Sahin Günşah, Ulubaş Bahar, Calikoğlu Mukadder, Erdoğan Canan
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mersin University, Mersin, Turkey.
South Med J. 2004 Jan;97(1):25-9. doi: 10.1097/01.SMJ.0000101146.95697.18.
It has been reported that patients with fibromyalgia syndrome (FMS) have lower maximal respiratory pressures than healthy subjects, indicating reduced pulmonary muscle strength. It has also been reported that patients with FMS have reduced grip strength. In this study, we aimed to examine the possible relationship between handgrip strength as a determinant of peripheral muscle strength and pulmonary muscle strength in patients with FMS by comparing them with healthy controls.
Forty-one consecutive women with FMS (diagnosed according to the American College of Rheumatology 1990 criteria) were compared with 40 age- and body mass index-matched healthy female controls. Pulmonary function tests were assessed by spirometry. Maximal pulmonary pressures were evaluated using an oral pressure meter. A dyspnea score was obtained. Pain was scored according to visual analogue scale and chest pain was classified (0-9) in fibromyalgia patients. Chest expansion was also measured in the two groups. Tender points were also evaluated in FMS patients. Grip strength (Jamar handheld dynamometer) was also measured in the two groups.
The difference in pulmonary function tests was not statistically significant between groups. Maximal respiratory pressures (maximum inspiratory pressure and maximum expiratory pressure) and endurance (maximum ventilatory volume) were significantly lower in patients with FMS than in controls. There was also a statistically significant difference between groups regarding grip strength. There was also significant correlation between maximal inspiratory pressure and maximal expiratory pressure values and handgrip strength in patients with FMS.
These data indicate that handgrip strength may be a determinant of pulmonary muscle strength in fibromyalgia patients.
据报道，纤维肌痛综合征（FMS）患者的最大呼吸压力低于健康受试者，这表明其肺肌力量下降。另据报道，FMS患者的握力也有所降低。在本研究中，我们旨在通过将FMS患者与健康对照进行比较，来检验作为外周肌肉力量决定因素的握力与FMS患者肺肌力量之间可能存在的关系。
将41名连续的FMS女性患者（根据美国风湿病学会1990年标准诊断）与40名年龄和体重指数相匹配的健康女性对照进行比较。通过肺活量测定法评估肺功能测试。使用口腔压力计评估最大肺压力。获得呼吸困难评分。根据视觉模拟量表对疼痛进行评分，并对纤维肌痛患者的胸痛进行分类（0 - 9级）。还测量了两组的胸廓扩张度。对FMS患者的压痛点也进行了评估。两组均测量了握力（Jamar手持测力计）。
两组之间肺功能测试的差异无统计学意义。FMS患者的最大呼吸压力（最大吸气压力和最大呼气压力）和耐力（最大通气量）显著低于对照组。两组之间在握力方面也存在统计学显著差异。FMS患者的最大吸气压力和最大呼气压力值与握力之间也存在显著相关性。
这些数据表明，握力可能是纤维肌痛患者肺肌力量的一个决定因素。
