Abstract
ObjectiveIndividuals with fibromyalgia (FM) have lower muscle strength and lower pressure pain thresholds (PPT). The primary aim of this study was to determine the associations between muscle strength and PPT in adults with FM to test the hypothesis that greater measures of muscle strength would be associated with greater values of PPT. Secondary aims included determining the effects of pain severity and the peak uptake of oxygen (Vo2) on the associations between muscle strength and PPT.MethodsKnee extensor and flexor strength (N = 69) was measured in the dominant leg using a dynamometer, and PPT was assessed using an electronic algometer. Pain severity was determined using the Multidimensional Pain Inventory, and peak Vo2 uptake was quantified using an electronically braked cycle ergometer.ResultsUnivariable linear regression analysis demonstrated a significant association between PPT (dependent variable) and isometric knee extensor (P<.001), isokinetic (60°/s) knee extensor (P = .002), and isokinetic (60°/s) knee flexor strength (P = .043). In a multiple variable linear regression analysis adjusted for age, sex, pain severity, body mass index and peak Vo2 uptake, a significant association was found between PPT and isometric knee extensor strength (P = .008). In a similar multiple variable analysis, a significant association was found between PPT and isokinetic knee extensor strength (P = .044).ConclusionGreater measures of isometric and isokinetic knee extensor strength were significantly associated with greater values of PPT in both univariable and multiple variable linear regression models.Trial RegistrationClinicalTrials.gov NCT01253395
Highlights
Individuals with fibromyalgia (FM) have been recognized to have lower knee extensor and flexor strength [1,2,3], and lower pressure pain thresholds (PPT) [4,5,6]
In univariable linear regression analyses, a significant association was found between PPT and isometric knee extensor (P,.001), isokinetic knee extensor (P = .002), and isokinetic knee flexor
In a multiple variable linear regression analysis adjusted for age, sex, pain severity, BMI and peak Vo2 uptake, a significant association was found between PPT and isometric knee extensor strength (P = .008), where every one point (Nm) increase in isometric knee extensor strength was associated with an 15 g increase in PPT (Table 3)
Summary
Individuals with fibromyalgia (FM) have been recognized to have lower knee extensor and flexor strength [1,2,3], and lower pressure pain thresholds (PPT) [4,5,6]. In a previous randomized equivalence trial, measures of knee extensor and flexor strength, PPT, peak uptake of oxygen (Vo2), and pain severity were assessed in a cohort of adults with FM undergoing interdisciplinary pain treatment [15]. In this previous study, maximum voluntary isometric knee extensor, isokinetic knee extensor and isokinetic knee flexor strength were assessed using a dynamometer which provided measures of maximum voluntary strength for both the hamstring and quadriceps muscle groups. A secondary aim was to determine the influence of pain severity, as measured by the Multidimensional Pain Inventory, and peak Vo2 uptake on the associations between muscle strength and PPT. The current study represents a secondary analysis of previously published data [15]
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