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握力测试作为评估女性纤维肌痛严重程度的补充工具。

Handgrip strength test as a complementary tool in the assessment of fibromyalgia severity in women.

机构信息

Department of Physical Education and Sport, University of Granada, Spain.

出版信息

Arch Phys Med Rehabil. 2011 Jan;92(1):83-8. doi: 10.1016/j.apmr.2010.09.010.

Abstract

OBJECTIVES

To determine the ability of handgrip strength test to discriminate between presence and absence of fibromyalgia (FM) and FM severity in women.

DESIGN

A case-control study.

SETTING

Granada, south Spain.

PARTICIPANTS

Women with FM (mean age ± SD, n=81; 50.0±7y) and healthy women (mean age ± SD, n=44; 47.7±6y).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Handgrip strength was measured in both hands (average score was used in the analyses) by a maximal isometric test using a hand dynamometer. Patients were classed as having moderate FM if the score in the Fibromyalgia Impact Questionnaire (FIQ) was less than 70 and as having severe FM if the FIQ was 70 or greater.

RESULTS

Handgrip strength levels were lower in patients with FM than healthy women (19.3 vs 27.9kg; P<.001) and in women with severe FM (FIQ≥70) compared with those with moderate FM (FIQ<70) (16.9 vs 20.2kg; P=.02). Receiver operating characteristic curve analyses revealed that the handgrip strength threshold that best discriminated between the presence and absence of FM was 23.1kg (area under the curve [AUC]=.88; 95% confidence interval [CI], 0.82-0.94; P<.001), whereas the handgrip strength threshold that best discriminate between severe and moderate FM was 16.9kg (AUC=.67; 95% CI, 0.53-0.80; P<.05). Logistic regression analysis showed that handgrip strength 23.1kg or less was associated with 33.8 times higher odds (95% CI, 9.4-121.5) for having FM after adjustment for age. In the FM group, handgrip strength 16.9kg or less was associated with 5.3 times higher odds (95% CI, 1.9-14.5) for having severe FM.

CONCLUSIONS

Handgrip strength is reduced in women with FM as well as those with severe FM from their peers with moderate FM. Identification of women who fail to meet the suggested standards can be a helpful and informative tool for clinician.

摘要

目的

确定握力测试鉴别纤维肌痛(FM)存在与否以及女性 FM 严重程度的能力。

设计

病例对照研究。

地点

西班牙南部格拉纳达。

参与者

患有 FM 的女性(平均年龄±标准差,n=81;50.0±7 岁)和健康女性(平均年龄±标准差,n=44;47.7±6 岁)。

干预措施

不适用。

主要观察指标

使用手持测力计进行最大等长测试测量双手握力(分析中使用平均得分)。如果纤维肌痛影响问卷(FIQ)得分低于 70,则将患者归类为中度 FM;如果 FIQ 为 70 或更高,则归类为严重 FM。

结果

患有 FM 的女性的握力水平低于健康女性(19.3 对 27.9kg;P<.001),也低于 FIQ≥70 的严重 FM 女性(16.9 对 20.2kg;P=.02)。接受者操作特征曲线分析显示,最佳区分 FM 存在与否的握力阈值为 23.1kg(曲线下面积[AUC]=.88;95%置信区间[CI],0.82-0.94;P<.001),而最佳区分严重和中度 FM 的握力阈值为 16.9kg(AUC=.67;95%CI,0.53-0.80;P<.05)。Logistic 回归分析显示,调整年龄后,握力 23.1kg 或以下与患 FM 的可能性高 33.8 倍(95%CI,9.4-121.5)相关。在 FM 组中,握力 16.9kg 或以下与患有严重 FM 的可能性高 5.3 倍(95%CI,1.9-14.5)相关。

结论

患有 FM 以及严重 FM 的女性的握力均低于其患有中度 FM 的同龄人。识别不符合建议标准的女性可能是临床医生的有用和信息丰富的工具。

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