Article

Research suggests that disordered autonomic function may be one
contributor to deconditioning reported in fibromyalgia; however, no study to date
has assessed these variables simultaneously with comprehensive measures.
OBJECTIVE: To characterize physical fitness and autonomic function with the use
of clinically validated measures and subjective questionnaires between patients
with fibromyalgia and healthy controls. DESIGN: Cross-sectional, observational,
controlled study. SETTING: Community sample of patients with fibromyalgia and
healthy controls. PARTICIPANTS: Thirty patients with fibromyalgia and 30 pain and
fatigue-free controls. METHODS: Participants completed a battery of self-report
questionnaires and physiological measures, including clinically validated
measures of physical fitness and autonomic function. MAIN OUTCOME MEASUREMENTS:
Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by
cardiopulmonary exercise testing, total steps using activity monitor, Composite
Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic
equivalents per week using the International Physical Activity Questionnaire, and
self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom
Score questionnaire. RESULTS: Autonomic function, as assessed by self-report, was
significantly different between patients and controls (P < .0001); in contrast,
the only difference between patients and controls on the Autonomic Reflex Screen
was in the adrenergic domain (P = .022), and these abnormalities were mild.
Self-reported physical activity was not significantly different between patients
and controls (P = .99), but levels of moderate and vigorous physical activity as
measured by actigraphy were significantly lower in patients (P = .012 and P =
.047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P
= .0006), but there was no significant difference in maximal volume of oxygen
consumption (P = .07). CONCLUSIONS: Patients with fibromyalgia report more severe
symptoms across all domains, including physical activity and autonomic symptoms,
compared with controls, but the objective assessments only showed modest
differences. Our results suggest that patients with widespread subjective
impairment of function have only modest objective measures of autonomic
dysfunction. We recommend that the primary treatment goal should be focused on
restoration of function, which may also ameliorate symptoms.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS