Decreased muscle blood flow in fibromyalgia patients during standardised muscle exercise: A contrast media enhanced colour doppler study

Abstract

The aim of the study was to investigate if contrast enhanced ultrasound (US) imaging of muscular blood flow during and following exercise could detect alterations in vascularity in fibromyalgia (FM) patients. Ten FM patients and 10 matched controls were examined with US during standardised static and directly following static and dynamic muscular contractions of the infraspinatus muscle. Doppler ultrasound evaluation was performed before and after the administration of ultrasound contrast media. The FM patients had lower magnitude of muscle vascularity following dynamic (p<0.001) and during (p<0.002) static exercise compared to controls. The immediate flow response to muscular activity was not only of a lower magnitude, but also of a shorter duration in FM patients following dynamic exercise (p<0.001) and during static exercise (p<0.01). There were no statistically significant group differences in blood flow intensity or duration following static contraction. In conclusion, contrast enhanced US was found useful to study real-time muscle blood flow changes during and following standardised, low-intensity exercise in FM patients and healthy controls. Our results support the suggestion that muscle ischemia can contribute to pain in FM, possibly by maintaining the central nervous changes such as central sensitisation/disinhibition. US with contrast can be a new valuable approach to assess muscle perfusion in pain patients during standardised exercise.

The Influence of Fatigue on Muscle Temperature

“…Bertmaring et al suggested that results obtained with IR thermography were sensitive to fatigue of the musculoskeletal system; however, various factors such as blood flow or muscle heating could affect the skin surface temperature [35]. The results of other studies also indicate that muscle effort causes changes in blood flow [27,28,29]. The changes in temperature on the surface of the skin, observed in the present study, may result not only from muscle heating but also from other factors such as blood flow.…”

“…Invasive experiments, with biochemical indicators (CrP, ATP, ADP) show changes in time of load even at levels under 10% MVC [25]. The results indicate that low-level effort causes changes in blood pressure, heart rate and blood flow [27,28,29]. Moreover, studies with the use of surface EMG show fatigue at levels of muscle contraction as low as 8% MVC [26].…”

Noninvasive optical quantification of absolute blood flow, blood oxygenation, and oxygen consumption rate in exercising skeletal muscle

“…Characterization of circulatory and metabolic function in skeletal muscle has important applications in exercise and sports medicine [1][2][3][4][5] and provides key information for understanding many common diseases (e.g., peripheral vascular disease, [6][7][8] fibromyalgia, 9 heart failure 10,11 ) affecting skeletal muscle. Because differences between healthy and diseased populations are not always apparent at rest, it is important to study muscle hemodynamic and metabolic changes in response to stimuli.…”

Autonomic Regulation in Musculoskeletal Pain

“…Impaired blood flow to the pain region has been observed in persons with both chronic regional and widespread pain during various provocations, e.g., cold water, needle stimulation by acupuncture, and static or dynamic contractions (Acero et al 1999;Larsson et al 1999;Sandberg et al 2005;Elvin et al 2006;; for comprehensive reviews on this topic see Passatore and Roatta (2006) and Vierck (2006).…”