Impact of cognitive tasks on biomechanical and kinematic parameters of gait in women with fibromyalgia: A cross-sectional study

Construct validity of the Mini-BESTest in individuals with chronic pain in specialized pain care

BACKGROUND

Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population. The purpose of this study was to evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care.

METHODS

In this cross-sectional study, 180 individuals with chronic pain (> 3 months) were assessed with the Mini-BESTest and included in the analyses. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. In addition, we tested the a priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW). Internal consistency was evaluated for the model with the best fit.

RESULTS

A one-factor model with added covariance via the modification indices showed adequate fit indices. In line with our hypotheses, Mini-BESTest showed convergent validity (r_s = > 0.70) with the 10-meter walk test, and divergent validity (r_s = < 0.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92).

CONCLUSIONS

Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain, who were referred to specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain. However, further studies are necessary to establish the reliability of the Mini-BESTest in the population.

Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome

Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.

Comparison between the Impacts of Memory and Arithmetic-Based Dual Tasks on Physical Performance in Women with Fibromyalgia

Background: Fibromyalgia symptoms have a significant impact on the ability to perform activities of daily living. These activities require the ability to perform two or more tasks at the same time, which is known as a dual task. Purpose: To analyze physical and cognitive performance differences between memory and arithmetic dual tasks. Methods: Twenty-five women with fibromyalgia participated in this study. Participants performed three physical tests (back scratch, arm curl, and 10-step stair) as a single task and under two types of dual task (memory and arithmetic). Results: Differences between the single and dual tasks were observed in the back scratch and the 10-step stair tests using the arithmetic dual-task. Significant differences were only observed for the memory dual-task in the 10-step stair test. In addition, the performance in the back scratch and in the 10-step stair was significantly lower under the arithmetic compared to the memory-based dual task. Furthermore, a significant difference between these two types of dual task was obtained in the dual-task cost of 10-step stair. Regarding cognitive performance, a significantly lower percentage of correct responses was found in the AbDT compared to the MbDT in the 10-step stair test. Conclusions: the AbDT could have a higher impact on physical performance than the MbDT during the back scratch and the 10-step stair tests. The characteristics of the sample, environment, complexity of the motor task, and difficulty of the simultaneous cognitive task may also be relevant for understanding the differences in dual-task interference.

[Bibliometric analysis of the thematic evolution in fibromyalgia and biomechanics (1985-2021)]

The main objective of the study is to analyse the scientific evolution of the research field of fibromyalgia and biomechanics. A search was carried out in Web of Science, from 1985 to 2021. With those results, a bibliometric map of keywords was created with VOSviewer. On top of that, scientific mapping and performance analysis were also conducted using SciMAT. A total of 233 articles from around the world were analysed, highlighting the production of the USA and Spain. The results show great diversity in topics with 54 different topics and 33 keywords. Although most of the topics found are not widely developed except the topics of physical activity and symptomatology. In conclusion, the study of fibromyalgia and biomechanics has generally grown over time.

Individuals with fibromyalgia have a different gait pattern and a reduced walk functional capacity: a systematic review with meta-analysis

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.

Effects of 6-Month Square Stepping Exercise Intervention on Physical and Cognitive Competence, Regucalcin, and Body Composition in Older People: Study Protocol for a Randomised Control Trial

Background: Age-related changes negatively affect physical fitness, body composition, and executive function and produce a decrease in regucalcin level expression in blood. The square-stepping exercise (SSE) is a balance and lower-limb strength training programme used to prevent falls and stimulate cognitive function in older adults. This project aims to analyse the effects of SSE on executive function, regucalcin expression, fall prevention, body composition, and physical fitness in people over 65 years old. Methods: A randomized controlled trial will be conducted. A total of 90 older people over 65 years old will be recruited and randomly assigned to 2 groups: experimental (n = 45) and control (n = 45). The experimental group will perform an SSE-based intervention for 6 months (2 times per week), while the control group do not follow any treatment. Results: The main outcome will be balance, but other motor (body mass index, upper- and lower-limb strength, flexibility, and speed-agility) and cognitive variables (executive functions and attention) will be assessed. The expression of regucalcin levels will also be evaluated. Therefore, this project aims to analyse the effect of a 6-month SSE intervention on cognitive and motor competence, physical fitness, regucalcin levels, fall risk, and body composition in older people. If the intervention proves to be effective, it could be implemented in centres, entities, and associations specialized in elderly care.

Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study

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.