Fibromiyalji Tanılı Hastalarda Denge ve Postürün Değerlendirilmesi
Yıl 2024,
Cilt: 46 Sayı: 1, 32 - 43, 16.01.2024
Onur Şahin
,
Nurettin Taştekin
,
Enis Uluçam
,
Menekşe Karahan
,
Necdet Süt
,
Murat Birtane
Öz
Denge sorunları son zamanlarda Fibromiyalji (FMS)’li hastalarda dikkat çeken semptomlar arasında gösterilmiştir. Bu çalışmada fibromiyalji hastalarında denge ve postürün değerlendirilmesini, bu durumların varlığı ile fibromiyalji şiddeti arasındaki ilişkiyi değerlendirme amaçlanmıştır. Çalışmaya TÜTF Hastanesi Fizik Tedavi ve Rehabilitasyon polikliniğine başvuran FMS tanılı 30-55 yaş aralığındaki 45 birey ve kontrol grubu olarak 44 birey dahil edildi. Olguların sosyo-demografik özellikleri, şikâyet ve tanı süresi kaydedildi. Vizüel analog skala (VAS) ile ağrı şiddeti, Fonksiyonel durum için Fibromiyalji Etki Skalası (FEA), Fibromiyalji Semptom Şiddet Skalası, Yaygın Ağrı İndeksi sorgulanarak kaydedildi. Olguların dinamik dengeleri Berg denge testi, statik dengeleri ise tek bacak üstünde durma testi ile değerlendirildi. Zebris CMS-20P-2 cihazı ile bilgisayar ortamında üç boyutlu ultrasonik sistem ile omurga postür analizi yapıldı. FMS grubunda sağ ve sol tek ayak üzerinde durma süreleri ile toplam Berg Denge Ölçeği sonuçlarının anlamlı derecede daha düşük bulunmuştur. Berg Denge Skoru ile Toplam FEA skoru, Semptom Şiddet Skalası skoru A, Fibromiyalji Şiddet skoru ve Total Gövde İnklinasyon Açısı arasında ters yönde ve orta düzeyde anlamlı ilişki olduğu bulduk. Omurga postür analizi ile hasta ve kontrol grupları arasındaki postür analizi sonuçlarının farklı saptanmamıştır. Sonuç olarak FMS’li hastalarda denge bozukluğunun sağlıklı bireylere göre daha sık rastlandığını tespit ettik. Postür analizinde her iki grup arasında anlamlı fark saptayamadık. Özellikle postür srunlarını ortaya koyabilmek için büyük popülasyonlu çalışmalara ihtiyaç vardır.
Kaynakça
- 1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72.
- 2. Bennett RM. Clinical manifestations and diagnosis of fibromyalgia. Rheum Dis Clin North. Am 2009;35(2):215-32.
- 3. Jones KD, King LA, Mist SD, Bennett RM, Horak FB. Postural control deficits in people with fibromyalgia: a pilot study. Arthritis Res Ther. 2011;13(4): R127.
- 4. Muto LH, Sauer JF, Yuan SL, Sausa A, Mango PC, Mrques AP. Postural control and balance self-efficacy in women with Muto fibromyalgia: are there differences? Eur J Phys Rehabil Med. 2015;51(2):149-54.
- 5. Bennett, RM, Jones J, Turk DC, Rusell IJ, Matalana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8(1): 27.
- 6. Gallagher EJ, Liebman M, Bijur PE. Prospeective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38:633-8.
- 7. Vellas BJ, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Gary PJ. One-Leg balance is an important predictor of injurious falls in older persons. JAGS .1997; 45: 735-8.
- 8. Sahin F, Yılmaz F, Özmaden A, Kotevoglu N, Sahin T, Kuran B. Reliability and validity of Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008;31:32-7.
- 9. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991; 18: 728-33.
- 10. Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of itsdevelopment, currentversion, operating characteristics and uses. Clin Exp Rheumatol. 2005; 23: S154-62.
- 11. Sarmer S, Ergin S, Yavuzer G. Thevalidityandreliabilityof theTurkishversion of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000; 20: 9-12.
- 12. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46:319-29.
