1
|
Llorente-Romero S, Herrador-Colmenero M, Acosta-Manzano P, Borges-Cosic M, Gavilán-Carrera B, Latorre Román PÁ, Delgado-Fernández M, Segura-Jiménez V. Association of Moderate-to-Vigorous Physical Activity, Sedentary Time, Fat Percentage, and Physical Fitness with Gait Parameters in Women with Fibromyalgia: The Al-Ándalus Project. Biomedicines 2024; 12:829. [PMID: 38672184 PMCID: PMC11048126 DOI: 10.3390/biomedicines12040829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/23/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024] Open
Abstract
Gait impairments have been found in women with fibromyalgia, reducing the physical activity possibilities in this population and leading to a negative correlation with fibromyalgia impact. The aim of this study was to analyze the individual and independent associations of moderate-to-vigorous physical activity (MVPA), sedentary time, fat percentage, and physical fitness with gait parameters in women with fibromyalgia. A total of 84 women with fibromyalgia were included. MVPA and sedentary time were assessed with accelerometry, fat percentage with bioimpedance analysis, and physical fitness with field-based fitness tests. Gait was assessed during a "6 min walk test" and categorized in velocity, cadence, step length, step cycle duration, unipedal stance phase, and bipedal stance phase. Individual relationships were analyzed by partial correlations and independent relationships by linear regressions, adjusting by age and height. MVPA, sedentary time, fat percentage, and physical fitness were correlated with most gait parameters (rpartial between |0.842| and |0.219|; p ≤ 0.05). Physical fitness was independently associated with all gait parameters (β between |0.346| and |0.761|; p ≤ 0.002). In addition, MVPA was independently associated with velocity and step length (β = 0.241 and 0.292; both p = 0.004), and fat percentage was associated with bipedal stance phase (β = 0.242; p = 0.049). Good levels of MVPA, physical fitness, and adequate weight balance are associated with improved gait parameters in women with fibromyalgia.
Collapse
Affiliation(s)
- Sergio Llorente-Romero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain (V.S.-J.)
| | - Manuel Herrador-Colmenero
- La Inmaculada Teacher Training Centre, Sport and Health University Research Institute (iMUDS), University of Granada, 18013 Granada, Spain
| | - Pedro Acosta-Manzano
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
- Sport and Health University Research Institute (IMUDS), University of Granada, 18007 Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain
- Physical Activity for Health Promotion Research Group (PAHELP), 18071 Granada, Spain
| | - Blanca Gavilán-Carrera
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
- Departamento de Didáctica de las Lenguas, las Artes y el Deporte, Facultad de Ciencias de la Educación, Universidad de Málaga, 29010 Málaga, Spain
| | - Pedro Ángel Latorre Román
- Department of Corporal Expression, University of Jaen, Campus Las Lagunillas, s/n, 23071 Jaén, Spain
| | - Manuel Delgado-Fernández
- Physical Activity for Health Promotion Research Group (PAHELP), Sport and Health University Research Institute (IMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain (M.D.-F.)
| | - Víctor Segura-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain (V.S.-J.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cádiz, Spain
- UGC Medicina Física y Rehabilitación, Hospital Universitario Virgen de las Nieves, 18013 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| |
Collapse
|
2
|
Brígida N, Catela D, Mercê C, Branco M. Predictability and Complexity of Fine and Gross Motor Skills in Fibromyalgia Patients: A Pilot Study. Sports (Basel) 2024; 12:90. [PMID: 38668558 PMCID: PMC11053813 DOI: 10.3390/sports12040090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Fine and gross motor tasks are usually used to evaluate behavioral dysfunctions and can be applied to diseases of the central nervous system, such as fibromyalgia (FM). Non-linear measures have allowed for deeper motor control analysis, focusing on the process and on the quality of movement. Therefore, to assess uncertainty, irregularity, and structural richness of a time series, different algorithms of entropy can be computed. The aim of this study was to (i) verify the single-scale and multiscale entropy values in fine and gross motor movements and (ii) to verify whether fine and gross motor tasks are sensitive to characterizing FM patients. METHODS The sample consisted of 20 females (46.2 ± 12.8 years) divided in two groups, an experimental group with 10 FM subjects and a control group with 10 subjects without FM. Inertial sensors were used to collect the finger tapping test (FTT), walking, and sit-and-stand task data. RESULTS Regarding fine motor skills, patients with FM showed a loss of structural richness (complexity), but they had information processing with greater control in the FTT, probably to simplify task execution and for correction of the movement. On the other hand, people without FM seemed to have more automatic control of the movement when performed with the preferred hand and exhibited similar difficulties to the FM group when performed with the non-preferred hand. Gross motor tasks showed similar entropy values for both groups. CONCLUSIONS The results show that FM patients have movement controls primarily at the level of the motor cortex, whereas people without FM perform movement at the medullary level, especially in fine motor tasks, indicating that the FTT is sensitive to the presence of FM, especially when performed with the preferred hand.
