Bazzichi Laura, Dini Marco, Rossi Alessandra, Corbianco Silvia, De Feo Francesca, Giacomelli Camillo, Zirafa Cristina, Ferrari Claudia, Rossi Bruno, Bombardieri Stefano
Department of Internal Medicine, Division of Rheumatology, S. Chiara Hospital, Pisa, Italy.
BMC Musculoskelet Disord. 2009 Apr 15;10:36. doi: 10.1186/1471-2474-10-36.
Several studies have been carried out in order to investigate surface electromyography (SEMG) response on fibromyalgic (FM) patients. Some studies failed to demonstrate differences between FM patients and healthy individuals while others found differences in SEMG parameters. Different muscular region have been analyzed in FM patients and heterogeneity is also produced because of the different ways in which the SEMG technique is used. The aims of this study were to evaluate muscle modifications by SEMG analysis in FM women with respect to a sample of healthy controls and to investigate the relationships between SEMG parameters and the clinical aspects of the disease.
SEMG was recorded in 100 FM women (48.10 +/- 11.96 yr) and in 50 healthy women (48.60 +/- 11.18 yr), from the tibialis anterior and the distal part of vastus medialis muscle during isometric contraction. Initial values and rate of change of median spectral frequency (MDF) and conduction velocity (CV) of the SEMG signal were calculated.The clinical parameters "Fibromyalgia Impact Questionnaire", pain, tender points, tiredness were evaluated and the relationships between these data and the SEMG results were also studied. For the statistical analysis Mann-Whitney test, chi-square test and Spearman correlation were used.
MDF absolute values and the so-called Fatigue Index (FI) were significantly lower (p < 0.001) in both muscles studied in FM patients (MDF: 93.2 microV; FI: 1.10, 0.89) with respect to healthy controls (MDF: 138.2 microV; FI: 2.41, 1.66) and a smaller reduction in the percentage values of MDF was observed in FM patients vs controls (22% vs 38%). A significant correlation was found between the SEMG parameter decrement of normalized median frequency (MNF) (%) and seriousness of FM (evaluated by means of tender points).
We have found some interesting muscle modifications in FM patients with respect to healthy controls, regarding MDF, CV and FI values which resulted significantly lower in FM. Patients might have a different fiber recruitment or a possible atrophy of type II fibers suggesting that they are not able to reach muscle relaxation.
为了研究纤维肌痛（FM）患者的表面肌电图（SEMG）反应，已经开展了多项研究。一些研究未能证明FM患者与健康个体之间存在差异，而另一些研究则发现SEMG参数存在差异。在FM患者中分析了不同的肌肉区域，并且由于使用SEMG技术的方式不同，也产生了异质性。本研究的目的是通过SEMG分析评估FM女性相对于健康对照样本的肌肉变化，并研究SEMG参数与疾病临床方面之间的关系。
对100名FM女性（48.10±11.96岁）和50名健康女性（48.60±11.18岁）在等长收缩期间记录胫前肌和股内侧肌远端的SEMG。计算SEMG信号的中位频谱频率（MDF）和传导速度（CV）的初始值和变化率。评估临床参数“纤维肌痛影响问卷”、疼痛、压痛点、疲劳，并研究这些数据与SEMG结果之间的关系。统计分析采用曼-惠特尼检验、卡方检验和斯皮尔曼相关性分析。
FM患者研究的两块肌肉的MDF绝对值和所谓的疲劳指数（FI）均显著低于健康对照（p<0.001）（MDF：93.2微伏；FI：1.10，0.89）（健康对照：MDF：138.2微伏；FI：2.41，1.66），并且与对照相比，FM患者MDF的百分比值下降幅度较小（22%对38%）。在归一化中位频率（MNF）（%）的SEMG参数减量与FM的严重程度（通过压痛点评估）之间发现显著相关性。
相对于健康对照，我们在FM患者中发现了一些有趣的肌肉变化，关于MDF、CV和FI值，这些在FM中显著较低。患者可能有不同的纤维募集或II型纤维可能萎缩，表明他们无法达到肌肉放松。
