Abstract
Patients with fibromyalgia syndrome (FMS) have a nonspecific postural balance disorder and a greater prevalence of falls. Objective: to clarify which aspects of maintaining balance are associated with the impact of the disorder and with balance confidence. Methods: A total of 182 persons with FMS agreed to participate in this study. After re-evaluation, 57 fully met inclusion criteria: age 40–70 years and moderate-severe impact of the illness according to the Fibromyalgia Impact Questionnaire (FIQ). All participants underwent a posture control analysis with a stabilometric platform, an evaluation of the perception of verticality and an exploration of the vestibular system via functional tests. Additionally, they self-completed questionnaires about balance confidence, central sensitization, pain catastrophizing, kinesiophobia, dizziness and days with episodes of instability. Results: The FIQ was associated with central sensitization and dizziness, which explained 56% of its variance (AdjR2 = 0.566), while days with instability, kinesiophobia and dizziness also explained more than half of the variance of the balance confidence scale (AdjR2 = 0.527). A high percentage of positive responses was found for functional tests (>50%) and a high dispersion in the stabilometric parameters. Conclusion: the detection of factors susceptible to intervention, such as disability due to dizziness, takes on special relevance in patients with FMS.
Highlights
Fibromyalgia syndrome (FMS) is a disorder principally characterized by chronic generalized pain, with increased sensitivity to pain with a low pain threshold, which is normally accompanied by non-restorative sleep, tiredness, rigidity, instability, cognitive difficulties, and mood disorders [1]
This study aimed to clarify which variables, among functional balance tests, stabilometry and perception of verticality variables and central sensitization, pain catastrophizing, kinesiophobia and disability due to dizziness are related to the impact of the disease—the severity of symptoms measured with the fibromyalgia impact questionnaire (FIQ)—and with the confidence of these patients in their own stability measured with the activities-specific balance confidence (ABC) scale
Exclusion criteria were as follows: (a) cognitive impairment impacting ability to fill out the scales and questionnaires, (b) musculoskeletal surgical intervention in the preceding six months and/or acute traumatic pathology to the inferior limb(s), (c) musculoskeletal disease with deformity of the inferior limbs, (d) diagnosed with vestibular, visual and/or auditory pathology, and (e) neurologic illness that could be the cause of a balance disorder
Summary
Recent studies have shown that patients with FMS present with a nonspecific postural balance disorder and an increased prevalence of falls [3]. The magnitude of this balance disorder may be related with the increase in pain, loss of quality of life, and balance confidence [4,5]. Confidence—ABC) and disease severity measured with the fibromyalgia impact questionnaire FIQ (r = −0.64) [3]. Patients with FMS identify balance issues as one of the ten most debilitating symptoms of this disease; with a reported prevalence of 45% [6]
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