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Torque and Muscle Activation Impairment Along With Insulin Resistance Are Associated With Falls in Women With Fibromyalgia

Góes, Suelen M.; Stefanello, Joice M. F.; Homann, Diogo; Lodovico, Angélica; Hubley-Kozey, Cheryl L.; Rodacki, André L. F.

Journal of Strength and Conditioning Research: November 2016 - Volume 30 - Issue 11 - p 3155–3164
doi: 10.1519/JSC.0000000000001395
Original Research

Góes, SM, Stefanello, JMF, Homann, D, Lodovico, A, Hubley-Kozey, CL, and Rodacki, ALF. Torque and muscle activation impairment along with insulin resistance are associated with falls in women with fibromyalgia. J Strength Cond Res 30(11): 3155–3164, 2016—Fibromyalgia (FM) is a chronic pain condition associated with reduced muscle strength, which can lead to functional incapacity and higher risk of falls. The purpose of the study was to compare maximal ankle joint torque, muscle activation, and metabolic changes between women with and without FM. In addition, the relationship between those aspects and retrospectively reported falls in women with FM was determined. Twenty-nine middle-aged women with FM and 30 controls were recruited. Fall history, pain intensity, and pain threshold were assessed. Plasma glucose levels and insulin resistance (IR) were determined. Peak torque and rate of torque development (RTD) were calculated, and muscle activation was assessed from maximum isometric voluntary ankle dorsiflexion and plantar flexion contractions. In addition, voluntary muscle activation failure of the anterior tibialis muscle during maximal dorsiflexion was calculated. When compared to controls, women with FM reported higher number of retrospectively reported falls, exhibited higher IR, showed reduced plantar flexion and dorsiflexion RTD, had lower plantar flexion peak torque, and demonstrated more antagonist coactivation and higher muscle activation failure (p ≤ 0.05). Higher muscle activation failure was explained by glucose level and pain intensity (adj R2 = 0.28; p ≤ 0.05). Reduced plantar flexion and dorsiflexion peak torque explained 80% of retrospectively reported falls variance; also, high antagonist coactivation (odds ratio [OR] = 1.6; p ≤ 0.05) and high IR (OR = 1.8; p ≤ 0.05) increased the chance of falls in the FM group. A combination of metabolic factors and muscle function increased the odds of retrospectively reporting a fall in FM. Both aspects may be considered in interventions designed for reducing falls in this population.

1Faculty of Health Professions, School of Physiotherapy, Dynamics of Human Motion Laboratory, Dalhousie University, Halifax, Nova Scotia, Canada;

2Physical Education Department, Center for Motor Behaviour Studies, Federal University of Paraná, Curitiba, Paraná, Brazil; and

3Physical Education Department, Center of Quality of Life, Federal University of Paraná, Curitiba, Paraná, Brazil

Address correspondence to Suelen M. Góes,

Copyright © 2016 by the National Strength & Conditioning Association.