Collapse
Affiliation(s)
- Nancy Brígida
- ESDRM Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal; (D.C.); (C.M.); (M.B.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, Centro de Investigação e Inovação em Desporto Atividade Física e Saúde, 2001-904 Santarém, Portugal
- Educação e Treino, Centro de Investigação em Qualidade de Vida (CIEQV), Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Psicologia Aplicada, Unidade de Investigação do Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
| | - David Catela
- ESDRM Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal; (D.C.); (C.M.); (M.B.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, Centro de Investigação e Inovação em Desporto Atividade Física e Saúde, 2001-904 Santarém, Portugal
- Educação e Treino, Centro de Investigação em Qualidade de Vida (CIEQV), Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Psicologia Aplicada, Unidade de Investigação do Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
| | - Cristiana Mercê
- ESDRM Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal; (D.C.); (C.M.); (M.B.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, Centro de Investigação e Inovação em Desporto Atividade Física e Saúde, 2001-904 Santarém, Portugal
- Educação e Treino, Centro de Investigação em Qualidade de Vida (CIEQV), Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Psicologia Aplicada, Unidade de Investigação do Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, 1499-002 Lisboa, Portugal
| | - Marco Branco
- ESDRM Escola Superior de Desporto de Rio Maior, Instituto Politécnico de Santarém, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal; (D.C.); (C.M.); (M.B.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, Centro de Investigação e Inovação em Desporto Atividade Física e Saúde, 2001-904 Santarém, Portugal
- Educação e Treino, Centro de Investigação em Qualidade de Vida (CIEQV), Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Psicologia Aplicada, Unidade de Investigação do Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, 1499-002 Lisboa, Portugal
| |
Collapse
|
3
|
Augière T, Simoneau M, Brun C, Pinard AM, Blouin J, Mouchnino L, Mercier C. Behavioral and Electrocortical Response to a Sensorimotor Conflict in Individuals with Fibromyalgia. Brain Sci 2023; 13:931. [PMID: 37371409 DOI: 10.3390/brainsci13060931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
People with fibromyalgia have been shown to experience more somatosensory disturbances than pain-free controls during sensorimotor conflicts (i.e., incongruence between visual and somatosensory feedback). Sensorimotor conflicts are known to disturb the integration of sensory information. This study aimed to assess the cerebral response and motor performance during a sensorimotor conflict in people with fibromyalgia. Twenty participants with fibromyalgia and twenty-three pain-free controls performed a drawing task including visual feedback that was either congruent with actual movement (and thus with somatosensory information) or incongruent with actual movement (i.e., conflict). Motor performance was measured according to tracing error, and electrocortical activity was recorded using electroencephalography. Motor performance was degraded during conflict for all participants but did not differ between groups. Time-frequency analysis showed that the conflict was associated with an increase in theta power (4-8 Hz) at conflict onset over the left posterior parietal cortex in participants with fibromyalgia but not in controls. This increase in theta suggests a stronger detection of conflict in participants with fibromyalgia, which was not accompanied by differences in motor performance in comparison to controls. This points to dissociation in individuals with fibromyalgia between an altered perception of action and a seemingly unaltered control of action.
Collapse
Affiliation(s)
- Tania Augière
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Martin Simoneau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
| | - Anne Marie Pinard
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Jean Blouin
- Laboratoire de Neurosciences Cognitives, Aix-Marseille University, National Center for Scientific Research (CNRS), 13331 Marseille, France
| | - Laurence Mouchnino
- Laboratoire de Neurosciences Cognitives, Aix-Marseille University, National Center for Scientific Research (CNRS), 13331 Marseille, France
- Institut Universitaire de France, 75005 Paris, France
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| |
Collapse
|
4
|
Increased temporal stride variability contributes to impaired gait coordination after stroke. Sci Rep 2022; 12:12679. [PMID: 35879393 PMCID: PMC9314431 DOI: 10.1038/s41598-022-17017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/19/2022] [Indexed: 11/08/2022] Open
Abstract
Heightened motor variability is a prominent impairment after stroke. During walking, stroke survivors show increased spatial and temporal variability; however, the functional implications of increased gait variability are not well understood. Here, we determine the effect of gait variability on the coordination between lower limbs during overground walking in stroke survivors. Ambulatory stroke survivors and controls walked at a preferred pace. We measured stride length and stride time variability, and accuracy and consistency of anti-phase gait coordination with phase coordination index (PCI). Stroke survivors showed increased stride length variability, stride time variability, and PCI compared with controls. Stride time variability but not stride length variability predicted 43% of the variance in PCI in the stroke group. Stride time variability emerged as a significant predictor of error and consistency of phase. Despite impaired spatial and temporal gait variability following stroke, increased temporal variability contributes to disrupted accuracy and consistency of gait coordination. We provide novel evidence that decline in gait coordination after stroke is associated with exacerbated stride time variability, but not stride length variability. Temporal gait variability may be a robust indicator of the decline in locomotor function and an ideal target for motor interventions that promote stable walking after stroke.
