Relationships between the Fibromyalgia Impact Questionnaire, pain severity, psychological profile and Muscle Strength in Female Patients with Fibromyalgia
Prof Sameh GHROUBIa, Dr Salma JRIBIa, Prof Rim AKROUTb, Dr Wafa ELLEUCHa, Dr Saoussan MAHERSIa, Prof Mohamed ELLEUCHc, Prof Sofiène BAKLOUTIb, Prof Mohamed Habib ELLEUCHa
a Service de Médecine Physique et de Réadaptation, CHU Habib Bourguiba, Sfax, Tunisie, et Unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, b Service de Rhumatologie, CHU HediChaker, Sfax-Tunisie Unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, c Service de Rhumatologie, CHU Rabta, Tunis-Tunisie
OBJECTIVES: The aim of this study was to compare various performances between women with fibromyalgia (FM) and healthy female controls and to assess the relationship between muscular function, pain intensity, disease severity and psychological profile in the fibromyalgia.
METHODS: We included forty-six women divided into two groups : th first group included 21 fibromyalgia patients and the second group included 25 healthy controls. All subjects had an evaluation of the trunk and knee muscular strength in the dominant limb using an isokinetic dynamometer. This assessment involved a measurement of the maximal concentric isokinetic muscle strength of the knee flexors and extensors at both 60°/s and 180°/s angular velocity, and a measurement of the maximal concentric isokinetic muscle strength of the trunk flexors and extensors at 60 and 150°/s. Muscular resistance to fatigue is assessed when the subject has performed 30 chained concentric contractions of maximum intensity at an angular velocity of 180°/s. The measured parameters were the peak of torque and the cumulative work . We evaluated the pain intensity both at rest and during exercise using visual analogical scale, the psychological profile via HAD scale, and the disease severity using the fibromyalgia impact questionnaire (FIQ).
RESULTS: The strength and endurance of knee and trunk muscles were lower in fibromyalgia. The difference between these groups was significant (p<0,05). The isokinetic trunk deficit predominated on the trunk extensors (p<0,001). Mean decrease were 34.5% (p<0.05) for trunk flexors, 70% (p<0.05) for the trunk extensors, 20% (p<0.05) for the knee flexors and extensors, and 75% (p<0.001) for fatigue resistance. There were no significant correlations between isokinetic parameters, FIQ, pain intensity and psychological profile.
Discussion: Muscular strength and endurance were decreased in both knee and trunk muscles in fibromyalgia patients. The relationship between muscular strength, psychological profile and disease severity is weak. This implies that separate evaluations and treatments for every single co-morbidity are imposed.
Reference: Marius Henriksen, etall. Relationships between the fibromyalgia impact questionnaire, tender Point count, and muscle strength in Female Patients With Fibromyalgia. Arthritis & Rheumatism 2009;61(6):732-39
Keywords : fibromyalgia, muscular strength, isokinetic, fatigue, Fibomyalgia impact questionnaire