Skip to main content
Log in

Trunk position sense, postural stability, and spine posture in fibromyalgia

  • Observational Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

This study aimed to investigate trunk position sense, postural stability, and spine posture in women with fibromyalgia syndrome (FMS). Fifteen (15) women with FMS and age- and gender-matched fifteen (15) healthy controls were included. Trunk position sense as indicated by trunk reposition errors (TRE) and spine posture (thoracic and lumbar curvature) was measured with a digital inclinometer. Postural stability [eyes open (EO) and eyes closed (EC) on bipedal stance (BS), EO on monopedal stance (MS), and limits of stability (LOS)] was assessed with a computerized stabilometer (Prokin, TecnoBody S.R.L., Dalmine, 24044 Bergamo, Italy). TRE (p = 0.002) and the angle of thoracic curvature (p = 0.009) were found higher in women with FMS compared to healthy controls; however, the angle of lumbar curvature was similar (p = 0.467). It was seen that women with FMS had higher anterior–posterior sway in EO-BS (p = 0.009) and EC-BS (p = 0.001), ellipse area in EC-BS (p = 0.015), EO-MS of the dominant side (p = 0.021), and EO-MS of the non-dominant side (p = 0.007), and medial–lateral sway in EO-MS of the dominant (DM) side (p = 0.004) and the non-dominant (NDM) side (p = 0.002). Ellipse area in EO-BS (p = 0.054), medial–lateral sway in EO-BS (p = 0.983) and EC-BS (p = 0.290), anterior–posterior sway in EO-MS of the DM (p = 0.059) and the NDM side (p = 0.065), and LOS did not differ between groups (p = 0.274). Women with FMS had poor trunk position sense and postural instability, and alterations in spine posture. Therefore, the training of trunk position sense, postural stability, and posture might be beneficial and, thus, should be considered while planning an optimal treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Schweiger V, Del Balzo G, Raniero D, De Leo D, Martini A, Sarzi-Puttini P, Polati E (2017) Current trends in disability claims due to fibromyalgia syndrome. Clin Exp Rheumatol 35(3):119–126

    PubMed  Google Scholar 

  2. Arnold LM, Crofford LJ, Mease PJ, Burgess SM, Palmer SC, Abetz L, Martin SA (2008) Patient perspectives on the impact of fibromyalgia. Patient Educ Couns 73(1):114–120

    Article  Google Scholar 

  3. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB (2011) Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol 38(6):1113–1122. https://doi.org/10.3899/jrheum.100594

    Article  PubMed  Google Scholar 

  4. Marques AP, do Espírito Santo ADS, Berssaneti AA, Matsutani LA, Yuan SLK (2017) Prevalence of fibromyalgia: literature review update. Rev Bras Reumatol (English Edition) 57(4):356–363

    Article  Google Scholar 

  5. Massion J (1992) Movement, posture and equilibrium: interaction and coordination. Prog Neurobiol 38(1):35–56

    Article  CAS  Google Scholar 

  6. Karthikbabu S, Chakrapani M, Ganesan S, Ellajosyula R, Solomon JM (2018) Efficacy of trunk regimes on balance, mobility, physical function, and community reintegration in chronic stroke: a parallel-group randomized trial. J Stroke Cerebrovasc Dis 27(4):1003–1011

    Article  Google Scholar 

  7. Ryerson S, Byl NN, Brown DA, Wong RA, Hidler JM (2008) Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther 32(1):14–20. https://doi.org/10.1097/NPT.0b013e3181660f0c

    Article  PubMed  Google Scholar 

  8. Granito RN, Aveiro MC, Renno ACM, Oishi J, Driusso P (2012) Comparison of thoracic kyphosis degree, trunk muscle strength and joint position sense among healthy and osteoporotic elderly women: a cross-sectional preliminary study. Arch Gerontol Geriatr 54(2):e199–e202

    Article  Google Scholar 

  9. Stillman BC (2002) Making sense of proprioception: the meaning of proprioception, kinaesthesia and related terms. Physiotherapy 88(11):667–676

    Article  Google Scholar 

  10. Jones KD, King LA, Mist SD, Bennett RM, Horak FB (2011) Postural control deficits in people with fibromyalgia: a pilot study. Arthritis Res Ther 13(4):R127. https://doi.org/10.1186/ar3432