Collapse
|
5
|
Carrasco-Vega E, Ruiz-Muñoz M, Cuesta-Vargas A, Romero-Galisteo RP, González-Sánchez M. Individuals with fibromyalgia have a different gait pattern and a reduced walk functional capacity: a systematic review with meta-analysis. PeerJ 2022; 10:e12908. [PMID: 35341042 PMCID: PMC8944336 DOI: 10.7717/peerj.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/18/2022] [Indexed: 01/11/2023] Open
Abstract
Background The aim of the present study was to perform a systematic review and meta-analysis comparing walking test performance and gait pattern between individuals with and without fibromyalgia (FM). Methodology This systematic review was registered in PROSPERO with the following reference: CRD42018116200.The search for the scientific articles in this systematic review was carried out using the MEDLINE, SCOPUS, PEDRO, CINHAL and WEB OF SCIENCE databases. A combination of three conceptual groups of terms was used: (1) fibromyalgia; (2) walk (performance) tests; and (3) gait analysis. The included articles were analyzed for both functional and pattern of walking data of patients with FM. In order to provide a better estimate of the difference between individuals with and without FM on gait, a meta-analysis was performed on the 6MWT (6-minute walk test). Results Thirty-six studies were analyzed, with a total population of 4.078 participants (3.369 FM and 709 individuals without FM). From a functional point of view, the 6MWT distance covered by the group of individuals without FM was significantly greater than that of the individuals with FM in all the analyzed studies. In addition, when comparing the results obtained in the gait pattern analysis, it was observed that individuals with FM walked slower, with a shorter stride length and lower cadence compare to individuals without FM. Conclusions It is possible to affirm that individuals with FM perform walking tests differently than individuals without FM. It was observed that individuals with FM walk performing a cycle of shorter length and lower frequency, producing a slower gait, which results in a shorter distance traveled, in the same period of time, with respect to healthy subjects.
Collapse
Affiliation(s)
- Elio Carrasco-Vega
- Department of Physiotherapy, Faculty of Health Sciences, Universidad de Málaga, Malaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), Malaga, Spain
| | - María Ruiz-Muñoz
- Institute of Biomedicine of Málaga (IBIMA), Malaga, Spain
- Department of Nursing and Podiatry, Faculty of Health Sciences,, Universidad de Málaga, Malaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Sciences, Universidad de Málaga, Malaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), Malaga, Spain
- School of Clinical Science, Faculty of Health Science,, Queensland University Technology, Brisbane, Australia
| | - Rita Pilar Romero-Galisteo
- Department of Physiotherapy, Faculty of Health Sciences, Universidad de Málaga, Malaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), Malaga, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, Universidad de Málaga, Malaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), Malaga, Spain
| |
Collapse
|
6
|
Ma R, Zhào H, Wei W, Liu Y, Huang Y. Gait characteristics under single-/dual-task walking conditions in elderly patients with cerebral small vessel disease: Analysis of gait variability, gait asymmetry and bilateral coordination of gait. Gait Posture 2022; 92:65-70. [PMID: 34826695 DOI: 10.1016/j.gaitpost.2021.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/16/2021] [Accepted: 11/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dual-task walking (DTW) is common in daily life and represents an ideal paradigm for elucidating gait irregularity. Under single-task walking (STW) and DTW conditions, the symmetric and bilaterally coordinated human gait pattern found in healthy individuals is absent in individuals with neurological ailments such as Parkinson's disease, Alzheimer's disease and post-stroke issues. Cerebral small vessel disease (CSVD) is a neuropathological and radiological issue that has been reported to be associated with cognitive and motor disorders. However, few gait analyses have focused on elderly individuals with CSVD under DTW conditions. RESEARCH QUESTION Are parameters of gait analysis helpful in elucidating gait abnormalities in elderly patients with CSVD under DTW conditions? METHODS A total of 46 elderly patients with CSVD (CSVD group) and 22 healthy, age-matched individuals (HE group) were recruited. Gait data were collected from both groups under STW and DTW conditions. Direct parameters and metrics reflecting gait variability, gait asymmetry, and bilateral coordination of gait in the two groups were compared. RESULTS Under STW conditions, elderly individuals with CSVD showed markedly shorter stride length, were slower, and had higher gait asymmetry (GA) and phase coordination index (PCI) than healthy controls after adjusting for age, sex and level of education. Under DTW conditions, there were statistically significant differences between the two groups in stride time, stride length, cadence, stride time variability, GA and PCI after adjusting for age, sex, and level of education. SIGNIFICANCE Reanalysis-generated parameters, such as gait variability, GA, and PCI, are biomarkers for gait dysfunction in elderly patients with CSVD. In this study, elderly individuals with CVSD showed abnormal gait features under both STW and DTW conditions.
