Articles & Research
Patients With Fibromyalgia Have Quantifiable Neurological Deficits
Pamela S. Johnson M.S./P.T., Helen Bourke-Taylor O.T.R./L., Dan s. Heffez M.D., Daniel G. Malone M.D., Ruth E. Ross Ph.D. and James W. Robertson B.S. (Sponsored by Daniel Malone) ¹Chicago Institute of Neurosurgery and Neuroresearch, Chicago, IL 60614 and University of Wisconsin at Madison, Madison, WI 53706
OBJECTIVE: An association has been proposed between fibromyalgia and cervical myelopathy. As part of an investigation of a possible neurological etiology of fibromyalgia, 42 consecutive patients with fibromyalgia were evaluated using a series of standardised tests of neurological function. We assessed upper extremity function including coordination and dexterity (Jebsen-Taylor Hand Test and nine-hole peg test) and strength (Jamar dynamometer and pinch gauge). Mobility and static and dynamic balances were assessed using the Berg Balance Scale and timed measures of ambulation. The median age of patients was 44 years. Patients carried the diagnosis of fibromyalgia for a median of 6 years. Eighty-seven percent of patients were female.
METHODS: Data analysis indicated that 68% of patients had balance deficits as shown by the Berg Balance Scale, including impaired functional reach (31%), tandem stance (24%) and single limb stance (26%). The sample size allowed for the analysis of the Jebsen-Taylor hand test of dexterity only for the 30 right-handed females; a statistically significant slowing as compared to accepted standard of normal was identified in 6 of 7 subtests. Forty-six percent and 33% of patients fell below the 25th percentile on nine-hole peg testing of the dominant and non-dominant hands, respectively. Tests of grip strength and dexterity showed a lack of the normal dominance pattern in 60% of patients.
CONCLUSION: We conclude that some patients with fibromyalgia have neurological dysfunction that can be objectively quantified. This database will allow for prospective objective analysis of the response of fibromyalgia to the treatment of cervical myelopathy.