Ornek Ceren, Coskun Benlidayi Ilke, Sariyildiz Aylin
Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Cukurova University, Adana, Türkiye.
Rheumatol Int. 2024 Dec;44(12):2997-3008. doi: 10.1007/s00296-024-05743-w. Epub 2024 Nov 6.
The aim of the study was to evaluate foot posture and the mechanical properties of extrinsic foot muscles in fibromyalgia.
Patients with fibromyalgia (n = 86) and age- and gender-matched controls (n = 41) were included in the study. Foot Posture Index (FPI), Beighton and Brighton criteria were used to evaluate static foot posture, joint hypermobility, and benign joint hypermobility syndrome (BJHS), respectively. Tonus, elasticity, and stiffness of the extrinsic foot muscles including gastrocnemius medialis, tibialis anterior, and peroneus longus were measured by the MyotonPRO device. Foot function, quality of life, and physical activity level were assessed by the Foot Function Index (FFI), Short Form-36 (SF-36), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively.
The frequency of abnormal foot posture in the fibromyalgia and control groups was 68.6% versus 39%, respectively; and neutral foot posture was approximately twice as prevalent in the control group compared to the fibromyalgia group (p = 0.006). Pronated foot posture was the most common abnormality in fibromyalgia (61.6%) and observed in 85.5% of the patients with joint hypermobility and in 87.1% of those meeting BJHS criteria. The elasticity of peroneus longus at rest and the elasticity of tibialis anterior in the standing position were significantly different between the fibromyalgia group and the control group [1.08 (0.22) vs. 1.02 (0.25), p = 0.037 and 0.92 (0.29) vs. 0.87 (0.24), p = 0.011, respectively]. Regarding the fibromyalgia group, no difference was detected among foot posture groups in terms of myotonometric data.
Pronation foot posture is common in fibromyalgia with a much higher frequency in fibromyalgia patients with hypermobility. In daily clinical practice for fibromyalgia, particular attention should be given to foot alignment.
本研究旨在评估纤维肌痛患者的足部姿势及足部外在肌肉的力学特性。
本研究纳入了纤维肌痛患者（n = 86）以及年龄和性别匹配的对照组（n = 41）。分别采用足部姿势指数（FPI）、贝顿和布莱顿标准来评估静态足部姿势、关节活动过度及良性关节活动过度综合征（BJHS）。使用MyotonPRO设备测量包括腓肠肌内侧头、胫骨前肌和腓骨长肌在内的足部外在肌肉的张力、弹性和僵硬度。分别通过足部功能指数（FFI）、简明健康状况调查量表（SF - 36）和国际体力活动问卷简表（IPAQ - SF）评估足部功能、生活质量和身体活动水平。
纤维肌痛组和对照组中足部姿势异常的发生率分别为68.6%和39%；与纤维肌痛组相比，对照组中中立足部姿势的发生率约为其两倍（p = 0.006）。旋前足姿势是纤维肌痛中最常见的异常情况（61.6%），在85.5%的关节活动过度患者和87.1%符合BJHS标准的患者中观察到。纤维肌痛组和对照组之间，静息时腓骨长肌的弹性以及站立位时胫骨前肌的弹性存在显著差异[分别为1.08（0.22）对1.02（0.25），p = 0.037；0.92（0.29）对0.87（0.24），p = 0.011]。对于纤维肌痛组，在肌动测量数据方面，足部姿势组之间未检测到差异。
旋前足姿势在纤维肌痛中很常见，在关节活动过度的纤维肌痛患者中频率更高。在纤维肌痛的日常临床实践中，应特别关注足部排列。
