Functional capacity, muscle strength and falls in women with fibromyalgia

Góes, Suelen Meira; Leite, Neiva; Shay, Barbara; Homann, Diogo; Stefanello, Joice Mara Facco; Rodacki, André Luíz Félix

doi:10.1016/j.clinbiomech.2011.12.009

Cited by 93 publications

(82 citation statements)

References 35 publications

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“…Intervention studies have shown concomitant increases in fitness with reduced levels of pain (3,4) and improved quality of life in FM patients. Likewise, low physical fitness has been related to exacerbated pain, fatigue, and stiffness (5) and to higher risk of falls in this population (6).…”

Section: Introductionmentioning

confidence: 99%

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Soriano‐Maldonado

Ruiz

Aparicio

et al. 2015

Arthritis Care & Research

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Objective. This population-based cross-sectional study aimed to characterize the association of different components of physical fitness with pain levels, pain-related catastrophizing, and chronic pain self-efficacy in women with fibromyalgia (FM). Methods. A total of 468 women with FM participated. The experience of pain was assessed with different tools (algometry, a numeric rating scale [revised FM impact questionnaire], a visual analog scale, and the bodily pain subscale on the Short Form 36 health survey). We also assessed pain-related catastrophizing and chronic pain self-efficacy. Physical fitness was assessed with performance-based tests (Senior Fitness Test battery and handgrip dynamometry). A standardized composite score was computed for each component of physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility), and their average comprised a clustered global fitness profile. Results. Overall, higher physical fitness was consistently associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy (regardless of the pain assessment method and the fitness test evaluated). Muscle strength and flexibility were independently associated with pain (P < 0.005 for both), and participants with high muscle strength plus high flexibility (combined effect) had the lowest levels of pain in this population. Aerobic fitness and flexibility were independently associated with pain-related catastrophizing (P < 0.001 for both) and chronic pain self-efficacy (P < 0.001 for both), and participants with high flexibility plus high aerobic fitness (combined effect) had the best catastrophizing and self-efficacy profiles. Conclusion. Our results suggest that higher physical fitness is associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy in women with FM. These results might have implications for future intervention studies in this population.

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Section: Introductionmentioning

confidence: 99%

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Soriano‐Maldonado

Ruiz

Aparicio

et al. 2015

Arthritis Care & Research

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“…However, interestingly, all 15 participants scored 3 for the latter measurement corresponding to a range of motion above the average, without characterizing joint hypermobility. Flexitest movements XVI (shoulder posterior adduction at 180º of abduction) and IX (trunk flexion) are similar to the procedures applied in other studies (shoulder 7,20 and trunk 8,9,20,21 ), allowing for a more robust methodological comparison between those studies and ours. Our results did not indicate a significant difference in those movements between the groups.…”

Section: Discussionmentioning

confidence: 59%

“…Nevertheless, no differences were detected for those movements between the groups. Thus, the use of the Flexitest was valuable in the present study because the previous studies merely recorded a rather narrow range of joint movements 7,8,15,20 that does not systematically reflect the actual level of flexibility of individuals or allow the determination of a more complete profile of body movements.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, flexibility has been undervalued in the studies on and interventions in FMS 13 . Another relevant issue is that pain has been described as the main limiting factor in physical performance tests 8,14 as well as in motor tasks as a whole, particularly when performing new exercises or unusual movements 11 . Thus, the application of active joint mobility tests might be a relevant factor in the physical and functional assessment of individuals with FMS.…”

Section: Kelley and Kelleymentioning

confidence: 99%

“…Mannerkorpi et al 7 detected reduced aerobic power and a lower rate of muscle strength production in women with FMS compared with asymptomatic women; however, the results regarding the active shoulder range of motion were conflicting between the two test protocols used. Additionally, Góes et al 8 found a reduction of functional capacity, particularly in strength production, but not in flexibility. By contrast, Pedro-Angel et al 9 found a significant reduction in flexibility among women with mild or severe FMS compared with asymptomatic women.…”

Section: Kelley and Kelleymentioning

confidence: 99%

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Aspectos da flexibilidade de mulheres com síndrome de fibromialgia

Almeida

Santos

2015

Rev. Bras. Cineantropom. Desempenho Hum.

