Physical Fitness in Postmenopausal Women with Fibromyalgia

Abstract

The purpose of this study was to compare physical fitness and health-related quality-of-life between twenty-three postmenopausal women with fibromyalgia (age 58 ± 3 years) and eleven healthy women (58 ± 5 years). Aerobic fitness and isometric force of different muscle groups were measured. Functional performance was assessed by walking and stair-climbing times. Symptoms were assessed by visual analog scale and quality-of-life by RAND-36 questionnaire. Women with fibromyalgia had significantly lower isometric force in bilateral leg extensors (1285 vs. 1898 N), unilateral knee extensors (414 vs. 502 N) and flexors (197 vs. 235 N) than healthy women, but no differences were observed in forces of the trunk and upper extremities. Maximal workload in the aerobic test (130 vs. 151 W), functional performance and quality-of-life were lower in women with fibromyalgia and they reported more symptoms than healthy subjects, while maximal oxygen uptake did not differ between the groups. A lower maximal load in the aerobic test suggests the patients' unsatisfactory ability to stand physical loading and resist overall fatigue. Moreover, fatigue rather than pain was the main factor to decrease the quality-of-life in women with fibromyalgia. Additional efforts should be addressed to strength training, when planning health promotion and rehabilitation programs in fibromyalgia.

Key words

pain syndrome - muscle strength - oxygen uptake

References

• 1 Aalto A M, Aro A R, Teperi J. RAND‐36 as a Measure of Health-Related Quality of Life. Reliability, Construct Validity and Reference Values in the Finnish General Population. Helsinki; Stakes, Research Reports 1999 Vol.101
• 2 Bennett R M, Schein J, Kosinski M R, Hewitt D J, Jordan D M, Rosenthal N R. Impact of fibromyalgia pain on health-related quality of life before and after treatment with tramadol/acetaminophen.  Arthr Care Res. 2005;  53 519-527
• 3 Bergman S. Psychosocial aspects of chronic widespread pain and fibromyalgia.  Disabil Rehabil. 2005;  27 675-683
• 4 Borman P, Celiker R, Hascelik Z. Muscle performance in fibromyalgia syndrome.  Rheumatol Int. 1999;  19 27-30
• 5 Dixon S, Bird H. Reproducibility along a 10 cm visual analogue scale.  Ann Rheum Dis. 1981;  40 87-89
• 6 Fleg J L, Morrell C H, Bos A G, Brant L J, Talbot L A, Wright J G, Lakatta E G. Accelerated longitudinal decline of aerobic capacity in healthy older adults.  Circulation. 2005;  112 674-682
• 7 Frontera W R, Hughes V A, Fielding R A, Fiatarone M A, Evans W J, Roubenoff R. Aging of skeletal muscle: a 12-year longitudinal study.  J Appl Physiol. 2000;  88 1321-1326
• 8 Hays R D, Sherbourne C D, Mazel R M. The RAND 36-item health survey 1.0.  Health Economics. 1993;  2 217-227
• 9 Henriksson K G, Bäckman E, Henriksson C, de Laval J H. Chronic regional muscular pain in women with precise manipulation work.  Scand J Rheumatol. 1996;  25 213-223
• 10 Häkkinen A, Häkkinen K, Hannonen P, Alén M. Force production capacity and acute neuromuscular responses to fatiguing loading in women with fibromyalgia are not different from those of healthy women.  J Rheumatol. 2000;  27 1277-1282
• 11 Häkkinen K, Alén M, Kallinen M, Izquierdo M, Jokelainen K, Lassila H, Mälkiä E, Kraemer W J, Newton R U. Muscle CSA, force production, and activation of leg extensors during isometric and dynamic actions in middle-aged and elderly men and women.  J Aging Phys Act. 1998;  6 232-247
• 12 Häkkinen K, Kallinen M, Izquierdo M, Jokelainen K, Lassila H, Mälkiä E, Kraemer W J, Newton R U, Alén M. Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people.  J Appl Physiol. 1998;  84 1341-1349
• 13 Lamé I E, Peters M L, Vlaeyen J WS, von Kleef M, Patijn J. Quality of life in chronic pain is more associated with beliefs about pain than with pain intensity.  Eur J Pain. 2005;  9 15-24