- 13. Glista J, Pop T, Weres A, Czenczek-Lewandowska E, Podgórska-Bednarz J, Rykała J, et al. Change in anthropometric parameters of the posture of students of physiotherapy after three years of professional training. Biomed Res Int. 2014:719837.
- 14. Kowalski IM, Protasiewicz-Fałdowska H, Dwornik M, Pierożyński B, Raistenskis J, Kiebzak W. Objective parallel-forms reliability assessment of 3 dimension real time body posture screening tests. BMC Pediatr. 2014;14:221.
- 15. Kia S, Choy EJB. Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines 2017;5(2):20.
- 16. Bazzichi L, Giacomelli C, Consensi A, Atzeni F, Batticciotto A, Di Franco M, et al. One year in review: Fibromyalgia. Clin Exp Rheumatol 2016;34(2):S145-9.
- 17. Sempere-Rubio N, Aguilar-Rodríguez M, Espí-López GV, Cortés-Amador S, Pascual E, Serra-Añó P. Impaired trunk posture in women with fibromyalgia. Spine 2018; 43(22):1536–42.
- 18. Meireles SA, Antero DC, Kulczycki MM, Skare TL. Prevalence of falls in fibromyalgia patients. Acta Ortop Bras 2014;22(3):163–6.
- 19. Jones KD, Horak FB, Winters-Stone K, Irvine JM, Bennett RM. Fibromyalgia is associated with impaired balance and falls. J Clin Rheumatol 2009;15(1):16.
- 20. Toprak Celenay S, Mete O, Coban O, Oskay D, Erten S. Trunk position sense, postural stability, and spine posture in fibromyalgia. Rheumatol Int 2019:39(12):2087-94.
- 21. Trevisan DC, Driusso P, Avila MA, Gramani-Say K, Moreira FMA, Parizotto NA. Static postural sway of women with and without fibromyalgia syndrome: a cross-sectional study. Clin Biomech (Bristol, Avon) 2017; 44:83–9.
- 22. Toprak CS, Anaforoglu KB, Kucuksahin O. Evaluation of balance, endurance and flexibility in women with fibromyalgia syndrome. Turk J Physiother Rehabil 2017; 28(3):125–31.
- 23. Kim D, Cho M, Park Y, Yang Y. Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci 2015;27:1791–94.
- 24. Sener U, Ucok K, Ulasli AM, Genc A, Karabacak H, Coban NF et al. Evaluation of health-related physical fitness parameters and association analysis with depression, anxiety, and quality of life in patients with fibromyalgia. Int J Rheum Dis 2016;16:763–72.
- 25. Canales JZ, Fiquer JT, Campos RN, Soeiro-de-Souza MG, Moreno RA. Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: A quantitative cross-sectional study. Gait Posture 2017; 52:258–64.
- 26. Rosario JL, Bezerra Diógenes MS, Mattei R, Leite JR. Differences and similarities in postural alterations caused by sadness and depression. J Bodyw Mov Ther 2014;18:540–4.
- 27. Nørregaard J, Bülow PM, Vestergaard-Poulsen P, Thomsen C, Danneskiold-Samøe B. Muscle strength, voluntary activation and cross-sectional muscle area in patients with fibromyalgia. BR J Rheumatol 1995:34(10):925-31.
- 28. Schweiger V, Del Balzo G, Raniero D, De Leo D, Martini A, Sarzi-Puttini P, Polati E. Current trends in disability claims due to fibromyalgia syndrome. Clin Exp Rheumatol 2017;35(3):119–26.
- 29. Sempere-Rubio N, Aguilar-Rodríguez M, Inglés M, Izquierdo-Alventosa R, Serra-Añó P. Physical Condition Factors that Predict a Better Quality of Life in Women with Fibromyalgia. Int J Environ Res Public Health 2019;16(17):3173.
- 30. Wilkes C, Kydd R, Sagar M, Broadbent E. Upright posture improves affect and fatigue in people with depressive symptoms. J Behav Ther Exp Psychiatry 2017; 54, 143–9.