Collapse
Affiliation(s)
- Rui Ma
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China; Department of Neurology, Emergency General Hospital, Beijing, 100028, China.
| | - Hóngyi Zhào
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China; Department of Neurology, NO 984 Hospital of PLA, Beijing, 100094, China.
| | - Wei Wei
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China.
| | - Yu Liu
- Department of Neurology, NO 984 Hospital of PLA, Beijing, 100094, China.
| | - Yonghua Huang
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China.
| |
Collapse
|
7
|
Ardalan A, Yamane N, Rao AK, Montes J, Goldman S. Analysis of gait synchrony and balance in neurodevelopmental disorders using computer vision techniques. Health Informatics J 2022; 27:14604582211055650. [PMID: 34989252 DOI: 10.1177/14604582211055650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gait tasks are commonly administered during motor assessments of children with neurodevelopmental disorders (NDDs). Gait analyses are often conducted in laboratory settings using costly and cumbersome experiments. In this paper, we propose a computational pipeline using computer vision techniques as an ecological and precise method to quantify gait in children with NDDs with challenging behaviors. We analyzed videos of 15 probands (PB) and 12 typically developing (TD) siblings, engaged in a preferred-pace walking task, using pose estimation software to track points of interest on their bodies over time. Analyzing the extracted information revealed that PB children had significantly less whole-body gait synchrony and poorer balance compared to their TD siblings. Our work offers a cost-effective method while preserving the validity of its results. This remote approach increases access to more diverse and distant cohorts and thus lowers barriers to research participation, further enriching our understanding of motor outcomes in NDDs.
Collapse
Affiliation(s)
- Adel Ardalan
- Zuckerman Mind Brain Behavior Institute, 538196Columbia University, New York, NY, USA
| | - Natasha Yamane
- Department of Neurology, 21611Columbia University Irving Medical Center, New York, NY, USA
| | - Ashwini K Rao
- Department of Neurology, Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, 21611Columbia University Irving Medical Center, New York, NY, USA
| | - Jacqueline Montes
- Department of Neurology, Division of Child Neurology, Department of Rehabilitation and Regenerative Medicine, Programs in Physical Therapy, Columbia, 21611University Irving Medical Center, New York, NY, USA
| | - Sylvie Goldman
- Department of Neurology, Division of Child Neurology and Cognitive Neuroscience, 21611Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
8
|
Validity and Reliability of a Smartphone App for Gait and Balance Assessment. SENSORS 2021; 22:s22010124. [PMID: 35009667 PMCID: PMC8747233 DOI: 10.3390/s22010124] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/28/2022]
Abstract
Advances in technology provide an opportunity to enhance the accuracy of gait and balance assessment, improving the diagnosis and rehabilitation processes for people with acute or chronic health conditions. This study investigated the validity and reliability of a smartphone-based application to measure postural stability and spatiotemporal aspects of gait during four static balance and two gait tasks. Thirty healthy participants (aged 20–69 years) performed the following tasks: (1) standing on a firm surface with eyes opened, (2) standing on a firm surface with eyes closed, (3) standing on a compliant surface with eyes open, (4) standing on a compliant surface with eyes closed, (5) walking in a straight line, and (6) walking in a straight line while turning their head from side to side. During these tasks, the app quantified the participants’ postural stability and spatiotemporal gait parameters. The concurrent validity of the smartphone app with respect to a 3D motion capture system was evaluated using partial Pearson’s correlations (rp) and limits of the agreement (LoA%). The within-session test–retest reliability over three repeated measures was assessed with the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). One-way repeated measures analyses of variance (ANOVAs) were used to evaluate responsiveness to differences across tasks and repetitions. Periodicity index, step length, step time, and walking speed during the gait tasks and postural stability outcomes during the static tasks showed moderate-to-excellent validity (0.55 ≤ rp ≤ 0.98; 3% ≤ LoA% ≤ 12%) and reliability scores (0.52 ≤ ICC ≤ 0.92; 1% ≤ SEM% ≤ 6%) when the repetition effect was removed. Conversely, step variability and asymmetry parameters during both gait tasks generally showed poor validity and reliability except step length asymmetry, which showed moderate reliability (0.53 ≤ ICC ≤ 0.62) in both tasks when the repetition effect was removed. Postural stability and spatiotemporal gait parameters were found responsive (p < 0.05) to differences across tasks and test repetitions. Along with sound clinical judgement, the app can potentially be used in clinical practice to detect gait and balance impairments and track the effectiveness of rehabilitation programs. Further evaluation and refinement of the app in people with significant gait and balance deficits is needed.
