BackgroundMicrocirculatory disorders are one of the most important clinical symptoms of systemic sclerosis (SSc), therefore we found it feasible to evaluate the clinical efficacy of biofeedback (BFB) in the complex therapy of patients with SSc based upon analysis of nailfold capillaroscopy.ObjectivesTo study the impact of the method of biofeedback therapy on microcirculation disturbances in patients with SSc.MethodsThe study included 40 patients with SSc under observation. Among the patients examined, 95% were women and 5% were men. The average age of the patients - 38±3,3 years, duration of illness - 14±2,6 years. Raynaud's phenomenon (RP) was observed in all the patients. A severe form of RP was seen in 80% of the patients. The effectiveness of biofeedback therapy was analyzed by studying the dynamics of the measures from the nailfold capillaroscopy and comparing the data obtained of patients from the main and control groups.ResultsIt was found that, patients who were under biofeedback therapy, showed significant positive dynamics in the following signs of capillaroscopic picture: dilation of the capillaries (c2 =9,643 p=0,026), morphological changes of the capillaries (c2 =4,90 p=0,027), and hemorrhage (c 2 =4,514 p=0,034). In the control group of patients, in only one indicator of capillaroscopy that a significant change was noted, particularly by the presence of dilated capillaries (c2 =5,833 with p=0,016). These findings suggest that treatment results were significantly better in the main study group of patients with SSc.ConclusionsThe implementation of biofeedback therapy favors a decrease in reflex musculo-tonic syndromes, improvement of microcirculation and peripheral blood flow and significantly allows an amelioration in the results of SSc therapy.Disclosure of InterestNone declared

Objectives Our aim was to study the phenomenon of alexithymia – a special mental quality of psychosomatic personality in systemic sclerosis patients. Methods We observed 54 patients suffering from systemic sclerosis (SS) using Toronto Alexithymia Scale (TAS). The majority of patients were women (94, 4%) of 45, 59 ± 1, 65 years in average. Average duration of the disease was 4, 42 ± 0, 44 years. 1st degree of SS activity has been diagnosed in 12 (22, 2%) patients, 2nd degree - in 37 (68, 5%) and 3rd degree - in 5 (9, 3%) patients. The chronic clinical course of the disease was observed in 16 (29, 6%) patients, subacute course of the disease - in 35 (64, 8%) and acute course - in 3 (5, 5%) patients. Results The data we obtained shows evidence of high level of alexithymia in SS patients (77,35 ± 1,8 test scores). Besides the results of our research, alexithymia was seen to play a certain role in the pathogenesis of psychosomatic disturbances in SS. Alexithymia doesn’t depend on gender and age of patients. The clinical course and activity of the disease on the one hand, reliably has a negative correlation between alexithymia expression and educational level of patients (r=-0,37 at p=0,028). Internality in the relation to disease (r=-0,64 at p=0,031), was also reliably in a direct correlation with “Jet formations” mechanism of psychological defense (r=0,58 at p=0,023) which was revealed on the other hand. Conclusions Thus, there are certain correlations between alexithymia development and some clinical and psychological characteristics of SS patients. Understanding the correlations is important in order to organize preventive psychological interventions with the purpose to correct alexithymic traits. Disclosure of Interest None Declared

Background Various methods of non-medicinal therapy of systemic sclerosis (SS) were offered, but any of them does not allow achieving desirable success. It is known that active participation of patient in treatment can improve efficiency of the therapy. One of promising method is biofeedback, referred on active participation of patient in the therapy. Objectives Our aim was to improve the efficiency of complex therapy of SS patients by means of biofeedback therapy. Methods We observed 90 SS patients. The middle age of patients was equal to 38,19±12,1 years, average duration of illness 11,2±3,4 years. The minimum degree of activity of disease (I) has been diagnosed for 47 (52,2%), medium (II) degree - in 38 (42,2%) and high (III) degree - in 5 (5,6%) patients. A chronic course of the disease was diagnosed in 39 (43,3%), subacute - in 48 (53,3%), and acute - in 3 patients (3,3%). The stage of initial changes has been diagnosed in 37 (41%), a stage of generalization of process - in 50 (55,5%), a late (terminal) stage – in 3 patients (3,5%). Depending on degree of skin changes limited SS has been diagnosed in 66 (73,3%), and diffuse SS form - in 24 (26,7%) patients. SS patients have been divided on two groups randomly: the basic (n=60) and control (n=30). Patients of basic group received 12-14 sessions of multimodal (temperature and EEG) biofeedback training using “Reacor” rehabilitation complex. Clinical assessment of biofeedback efficiency was assessed by dynamics of following clinical and laboratory indices: skin count by G.P.Rodnan, capillaroscopies of nails, pain by VAS, joint count, number of swelling joints, swallow index, ESR, antibodies to Scl-70, SF-36 questionnaire was applied for quality of life evaluation. Results Reliable changes of capillaroscopy index (morphological variations of capillary tubes (χ2=6,19, p=0,013), a pain by VAS, ESR were noted in control group of SS patients after the course of conventional therapy. At the same time reliable positive dynamics of the skin count, joint count, number of swelling joints, swollen index, ESR was founded in patients of basic group after biofeedback therapy. Besides, capillaroscopy indices, namely angiectasia (χ2=8,192, p=0,004), morphological variations of capillary tubes (χ2=4,14, p=0,042) and hemorrhages (χ2=7,906, p=0,005) were reliable improved after the treatment. There is the evidence that biofeedback therapy has positive influence on microcirculation disturbances. It was founded that indices reflecting a physical component of quality of life - physical functioning (p<0,001), role physical functioning (p<0,01), somatic pain (p<0,001), and also overall health (p<0,001), social (p<0,05) and role emotional functioning (p<0,01) were reliable raised in SS patients of basic group. The results of assessment of physical and psychological health are similar in group of SS patients receiving conventional therapy, but changes of smaller quantity of indices were reliable. Conclusions Thus, results of the researches are the evidence of considerable efficiency ...

Results Nearly all FM were female (98%); main reason for exclusion was the inability to interrupt drugs with analgesic properties for >10 days. Age [FM mean 49(SEM1) vs C 46(2) y.], gender and socio-demographic characteristics were similar in both groups. Mean duration of symptoms was 8 y (range 0.4-49). RPS was 64(13-98), VAS was 5.7 (SD 2). Means for clinical examination were: TP 16(0.3), MS 29(0.9) and PGI 2.7(0.1). R-III reflex threshold was reduced in FM [26(2) vs 38(2) mA, p < 0.01]. Thermal perceptions (hot and cold) were similar in both groups, whereas thermal pain thresholds and latency (hot, cold, and cold pressure test) were drastically decreased in FM(p < 0.001). Correlation analysis showed a significant relationship between PGI, and central QST(Pearson r = -0.28; p = 0.02) and between PGI, MS and TP(r = 0.34 and r = 0.66, respectively p < 0.01). Correlation with CYP2D6 activity is under analysis. Conclusion Physician global impression, but not the other clinical scores, correlates with the extent of central sensitisation. Supported by the SNSF (3200-056028.98).