Protocol for physical assessment in patients with fibromyalgia syndrome

Santos, Michele R. dos; Moro, Claudia M.C.; Vosgerau, Dilmeire S.R.

doi:10.1016/j.rbr.2014.03.006

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Original Articles • Rev. Bras. Reumatol. 54 (2) • Mar-Apr 2014 • https://doi.org/10.1016/j.rbr.2014.03.006 copy

Protocol for physical assessment in patients with fibromyalgia syndrome

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

Fibromyalgia syndrome (FMS) is a chronic disease that causes pain and fatigue, presenting a negative impact on quality of life. Exercise helps maintaining physical fitness and influences directly on the improvement of quality of life.

Objective:

Develop a protocol for health-related physical fitness assessment of patients with FMS with tests that are feasible and appropriate for this population.

Method:

An exploratory and analytical literature review was performed, seeking to determine the tests used by the scientific community. With this in mind, we performed a literature revision through the use of virtual libraries databases: PubMed, Bireme, Banco de Teses e Dissertações da Capes and Biblioteca Digital Brasileira de Teses e Dissertações, published in between 1992-2012.

Results:

A variety of tests was found; the following, by number of citations, stood out: Body Mass Index (BMI) and bioimpedance; 6-minute walk; handgrip strength (dynamometer, 1RM [Repetition Maximum]); Sit and reach and Shoulder flexibility; Foot Up and Go, and Flamingo balance.

Conclusion:

These are the tests that should make up the protocol for the physical evaluation of FMS patients, emphasizing their ease of use.

Fibromyalgia; Protocol; Physical assessment

Tests	Quantity	%	By research group	%
BMI (Body Mass Index)	19	61.29	11	57.89
Bioimpedance	7	22.58	3	15.79
Waist circumference	3	9.68	3	15.79
Skin folds	1	3.23	1	5.26
WHR (Waist-Hip Ratio)	1	3.23	1	5.26
Total	31	100.00	19	100.00

Tests	Quantity	%	By research group	%
6-minute walk	24	54.55	15	42.86
Anaerobic threshold and VO_2max (maximal oxygen consumption) by gas analysis	4	9.09	4	11.43
Submaximal cycle ergometer	4	9.09	4	11.43
10-meter walk	4	9.09	4	11.43
Chest expansion	3	6.82	3	8.57
Treadmill test (20' with deliberate speed)	2	4.55	2	5.71
Bench test	2	4.55	2	5.71
Maximum load	1	2.27	1	2.86
Total	44	100.00	35	100.00

Tests	Quantity	%	By research	%
Handgrip strength (dynamometer)	20	24.39	group 13	22.41
Isometric force apparatus	18	21.95	12	20.69
30-second sit to stand from a chair test	15	18.29	9	15.52
Isokinetic strength apparatus	10	12.20	8	13.79
1RM (Repetition Maximum)	8	9.76	6	10.34
Leg	4	4.88	3	5.17
Biceps curl test	2	2.44	2	3.45
Pelvic elevation	2	2.44	2	3.45
Standing flexion	1	1.22	1	1.72
Phantom chair (wall squat)	1	1.22	1	1.72
Abdominal and lumbar	1	1.22	1	1.72
Total	82	100.00	58	100.00

Tests	Quantity	%	By research group	%
Sit and Reach	15	42.86	9	40.91
Shoulder flexibility	10	28.57	4	18.18
3rd finger to the ground	6	17.14	5	22.73
Joint range of motion	3	8.57	3	13.64
Passive flexibility	1	2.86	1	4.55
Total	35	100.00	22	100.00

Tests	Quantity	%	By research group	%
Foot Up and Go (dynamic balance and motor agility)	10	45.45	5	41.67
Flamingo balance (static equilibrium)	9	40.91	4	33.33
FAB (Fullerton Advanced Balance - rotating 360 degrees; retrieve object with closed eyes on a surface)	1	4.55	1	8.33
Vibratory platform	1	4.55	1	8.33
Berg Balance Scale	1	4.55	1	8.33
Total	22	100.0	12	100.0

Physical fitness	Test
Body composition	Bioelectrical impedance and BMI.
	Note: Possibility of a choice between one test, or both combined.
Cardiorespiratory fitness	6-Minute walk.
Muscular strength and endurance	Isometric strength apparatus (ideal); 30-second sit to stand from a chair test, combined with handgrip strength (dynamometer), or 1-RM test.
Flexibility	Sit and reach or 3rd finger to the ground test, combined with shoulder flexibility test.
Agility and Balance	Flamingo Balance with Foot Up and Go

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[1] Corresponding author. E-mail: claudia.moro@gmail.com (C.M.C. Moro).