Fibromyalgia and gait pattern

Admin2 · Oct 19, 2005

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From Gait and Posture

Most individuals can use different movement and muscle recruitment patterns to perform a stated task but often only one pattern is selected which optimizes an unknown global objective given the individual's neuromusculoskeletal characteristics. Patients with fibromyalgia syndrome (FS), characterized by their chronic pain, reduced physical work capacity and muscular fatigue, could exhibit a different control signature compared to asymptomatic control volunteers (CV). To test this proposal, 22 women with FS, and 11 CV, were assessed in a gait analysis laboratory. Each subject walked repeatedly at self-selected slow, comfortable, and fast walking speeds. The gait analysis provided, for each walk, each subject's stride time, length, and velocity, and ground reaction force, and lower extremity joint kinematics, moments and powers. The data were then anthropometrically scaled and velocity normalized to reduce the influence of subject mass, leg length, and walking speed on the measured gait outcomes. Similarities and differences in the two groups’ scaled and normalized gait patterns were then determined. Results show that FS and CV walk with externally similar stride lengths, times, and velocities, and joint angles and ground reaction forces but they use internally different muscle recruitment patterns. Specifically, FS preferentially power gait using their hip flexors instead of their ankle plantarflexors. Interestingly, CV use a similar muscle fatiguing recruitment pattern to walk fast which parallels the common complaint of fatigue reported by FS walking at comfortable speed.
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Jaimee Brent · Mar 16, 2013

Due to this, wouldn't it be logical that foot orthoses, even a basic device would be effective in fibromyalgia treatment by increasing probrioception and hence possibly increase the use of ankle plantar flexors and decreasing the need for hip joint over use?
This also seems to link with the concept that tai chi assists in decreasing fibro pain over the long term...as tai chi also naturally increases proprioceptive responses in the body...
ANy thoughts???

NewsBot · Jan 13, 2016

Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia
J. Heredia-Jimenez, PhD, E. Orantes-Gonzalez, PhD Student, V.M. Soto-Hermoso, PhD
Gait and Posture; Article in Press

Highlights
•Gait variability, bilateral coordination, and asymmetry were analyzed in fibromyalgia women.
•Gait was characterized by its variability and reflected fibromyalgia's gait coordination.
•The fibromyalgia group showed more gait asymmetry when walking quickly.
•The variability and the bilateral coordination could complement the evaluation of fibromyalgia symptoms.
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Purpose
To analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds.

Methods
65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed.

Results
FM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p = 0.04; p < 0.001), CV_SwingTime (p < 0.001; p < 0.001), CV_StepWidth (p = 0.004; p < 0.001), phase coordination index (p = 0.01; p = 0.03), and p_CV (p < 0.001; p = 0.001) than the control group, walking at comfortable or fast speeds. Gait asymmetry only showed significant differences in the fast condition.

Conclusion
FM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients.
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NewsBot · Jan 30, 2016

The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program
Dan Vaughn et al
Journal of Bodywork and Movement Therapies; Article in Press

Purpose
The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program.

Participants
Patients between the ages of 18 – 65 with the medical diagnosis of FM.

Methods
Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises.

Outcome Measures
The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL).

Results
Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant.

Conclusions
This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening
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NewsBot · Jul 23, 2016

TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia
Omid Rasouli et al
Gait and Posture; Article in Press

Highlights
•Fibromyalgia and chronic fatigue syndrome showed a lower level of postural control in gait initiation.
•There was no significant difference between fibromyalgia and chronic fatigue syndrome in dynamic postural control.
•Fibromyalgia patients showed a higher K value compared to the controls.
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Background
Impaired postural control has been reported in static conditions in chronic fatigue syndrome and fibromyalgia, but postural control in dynamic tasks have not yet been investigated. Thus, we investigated measurements from a force plate to evaluate dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia compared to matched healthy controls.

Methods
Thirty female participants (10 per group) performed five trials of gait initiation. Center of pressure (CoP) trajectory of the initial weight shift onto the supporting foot in the mediolateral direction (CoPX) was analyzed using General Tau Theory. We investigated the hypothesis that tau of the CoPX motion-gap (τCoPx) is coupled onto an intrinsic tauG-guide (τG) by keeping the relation τCoPx = KτG, where K is a scaling factor that determines the relevant kinematics of a movement.

Findings
Mean K values were 0.57, 0.55, and 0.50 in fibromyalgia, chronic fatigue syndrome, and healthy controls, respectively. Both patient groups showed K values significantly higher than 0.50 (P < 0.05), indicating that patients showed poorer dynamic balance control, CoPX colliding with the boundaries of the base of support (K > 0.5).

