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Cited by 105Balance, Gait, and Falls PreventionFibromyalgia and Chronic Fatigue Syndrome ResearchCardiovascular Syncope and Autonomic Disorders

Postural control deficits in people with fibromyalgia: a pilot study

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Jones, Kim D, King, Laurie A, Mist, Scott D, Bennett, Robert M, Horak, Fay B·2011·Arthritis Research & Therapy
DOI 10.1186/ar3432PMC PMC3239367
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Abstract

Introduction: Postural instability and falls are increasingly recognized problems in patients with fibromyalgia (FM). The purpose of this study was to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability. We further sought to determine whether postural instability is associated with strength, proprioception and lower-extremity myofascial trigger points (MTPs); FM symptoms and physical function; dyscognition; balance confidence; and medication use. Last, we evaluated self-reported of falls over the past six months. Methods: In this cross-sectional study, we compared middle-aged FM patients and age-matched HCs who underwent computerized dynamic posturography testing and completed the Fibromyalgia Impact Questionnaire-Revised (FIQR) and balance and fall questionnaires. All subjects underwent a neurological and musculoskeletal examination. Descriptive statistics were used to characterize the sample and explore the relationships between variables. The relationships between subjective, clinical and objective variables were evaluated by correlation and regression analyses. Results: Twenty-five FM patients and twenty-seven HCs (combined mean age ± standard deviation (SD): 48.6 ± 9.7 years) completed testing. FM patients scored statistically lower on composite sensory organization tests (primary outcome; P < 0.010), as well as with regard to vestibular, visual and somatosensory ratio scores on dynamic posturography. Balance confidence was significantly different between groups, with FM patients reporting less confidence than HCs (mean ± SD: 81.24 ± 19.52 vs. 98.52 ± 2.45; P < 0.001). Interestingly, 76% to 84% of FM patients had gastrocnemius and/or anterior tibialis MTPs. Postural stability was best predicted by dyscognition, FIQR score and body mass index. Regarding falls, 3 (11%) of 27 HCs had fallen only once during the past 6 months, whereas 18 (72%) of 25 FM patients had fallen at least once. Fifteen FM patients (60%) reported falling at least three times in the past six months. Conclusions: In this study, we report that middle-aged FM patients have consistent objective sensory deficits on dynamic posturography, despite having a normal clinical neurological examination. Further study is needed to determine prospective fall rates and the significance of lower-extremity MTPs. The development of interventions to improve balance and reduce falls in FM patients may need to combine balance training with exercise and cognitive training.

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  • Obesity is a common comorbidity with fibromyalgia compared to healthy controls.

    “A progressive decline in physical activity can contribute to excessive weight gain, with obesity being a common comorbidity with FM compared to HC.31”

    From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [31]

    In Results > Comorbidities (Table 4; page unavailable), the fibromyalgia group had a higher mean BMI than healthy controls (30.7 versus 26.3), supporting a difference in body weight. The paper does not report obesity prevalence or identify obesity as a common comorbidity; it also does not establish the citing sentence’s proposed link between declining physical activity and weight gain. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • A progressive decline in physical activity can contribute to excessive weight gain.

    “A progressive decline in physical activity can contribute to excessive weight gain, with obesity being a common comorbidity with FM compared to HC.31”

    From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [31]

    The Results (Comorbidities, Table 4) show higher mean BMI in the fibromyalgia group than in healthy controls. The Discussion (Limitations) says the study did not determine whether obesity was related to poor physical fitness. It does not establish that declining physical activity causes weight gain, or report obesity as a common comorbidity. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Many drugs used to relieve pain in fibromyalgia, such as opiates, muscle relaxants, and antidepressants, may impair balance.

    “Additionally, many drugs to relieve pain for FM, such as opiates, muscle relaxants, and antidepressants, may impair balance.”

    From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [31]

    The Introduction says many medications used by people with fibromyalgia are associated with postural instability and names opioids and tricyclic antidepressants as examples. It does not name muscle relaxants or extend the point to antidepressants generally. The Results (Medications) and Conclusions also report that opioid use did not predict balance problems in this pilot study. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Poor perceived balance is reported as one of the most debilitating symptoms in fibromyalgia.

    “with poor perceived balance reported as one of the most debilitating symptoms.31”

    From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [31]

  • Obese persons may not be able to generate the adequate force required to quickly regain postural control.

    “It is likely that muscle strength does not increase in proportion to total weight in obese individuals; therefore, obese persons may not be able to generate the adequate force required to quickly regain postural control.31”

    From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [31]

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Authors
Jones, K. D., King, L. A., Mist, S. D., Bennett, R. M., & Horak, F. B.
Affiliations
Oregon Health & Science University (US)
Corresponding author
Jones, Kim D
ORCID
Venue
Arthritis Research & Therapy
Publisher
Springer Science and Business Media LLC
Published
2011-08-02
Volume
13
Issue
4
Pages
R127-R127
ISSN
1478-6354 (ISSN-L)
DOI
10.1186/ar3432
PMC
PMC3239367
OpenAlex
W2108791624
Cited by
105
References
68
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 9 · 2022: 18 · 2021: 8 · 2020: 8 · 2019: 2 · 2018: 8 · 2017: 10 · 2016: 10 · 2015: 4 · 2014: 4 · 2013: 11 · 2012: 6
FWCI
17.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Arthritis Research & Therapy (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (AG006457, 5r37ag006457-28)
  • National Institute on Aging (R37-AG006457, AG-006457, R-37 AG006457-19)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
Keywords
fibromyalgia, postural control, postural instability, falls, dynamic posturography, sensory organization, balance confidence, myofascial trigger points, proprioception, vestibular function, gastrocnemius, tibialis anterior, physical function, body mass index, middle-aged women, fall risk
MeSH terms
Accidental Falls, Adult, Cross-Sectional Studies, Postural Balance, Female, Fibromyalgia, Humans, Male, Middle Aged, Pilot Projects, Posture, Surveys and Questionnaires, Sensation Disorders

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