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Muscle strength, voluntary activation, twitch properties, & endurance in patients with fibromyalgia (FM)

  [ 38 votes ]   [ Discuss This Article ] • September 3, 1994

Previous studies have shown decreased voluntary muscle strength and
endurance in patients with fibromyalgia. The aim of this study
was to determine to what extent this is due to lack of
exertion. The twitch interpolation technique was used to
determine the degree of central activation and estimate the
"true" quadriceps muscle strength in patients with
fibromyalgia and age and sex matched controls. Subjects
hereafter performed an endurance test consisting of repetitive
contractions at 50% of estimated "true" muscle strength of
four seconds duration followed by a six second rest until
exhaustion, or maximally for 40 minutes. Twitch decline and
increases in mean rectified EMG were used as objective markers
of fatigue. The estimated "true" muscle strength was 82 (SD
26) Nm in 20 patients with fibromyalgia compared with 133 Nm
(SD 28) Nm in the 21 controls (p < 0.001). The "true" muscle
strength per cm2 midthigh cross sectional area was lower 0.50
(SD 0.15) Nm/cm2 in the patients compared with 0.74 (SD 0.15)
Nm/cm2 in the controls (p < 0.001). The decline over time in
twitch sizes was similar in the two groups. The mean rectified
EMG signal at a fixed force level of 50% of "true" muscle
strength increased similarly in the two groups. Relaxation
rates and contraction rates also increased equally in the two
In conclusion, a reduction of the estimated muscle
strength per area unit of about 35% was found in the patients
with fibromyalgia. This might be secondary to physical
inactivity or neuroendocrine factors. No differences in
changes in the neurophysiological indices associated with
fatigue were found between the two groups.

Norregaard J, Bulow PM, Danneskiold-Samsoe B

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