• 14 Landers K A, Hunter G R, Wetzstein C J, Bamman M M, Weinsier R L. The interrelationship among muscle mass, strength, and the ability to perform physical tasks of daily living in younger and older women.  J Gerontol A Biol Sci Med Sci. 2001;  56 B443-B448
• 15 Lindh M H, Johansson G A, Hedberg M, Grimby G L. Studies on maximal voluntary muscle contraction in patients with fibromyalgia.  Arch Phys Med Rehabil. 1994;  75 1217-1222
• 16 Lund E, Kendall S A, Janerot-Sjöberg B, Bengtsson A. Muscle metabolism in fibromyalgia studied by P‐31 magnetic resonance spectroscopy during aerobic and anaerobic exercise.  Scand J Rheumatol. 2003;  32 138-145
• 17 Martinez-Lavin M. Fibromyalgia as a sympathetically maintained pain syndrome.  Curr Pain Headache Rep. 2004;  8 385-389
• 18 Mengshoel A M, Forre O, Komnaes H B. Muscle strength and aerobic capacity in primary fibromyalgia.  Clin Exp Rheumatol. 1990;  8 475-479
• 19 Miller T A, Allen G M, Gandevia S C. Muscle force, perceived effort and voluntary activation of the elbow flexors assessed with sensitive twitch interpolation in fibromyalgia.  J Rheumatol. 1996;  23 1621-1627
• 20 Mäkelä M, Heliövaara M. Prevalence of primary fibromyalgia in the Finnish population.  BMJ. 1991;  303 216-219
• 21 Nørregaard J, Bülow P M, Mehlsen J, Danneskiold-Samsøe B. Biochemical changes in relation to a maximal exercise test in patients with fibromyalgia.  Clin Physiol. 1994;  14 159-167
• 22 Shvartz E, Reibold R C. Aerobic fitness norms for males and females aged 6 to 75 years: a review.  Aviat Space Environ Med. 1990;  61 3-11
• 23 Simms R W, Roy S H, Hrovat M, Anderson J J, Skinar G, LePoole S R, Zerbini C A, de Luca C, Jolesz F. Lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism.  Arthritis Rheum. 1994;  37 794-800
• 24 Sowers M R, Crutchfield M, Richards K, Wilkin M K, Furniss A, Jannausch M, Zhang D, Gross M. Sarcopenia is related to physical functioning and leg strength in middle-aged women.  J Gerontol Med Sci. 2005;  60 A 486-490
• 25 Valim V, Oliveira L M, Suda A L, Silva L E, Faro M, Neto T L, Feldman D, Natour J. Peak oxygen uptake and ventilatory anaerobic threshold in fibromyalgia.  J Rheumatol. 2002;  29 353-357
• 26 Valkeinen H, Alén M, Hannonen P, Häkkinen A, Airaksinen O, Häkkinen K. Changes in knee extension and flexion force, EMG and functional capacity during strength training in elderly females with fibromyalgia and healthy controls.  Rheumatology (Oxford). 2004;  43 225-228
• 27 Valkeinen H, Häkkinen A, Hannonen P, Häkkinen K, Alén M. Acute heavy resistance exercise-induced pain and neuromuscular fatigue in elderly women with fibromyalgia and healthy controls: effects of strength training.  Arthritis Rheum. 2006;  54 1334-1339
• 28 Verstappen F TJ, van Santen-Hoeufft H MS, van Sloun S, Bolwijn P H, van der Linden S. Fitness characteristics of female patients with fibromyalgia.  J Musculoskeletal Pain. 1995;  3 45-58
• 29 Viitasalo J, Viljamaa K, Komi P V. Dynamometers for measurements of isometric trunk and leg forces. Research Reports from Department of Biology of Physical Activity, University of Jyväskylä. Jyväskylä; University of Jyväskylä 1977: 22
• 30 Vøllestad N K, Mengshoel A M. Relationships between neuromuscular functioning, disability and pain in fibromyalgia.  Disabil Rehabil. 2005;  27 667-673
• 31 Wolfe F, Smythe H A, Yunus M B, Bennett R M, Bombardier C, Goldenberg D L, Tugwell P, Campbell S M, Abeles M, Clark P, Fam A G, Farber S J, Fiechtner J J, Franklin C M, Gatter R A, Hamaty D, Lessard J, Lichtbroun A S, Masi A T, McCain G A, Reynolds W J, Romano T J, Russell I J, Sheon R P. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multi-center criteria committee.  Arthritis Rheum. 1990;  33 160-172
• 32 Wolfe F, Ross K, Anderson J, Russell I J, Herbert L. The prevalence and characteristics of fibromyalgia in the general population.  Arthritis Rheum. 1995;  38 19-28