Collapse
|
9
|
Augière T, Desjardins A, Paquette Raynard E, Brun C, Pinard AM, Simoneau M, Mercier C. Tactile Detection in Fibromyalgia: A Systematic Review and a Meta-Analysis. FRONTIERS IN PAIN RESEARCH 2021; 2:740897. [PMID: 35295451 PMCID: PMC8915638 DOI: 10.3389/fpain.2021.740897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Fibromyalgia is a chronic pain syndrome characterized by sensorimotor deficits and distortions of body representation, that could both be caused by alterations in sensory processing. Several studies suggest a hypersensitivity to various sensory stimulations in fibromyalgia but results on detection of both noxious and non-noxious tactile stimulation, which are particularly relevant for body representation and motor control, remain conflicting. Therefore, the aim of this study is to systematically review and quantify the detection thresholds to noxious and non-noxious tactile stimuli in individuals with fibromyalgia compared to pain-free controls. A systematic review and a meta-analysis were performed in the MEDLINE, EMBASE, CINAHL, Cochrane, PsycInfo and Web of Science databases using keywords related to fibromyalgia, tactile pain detection threshold, tactile detection threshold and quantitative sensory testing. Nineteen studies were included in the review, with 12 in the meta-analysis. Despite the heterogeneity of the results, the data from both the review and from the meta-analysis suggest a trend toward hyperalgesia and no difference of sensitivity to non-noxious tactile stimuli in participants with fibromyalgia compared to healthy controls. This contradicts the hypothesis of a general increase in responsiveness of the central nervous system to noxious and non-noxious stimulations in fibromyalgia. This study shows no alteration of the sensitivity to non-noxious tactile stimulation in fibromyalgia, suggesting that an altered unimodal processing is not sufficient to explain symptoms such as sensorimotor impairments and body representation distortions. Future research should investigate whether alterations in multisensory integration could contribute to these symptoms.
Collapse
Affiliation(s)
- Tania Augière
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Audrey Desjardins
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | | | - Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
| | - Anne Marie Pinard
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Martin Simoneau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| |
Collapse
|
10
|
Radunović G, Veličković Z, Rašić M, Janjić S, Marković V, Radovanović S. Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study. Adv Rheumatol 2021; 61:53. [PMID: 34446109 DOI: 10.1186/s42358-021-00212-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients' functional status and presence or absence of clinical symptoms associated with FM. METHODS Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. RESULTS The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. CONCLUSIONS Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups.
Collapse
Affiliation(s)
- Goran Radunović
- Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Resavska 69, Belgrade, Serbia
| | - Zoran Veličković
- Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Resavska 69, Belgrade, Serbia
| | - Melanija Rašić
- Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Resavska 69, Belgrade, Serbia
| | - Saša Janjić
- Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Resavska 69, Belgrade, Serbia
| | - Vladana Marković
- Neurology Clinic, Faculty of Medicine, University of Belgrade, Dr Subotića 6, Belgrade, Serbia
| | - Saša Radovanović
- Institute for Medical Research, University of Belgrade, Dr Subotića 4, 11129, Belgrade, Serbia.