- 31. Lelard T, Ahmaidi S. Effects of physical training on age-related balance and postural control. Neurophysiol Clin 2015;45(4-5):357-69.
- 32. Kibar S, Yıldız HE, Ay S, Evcik D, Ergin ES. New approach in fibromyalgia exercise program: a preliminary study regarding the effectiveness of balance training. 2015;96(9):1576-82.
- 33. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol 2019;4(1):143-53.
Evaluation of Balance and Posture in Patients with Fibromyalgia Diagnosis
Yıl 2024,
Cilt: 46 Sayı: 1, 32 - 43, 16.01.2024
Onur Şahin
,
Nurettin Taştekin
,
Enis Uluçam
,
Menekşe Karahan
,
Necdet Süt
,
Murat Birtane
Öz
Balance problems recently have been indicated as one of the notable symptoms in fibromyalgia patients. In this study, it is aimed to evaluate posture and balance in fibromyalgia patients and association between presence of these conditions and fibromyalgia severity. 45 individuals diagnosed with FMS diagnose and 44 individuals of control group between the age of 30 and 55 who attended Trakya University, Faculty of Medicine, Department of Physical Therapy and Rehabilitation were included in the study. Socio-demographic features of cases, complaints and time of diagnoses was recorded. Pain intensity with visual analog scale (VAS), fibromyalgia impact questionnaire (FIQ) for functional condition, fibromyalgia symptome intensity scale, extensive pain index were used for patient records. Dynamical balances of cases were assessed with Berg balance test and statical balance was assessed with one leg stand test. Vertebrate posture analysis was performed with Zebris CMS-20P-2 device by using virtual 3D ultrasonic system. Durations of right and left one leg stand and Berg balance test results were significantly lower in FMS group. We also found that there is a moderately significant and inverse correlation between Berg Balance score and total FIQ scores, symptom intensity scale scores A, fibromyalgia intensity scores and Total Body Inclination Angle. Comparison of Vertebrate posture analizys with 3D-USG system scores of patients and control group did not show a statistically significant difference. In conclusion, we found that balance disorders are more commonly encountered in FMS patients compared to healthy people. We could not detect a significant difference between two groups in posture analysis. When preparing a treatment planning for FMS patient, possibility of balance disorders should be taken into consideration and an appropriate treatment should be planned in this light.
Kaynakça
- 1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72.
- 2. Bennett RM. Clinical manifestations and diagnosis of fibromyalgia. Rheum Dis Clin North. Am 2009;35(2):215-32.
- 3. Jones KD, King LA, Mist SD, Bennett RM, Horak FB. Postural control deficits in people with fibromyalgia: a pilot study. Arthritis Res Ther. 2011;13(4): R127.
- 4. Muto LH, Sauer JF, Yuan SL, Sausa A, Mango PC, Mrques AP. Postural control and balance self-efficacy in women with Muto fibromyalgia: are there differences? Eur J Phys Rehabil Med. 2015;51(2):149-54.
- 5. Bennett, RM, Jones J, Turk DC, Rusell IJ, Matalana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8(1): 27.
- 6. Gallagher EJ, Liebman M, Bijur PE. Prospeective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38:633-8.
- 7. Vellas BJ, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Gary PJ. One-Leg balance is an important predictor of injurious falls in older persons. JAGS .1997; 45: 735-8.
- 8. Sahin F, Yılmaz F, Özmaden A, Kotevoglu N, Sahin T, Kuran B. Reliability and validity of Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008;31:32-7.
- 9. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991; 18: 728-33.
- 10. Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of itsdevelopment, currentversion, operating characteristics and uses. Clin Exp Rheumatol. 2005; 23: S154-62.
- 11. Sarmer S, Ergin S, Yavuzer G. Thevalidityandreliabilityof theTurkishversion of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000; 20: 9-12.
- 12. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46:319-29.
- 13. Glista J, Pop T, Weres A, Czenczek-Lewandowska E, Podgórska-Bednarz J, Rykała J, et al. Change in anthropometric parameters of the posture of students of physiotherapy after three years of professional training. Biomed Res Int. 2014:719837.
