Study Validates Physical Impact of FM

February 28, 2009

People with fibromyalgia (FM) self-report high levels of functional

impairment similar to rheumatoid arthritis (RA) patients.

Unfortunately, patients with FM do not have an objective disease

marker or visibly swollen joints, as those with RA, so the validity

of their self-reported functional limits are constantly being

challenged. In fact, the authors of a study comparing the health

status and activity levels of FM and RA patients state the problem

clearly: " Patients with FM are perceived to make `heavy weather' of

their disease and indeed their lives. " * As a result, people may

suspect that FM patients are exaggerating the effects of their

illness. The research team, all from the United Kingdom, set out to

determine if this was the case.

After recruiting 12 female subjects with FM from a primary care

practice, 12 age-matched subjects with RA were recruited for

comparison. Each FM patients was matched with an RA patient according

to their scores on the Health Assessment Questionnaire (HAQ). This

questionnaire was selected because it has been validated for use in

many diseases, including RA and FM, and it evaluates self-reported

patient abilities related to activities of daily living. It does not

ask about the number of joints that hurt or the number of painful

muscles, rather the HAQ is a more general assessment of a person's

functional capacity or limitations on a typical day.

Both patient groups were fitted with a Numact activity monitor that

had two sensors, one on the chest and one on the thigh, which was

worn for 24 hours. The Numact detects posture (sitting, standing, and

lying down), the number and vigor of steps taken, and it computes the

amount of total energy expended during a 24-hour period. All subjects

were instructed to go about their daily activities as usual and then

return the next day to have the monitors removed.

Comparing the HAQ scores and the total energy expended for the 24-

hour period, there was no significant difference found between the RA

and FM patients. Even the number of steps taken, the vigor of the

step movement, and the amount of time spent standing was the same for

both patient groups. In fact, there was a strong correlation between

the HAQ scores and total walking, or ambulatory, activity for the FM

group.

Based on the study results, the authors write, " This indicates that

they (FM patients) really do live a restricted lifestyle. ... For the

first time, we have shown a strong correlation between HAQ score and

measured ambulatory activity. It is interesting that the degree of

self-reported disability does translate to objectively measured, real-

life changes in activity. " The authors speculate that the widespread

pain throughout the muscles could be partly responsible for limiting

activity, but more research is needed. They also suggest that the HAQ

and the Numact be applied in future studies to measure the " real

impact " of therapies tested in FM patients.

* Raftery G, et al. Clin Rheumatol [epub ahead of print February 20,

2009] DOI: 10.1007/s10067-009-1107-1.

--

Dodge

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March 1, 2009

At first, I was really excited about this study! (At least there is a

study.) I have many friends and clients with fibro. They get treated like

mad people much of the time. Anything that can help 'prove' their pain to

others is very needed. However, 12-24 people is a very tiny study and 24

hours is really too short to determine much. I hope some other researcher

takes this study and expands upon it.

_____

From: [mailto: ] On

Behalf Of Dodge Porter

Sent: Saturday, February 28, 2009 2:32 PM

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Subject: [ ] Study Validates Physical Impact of FM