Fibromyalgia, Muscular Weakness in

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A small study of stair climbing was conducted in women with fibromyalgia. In one scenario they did not carry weights and in the other they carried 5 pounds in each hand. Results showed: “Trunk tilt in the stair-climbing task carrying a load was significantly higher in women with fibromyalgia when compared to the healthy controls.” The author’s opined that this could increase the risk of falling. They also found that “women with fibromyalgia experienced a higher pace slowdown as a consequence of the load, which supports the need of including specific strength and resistance training to physical therapies for this population.” (Performance of women with fibromyalgia in walking up stairs while carrying a load. Collado-Mateo D1, Adsuar JC1, Olivares PR2, Dominguez-Muñoz FJ1, Maestre-Cascales C1, Gusi N1. PeerJ. 2016 Feb 1;4:e1656, available in full online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741081/.)

Fibromyalgia patients may have “exercise-induced pain”. (Prescribing exercise for people with fibromyalgia. Jones KD1, Clark SR, Bennett RM. AACN Clin Issues. 2002 May;13(2):277-93.) Jones et al. state: “Difficulties remaining active with fibromyalgia may lead to extreme deconditioning, inability to remain employed, and eventually even impaired ability in complete activities of daily living. Exercise that combats deconditioning without triggering pain is, therefore, a key component in treating fibromyalgia. Clinicians who understand fibromyalgia pain and associated symptoms can minimize the negative impact of deconditioning by prescribing disease-specific exercise for people with fibromyalgia.”

Bennett et al. state that “both peripheral and central mechanisms may operate in the pathophysiology of both impaired muscle function and pain in fibromyalgia. The argue that: “These mechanisms may in part be attributable to physical deconditioning and disuse of muscle secondary to the characteristic pain and fatigue so often seen in fibromyalgia. Most likely the initiation of this condition is multifactorial and the combination of peripheral and central factors that constitute a vicious circle may perpetuate the condition into a chronic state.” (Muscle function and origin of pain in fibromyalgia. Bennett RM1, Jacobsen S. Baillieres Clin Rheumatol. 1994 Nov;8(4):721-46.)

[Author’s comments: The assessment of fibromyalgia patients should include a review of their exercise tolerance or intolerance and their mobility status. In some severe cases involve young women using canes even in their twenties. Severe cases may involve patients bent over forwards when they walk. Reasons for this seen by the author include: exhaustion from terrible sleep, fear of falling and deconditioning due to inactivity secondary to exhaustion and pain.]