    Article  PubMed  PubMed Central  Google Scholar 

  11. Horak FB (2006) Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35(suppl_2):ii7–ii11

    Article  Google Scholar 

  12. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L (2007) An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord 8(1):27

    Article  Google Scholar 

  13. Muto L, Sauer J, Yuan S, Sousa A, Mango P, Marques A (2015) Postural control and balance self-efficacy in women with fibromyalgia: are there differences? Eur J Phys Rehabil Med 51(2):149–154

    CAS  PubMed  Google Scholar 

  14. Akkaya N, Akkaya S, Atalay NS, Acar M, Catalbas N, Sahin F (2013) Assessment of the relationship between postural stability and sleep quality in patients with fibromyalgia. J Clin Rheumatol 32(3):325–331. https://doi.org/10.1007/s10067-012-2117-y

    Article  Google Scholar 

  15. Trevisan DC, Driusso P, Avila MA, Gramani-Say K, Moreira FMA, Parizotto NA (2017) Static postural sway of women with and without fibromyalgia syndrome: a cross-sectional study. Clin Biomech (Bristol, Avon) 44:83–89. https://doi.org/10.1016/j.clinbiomech.2017.03.011

    Article  Google Scholar 

  16. Toprak Celenay S, Anaforoglu Kulunkoglu B, Kucuksahin O (2017) Evaluation of balance, endurance and flexibility in women with fibromyalgia syndrome. Turk J Physiother Rehabil 28(3):125–131

    Google Scholar 

  17. Juras G, Słomka K, Fredyk A, Sobota G, Bacik B (2008) Evaluation of the limits of stability (LOS) balance test. J Hum Kinet 19:39–52

    Article  Google Scholar 

  18. Girardi M, Konrad HR, Amin M, Hughes LF (2001) Predicting fall risks in an elderly population: computer dynamic posturography versus electronystagmography test results. Laryngoscope 111(9):1528–1532

    Article  CAS  Google Scholar 

  19. Russek LN, Fulk GD (2009) Pilot study assessing balance in women with fibromyalgia syndrome. Physiother Theory Pract 25(8):555–565. https://doi.org/10.3109/09593980802668050

    Article  PubMed  Google Scholar 

  20. Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA (1992) Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther 72(6):425–431

    Article  CAS  Google Scholar 

  21. Lau KT, Cheung KY, Chan KB, Chan MH, Lo KY, Chiu TT (2010) Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man Ther 15(5):457–462. https://doi.org/10.1016/j.math.2010.03.009

    Article  PubMed  Google Scholar 

  22. Macovei L-A, Rezus E (2016) Cervical spine lesions in rheumatoid arthritis patients. Rev Med Chir Soc Med Nat Iasi 120(1):70–76

    PubMed  Google Scholar 

  23. Sempere-Rubio N, Aguilar-Rodríguez M, Espí-López GV, Cortés-Amador S, Pascual E, Serra-Añó P (2018) Impaired trunk posture in women with fibromyalgia. Spine 43(22):1536–1542

    Article  Google Scholar 

  24. Álvarez-Gallardo IC, Carbonell-Baeza A, Segura-Jiménez V, Soriano-Maldonado A, Intemann T, Aparicio VA, Estévez-López F, Camiletti-Moirón D, Herrador-Colmenero M, Ruiz JR (2017) Physical fitness reference standards in fibromyalgia: the al-Ándalus project. Scand J Med Sci Sports 27(11):1477–1488

    Article  Google Scholar 

  25. Goldberg A, Hernandez ME, Alexander NB (2005) Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci 60(10):1310–1314

    Article  Google Scholar 

  26. Lewis JS, Valentine RE (2010) Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord 11:39. https://doi.org/10.1186/1471-2474-11-39

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ng JK, Kippers V, Richardson CA, Parnianpour M (2001) Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values. Spine 26(1):53–60

    Article  CAS  Google Scholar 

  28. Han J, Waddington G, Adams R, Anson J, Liu Y (2016) Assessing proprioception: a critical review of methods. J Sport Health Sci 5(1):80–90. https://doi.org/10.1016/j.jshs.2014.10.004

