Fibromyalgia: is there association between balance and pain? a pilot study

Studies of balance and risk factors for falling typically focus on the elderly population or on individuals with musculoskeletal pain. Although fibromyalgia is associated with intrinsic factors that predispose to falls (pain, depression, fatigue), few studies have researched balance and falls in this syndrome. The aim of this study was to verify the association between balance, balance self-efficacy and pain in women with and without fibromyalgia, and verify the association between Berg Balance Scale and Activities-specific Balance Confidence Scale (ABC Scale). The sample consisted of 48 women aged between 40 and 59 years, divided into two groups: Fibromyalgia group (n=22) and Control group (n=26) with asymptomatic people. Balance was assessed by Berg Balance Scale, balance self-efficacy by the ABC Scale and pain by the visual analog scale. Mean scores for pain, Berg and ABC Scale were 5.4 cm (SD 2.6), 55 (interquartile range 54-56), and 54.6 (SD 26.6) respectively for Fibromyalgia group, and 0 cm, 56 (interquartile range 55-56), and 89.4 (SD 14.4) respectively for Control group. Statistically significant differences were found in balance on comparing both groups (p=0.000 for Berg Balance Scale and 0.009 for ABC Scale) with lower values for Fibromyalgia group. In Fibromyalgia group, pain was negatively correlated with balance (r=-0.48, p=0.020) and balance self-efficacy (rs=-0.56, p=0.006). Correlation between Berg Balance Scale and ABC Scale was found only in the Fibromyalgia group (rs =0.55, p=0.007). There are associations between poor balance and pain, and poor balance and decreased balance self-efficacy in women with fibromyalgia. There is an association between scales in the Fibromyalgia group.

有关跌倒平衡与危险因素的研究通常聚焦于老年人群或肌肉骨骼疼痛患者。尽管纤维肌痛综合征（fibromyalgia）存在易导致跌倒的内在危险因素（疼痛、抑郁、疲劳），但针对该综合征患者的平衡与跌倒相关研究却较为匮乏。本研究旨在验证伴或不伴纤维肌痛综合征的女性群体中，平衡能力、平衡自我效能感与疼痛之间的关联，并验证伯格平衡量表（Berg Balance Scale）与活动特异性平衡信心量表（ABC Scale）之间的相关性。本研究纳入48名年龄介于40至59岁的女性，分为两组：纤维肌痛组（n=22）与无症状对照组（n=26）。平衡能力通过伯格平衡量表进行评估，平衡自我效能感采用活动特异性平衡信心量表进行测评，疼痛程度则使用视觉模拟量表（visual analog scale）进行量化。纤维肌痛组的疼痛、伯格平衡量表及ABC量表平均得分分别为5.4 cm（标准差2.6）、55分（四分位间距54~56）与54.6（标准差26.6）；对照组则分别为0 cm、56分（四分位间距55~56）与89.4（标准差14.4）。两组平衡能力对比存在统计学显著性差异（伯格平衡量表p=0.000，ABC量表p=0.009），纤维肌痛组的相关评分更低。在纤维肌痛组中，疼痛与平衡能力呈负相关（r=-0.48，p=0.020），与平衡自我效能感亦呈负相关（rs=-0.56，p=0.006）。仅在纤维肌痛组中观察到伯格平衡量表与ABC量表之间存在相关性（rs=0.55，p=0.007）。纤维肌痛女性群体中，平衡能力低下与疼痛、平衡自我效能感下降存在关联。纤维肌痛组内的两类量表评分亦存在相关性。