyses were performed using Student's t-test, with a = 0.05. RESULTS: Statistically significant differences between test and control groups were found via all questionnaires (p

The systematic review aimed to evaluate the effectiveness of massage in fibromyalgia. An electronic search was conducted at MEDLINE, SCiELO, EMBASE, ISI, PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (Jan 1990–May 2013). Ten randomized and non-randomized controlled trials investigating the effects of massage alone on symptoms and health-related quality of life of adult patients with fibromyalgia were included. Two reviewers independently screened records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Meta-analysis (pooled from 145 participants) shows that myofascial release had large, positive effects on pain and medium effects on anxiety and depression at the end of treatment, in contrast with placebo; effects on pain and depression were maintained in the medium and short term, respectively. Narrative analysis suggests that: myofascial release also improves fatigue, stiffness and quality of life; connective tissue massage improves depression and quality of life; manual lymphatic drainage is superior to connective tissue massage regarding stiffness, depression and quality of life; Shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life; and Swedish massage does not improve outcomes. There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and Shiatsu. Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.

BACKGROUND: Fibromyalgia is a painful syndrome characterized by widespread chronic pain and associated symptoms with a negative impact on quality of life. OBJECTIVES: Considering the subjectivity of quality of life measurements, the aim of this study was to verify the discriminating power of two quality of life questionnaires in patients with fibromyalgia: the generic Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the specific Fibromyalgia Impact Questionnaire (FIQ). METHODS: A cross-sectional study was conducted on 150 participants divided into Fibromyalgia Group (FG) and Control Group (CG) (n=75 in each group). The participants were evaluated using the SF-36 and the FIQ. The data were analyzed by the Student t-test (α=0.05) and inferential analysis using the Receiver Operating Characteristics (ROC) Curve - sensitivity, specificity and area under the curve (AUC). The significance level was 0.05. RESULTS: The sample was similar for age (CG: 47.8±8.1; FG: 47.0±7.7 years). A significant difference was observed in quality of life assessment in all aspects of both questionnaires (p

OBJETIVO: Desenvolver uma versão transcultural do Fibromyalgia Impact Questionnaire (FIQ) para a população brasileira e analisar sua validade e eficácia quando aplicado em pacientes com fibromialgia. PACIENTES E MÉTODOS: Participaram do estudo 44 pacientes com fibromialgia (FM), diagnosticados segundo os critérios do American College of Rheumatology (ACR), 1990. Baseados nas orientações de Guillemin et al(22), foram convidados quatro professores de língua inglesa, um reumatologista e dois fisioterapeutas. O procedimento seguiu as etapas: tradução inicial por dois professores de inglês, avaliação das duas traduções para uma versão única, versão para a língua inglesa por dois professores de inglês nativos, reunião de consenso com dois professores de inglês, reumatologista e fisioterapeutas para versão teste, avaliação da equivalência cultural, versão final, avaliação da confiabilidade e reprodutibilidade. A versão teste foi aplicada em 20 pacientes com FM, tendo em todas as questões o item "não-aplicável". Substituição de possíveis questões com mais de 15% de respostas "não-aplicável" por outras de mesmo conceito, resultando na versão final. Aplicação dessa versão em 24 pacientes com FM por dois avaliadores que fizeram a entrevista no mesmo dia com intervalo de uma hora e, após um período de sete dias da primeira avaliação, o questionário foi reaplicado pelo primeiro avaliador. RESULTADOS: Na aplicação da versão teste não houve questões com mais de 15% de respostas "não-aplicável". Sendo assim, não foi mudado o texto para a versão final. Porém, houve dificuldade de compreensão das escalas visuais analógicas (questões 4 a 10). Com isso, foram acrescidas "carinhas" nos dois extremos: à esquerda uma "carinha" feliz e à direita, uma infeliz. Esse processo deu origem à versão final. Na avaliação da confiabilidade, os resultados do avaliador 1 (primeira e segunda aplicação) e do avaliador 2 foram comparados, bem como as duas aplicações do avaliador 1. Ambas demonstraram que não houve diferença entre os dois avaliadores no que diz respeito a aplicação do questionário. A comparação entre os avaliadores foi feita com base nas médias globais. Os valores de p foram todos superiores a 10%, indicando que não houve evidência de diferenças significantes entre aplicações dos questionários nos mesmos pacientes. CONCLUSÃO: A versão brasileira do FIQ, o QIF, mostrou ser um instrumento válido e confiável para medir a capacidade funcional e o estado de saúde de pacientes brasileiros com FM. OBJECTIVE: To develop a cross-cultural validation of the Fibromyalgia Impact Questionnaire (FIQ) to the Brazilian population and to analyze its validity and efficacy when applied to fibromyalgia patients. PATIENTS AND METHODS: Forty-four fibromyalgia patients classified following the 1990 American College Rheumatology (ACR) criteria. According to the 1993 Guillemin et al(22) guidelines, four English teachers, one rheumatologist and two physical therapist were invited to participate. The procedure was established according to the following steps: initial translation by two English teachers, evaluation of these two translations to a unique version, back translation to English by two native teachers, a consensus meeting where there were two English teachers, one rheumatologist and physiotherapists for the test-translation, evaluation of cultural equivalency, final version, reliability and reproducibility. The test-translation has been applied to 20 fibromyalgia patients, having in all questions the item "not applicable". Questions answered as "not applicable" by 15% or more patients were reformulated, resulting in the final version. Application of the final version to 24 fibromyalgia patients by two different interviewers who applied the final questionnaire in the same day, with one hour interval and seven days after the first interview, the questionnaire was re-applied by the first interviewer. RESULTS: During the application of the test-version none of the questions were answered as "not applicable" for 15% or more. Consequently, the text was not reformulated. However, there were some difficulty for understanding the visual analogic scales (questions 4 to 10). As a result, "small faces" were added in both ends: a "happy face" to the left and a "sad face" to the right. The evaluation of reliability and reproducibility obtained by the first interviewer (between the first and second application) as well as results obtained by the second interviewer were compared. Both showed no difference among the two interviewers in what concerns the questionnaire application. The p values were above 10% indicating no significant difference between questionnaires application. CONCLUSION: The FIQ Brazilian version, QIF, showed to be a reliable and valid instrument to measure the functional ability and the health state of Brazilian fibromyalgia patients.

