Góes Suelen M, Stefanello Joice M F, Homann Diogo, Lodovico Angélica, Hubley-Kozey Cheryl L, Rodacki André L F
1Faculty of Health Professions, School of Physiotherapy, Dynamics of Human Motion Laboratory, Dalhousie University, Halifax, Nova Scotia, Canada; 2Physical Education Department, Center for Motor Behaviour Studies, Federal University of Paraná, Curitiba, Paraná, Brazil; and 3Physical Education Department, Center of Quality of Life, Federal University of Paraná, Curitiba, Paraná, Brazil.
J Strength Cond Res. 2016 Nov;30(11):3155-3164. doi: 10.1519/JSC.0000000000001395.
Góes, SM, Stefanello, JMF, Homann, D, Lodovico, A, Hubley-Kozey, CL, and Rodacki, ALF. Torque and muscle activation impairment along with insulin resistance are associated with falls in women with fibromyalgia. J Strength Cond Res 30(11): 3155-3164, 2016-Fibromyalgia (FM) is a chronic pain condition associated with reduced muscle strength, which can lead to functional incapacity and higher risk of falls. The purpose of the study was to compare maximal ankle joint torque, muscle activation, and metabolic changes between women with and without FM. In addition, the relationship between those aspects and retrospectively reported falls in women with FM was determined. Twenty-nine middle-aged women with FM and 30 controls were recruited. Fall history, pain intensity, and pain threshold were assessed. Plasma glucose levels and insulin resistance (IR) were determined. Peak torque and rate of torque development (RTD) were calculated, and muscle activation was assessed from maximum isometric voluntary ankle dorsiflexion and plantar flexion contractions. In addition, voluntary muscle activation failure of the anterior tibialis muscle during maximal dorsiflexion was calculated. When compared to controls, women with FM reported higher number of retrospectively reported falls, exhibited higher IR, showed reduced plantar flexion and dorsiflexion RTD, had lower plantar flexion peak torque, and demonstrated more antagonist coactivation and higher muscle activation failure (p ≤ 0.05). Higher muscle activation failure was explained by glucose level and pain intensity (adj R = 0.28; p ≤ 0.05). Reduced plantar flexion and dorsiflexion peak torque explained 80% of retrospectively reported falls variance; also, high antagonist coactivation (odds ratio [OR] = 1.6; p ≤ 0.05) and high IR (OR = 1.8; p ≤ 0.05) increased the chance of falls in the FM group. A combination of metabolic factors and muscle function increased the odds of retrospectively reporting a fall in FM. Both aspects may be considered in interventions designed for reducing falls in this population.
戈伊斯，SM，斯特凡内洛，JMF，霍曼，D，洛多维科，A，哈布利 - 科齐，CL，以及罗达基，ALF。扭矩和肌肉激活受损以及胰岛素抵抗与纤维肌痛女性跌倒有关。《力量与体能研究杂志》30(11): 3155 - 3164，2016年 - 纤维肌痛（FM）是一种与肌肉力量降低相关的慢性疼痛病症，可导致功能丧失和更高的跌倒风险。该研究的目的是比较患有和未患有FM的女性之间的最大踝关节扭矩、肌肉激活和代谢变化。此外，还确定了这些方面与FM女性回顾性报告的跌倒之间的关系。招募了29名中年FM女性和30名对照者。评估了跌倒史、疼痛强度和疼痛阈值。测定了血糖水平和胰岛素抵抗（IR）。计算了峰值扭矩和扭矩发展速率（RTD），并通过最大等长自愿踝关节背屈和跖屈收缩评估肌肉激活。此外，计算了最大背屈期间胫骨前肌的自愿性肌肉激活失败情况。与对照组相比，患有FM的女性回顾性报告的跌倒次数更多，表现出更高的IR，跖屈和背屈RTD降低，跖屈峰值扭矩更低，并且表现出更多的拮抗肌共同激活和更高的肌肉激活失败（p≤0.05）。血糖水平和疼痛强度解释了更高的肌肉激活失败（调整R = 0.28；p≤0.05）。跖屈和背屈峰值扭矩降低解释了回顾性报告的跌倒差异的80%；此外，高拮抗肌共同激活（优势比[OR] = 1.6；p≤0.05）和高IR（OR = 1.8；p≤0.05）增加了FM组跌倒的可能性。代谢因素和肌肉功能的组合增加了FM患者回顾性报告跌倒的几率。在为减少该人群跌倒而设计的干预措施中，可能需要考虑这两个方面。
