The relationship between cervical proprioception and balance in patients with fibromyalgia syndrome

Abstract

Proprioceptive abnormalities, balance, and postural disorders have been previously reported in fibromyalgia syndrome (FMS). Unlike previous research, the aim of this study was to compare the proprioception of the cervical region of patients with FMS with a healthy control group. The relationship between cervical proprioception impairment and loss of balance was also examined. A total of 96 female FMS patients and 96 female healthy control subjects were enrolled in this case-control study. The cervical joint position error test (CJPET) was administered to the patient and control groups for cervical proprioception evaluation. FMS patients were assessed with a visual analogue scale (VAS), fibromyalgia impact questionnaire (FIQ), and fatigue severity scale (FSS). Balance tests were applied to both groups. FMS patients had significantly impaired CJPET results in all directions (p < 0.001). There were significant positive correlations between FIQ scores and CJPET results (r = 0.542 and p < 0.001 for right rotation; r = 0.604 and p < 0.001 for left rotation; r = 0.550 and p < 0.001 for flexion; r = 0.612 and p < 0.001 for extension). Significant correlations were found between CJPET measurements and balance tests (for sit-tostand test; r = 0.510 and p < 0.001 for right rotation; r = 0.431 and p < 0.001 for left rotation; r = 0.490 and p < 0.001 for flexion; r = 0.545 and p < 0.001 for extension), (for timed up and go test; r = 0.469 and p < 0.001 for right rotation; r = 0.378 and p < 0.001 for left rotation; r = 0.410 and p < 0.001 for flexion; r = 0.496 and p < 0.001 for extension) and (for one-legged balance test; r = −0.479 and p < 0.001 for right rotation; r = −0.365 and p < 0.001 for left rotation; r = −0.392 and p < 0.001 for flexion; r = −0.469 and p < 0.001 for extension). Cervical proprioception and balance were impaired in FMS patients. As the disease activity and fatigue level increased, so the deterioration in cervical proprioception became more evident. There were correlations that demonstrated an association between impaired cervical proprioception and poor balance tests. Therefore, proprioception and balance assessments should be integrated into the physical examination processes of FMS patients.

Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome

“…Similar to our study results, Gucmen et al [24] demonstrated a strong relationship between cervical repositioning tests and static and dynamic balance. Cervical JPS errors in flexion, extension, left and right rotations were correlated with the one-leg balance test and timed up-and-go test (p < 0.001) [24].…”

“…Impaired postural control and risk of falling were identified in FMS individuals compared to controls, and the risk of falling was increased in individuals without taking medication [22]. Similar to our study results, Gucmen et al [24] demonstrated a strong relationship between cervical repositioning tests and static and dynamic balance. Cervical JPS errors in flexion, extension, left and right rotations were correlated with the one-leg balance test and timed up-and-go test (p < 0.001) [24].…”

“…Chronic pain and fatigue are the primary symptoms of FMS [23]. Previous research indicates that several populations, including those with neck pain, proprioceptive, and postural disturbances, are associated with pain and muscle fatigue [24,25]. In addition, different authors showed that proprioceptive retraining enhanced postural control [26,27].…”

Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients

“…Also, joint hypermobility is three times more frequent in fibromyalgia than in control groups [60]. And, importantly, upon specific proprioception testing in fibromyalgia cohorts, significant alterations have been demonstrated in muscle contraction [61,62], muscle relaxation [63], vibration perception [61], joint position sense [64][65][66][67], and the proprioceptive component of postural control [61,65,[68][69][70][71] with frequent falls [68,72,73]. Problems in postural control or balance are also related to altered vestibular and visual dysfunction [68,73,74], which may indicate that sensory weakness is not limited to proprioception in fibromyalgia [50,51].…”

Evaluation of visual reaction time in patients with fibromyalgia syndrome

“…Fibromyalgia (FMS) is a complex of symptoms included in the class of rheumatological disorders, in which chronic musculoskeletal pain is the leading complaint. This complex condition can be accompanied by fatigue, impaired sleep quality, stiffness, tenderness, perturbed psychiatric condition, and cognitive imbalance [1,2]. The etiopathogenesis of FMS is complex [3].…”