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Altered gait, biomechanics seen in patients with juvenile fibromyalgia
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Patients with juvenile fibromyalgia showed alterations in walking patterns, greater knee weakness, lower bilateral hip abduction strength, reduced ankle dorsiflexion and other physical and psychosocial alterations compared with a group of healthy controls, according to researchers.
Study participants included 17 patients with juvenile fibromyalgia (FM) and no other rheumatic or untreated psychiatric conditions and 14 healthy control participants matched by age and sex.
Gait analysis was conducted using a 3-D motion analysis system to measure characteristics of non-coached, self-selected pace and coached walking at a standardized pace across a 3-meter distance. Knee and hip strength and functional performance were also measured.
Self-reported data were collected to assess perceived difficulty in performing various activities at home, school, social domains and other areas due to pain with the Functional Disability Index (FDI) based on a five-point Likert scale. VAS pain score and depressive symptoms were also recorded. Due to a change in study protocols, the latter was completed in only 11 of the 17 patients with FM and by all of the healthy participants.
An analysis of biometric data, reported pain and depressive symptoms showed patients with FM exhibited deficiencies compared with their peers across most areas. Those in the FM group walked in shorter strides during the self-selected pace walk and exhibited mild but significant alterations in dorsiflexion and increased eversion. Differences in increased internal rotation at the knee trended toward a significant outcome, according to the researchers.
After Bonferroni correction, patients with FM showed lower peak torque in left knee extension and knee flexion. Bilateral hip abduction strength was also lower in patients with FM. Ankle dorsiflexion was reduced on landing after the DVJ, as was trunk flexion, according to the researchers.
Patients with FM also reported poorer physical and psychosocial functioning compared with the control peer group. Functional disability was in the moderate range in patients with FM, who also reported marked fear of movement and mild levels of depressive symptoms.
The authors concluded that early interventions to correct functional deficits, instill confidence in patients and to encourage vigorous activity could lead to improved outcomes for patients with FM. – by Shirley Pulawski
Disclosure: Sil has no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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