Interpretation
The findings revealed a lower level of dynamic postural control in both fibromyalgia and chronic fatigue syndrome compared to controls.
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NewsBot · Nov 15, 2016

Torque and Muscle Activation Impairment Along With Insulin Resistance Are Associated With Falls in Women With Fibromyalgia
Góes, Suelen M.; Stefanello, Joice M. F.; Homann, Diogo; Lodovico, Angélica; Hubley-Kozey, Cheryl L.; Rodacki, André L. F.
Journal of Strength & Conditioning Research: November 2016 - Volume 30 - Issue 11 - p 3155–3164

Fibromyalgia (FM) is a chronic pain condition associated with reduced muscle strength, which can lead to functional incapacity and higher risk of falls. The purpose of the study was to compare maximal ankle joint torque, muscle activation, and metabolic changes between women with and without FM. In addition, the relationship between those aspects and retrospectively reported falls in women with FM was determined. Twenty-nine middle-aged women with FM and 30 controls were recruited. Fall history, pain intensity, and pain threshold were assessed. Plasma glucose levels and insulin resistance (IR) were determined. Peak torque and rate of torque development (RTD) were calculated, and muscle activation was assessed from maximum isometric voluntary ankle dorsiflexion and plantar flexion contractions. In addition, voluntary muscle activation failure of the anterior tibialis muscle during maximal dorsiflexion was calculated. When compared to controls, women with FM reported higher number of retrospectively reported falls, exhibited higher IR, showed reduced plantar flexion and dorsiflexion RTD, had lower plantar flexion peak torque, and demonstrated more antagonist coactivation and higher muscle activation failure (p ≤ 0.05). Higher muscle activation failure was explained by glucose level and pain intensity (adj R2 = 0.28; p ≤ 0.05). Reduced plantar flexion and dorsiflexion peak torque explained 80% of retrospectively reported falls variance; also, high antagonist coactivation (odds ratio [OR] = 1.6; p ≤ 0.05) and high IR (OR = 1.8; p ≤ 0.05) increased the chance of falls in the FM group. A combination of metabolic factors and muscle function increased the odds of retrospectively reporting a fall in FM. Both aspects may be considered in interventions designed for reducing falls in this population.
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NewsBot · Apr 19, 2017

The Effects of Exercise Training on Anxiety in Fibromyalgia Patients: A Meta-analysis.
McDowell, Cillian P.; Cook, Dane B.; Herring, Matthew P.
Medicine & Science in Sports & Exercise: Post Acceptance: April 18, 2017

Physical inactivity and comorbid anxiety symptoms are prevalent among fibromyalgia (FM) patients. Exercise training may be an effective alternative therapy to reduce these symptoms.

Purpose: To evaluate the effects of exercise training on anxiety symptoms in patients with FM, and to examine whether variables of theoretical or practical importance moderate the estimated mean effect.

Methods: Twenty-five effects were derived from 10 articles published before June 2016 located using Google Scholar, MEDLINE, PsycINFO, PubMed, and Web of Science. Trials involved 595 patients with FM (mean age: 47.6 years, 97.5% female) and included both randomization to exercise training (n=297) or a non-exercise control condition (n=298) and an anxiety outcome measured at baseline and during and/or after exercise training. Hedges' d effect sizes were computed, data for moderator variables were extracted, and random effects models were used to estimate sampling error and population variance for all analyses. Meta-regression quantified the extent to which patient and trial characteristics moderated the mean effect.

Results: Exercise training significantly reduced anxiety symptoms by a mean effect [DELTA] of 0.28 (95%CI: 0.16-0.40). No significant heterogeneity was observed (Q24=30.79; p=0.16; I2=25.29%). Program duration ([beta]=1.44; z=2.50; p<=0.01) was significantly related to the overall effect, with significantly larger anxiety improvements resulting from programs lasting greater than 26 weeks ([DELTA]=0.35; 95%CI, 0.05-0.66) compared with those lasting less than 26 weeks ([DELTA]=0.26; 95%CI, 0.13-0.39).

Conclusion: Exercise training improves anxiety symptoms among FM patients. The findings also suggest that larger anxiety symptom reductions will be achieved by focusing on longer exercise programs while promoting long-term adherence. Future well-designed investigations are required to examine the potential moderating effect of pain-related improvements in FM patients.
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NewsBot · Sep 26, 2018

Gender differences in patients with fibromyalgia: a gait analysis
Jose Heredia-Jimenez & Eva Orantes-Gonzalez
Clinical Rheumatology: 21 September 2018

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.
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NewsBot · Feb 22, 2021

Muscle activity and acute stress in fibromyalgia
Teemu Zetterman, Ritva Markkula, Juhani V. Partanen, Teemu Miettinen, Ann-Mari Estlander & Eija Kalso
BMC Musculoskeletal Disorders volume 22, Article number: 183 (2021)

Background
Fibromyalgia (FM) patients are likely to differ from healthy controls in muscle activity and in reactivity to experimental stress.

Methods
We compared psychophysiological reactivity to cognitive stress between 51 female FM patients aged 18 to 65 years and 31 age- and sex-matched healthy controls. They underwent a 20-minute protocol consisting of three phases of relaxation and two phases of cognitive stress. We recorded surface electromyography normalized to maximum voluntary muscle contraction (%EMG), the percentage of time with no muscle activity (EMG rest time), and subjective pain and stress intensities. We compared group reactivity using linear modelling and adjusted for psychological and life-style factors.

Results
The FM patients had a significantly higher mean %EMG (2.2 % vs. 1.0 %, p < 0.001), pain intensity (3.6 vs. 0.2, p < 0.001), and perceived stress (3.5 vs. 1.4, p < 0.001) and lower mean EMG rest time (26.7 % vs. 47.2 %, p < 0.001). In the FM patients, compared with controls, the pain intensity increased more during the second stress phase (0.71, p = 0.028), and the %EMG decreased more during the final relaxation phase (-0.29, p = 0.036). Within the FM patients, higher BMI predicted higher %EMG but lower stress. Leisure time physical activity predicted lower %EMG and stress and higher EMG rest time. Higher perceived stress predicted lower EMG rest time, and higher trait anxiety predicted higher pain and stress overall.

Conclusions
Our results suggest that repeated cognitive stress increases pain intensity in FM patients. FM patients also had higher resting muscle activity, but their muscle activity did not increase with pain. Management of stress and anxiety might help control FM flare-ups.
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NewsBot · Apr 18, 2022

Individuals with fibromyalgia have a different gait pattern and a reduced walk functional capacity: a systematic review with meta-analysis
Elio Carrasco-Vega et al
PeerJ 10:e12908

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.
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NewsBot · Dec 28, 2023

Is connective tissue massage effective in individuals with fibromyalgia?
Bilge Basakci Calik et al
December 26, 2023

Objectives
The aim of the study was to examine the effectiveness of Clinical Pilates exercises and connective tissue massage (CTM) in individuals with Fibromyalgia (FM) on pain, disease impact, functional status, anxiety, quality of life and biopsychosocial status.
Methods
32 women were randomly divided into two groups as intervention gorup (CTM + Clinical Pilates exercises, n = 15, mean age = 48.80 ± 7.48) and control gorup (Clinical Pilates exercises, n = 17, mean age = 55.64 ± 7.87). The number of painful regions were assessed with Pain Location Inventory (PLI), disease impact with Fibromyalgia Impact Questionnare (FIQ), functional status with Health Assessment Questionnare (HAQ), anxiety with Beck Anxiety Inventory (BAI), quality of life with Short Form-36 (SF-36) and biopsychosocial status with Biopsychosocial Questionnaire (BETY-BQ) were evaluated. All evaluations were made before and after treatment. Both treatments were applied 3 times a week for 6 weeks.
Results
When the pre-treatment and post-treatment results are analyzed; significant difference was observed in PLI (p = 0.007; effect size 1.273), FIQ (p = 0.004; effect size 0.987), SF-36 physical component (p = 0.025; effect size −0.496) and mental component (p = 0.017; effect size −0.761) in the intervention group while the significant difference was observed in FIQ (p = 0.001; effect size 1.096) and BAI (p = 0.043; effect size 0.392), SF-36 physical component (p = 0.008; effect size −0.507) and mental component (p = 0.024; effect size −0.507) in the control group. When the delta values of the groups are compared, the difference was determined only in the PLI (p = 0.023) in favor of the intervention group.
Conclusions
CTM can be effective in reducing the number of painful areas in addition to the positive effects of clinical Pilates exercises in women with FM.
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Fibromyalgia and gait pattern

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Jaimee Brent Active Member

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Fibromyalgia and gait pattern

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Jaimee Brent Active Member

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Tarsal Tunnel Syndrome in Fibromyalgia

Foot Function in Fibromyalgia

Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Fibromyalgia

Custom Foot Orthotics in Fibromyalgia

Ankle joint stiffness and fibromyalgia

Poor Foot bio-mechanice and Fibromyalgia Syndrome

Fibromyalgia

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