{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:38:23Z","timestamp":1773974303294,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,10,31]],"date-time":"2020-10-31T00:00:00Z","timestamp":1604102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CITSAM (Centro de Investigaci\u00f3n San Alberto Magno), Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir","award":["grant numbers 2019-266-001 and 2019-270-002"],"award-info":[{"award-number":["grant numbers 2019-266-001 and 2019-270-002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Current pharmacological treatments of Fibromyalgia (FM) are merely symptom palliative, as clinical trials have so far failed to provide overall benefits without associated harms. Polypharmacy often leads to patient\u2019s health deterioration and chronic drug use to an eventual lack of patient\u2019s response. Emerging evidence supports that physiotherapy treatments based on mechanical triggers improve FM symptoms and therefore could be used for therapeutic purposes by themselves or in combination with current pharmacological treatments, as part of integrative medicine programs. However, a paucity of studies rigorously and systematically evaluating this possibility exists. This study uses scores from validated standardized questionnaires, algometer pressure point threshold (PPT) readings and responses from a custom self-developed questionnaire to determine the impact of a pressure-controlled custom manual protocol on FM hyperalgesia\/allodynia, fatigue and patient\u2019s quality of life. The results show that patient\u2019s baseline sensitivity to pain inversely correlates with treatment response in FM. Moreover, post-stratification analysis unexpectedly reveals that patients presenting comorbid ME\/CFS do not seem to respond to the applied therapy as those presenting FM only. Therefore, pre-treatment PPTs and ME\/CFS comorbidity may serve as indicators to predict patient\u2019s response to physiotherapy programs based on mechanical triggers. Further exploration of these findings is granted. In addition, the study of gene expression profiles in the blood collection generated by this study should help unveil the molecular mechanisms behind patient\u2019s differential response to manual therapy.<\/jats:p>","DOI":"10.3390\/ijerph17218044","type":"journal-article","created":{"date-parts":[[2020,10,31]],"date-time":"2020-10-31T21:39:56Z","timestamp":1604180396000},"page":"8044","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pressure Point Thresholds and ME\/CFS Comorbidity as Indicators of Patient\u2019s Response to Manual Physiotherapy in Fibromyalgia"],"prefix":"10.3390","volume":"17","author":[{"given":"Francisco Javier","family":"Falaguera-Vera","sequence":"first","affiliation":[{"name":"Escuela de Doctorado, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46008 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5522-056X","authenticated-orcid":false,"given":"Mar\u00eda","family":"Garcia-Escudero","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46900 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Traslacional San Alberto Magno, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4926-5539","authenticated-orcid":false,"given":"Javier","family":"Bonastre-F\u00e9rez","sequence":"additional","affiliation":[{"name":"Escuela de Doctorado, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46008 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Zacar\u00e9s","sequence":"additional","affiliation":[{"name":"School of Experimental Sciences, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Oltra","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Traslacional San Alberto Magno, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"},{"name":"School of Medicine, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1016\/S0140-6736(16)31851-7","article-title":"Revising the ICD: Explaining the WHO approach","volume":"388","author":"Boerma","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/art.1780330203","article-title":"The american college of rheumatology. 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