INTRODUCTION AND OBJECTIVE: The aim of this study was to review the literature concerning of the prevalence of fibromyalgia in general population using the criteria from the American College of Rheumatology (ACR). METHODS: The literature envolved the period of 1990 to 2005, in the databases Medline, Lilacs, Embase and ISI. The keywords "fibromialgia" and "prevalencia" and the correspondents in English "fibromyalgia" and "prevalence" had been used. It was selected 97 articles and after reading the summaries, the ones related to the fibromyalgia prevalence with oher diseases were excluded. Only 30 articles evoked the subject prevalence of the fibromyalgia in the population. The selected articles were grouped in five items: a) the prevalence of fibromyalgia in adult populations; b) prevalence of fibromyalgia in women; c) prevalence of fibromyalgia in children and adolescents; d) prevalence of fibromyalgia in specific populations; e) prevalence of chronic and diffuse pain in the population according to the ACR criteria. RESULTS: Literature points that the prevalence of fibromyalgia in the general population has values between 0,66 and 4,4%, being more prevalent in women than in men, especially in individuals aged between 35 to 60 years. Studies involving children, adolescents or other special groups are few or inconclusive. The prevalence of chronic and diffuse pain in general population althoug rarily been studied points to values between 11 and 13%. CONCLUSION: More studies on prevalence of chronic and diffuse pain must be stimulated, as well as the ones concerning prevalence in the adult population, children and young.

The most typical symptom of fibromyalgia (FM) is diffuse pain, and pain at specific points-tender points-is crucial for its diagnosis. By comparing healthy individuals and FM patients, this study was aimed at assessing pain and quality of life of Brazilian females with FM, while seeking for a correlation between pain threshold and quality of life. A total of 178 women were evaluated: 124 were FM patients and 54 were healthy women. Pain threshold at tender points was quantified by dolorimetry, and diffuse pain by means of the visual analogue scale (VAS); the Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate quality of life. Statistical treatment of the data allowed for proposing two indexes: a pain threshold index (PT) and a quality of life one (QOL). PT is the lowest value among all pain thresholds measured at the 18 tender points; QOL is the mean of responses to the FIQ and VAS. Both indexes were tested and showed significant differences between the test and control groups. By pairing pain threshold values of each tender point in the test and control groups, it was found that the most sensitive points matched between the two groups, that is, the most sensitive anatomic spots in a healthy individual are also likely to be the most sensitive points in a person with FM. This suggests that a stimulus that provokes slight discomfort to a healthy person may produce more pain in FM patients--which may bear implications for FM clinical treatment. In this sample of Brazilian women, FM patients had both lower pain threshold and worse quality of life than healthy women.