- 14. Kowalski IM, Protasiewicz-Fałdowska H, Dwornik M, Pierożyński B, Raistenskis J, Kiebzak W. Objective parallel-forms reliability assessment of 3 dimension real time body posture screening tests. BMC Pediatr. 2014;14:221.
- 15. Kia S, Choy EJB. Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines 2017;5(2):20.
- 16. Bazzichi L, Giacomelli C, Consensi A, Atzeni F, Batticciotto A, Di Franco M, et al. One year in review: Fibromyalgia. Clin Exp Rheumatol 2016;34(2):S145-9.
- 17. Sempere-Rubio N, Aguilar-Rodríguez M, Espí-López GV, Cortés-Amador S, Pascual E, Serra-Añó P. Impaired trunk posture in women with fibromyalgia. Spine 2018; 43(22):1536–42.
- 18. Meireles SA, Antero DC, Kulczycki MM, Skare TL. Prevalence of falls in fibromyalgia patients. Acta Ortop Bras 2014;22(3):163–6.
- 19. Jones KD, Horak FB, Winters-Stone K, Irvine JM, Bennett RM. Fibromyalgia is associated with impaired balance and falls. J Clin Rheumatol 2009;15(1):16.
- 20. Toprak Celenay S, Mete O, Coban O, Oskay D, Erten S. Trunk position sense, postural stability, and spine posture in fibromyalgia. Rheumatol Int 2019:39(12):2087-94.
- 21. Trevisan DC, Driusso P, Avila MA, Gramani-Say K, Moreira FMA, Parizotto NA. Static postural sway of women with and without fibromyalgia syndrome: a cross-sectional study. Clin Biomech (Bristol, Avon) 2017; 44:83–9.
- 22. Toprak CS, Anaforoglu KB, Kucuksahin O. Evaluation of balance, endurance and flexibility in women with fibromyalgia syndrome. Turk J Physiother Rehabil 2017; 28(3):125–31.
- 23. Kim D, Cho M, Park Y, Yang Y. Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci 2015;27:1791–94.
- 24. Sener U, Ucok K, Ulasli AM, Genc A, Karabacak H, Coban NF et al. Evaluation of health-related physical fitness parameters and association analysis with depression, anxiety, and quality of life in patients with fibromyalgia. Int J Rheum Dis 2016;16:763–72.
- 25. Canales JZ, Fiquer JT, Campos RN, Soeiro-de-Souza MG, Moreno RA. Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: A quantitative cross-sectional study. Gait Posture 2017; 52:258–64.
- 26. Rosario JL, Bezerra Diógenes MS, Mattei R, Leite JR. Differences and similarities in postural alterations caused by sadness and depression. J Bodyw Mov Ther 2014;18:540–4.
- 27. Nørregaard J, Bülow PM, Vestergaard-Poulsen P, Thomsen C, Danneskiold-Samøe B. Muscle strength, voluntary activation and cross-sectional muscle area in patients with fibromyalgia. BR J Rheumatol 1995:34(10):925-31.
- 28. Schweiger V, Del Balzo G, Raniero D, De Leo D, Martini A, Sarzi-Puttini P, Polati E. Current trends in disability claims due to fibromyalgia syndrome. Clin Exp Rheumatol 2017;35(3):119–26.
- 29. Sempere-Rubio N, Aguilar-Rodríguez M, Inglés M, Izquierdo-Alventosa R, Serra-Añó P. Physical Condition Factors that Predict a Better Quality of Life in Women with Fibromyalgia. Int J Environ Res Public Health 2019;16(17):3173.
- 30. Wilkes C, Kydd R, Sagar M, Broadbent E. Upright posture improves affect and fatigue in people with depressive symptoms. J Behav Ther Exp Psychiatry 2017; 54, 143–9.
- 31. Lelard T, Ahmaidi S. Effects of physical training on age-related balance and postural control. Neurophysiol Clin 2015;45(4-5):357-69.
- 32. Kibar S, Yıldız HE, Ay S, Evcik D, Ergin ES. New approach in fibromyalgia exercise program: a preliminary study regarding the effectiveness of balance training. 2015;96(9):1576-82.
- 33. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol 2019;4(1):143-53.