| |
Collapse
|
11
|
The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson's disease using inertial sensor. NPJ PARKINSONS DISEASE 2021; 7:42. [PMID: 33990608 PMCID: PMC8121791 DOI: 10.1038/s41531-021-00186-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/17/2021] [Indexed: 11/09/2022]
Abstract
This study aimed to evaluate the effect of levodopa on the phase coordination index (PCI) and gait asymmetry (GA) of patients with Parkinson's disease (PD) and to investigate correlations between the severity of motor symptoms and gait parameters measured using an inertial sensor. Twenty-six patients with mild-to-moderate-stage PD who were taking levodopa participated in this study. The Unified Parkinson's Disease Rating Scale part III (UPDRS III) was used to assess the severity of motor impairment. The Postural Instability and Gait Difficulty (PIGD) subscore was calculated from UPDRS III. Patients were assessed while walking a 20-m corridor in both "OFF" and "ON" levodopa medication states, and gait analysis was performed using inertial sensors. We investigated the changes in gait parameters after taking levodopa and the correlations between UPDRS III, PIGD, and gait parameters. There was a significant improvement in PCI after taking levodopa. No significant effect of levodopa on GA was found. In "OFF" state, PCI and GA were not correlated with UPDRS III and PIGD. However, in "ON" state, PCI was the only gait parameter correlating with UPDRS III, and it was also highly correlated with PIGD compared to other gait parameters. Significant improvement in bilateral-phase coordination was identified in patients with PD after taking levodopa, without significant change in gait symmetricity. Considering the high correlation with UDPRS III and PIGD in "ON" states, PCI may be a useful and quantitative parameter to measure the severity of motor symptoms in PD patients who are on medication.
Collapse
|
12
|
Fujiwara S, Sato S, Sugawara A, Nishikawa Y, Koji T, Nishimura Y, Ogasawara K. The Coefficient of Variation of Step Time Can Overestimate Gait Abnormality: Test-Retest Reliability of Gait-Related Parameters Obtained with a Tri-Axial Accelerometer in Healthy Subjects. SENSORS 2020; 20:s20030577. [PMID: 31972959 PMCID: PMC7036754 DOI: 10.3390/s20030577] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/18/2019] [Accepted: 01/16/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate whether variation in gait-related parameters among healthy participants could help detect gait abnormalities. In total, 36 participants (21 men, 15 women; mean age, 35.7 ± 9.9 years) performed a 10-m walk six times while wearing a tri-axial accelerometer fixed at the L3 level. A second walk was performed ≥1 month after the first (mean interval, 49.6 ± 7.6 days). From each 10-m data set, the following nine gait-related parameters were automatically calculated: assessment time, number of steps, stride time, cadence, ground force reaction, step time, coefficient of variation (CV) of step time, velocity, and step length. Six repeated measurement values were averaged for each gait parameter. In addition, for each gait parameter, the difference between the first and second assessments was statistically examined, and the intraclass correlation coefficient (ICC) was calculated with the level of significance set at p < 0.05. Only the CV of step time showed a significant difference between the first and second assessments (p = 0.0188). The CV of step time also showed the lowest ICC, at <0.50 (0.425), among all parameters. Test-retest results of gait assessment using a tri-axial accelerometer showed sufficient reproducibility in terms of the clinical evaluation of all parameters except the CV of step time.
Collapse
Affiliation(s)
- Shunrou Fujiwara
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
- Institute for Open and Transdisciplinary Research Initiative, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
- Correspondence: ; Tel.: +81-19-651-5111
| | - Shinpei Sato
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
| | - Atsushi Sugawara
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
| | - Yasumasa Nishikawa
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
| | - Takahiro Koji
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan;
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Iwate 028-3695, Japan; (S.S.); (A.S.); (Y.N.); (T.K.); (K.O.)
| |
Collapse
|
13
|
Han SH, Kim CO, Kim KJ, Jeon J, Chang H, Kim ES, Park H. Quantitative analysis of the bilateral coordination and gait asymmetry using inertial measurement unit-based gait analysis. PLoS One 2019; 14:e0222913. [PMID: 31574130 PMCID: PMC6771998 DOI: 10.1371/journal.pone.0222913] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 09/10/2019] [Indexed: 11/18/2022] Open
Abstract
Inertial measurement unit (IMU)-based gait analysis can be used to quantitatively analyze the bilateral coordination and gait asymmetry (GA). The purpose of this study was to investigate changes in bilateral coordination and GA due to gait speed using an IMU based gait analysis and identify spatiotemporal factors affecting bilateral coordination and GA. Eighty healthy adults (40 men and 40 women) participated in the study. The mean age was 26.2 years, and the mean body mass index was 22.8 kg/m2. Three different walking speeds (80%, 100%, and 120% of preferred walking speed) on a treadmill were applied for 1 min of continuous level walking using a shoe-type IMU-based gait analysis system. The phase coordination index (PCI) and GA were calculated on three different walking speeds. Several variables (gait speed, height, body mass index, cadence, and step length) were analyzed as possible factors affecting the PCI and GA. Bilateral coordination and GA improved during fast walking (p = 0.005 and p = 0.019, respectively) and deteriorated during slow walking (p<0.001 and p = 0.008, respectively), compared with the participants' preferred walking speeds. The correlation analysis revealed that PCI was negatively correlated with step length at each walking condition and lower gait speed was negatively correlated with PCI and GA during slow walking. Both bilateral coordination and GA had a negative linear relationship with gait speed, showing an improvement in the fast walking condition and deterioration in the slow walking condition. Step length was the factor associated with the change in the bilateral coordination.
Collapse
Affiliation(s)
- Seung Hwan Han
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeanhong Jeon
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hsienhao Chang
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seo Kim
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hoon Park
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
14
|
Relation between the amount of daily activity and gait quality in transfemoral amputees. Int J Rehabil Res 2019; 42:139-144. [DOI: 10.1097/mrr.0000000000000337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Empirical Grouping of Pain Zones in Fibromyalgia: A Preliminary Study. Clin J Pain 2019; 35:611-617. [PMID: 30994512 DOI: 10.1097/ajp.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Widespread pain is important for the diagnosis of fibromyalgia (FM). For this purpose, the sum of pain regions obtained from a topographical distribution has been used to compute a Widespread Pain Index (WPI), but there is no empirical basis for choosing the regions. The aim of this study was to find an empirical distribution of the pain regions. MATERIALS AND METHODS We evaluated 228 female patients with FM. They completed the Fibromyalgia Survey Questionnaire, Fibromyalgia Impact Questionnaire (FIQ), Combined Index of Severity in Fibromyalgia (ICAF), and Short Form-36 Health Survey. The pain regions of the WPI were grouped by the topographical distribution (WPIR) and compared with a new empirical distribution (WPIE) obtained through exploratory factor analysis. A decision- tree analysis was conducted to identify the optimal algorithm for selecting pain regions related to the severity of FM. RESULTS The WPIE has a normal distribution compared with the WPIR. It also shows higher correlations with FM severity. From the factor analysis, 4 factors explain 48.5% of the variance. Two factors (emotional and physical) can conform to the decision-tree analysis using the dependent variables FIQ and ICAF. These factors are very congruent with the cutoff points previously proposed for FIQ and ICAF. The emotional factor is the first in the decision-tree. DISCUSSION WPIE has a normal distribution and shows better predictive qualities than WPIR. The emotional factor is conceptualized as emotional because of the relative importance of the right hemisphere in negative emotions and pain. The physical factor could be responsible for the decreased ability to coordinate left-right stepping.
Collapse
|
16
|
Castagneri C, Agostini V, Rosati S, Balestra G, Knaflitz M. Asymmetry Index in Muscle Activations. IEEE Trans Neural Syst Rehabil Eng 2019; 27:772-779. [PMID: 30843847 DOI: 10.1109/tnsre.2019.2903687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns. The aim of this paper is to define a robust index to quantitatively assess the asymmetry of muscle activations during locomotion, based on the extraction of the principal activations. SEMG signals were analyzed combining statistical gait analysis (SGA) and a clustering algorithm that allows for obtaining the muscle principal activations. We evaluated the asymmetry levels of four lower limb muscles in: (1) healthy subjects of different ages (children, adults, and elderly); (2) different populations of orthopedic patients (adults with megaprosthesis of the knee after bone tumor resection, elderly subjects after total knee arthroplasty, and elderly subjects after total hip arthroplasty); and (3) neurological patients (children with hemiplegic cerebral palsy and elderly subjects affected by idiopathic normal pressure hydrocephalus). The asymmetry index obtained for each pathological population was then compared to that of age-matched controls. We found asymmetry levels consistent with the expected impact of the different pathologies on muscle activation during gait. This suggests that the proposed index can be successfully used in clinics for an objective assessment of the muscle activation asymmetry during locomotion.