Fibromialgia é uma síndrome de etiologia desconhecida e caracterizada pela presença de dor difusa e crônica e pelo menos 11 dos 18 tender points específicos. É fundamental encontrar alternativas eficazes de tratamento que objetivem minimizar o impacto da fibromialgia (FM) sobre a qualidade de vida dos pacientes. O objetivo deste estudo foi avaliar a eficácia de um tratamento fisioterapêutico composto de terapia a laser nos tender points e exercícios de alongamento muscular sobre a qualidade de vida de pacientes com FM. Participaram do estudo 28 pacientes com FM que foram divididos em três grupos: GLA (n=10) que realizou 10 sessões de terapia a laser nos tender points e exercícios de alongamento; GA (n=10) que realizou 10 sessões de alongamento muscular e; GC (n=8) que realizou uma sessão educativa. Foram utilizadas as medidas da escala analógica visual da dor (VAS), dolorimetria dos tender points, Fibromyalgia Impact Questionnaire (FIQ) e SF-36. Os resultados mostraram que os grupos GLA e GA, quando comparadas as avaliações inicial e final, apresentaram diferença significante na VAS (p=0,006 e p=0,002; respectivamente); no limiar de dor dos tender points (p=0,001 e p=0,007; respectivamente); no FIQ (p=0,04 e p=0,006; respectivamente) e no SF-36 (p=0,001 e p=0,000; respectivamente). O grupo GC não apresentou diferença significante em nenhuma das medidas. Não houve diferença significante entre os grupos GLA e GA, mas houve diferença destes com o grupo GC nas medidas da VAS e do limiar de dor nos tender points. Neste estudo, conclui-se que os exercícios de alongamento são eficazes na melhora da dor, sensibilidade dolorosa dos tender points e qualidade de vida dos pacientes. Devem ser revistos alguns parâmetros da terapia a laser de baixa potência no tratamento desses pacientes, como o intervalo entre as sessões e o comprimento de onda do laser adotados. Sugere-se ainda que a abordagem educativa seja empregada como parte integrante do tratamento e que a relação fisioterapeuta-paciente deva ser valorizada, pois são aspectos importantes que podem contribuir para a melhora da qualidade de vida dos pacientes com FM. Fibromyalgia is a syndrome of unknown etiology characterized by the presence of chronic and diffuse pain, and at least 11 of the 18 specific tender points. Its fundamental to find effective options of treatment that look for minimize the impact of fibromyalgia (FM) in the patients quality of life. The purpose of this study was to evaluate the efficacy of a physical therapy treatment compounded of laser therapy in the tender points and stretching exercises, in quality of life of patients with FM. Twenty-eight patients with FM participated of this study were divided in three groups: GLA (n=10) performed 10 sessions of laser therapy in the tender points and stretching exercises; GA (n=10) performed 10 sessions of stretching exercises and; GC (n=8) performed a single session of an educational approach. Measures of visual analogue scale of pain (VAS), dolorimetry of the tender points, Fibromyalgia Impact Questionnaire (FIQ) and SF-36 were assessed. The results showed, comparing initial and final assessments, the groups GLA and GA presented significant differences of VAS (p=0.006 and p=0.002; respectively); pain threshold of tender points (p=0.001 and p=0.007; respectively); FIQ (p=0.04 and p=0.006; respectively) and SF-36 (p=0.001 and p=0.000; respectively). There was no significant difference in any of the measures in the GC group. No significant groups GLA and GA differences were found, but compared with the controls (GC) the measures of VAS and pain threshold were significant different. In conclusion, in this study the stretching exercises were effective in the improvement to pain, tenderness threshold of the tender points and quality of life of patients with FM. Some parameters should be reviewed about low-power laser therapy in the treatment of patients with FM, as treatment intervals and laser wavelength. This study suggests that an educational approach could be employed as an integrant part of the treatment, and the relationship between physical therapist and patient plays an essential role in the treatment, since they are important aspects that contribute to the improvement in quality of life of patients with FM.