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-Regular physical exercise tends to benefit people with fibromyalgia syndrome (FMS). The effects have been observed regarding aerobic power and strength; however, results concerning flexibility have been controversial. In general, studies have evaluated specific joints or tests involving only a single body movement. The aim of this study was to compare the flexibility profile of FMS and asymptomatic women using a more comprehensive test protocol regarding the number of movements and joints involved. The sample consisted of 30 women divided into two groups: asymptomatic (n = 15; mean age: 50.2 ± 8.2 years; mean weight: 63.0 ± 9.6 kg; mean height: 157 ± 6 cm) and fibromyalgia (n = 15; mean age: 47.3 ± 9.4 years; mean weight: 61.9 ± 12.2 kg; mean height: 159 ± 7 cm). Flexibility was measured using the Flexitest, which was evaluated by the global index of flexibility (Flexindex), and the five indices of variability of joint mobility: intermovement (IVIM), interjoint (IVIA), flexion-extension (IVFE), between segment (IVES) and distal-proximal (IVDP). All of the indices were calculated based on the results of the 20 movements of the Flexitest. There was no difference between groups (44.4 ± 3.7 vs. 45.7 ± 4.1 points, for asymptomatic and fibromyalgia, respectively; p = 0.379; 95% confidence interval (CI): -4.2 to 1.6). Most of the sample (83%) showed an average level of flexibility based on reference values for gender and age. Only IVIM showed a significant difference between the groups. Asymptomatic and fibromyalgic women have similar overall levels of flexibility but with different profiles. Key words: Chronic pain; Joints; Range of motion. (n = 15; 50,2 ± 8,2 anos; 63,0 ± 9,6 kg; 157 ± 6 cm) e fibromiálgicas (n = 15; 47,3 ± 9,4 anos; 61,9 ± 12,2 kg; 159 ± 7 (44,4 ± 3,7 vs 45,7 ± 4,1 pontos, para assintomáticas e fibromiálgicas respectivamente; p=0,379;2 a 1,6 Resumo -Exercícios físicos em mulheres com síndrome de fibromialgia (SFM) têm apresentado efeitos na força e potência aeróbica, contudo, os resultados acerca da flexibilidade têm sido controversos. Além disso, os estudos têm avaliado articulações específicas ou testes que envolvam apenas um único movimento corporal. Objetivou-se comparar o perfil de flexibilidade global de mulheres acometidas pela SFM e assintomáticas a partir de um protocolo de teste mais abrangente quanto ao número de movimentos e articulações envolvidas. Participaram da pesquisa 30 mulheres divididas em dois grupos: assintomáticas cm). A flexibilidade medida pelo Flexiteste foi avaliada pelo índice global de flexibilidade (flexíndice) e pelos cinco índices de variabilidade da mobilidade articular: intermovimentos (IVIM), intra-articulação (IVIA), flexão-extensão (IVFE), entre segmentos (IVES) e distal-proximal (IVDP). Todos os índices foram calculados com base nos resultados dos 20 movimentos do flexiteste. Não houve diferença no flexíndice entre os grupos

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Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

Bachasson¹,

Guinot²,

Wuyam³

et al. 2013

Arthritis Care & Research

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Objective. To assess quadriceps strength and fatigability by using femoral nerve magnetic stimulation (FNMS) and their relationship to exercise capacity in patients with fibromyalgia syndrome (FMS) and healthy controls. Methods. Twenty-two women (11 with FMS, 11 controls) performed a maximal incremental cycling test and a quadriceps fatigue test on 2 separate visits. For quadriceps assessment, we used FNMS during and after maximum voluntary contraction (MVC) to evaluate central and peripheral factors of neuromuscular fatigue. Subjects performed sets of 10 intermittent (5 seconds on/5 seconds off ) isometric contractions starting at 10% MVC, in 10% MVC increments from one set to another until exhaustion. Neuromuscular fatigue was assessed with FNMS after each set. Results. FMS patients had reduced initial MVC compared to controls (mean ؎ SD 102 ؎ 18 versus 120 ؎ 24 Nm; P < 0.05) without significant impairment of voluntary activation (mean ؎ SD 93.5% ؎ 3.0% versus 93.1% ؎ 3.4%; P ‫؍‬ 0.74). During the fatigue task, FMS patients exhibited a greater fall in evoked muscular responses (mean ؎ SD ؊26% ؎ 6% versus ؊16% ؎ 8% at set 50% MVC; P < 0.05), but not in MVC (mean ؎ SD ؊24% ؎ 7% versus ؊19% ؎ 4% at set 50% MVC; P ‫؍‬ 0.12). During the cycling test, FMS patients had lowered maximal exercise capacity and an enhanced rate of perceived exertion (RPE) compared to controls. The percent reduction in evoked muscular responses during the quadriceps fatigue test correlated with maximum oxygen consumption (r ‫؍‬ 0.56, P < 0.05) and RPE at submaximal intensity (r ‫؍‬ 0.84, P < 0.05) during cycling. Conclusion. Greater impairment in muscle contractility is associated with enhanced perception of exertion and reduced maximal exercise capacity in FMS patients. Neuromuscular impairments should be considered as an important factor underlying functional limitations in FMS patients.

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Functional capacity, muscle strength and falls in women with fibromyalgia

Cited by 93 publications

References 35 publications

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Aspectos da flexibilidade de mulheres com síndrome de fibromialgia

Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

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