Elsevier

Joint Bone Spine

Volume 69, Issue 3, May 2002, Pages 293-299
Joint Bone Spine

ORIGINAL ARTICLE
Muscle performance in patients with fibromyalgia

https://doi.org/10.1016/S1297-319X(02)00373-1Get rights and content

Abstract

Objectives. To compare muscle performance in women with fibromyalgia and in healthy women. Patients and methods. Sixteen women with fibromyalgia syndrome (FMS) and 85 healthy women who were physically inactive or engaged in recreational sports underwent measurements of four parameters: maximal concentric isokinetic muscle strength of the knee extensors and flexors in the dominant limb, isometric grip strength on a Colin dynamometer, muscle fatigue resistance during 30 maximal concentric isokinetic contractions of the dominant knee flexors and extensors at 180° angular velocity, and static endurance during posture maintenance. Results. All muscle variables were decreased in the FMS patients as compared to the controls. The decreases were more marked during aerobic than during anaerobic exercise. Mean decreases were 39% (P<0.001) for muscle strength, 40% (P<0.0001) for fatigue resistance, and 81% (P<0.0001) for static endurance. Pain during exercise as evaluated using a visual analog scale was more marked in the FMS patients. Conclusion. This study of the three pathways supplying energy to muscle confirms that muscle function is globally impaired in FMS patients. The results suggest that the impairment predominates on aerobic processes.

Introduction

Fibromyalgia syndrome (FMS) manifests as diffuse axial plus upper- and lower-segment muscle pain with a duration of at least 3 months 〚1〛. Tenderness to palpation is found at specific soft tissue sites 〚1〛. Whether peripheral or central mechanisms are involved remains debated. Most patients have chronic fatigue and disorders in pain perception 〚2〛, as well as sleep architecture disturbances 3, 4. Abnormalities in muscle microcirculation and energy metabolism have been reported 5, 6, 7, 8. Impaired maximal isometric and isokinetic muscle performance has been found in several studies 9, 10. The role for physiological, psychological, or deconditioning factors is not agreed on 〚7〛.

We evaluated muscle function parameters reflecting all three sources of energy supply to muscles in patients with FMS and in healthy controls.

Section snippets

Group with FMS

We included 16 women meeting American College of Rheumatology criteria for FMS 〚1〛, which are based on subjective complaints of pain and make no reference to muscle fatigability. The biometric parameters in the 16 patients are displayed in table I. Disease duration ranged from 1 to 5 years. Scores were high on a 7-point fatigue severity scale 〚11〛 (mean ±SD, 5.9±1.6) and on a 10-point visual analog scale (VAS) for pain (mean, 7.2±2). Only 6 of the 16 patients were in paid jobs, and mean time

Grip strength

Grip strength was significantly lower in the FMS group than in the control group (20±9 kg vs. 27±7 kg; P<0.01) (table III). The difference remained significant in the age subgroup analysis (table IV).

Isokinetic muscle strength

All isokinetic muscle parameters were significantly lower in the FMS group than in the control group, with differences ranging from –26% to –54%. In comparisons of percent reductions in the FMS group, P was 0.01 for the raw data and 0.0001 for the data normalized for body weight. Reductions were

Discussion

We evaluated muscle function in a group of women with FMS and in a group of control women free of muscle and joint disease. Variables reflecting muscle strength, muscle fatigue resistance, and static muscle endurance were diminished in the FMS group. Earlier studies evaluated selected muscle parameters in FMS patients. Jacobson et al. 〚10〛 found a 45% reduction in knee extensor and flexor strength. A study by Mengshoel et al. 〚14〛 showed that static muscle resistance was reduced in FMS

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