    Article  PubMed  Google Scholar 

  29. Vaillant J, Coisne A, Dumolard A (2017) Alteration of neck proprioceptive capacity in women with fibromyalgia. Ann Phys Rehabil Med 60:e18

    Article  Google Scholar 

  30. Ulus Y, Akyol Y, Tander B, Bilgici A, Kuru O (2013) Knee proprioception and balance in Turkish women with and without fibromyalgia syndrome. Turk J Phys Med Rehabil 59(2):128–133

    Article  Google Scholar 

  31. Oliver GD, Washington JK, Barfield JW, Gascon SS, Gilmer G (2018) Quantitative analysis of proximal and distal kinetic chain musculature during dynamic exercises. J Strength Cond Res 32(6):1545–1553. https://doi.org/10.1519/jsc.0000000000002036

    Article  PubMed  Google Scholar 

  32. Jones KD, Horak FB, Winters-Stone K, Irvine JM, Bennett RM (2009) Fibromyalgia is associated with impaired balance and falls. J Clin Rheumatol 15(1):16–21. https://doi.org/10.1097/RHU.0b013e318190f991

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hof AL (2007) The equations of motion for a standing human reveal three mechanisms for balance. J Biomech 40(2):451–457. https://doi.org/10.1016/j.jbiomech.2005.12.016

    Article  PubMed  Google Scholar 

  34. Carpenter MG, Frank JS, Silcher CP, Peysar GW (2001) The influence of postural threat on the control of upright stance. Exp Brain Res 138(2):210–218

    Article  CAS  Google Scholar 

  35. Brumagne S, Janssens L, Janssens E, Goddyn L (2008) Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait Posture 28(4):657–662. https://doi.org/10.1016/j.gaitpost.2008.04.015

    Article  PubMed  Google Scholar 

  36. Ge H-Y, Wang Y, Fernández-de-las-Peñas C, Graven-Nielsen T, Danneskiold-Samsøe B, Arendt-Nielsen L (2011) Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients. Arthritis Res Ther 13(2):R48. https://doi.org/10.1186/ar3289

    Article  PubMed  PubMed Central  Google Scholar 

  37. Muller W, Kelemen J, Stratz T (1998) Spinal factors in the generation of fibromyalgia syndrome. Z Rheumatol 57(Suppl 2):36–42

    Article  Google Scholar 

  38. Mirbagheri S-S, Rahmani-Rasa A, Farmani F, Amini P, Nikoo M-R (2015) Evaluating kyphosis and lordosis in students by using a flexible ruler and their relationship with severity and frequency of thoracic and lumbar pain. Asian Spine J 9(3):416–422. https://doi.org/10.4184/asj.2015.9.3.416

    Article  PubMed  PubMed Central  Google Scholar 

  39. Endo K, Suzuki H, Sawaji Y, Nishimura H, Yorifuji M, Murata K, Tanaka H, Shishido T, Yamamoto K (2016) Relationship among cervical, thoracic, and lumbopelvic sagittal alignment in healthy adults. J Orthop Surg (Hong Kong) 24(1):92–96. https://doi.org/10.1177/230949901602400121

    Article  CAS  Google Scholar 

Download references

Funding

This study was not funded.

Author information

Authors and Affiliations

Authors

Contributions

STE: the design of the work, the analysis and interpretation of data for the work OM: the design of the work, the acquisition and interpretation of data for the work. OC: the acquisition, analysis and interpretation of data for the work. DO: the interpretation of data for the work. SE: the interpretation of data for the work, the acquisition of data for the work.

Corresponding author

Correspondence to Seyda Toprak Celenay.

Ethics declarations

Conflict of interest

Author Toprak Celenay, author Mete, author Coban, author Oskay, and author Erten declare that they have no conflict of interest.

Ethical approval

Patients were informed and their informed consents were obtained prior to the study. The study design was approved by the ethics committee of Ankara Yildirim Beyazit University (approval number: 43/43).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Toprak Celenay, S., Mete, O., Coban, O. et al. Trunk position sense, postural stability, and spine posture in fibromyalgia. Rheumatol Int 39, 2087–2094 (2019). https://doi.org/10.1007/s00296-019-04399-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-019-04399-1

Keywords

Navigation