Bergenheim A1,2,3, Johannesson S1,3, Nordeman L1,2, Joelsson M3, Mannerkorpi K1
1Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Physiotherapy, Göteborg, Sweden, 2Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Sweden, 3Närhälsan Rehabilitation Centres, Region Västra Götaland, Sweden
Background: The prevalence in the Western world is about 10-15 % for chronic widespread pain (CWP) and 1-3 % for Fibromyalgia (FM). The ACR 1990 criteria define CWP as pain ≥ 3 months on both sides of the body, above and below the waist and axial skeletal pain. FM is defined as CWP in combination with pain in ≥11 of 18 tender points. Women with FM or CWP have decreased physical capacity in comparisons with healthy women which contributes to impairment. There is limited knowledge of the course of impairment and physical capacity in women with FM or CWP over a longer period of time.
Purpose: To investigate the course of self-assessed overall impairment, walking capacity and handgrip strength in a cohort of women with FM or CWP after 12 years.
Methods: A longitudinal cohort study. 166 women with FM or CWP were invited to follow-up after 12 years. At baseline and follow-up, they completed the Fibromyalgia Impact Questionnaire (FIQ), performed the 6 minute walk test (6MWT) and measured hand grip strength with the Grippit. The FIQ score (0-100 p) was divided into categories of mild (>39 p), moderate (≥39 to 59 p) and severe impairment (≥59 p). Changes within the cohort from baseline to follow-up were calculated with Sign test for the FIQ and Paired t-test for the 6MWT and the Grippit.
Results: At the 12 year follow-up, 125 women (75%) completed the FIQ and 106 (64 %) participated in the 6MWT and the Grippit. Mean age at follow-up was 57 years (range 33-71).
The level of self-assessed impairment in the FIQ improved within the cohort over 12 years (p 0.001), from baseline (Mild 9 %, moderate 28 % and severe 63 %) to follow-up (Mild 34 %, moderate 32 % and severe 33 %).
The 6MWT did not change significantly (p=0.074) from baseline (mean 514 m, SD 87) to follow-up (mean 498 m, SD 83 m). About 50 % of the 106 women remained unchanged (+/-15 m) or improved in 6MWT.
The Grippit decreased for right (p=0.050) and left (p 0.001) hand from baseline (right 160 N, SD 67; left 160 N, SD 64) to follow-up (right 148 N, SD 65; left 136 N, SD 59).
Conclusion(s): The level of self-assessed impairment improved on group-level over 12 years in women with FM or CWP. Although 12 years increase of age, the walking capacity did not decrease significantly. However, the hand grip strength decreased over 12 years from very low values at baseline to even lower at the follow-up.
Implications: Health care professionals often have a negative notion of the long-term prognosis for women with FM or CWP. This study shows that many women with FM or CWP improve in self-assessed impairment and walking capacity with increasing age, which should be mediated to patients in primary care. They have however low hand grip strength which decreases further over time, which is a known risk factor of all-cause mortality. Thus, women with FM or CWP should be encouraged to perform continuous resistance exercise.
Keywords: Fibromyalgia, Walk test, Hand strength
Funding acknowledgements: The Healthcare Committee, Region Västra Götaland, Sweden
Purpose: To investigate the course of self-assessed overall impairment, walking capacity and handgrip strength in a cohort of women with FM or CWP after 12 years.
Methods: A longitudinal cohort study. 166 women with FM or CWP were invited to follow-up after 12 years. At baseline and follow-up, they completed the Fibromyalgia Impact Questionnaire (FIQ), performed the 6 minute walk test (6MWT) and measured hand grip strength with the Grippit. The FIQ score (0-100 p) was divided into categories of mild (>39 p), moderate (≥39 to 59 p) and severe impairment (≥59 p). Changes within the cohort from baseline to follow-up were calculated with Sign test for the FIQ and Paired t-test for the 6MWT and the Grippit.
Results: At the 12 year follow-up, 125 women (75%) completed the FIQ and 106 (64 %) participated in the 6MWT and the Grippit. Mean age at follow-up was 57 years (range 33-71).
The level of self-assessed impairment in the FIQ improved within the cohort over 12 years (p 0.001), from baseline (Mild 9 %, moderate 28 % and severe 63 %) to follow-up (Mild 34 %, moderate 32 % and severe 33 %).
The 6MWT did not change significantly (p=0.074) from baseline (mean 514 m, SD 87) to follow-up (mean 498 m, SD 83 m). About 50 % of the 106 women remained unchanged (+/-15 m) or improved in 6MWT.
The Grippit decreased for right (p=0.050) and left (p 0.001) hand from baseline (right 160 N, SD 67; left 160 N, SD 64) to follow-up (right 148 N, SD 65; left 136 N, SD 59).
Conclusion(s): The level of self-assessed impairment improved on group-level over 12 years in women with FM or CWP. Although 12 years increase of age, the walking capacity did not decrease significantly. However, the hand grip strength decreased over 12 years from very low values at baseline to even lower at the follow-up.
Implications: Health care professionals often have a negative notion of the long-term prognosis for women with FM or CWP. This study shows that many women with FM or CWP improve in self-assessed impairment and walking capacity with increasing age, which should be mediated to patients in primary care. They have however low hand grip strength which decreases further over time, which is a known risk factor of all-cause mortality. Thus, women with FM or CWP should be encouraged to perform continuous resistance exercise.
Keywords: Fibromyalgia, Walk test, Hand strength
Funding acknowledgements: The Healthcare Committee, Region Västra Götaland, Sweden
Topic: Rheumatology; Pain & pain management
Ethics approval required: Yes
Institution: University of Gothenburg
Ethics committee: The Regional ethical review board in Gothenburg
Ethics number: 097-16
All authors, affiliations and abstracts have been published as submitted.
