Postural control deficits in people with fibromyalgia: a pilot study.
Postural control deficits in people with fibromyalgia: a pilot study.
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DOI：
10.1186/ar3432
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发表时间：
2011-08-02
影响因子：
4.9
通讯作者：
Horak FB
中科院分区：
文献类型：
--
作者：
Jones KD;King LA;Mist SD;Bennett RM;Horak FB
姿势不稳和跌倒日益成为纤维肌痛 (FM) 患者面临的问题。本研究的目的是确定 FM 患者与年龄匹配的健康对照 (HC) 相比，在动态姿势描记（包括感觉、运动和稳定性限制）方面是否存在差异。我们进一步试图确定姿势不稳定是否与力量、本体感觉和下肢肌筋膜触发点（MTP）有关； FM症状和身体机能；认知障碍；平衡信心；和药物的使用。最后，我们评估了过去六个月内自我报告的跌倒情况。在这项横断面研究中，我们比较了接受计算机动态姿势描记测试并完成纤维肌痛影响问卷修订版 (FIQR) 以及平衡和跌倒问卷的中年 FM 患者和年龄匹配的 HC。所有受试者均接受了神经系统和肌肉骨骼检查。描述性统计用于表征样本并探索变量之间的关系。通过相关性和回归分析评估主观、临床和客观变量之间的关系。 25 名 FM 患者和 27 名 HC（合并平均年龄 ± 标准差 (SD)：48.6 ± 9.7 岁）完成了测试。 FM 患者在复合感觉组织测试中的得分（主要结果；P < 0.010）以及动态姿势描记法的前庭、视觉和体感比率得分均较低。各组之间的平衡置信度存在显着差异，FM 患者的置信度低于 HC（平均值 ± SD：81.24 ± 19.52 对比 98.52 ± 2.45；P < 0.001）。有趣的是，76% 至 84% 的 FM 患者有腓肠肌和/或胫骨前肌 MTP。姿势稳定性最好通过认知障碍、FIQR 评分和体重指数来预测。关于跌倒，27 名 HC 中有 3 名 (11%) 在过去 6 个月内仅跌倒过一次，而 25 名 FM 患者中有 18 名 (72%) 至少跌倒过一次。 15 名 FM 患者 (60%) 报告在过去六个月内至少跌倒过 3 次。在这项研究中，我们报告说，尽管中年 FM 患者的临床神经系统检查正常，但动态姿势描记术中仍存在一致的客观感觉缺陷。需要进一步研究来确定预期跌倒率和下肢 MTP 的意义。制定改善 FM 患者平衡能力和减少跌倒的干预措施可能需要将平衡训练与运动和认知训练结合起来。
Postural instability and falls are increasingly recognized problems in patients with fibromyalgia (FM). The purpose of this study was to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability. We further sought to determine whether postural instability is associated with strength, proprioception and lower-extremity myofascial trigger points (MTPs); FM symptoms and physical function; dyscognition; balance confidence; and medication use. Last, we evaluated self-reported of falls over the past six months. In this cross-sectional study, we compared middle-aged FM patients and age-matched HCs who underwent computerized dynamic posturography testing and completed the Fibromyalgia Impact Questionnaire-Revised (FIQR) and balance and fall questionnaires. All subjects underwent a neurological and musculoskeletal examination. Descriptive statistics were used to characterize the sample and explore the relationships between variables. The relationships between subjective, clinical and objective variables were evaluated by correlation and regression analyses. Twenty-five FM patients and twenty-seven HCs (combined mean age ± standard deviation (SD): 48.6 ± 9.7 years) completed testing. FM patients scored statistically lower on composite sensory organization tests (primary outcome; P < 0.010), as well as with regard to vestibular, visual and somatosensory ratio scores on dynamic posturography. Balance confidence was significantly different between groups, with FM patients reporting less confidence than HCs (mean ± SD: 81.24 ± 19.52 vs. 98.52 ± 2.45; P < 0.001). Interestingly, 76% to 84% of FM patients had gastrocnemius and/or anterior tibialis MTPs. Postural stability was best predicted by dyscognition, FIQR score and body mass index. Regarding falls, 3 (11%) of 27 HCs had fallen only once during the past 6 months, whereas 18 (72%) of 25 FM patients had fallen at least once. Fifteen FM patients (60%) reported falling at least three times in the past six months. In this study, we report that middle-aged FM patients have consistent objective sensory deficits on dynamic posturography, despite having a normal clinical neurological examination. Further study is needed to determine prospective fall rates and the significance of lower-extremity MTPs. The development of interventions to improve balance and reduce falls in FM patients may need to combine balance training with exercise and cognitive training.
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影响因子：
2.2
作者：
Hillman, CH;Belopolsky, AV;McAuley, E
通讯作者：
McAuley, E
影响因子：
3.4
作者：
Ediz, Levent;Hiz, Ozcan;Ercan, Songul
通讯作者：
Ercan, Songul
影响因子：
3.4
作者：
Gianoli, G;McWilliams, S;Belafsky, P
通讯作者：
Belafsky, P
影响因子：
2.3
作者：
Bazzichi L;Dini M;Rossi A;Corbianco S;De Feo F;Giacomelli C;Zirafa C;Ferrari C;Rossi B;Bombardieri S
通讯作者：
Bombardieri S
影响因子：
4.2
作者：
Auvinet, Bernard;Bileckot, Richard;Barrey, Eric
通讯作者：
Barrey, Eric