Collapse
|
17
|
Gender differences in patients with fibromyalgia: a gait analysis. Clin Rheumatol 2018; 38:513-522. [PMID: 30242637 DOI: 10.1007/s10067-018-4293-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/15/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022]
Abstract
This study analysed the spatio-temporal parameters, asymmetry, variability and bilateral coordination of gait in women and men with fibromyalgia and healthy subjects walking at their usual velocity and at a faster walking velocity. Fifty-five women and 12 men with fibromyalgia were analysed. A healthy group of 44 women and 17 men was analysed as the control group. A GAITRite system was used to obtain the spatio-temporal gait parameters for the participants when walking at their usual velocity and at a faster velocity. Coefficients of variation, bilateral coordination and gait asymmetry indexes were calculated. All groups exhibited a significant increase (p < 0.001) in spatio-temporal parameters when walking fast. The fibromyalgia groups showed increased bilateral coordination, asymmetry and variability of stance phase when walking fast. The fibromyalgia women showed significant spatio-temporal, variability and bilateral coordination of gait differences compared with the healthy women. The fibromyalgia men reported significant differences in velocity, cadence, stride length, swing time variability and stance gait asymmetry indices compared with the healthy men. No significant differences were observed between the men and women in the fibromyalgia groups. The findings of the present study did not support gender-specific differences in walking variables and indices in FM patients. The differences found between both genders of FM patients and healthy subjects in walking indices at fast velocities could be a useful tool for diagnoses and evaluation of male and female patients with FM during short-term fast walking tests.
Collapse
|
18
|
Bordoni B, Marelli F, Morabito B, Cavallaro F, Lintonbon D. Fascial preadipocytes: another missing piece of the puzzle to understand fibromyalgia? Open Access Rheumatol 2018; 10:27-32. [PMID: 29750060 PMCID: PMC5935082 DOI: 10.2147/oarrr.s155919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Fibromyalgia (FM) syndrome is a chronic condition causing pain, affecting approximately 0.5%-6% of the developed countries' population, and on average, 2% of the worldwide population. Despite the large amount of scientific literature available, the FM etiology is still uncertain. The diagnosis is based on the clinical presentation and the severity of the symptomatology. Several studies pointed out pathological alterations within the central nervous system, suggesting that FM could originate from a central sensitization of the pain processing centers. Research supports the thesis of a peripheral neuropathic component, with the finding of axonal damages. The fibromyalgia patient has many myofascial system abnormalities, such as pain and fatigue, impairing the symptomatic profile. This paper revises the myopathic compensations, highlighting the possible role of the fascia in generating symptoms, being aware of the new information about the fascia's activity in stimulating inflammation and fat cell production.
Collapse
Affiliation(s)
- Bruno Bordoni
- Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific, Milan, Italy
| | - Fabiola Marelli
- CRESO, School of Osteopathic Center for Research and Studies, Department of Fascial Osteopathic Research: FORe, Gorla Minore, Italy
- CRESO, School of Osteopathic Center for Research and Studies, Department of Fascial Osteopathic Research, Fano, Italy
| | - Bruno Morabito
- CRESO, School of Osteopathic Center for Research and Studies, Department of Fascial Osteopathic Research: FORe, Gorla Minore, Italy
- CRESO, School of Osteopathic Center for Research and Studies, Department of Fascial Osteopathic Research, Fano, Italy
- Sapienza University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences, Rome, Italy
| | | | - David Lintonbon
- London School of Osteopathy, Department of Osteopathic Technique, London, UK
| |
Collapse
|
19
|
Cohen H. Controversies and challenges in fibromyalgia: a review and a proposal. Ther Adv Musculoskelet Dis 2017; 9:115-127. [PMID: 28458723 DOI: 10.1177/1759720x17699199] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 02/04/2017] [Indexed: 12/13/2022] Open
Abstract
Fibromyalgia (FM) is the most commonly encountered chronic widespread pain (CWP) condition in rheumatology. In comparison to inflammatory arthritis (IA), it can seem ill defined with no clear understanding of the pathology and therefore no specific targeted treatment. This inevitably raises controversies and challenges. However, this is an outdated view perpetuated by poor teaching of pain at undergraduate and postgraduate levels, and the perennial problem of advances in relevant cross-speciality knowledge penetrating speciality silos. Research has provided a better understanding of the aetiopathology and FM is now regarded as a centralized pain state. Effective treatment is possible utilizing a multidisciplinary approach combining nonpharmacologic and pharmacologic treatments rooted in a biopsychosocial model. This article will provide a review of the mechanisms, diagnosis and treatment of FM, focus on some ongoing contentious issues and propose a change to the diagnostic terminology.
Collapse
Affiliation(s)
- Helen Cohen
- Royal National Orthopaedic Hospital, Stanmore, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| |
Collapse
|