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Identification of subgroups among fibromyalgia patients – Source: Reumatismo, Sep 2012

  [ 86 votes ]   [ 2 Comments ]
By Bernard Auvinet, Denis Chaleil • www.ProHealth.com • October 2, 2012

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[Note: This open-access paper (on how three types of CNS-related gait dysfunction correlate with other symptoms) is part of a special fibromyalgia issue of Reumatismo, the official journal of the Italian Society for Rheumatology. To read this & the other papers, all in English, CLICK HERE.]

This paper presents some hypotheses concerning the identification of homogeneous subgroups among fibromyalgia (FM) patients in order to improve the management of the disease. It also reviews the available literature about this subject.

Three methods for subgrouping are discussed according to clinical features, biomarkers, and gait analysis.

Clinical subgrouping based on cluster analysis has been used for the identification of homogeneous subgroups of patients and, more recently, homogeneous clinical features. So far, longitudinal studies using clinical subgroups to direct treatment and predict outcome are still required.

Biomarkers in FM, which is a neurobiological disease, are of promising interest, nevertheless currently, none of them can be used to subgroup FM patients.

• Due to the fact that cortical and subcortical mechanisms of gait control share some cognitive functions which are involved in FM, gait markers have been proposed to evaluate and to subgroup FM patients, in clinical settings. Three out of 4 core FM symptoms are linked to gait markers.

• Kinesia [muscle movement] measured by means of cranio-caudal power is correlated to pain, and could be proposed to assess pain behavior (kinesiophobia).

• Stride frequency, which is linked to physical component, allows the identification of a hyperkinetic subgroup. Moreover, SF has been correlated to fatigue during the 6 minute walking test.

• Stride regularity, which expresses the unsteadiness of gait, is correlated to cognitive dysfunction in FM. Decreased stride regularity allows the recognition of a homogeneous subgroup characterized by an increased anxiety and depression, and decreased cognitive functions.

These results need further studies to be validated and so used in the daily clinical practice.

Source: Reumatismo. 2012 Sep 28;64(4):250-60. PMID: 23024969, Auvinet B, Chaleil D. Polyclinique du Maine, Laval Cedex; Department of Pharmacy, University Hospital, Angers, France. [Email: bernard.auvinet@gmail.com]
 



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Gait in Fibro
Posted by: gillybean
Oct 12, 2012
Just read the latest information on gait as an indicator in Fibromyalgia with interest.

I walk very badly with stiff legs and wobbles (I dance around my walking stick sometimes) and wondered whether anyone else has this symptom. As I also have Arthritis and DDD in my spine I always thought that they were the cause. Now it looks as though it may be Fibromyalgia after all.
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Gait analysis and cognitive function
Posted by: gillybean
Oct 12, 2012
Having just read the entire paper I am hoping that the results of these analyses will be made available to physicians in the UK such that they will not only help to subgroup sufferers but also to aid in diagnosis.

As research on FM increases and more results show how the illness manifests then perhaps these findings will help those who, to all intents and purposes, don't necessarily look ill. FM is debilitating but, in the UK, still regarded somewhat suspiciously.

As a sufferer who has cognitive problems which have significantly reduced my memory and ability to function as I used to (I was a member of MENSA) it is worrying that this may be linked to cognitive problems which exist in other illnesses mentioned in the paper.

As nothing has ever been recorded, in research I have read so far, about FM doing damage to the body, I find the cognitive diminution a worrying symptom as this seems to be degenerative. If so, are any other findings going to show that FM is more than just a list of symptoms. Personally I find the cognitive problems to be the greatest for me as I feel that I have lost a lot of my IQ to the illness. I can deal with the other problems, even though they are debilitating, because they are not harming my body. If my memory function is reduced then there doesn't seem to be any reason why the other symptoms are, in some way, harming me too. I would be very interested to find out if this is so.
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