A fibromialgia é uma condição de alta prevalência, que causa desconforto físico, sofrimento mental e comprometimento das relações sociais. Com o aumento da popularidade de Mobile Health, considerou-se o uso de aplicativo móvel como recurso de suporte no tratamento de indivíduos com fibromialgia. Há uma carência de aplicativos para brasileiros portadores de fibromialgia, desenvolvidos por profissionais de saúde, a partir de fontes de informação confiáveis, em linguagem adequada, com alto grau de funcionalidade, testados quanto à sua eficácia em ensaios clínicos. O presente projeto constitui-se de dois estudos. O Estudo I teve como objetivo desenvolver um aplicativo móvel para promover o autocuidado em indivíduos com fibromialgia, e o Estudo II teve como objetivo avaliar sua eficácia na melhora da qualidade de vida e dos sintomas e na promoção do autocuidado, e verificar a adesão dos pacientes ao uso do aplicativo. Desenvolveu-se o aplicativo denominado ProFibro segundo o paradigma da prototipação, em cinco etapas: (1) análise de requisitos e conteúdo e estabelecimento de objetivos do software; (2) desenvolvimento da interface pela designer; (3) desenvolvimento do protótipo pela programadora para o sistema operacional Android (Google Inc., Mountain View, CA); (4) teste-piloto para avaliação da qualidade de uso do protótipo com pacientes; (5) refinamento do protótipo e construção do produto final. Suas principais funções são: animação educativa; automonitoramento com o Questionário de Impacto da Fibromialgia Revisado; estratégias do sono com a técnica de relaxamento por imaginação guiada, terapia de controle de estímulo e higiene do sono; agenda para facilitar o planejamento da rotina diária; programa gradual de exercícios aeróbicos, alongamento e fortalecimento; diário para a prática da gratidão; livro eletrônico com atividades para a família; dicas por meio de notificações. O Estudo II foi um ensaio clínico controlado e aleatorizado com 40 indivíduos com fibromialgia, alocados em grupos experimental e controle. Os participantes foram avaliados na linha de base e após seis semanas por um avaliador cego, quanto às seguintes variáveis: qualidade de vida (Questionário de Impacto da Fibromialgia Revisado); dor (Índice de Dor Generalizada e Escala Visual Analógica); sintomas (Escala de Severidade de Sintomas); agenciamento do autocuidado (Escala de Avaliação de Agenciamento de Autocuidados Revisada). O grupo experimental recebeu smartphones com o aplicativo ProFibro para uso durante seis semanas, enquanto o grupo controle recebeu uma apostila em papel de conteúdo similar. A adesão dos pacientes ao aplicativo foi avaliada contabilizando o número de acessos às suas funcionalidades. O uso do aplicativo ProFibro durante seis semanas, sem o acompanhamento de um profissional de saúde, foi eficaz para a redução da severidade de sintomas e do impacto geral da fibromialgia na qualidade de vida, em comparação com a linha de base. Os efeitos do uso do aplicativo foram similares aos da apostila. Cerca de 40% dos participantes do Grupo Experimental tiveram uma baixa adesão ao uso do aplicativo. As estratégias do sono foram a funcionalidade mais utilizada, seguidas do programa de exercício físico e do diário Fibromyalgia is a prevalent condition that causes physical problems, mental distress and impaired social functioning. With the increasing popularity of Mobile Health, the use of a mobile application as a support tool in the management of fibromyalgia was considered. There is a shortage of applications for Brazilian patients with fibromyalgia, which are developed by health professionals, based on reliable sources of information, in proper language, with a high degree of functionality, and are tested for effectiveness in clinical trials. This project is formed of two studies. Study I aimed to develop a mobile application to promote self-care in individuals with fibromyalgia, and Study II aimed to evaluate its effectiveness in improving quality of life and symptoms, and promoting self-care, and to verify patient compliance to the use of the application. The application which was named ProFibro was developed according to the prototyping paradigm, in five stages: (1) analysis of requirements and content and establishment of software objectives; (2) interface development by the designer; (3) development of the prototype by the programmer for the Android operating system (Google Inc., Mountain View, CA); (4) pilot test with patients to evaluate the quality of use of the prototype; (5) improvement of the prototype and construction of the final product. Its main functions are: educational animation; self-monitoring with the Revised Fibromyalgia Impact Questionnaire; sleep strategies with guided imagery relaxation technique, stimulus control therapy and sleep hygiene; scheduling function to facilitate planning the daily routine; graded exercise programme with aerobic, stretching and strengthening exercises; a diary for the practice of gratitude; an eBook about family adjustments; hints through notifications. The Study II was a randomized controlled trial of 40 individuals with fibromyalgia, which were allocated into Experimental and Control groups. A blind evaluator assessed the participants at baseline and after six weeks regarding the following outcomes: quality of life (Revised Fibromyalgia Impact Questionnaire); Pain (Generalized Pain Index and Visual Analog Scale); symptoms (Severity of Symptoms Scale); self-care agency (Revised Self-Care Agency Assessment Scale). The Experimental Group received smartphones with the ProFibro application and were instructed to use it for six weeks while the control group received a paper book with similar content. Patient adherence to the application was evaluated according to the number of accesses to its functions. The use of ProFibro application for six weeks, without the health professional support, was effective in reducing the severity of symptoms and the overall impact of fibromyalgia on quality of life compared to baseline. The effects of the use of the application were similar to those of the paper book. About 40% of the participants of the Experimental Group had a low adherence to the use of the application. The sleep strategies were the most used function, followed by the exercise programme and the diary