Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction

Ann Vincent, Mary O. Whipple, Phillip Anson Low, Michael Joseph Joyner, Tanya L. Hoskin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. Objective: To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Design: Cross-sectional, observational, controlled study. Setting: Community sample of patients with fibromyalgia and healthy controls. Participants: Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Methods: Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Main Outcome Measurements: Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Results: Autonomic function, as assessed by self-report, was significantly different between patients and controls (P <.0001); in contrast, the only difference between patients and controls on the Autonomic Reflex Screen was in the adrenergic domain (P = .022), and these abnormalities were mild. Self-reported physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Conclusions: Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of function have only modest objective measures of autonomic dysfunction. We recommend that the primary treatment goal should be focused on restoration of function, which may also ameliorate symptoms.

Original languageEnglish (US)
Pages (from-to)425-435
Number of pages11
JournalPM and R
Volume8
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Fibromyalgia
Exercise
Physical Fitness
Oxygen Consumption
Self Report
Reflex
Metabolic Equivalent
Actigraphy
Adrenergic Agents
Observational Studies
Fatigue

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction. / Vincent, Ann; Whipple, Mary O.; Low, Phillip Anson; