Alshahrani Mastour Saeed, Reddy Ravi Shankar
Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia.
J Clin Med. 2023 Apr 9;12(8):2791. doi: 10.3390/jcm12082791.
(1) Background: Individuals with fibromyalgia syndrome (FMS) may experience proprioceptive and balance impairments. Kinesiophobia is a factor that can mediate the relationship between cervical joint position sense (JPS) and limits of stability. The objectives of this study were to (1) compare the cervical JPS and limits of stability between FMS and asymptomatic individuals, (2) assess the relationship between cervical JPS and limits of stability, and (3) assess the mediation effect of kinesiophobia on the relationship between cervical JPS and limits of stability in FMS individuals. (2) Methods: In this comparative cross-sectional study, 100 individuals with FMS and 100 asymptomatic individuals were recruited. Cervical JPS was assessed using a cervical range of motion device, limits of stability (reaction time, maximum excursion, and direction control) were assessed using dynamic posturography, and FMS individuals' kinesiophobia was assessed using the Tampa scale of kinesiophobia (TSK). Comparison, correlation, and mediation analyses were performed. (3) Results: The magnitude of the mean cervical joint position error (JPE) was significantly larger in FMS individuals ( < 0.001) compared to the asymptomatic individuals. The limits of the stability test showed that FMS individuals had a longer reaction time (F = 128.74) and reduced maximum excursion (F = 976.75) and direction control (F = 396.49) compared to the asymptomatic individuals. Cervical JPE showed statistically significant moderate-to-strong correlations with reaction time (r = 0.56 to 0.64, < 0.001), maximum excursion (r = -0.71 to -0.74, < 0.001), and direction control (r = -0.66 to -0.68, < 0.001) parameters of the limits of the stability test. (4) Conclusions: Cervical JPS and limits of stability were impaired in FMS individuals, and the cervical JPS showed a strong relationship with limits of stability variables. Moreover, kinesiophobia mediated the relationship between JPS and limits of stability. These factors may be taken into consideration when evaluating and developing treatment strategies for FMS patients.
（1）背景：纤维肌痛综合征（FMS）患者可能会出现本体感觉和平衡障碍。运动恐惧是一个可以调节颈椎关节位置觉（JPS）和稳定极限之间关系的因素。本研究的目的是：（1）比较FMS患者和无症状个体之间的颈椎JPS和稳定极限；（2）评估颈椎JPS与稳定极限之间的关系；（3）评估运动恐惧对FMS患者颈椎JPS与稳定极限之间关系的中介作用。（2）方法：在这项比较性横断面研究中，招募了100名FMS患者和100名无症状个体。使用颈椎活动度测量仪评估颈椎JPS，使用动态姿势描记法评估稳定极限（反应时间、最大偏移和方向控制），并使用坦帕运动恐惧量表（TSK）评估FMS患者的运动恐惧。进行了比较、相关和中介分析。（3）结果：与无症状个体相比，FMS患者的平均颈椎关节位置误差（JPE）幅度显著更大（<0.001）。稳定测试结果表明，与无症状个体相比，FMS患者的反应时间更长（F = 128.74），最大偏移减少（F = 976.75），方向控制能力下降（F = 396.49）。颈椎JPE与稳定测试极限的反应时间（r = 0.56至0.64，<0.001）、最大偏移（r = -0.71至-0.74，<0.001）和方向控制（r = -0.66至-0.68，<0.001）参数之间存在统计学上显著的中度至强相关性。（4）结论：FMS患者的颈椎JPS和稳定极限受损，且颈椎JPS与稳定极限变量之间存在密切关系。此外，运动恐惧介导了JPS与稳定极限之间的关系。在评估和制定FMS患者的治疗策略时，可能需要考虑这些因素。
