(Norwegian) Motor behavior in Chronic Fatigue Syndrome and Fibromyalgia

https://brage.bibsys.no/xmlui/handle/11250/2466218

MOTOR BEHAVIOR IN CHRONIC FATIGUE SYNDROME AND FIBROMYALGIA
Rasouli, Omid

Doctoral thesis

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http://hdl.handle.net/11250/2466218

Issue date
2017

Abstract
Bakgrunn: Kronisk utmattelsessyndrom (CFS) er karakterisert ved funksjonsnedsettende utmattelse, mens fibromyalgi (FM) karakteriseres av utbredte kroniske smerter, men det er stor grad av overlapp mellom symptom mellom disse diagnoser. Det er derfor et spørsmål hvorvidt disse likheter handler om komorbiditet mellom diagnoser eller er ulike uttrykk for samme lidelse. Patologi og underliggende mekanismer som forklarer CFS og FM er uklare.


Mål: Denne avhandlingen har undersøkt ulike aspekter av motorisk kontroll, spesielt statisk og dynamisk postural kontroll, hos pasienter med FM og CFS sammenlignet med friske kontrollpersoner (HC) for å lære mer om likheter og ulikheter mellom lidelsene.


Metoder: Vi rekrutterte 75 kvinnelige deltakere i alderen 19-49 år, jevnt fordelt på tre grupper (CFS, FM og HC). Statisk postural kontroll ble testet med 60 sekunder stående stille på en kraftplattform i fire ulike tilstander: med øyene åpne, med øyene lukket, på mykt underlag og med en samtidig kognitiv oppgave å telle baklengs. Statisk kontroll ble analysert som amplitude og frekvens av kroppssvai og av dreiemoment over ankelleddet (som kontrollerer kroppssvai). Dynamisk postural kontroll ble testet ved initiering av gange og ble analysert ved bruk av tau-konseptet for relasjonen mellom posisjon og hastighet, og for reaksjonstid. Finmotorisk kontroll for øvre ekstremitet ble evaluert med Purdue Pegboard Test, dvs. utfra antall pinner plassert på brettet i løpet av 30 sekunder.


Resultater: Resultatene viste lavere postural kontroll hos pasienter med FM og CFS, men ingen signifikante forskjeller mellom pasientgruppene. Dog, sammenlignet med HC, viste pasientene med FM dårligere kontroll enn de med CFS når persepsjon, dvs. syn og underlag, ble manipulert. Motsatt viste de med CFS (sammenlignet med HC) dårligere kontroll enn de med FM da kognisjon ble stresset. Stående på mykt underlag viste begge pasientgruppene større amplitude og lavere frekvens for kroppssvai sammenlignet med HC (p˂ 0.05). Også ved telleoppgaven viste pasientene lavere frekvens for kroppssvai men større amplitude av dreiemoment over ankelleddet enn HC (p˂ 0.01). Sammenlignet med HC viste begge pasientgruppene dårligere dynamisk kontroll av balanse (p < 0.05) og signifikant lenger reaksjonstid ved initiering av gange (p˂ 0.01). For Purdue Pegboard testen scoret 20% av pasientene med FM og 15% av pasientene med CFS lavere enn terskelverdien for forventet prestasjon, men det var ingen signifikant forskjell mellom pasientgruppene.


Konklusjon: I sum viste pasientene med FM og de med CFS omtrent samme lave nivå av motorisk kontroll, men ulike trender sammenlignet med HC: lavere postural kontroll hos pasienter med FM ved økte krav til persepsjon og lavere postural kontroll hos pasienter med CFS ved stress av kognisjon. Trendene indikerer at somatisk nedsettelse kan være mer påvirket ved FM, mens kognitiv evne virker mer nedsatt ved CFS. Resultatet hentyder subtile ulikheter mellom CFS og FM.
Publisher
NTNU
Series
Doctoral theses at NTNU;2017:233

 

Google Translate (and broken up a bit for readability):

Abstract
Background: Chronic fatigue syndrome (CFS) is characterized by impairment of fatigue while fibromyalgia (FM) is characterized by widespread chronic pain, but there is a large degree of overlap between symptoms between these diagnoses. It is therefore a question whether these similarities are about comorbidity between diagnoses or are different expressions of the same disorder. Pathology and underlying mechanisms explaining CFS and FM are unclear.


Aim: This thesis has examined various aspects of motor control, especially static and dynamic postural control, in FM and CFS patients compared to healthy control subjects (HC) to learn more about similarities and differences between the disorders.


Methods: We recruited 75 female participants aged 19-49, evenly divided into three groups (CFS, FM and HC). Static postural control was tested with 60 seconds standing on a power platform in four different states: with the islands open, with the eyes closed, on soft surfaces and with a simultaneous cognitive task counting backwards.

Static control was analyzed as the amplitude and frequency of body surges and torque over the ankle joint (which controls body sway). Dynamic postural control was tested at initiation times and was analyzed using the tau concept for the relationship between position and velocity and for reaction time.

Fine motor control for upper extremity was evaluated with Purdue Pegboard Test, ie based on the number of sticks placed on the tray within 30 seconds.

Results: Results showed lower postural control in patients with FM and CFS, but no significant differences between patient groups. However, compared with HC, patients with FM showed poorer control than those with CFS when perception, ie vision and support, were manipulated.

Conversely, with CFS (compared with HC), they showed worse control than those with FM when cognition was stressed. Standing on soft surfaces, both patient groups showed greater amplitude and lower body vibration frequency compared to HC (p 0.05). Also in the counting task, patients showed lower frequency of body sweep but greater amplitude of torque over the ankle joint than HC (p 0.01).

Compared with HC, both patient groups showed poorer dynamic control of balance (p <0.05) and significantly longer response time at initiation times (p 0.01). For the Purdue Pegboard test, 20% of patients with FM and 15% of patients with CFS scored less than the expected achievement threshold, but there was no significant difference between the patient groups.

Conclusion: In total, patients with FM and those with CFS showed approximately the same low level of motor control, but different trends compared with HC: lower postural control in patients with FM with increased perception requirements and lower postural control in CFS patients by stress of cognition.

Trends indicate that somatic impairment may be more affected by FM, while cognitive ability seems more impaired in CFS. The result indicates subtle differences between CFS and FM.

 

@Sasha

Is this the answer to your question?

 

I wondered that...

 

One of the contributor advisors is professor Egil Fors - very keen on a psychosomatic approach to ME, and has claimed that such a diagnosis makes it easy to "choose" benefits.

The same author of the thesis, Omid Rasouli, is also behind Gross and fine motor function in fibromyalgia and CFS from February this year, and it is in English.

 

Maybe they could check the neuromusculairjunction.

 

The cognitive stress thing makes sense to me. When I was well enough to think it was achievable, choosing items standing in a supermarket with ME and POTS was terrible. Also things combining fine motor control and concentration I now find really draining (eg sewing machine).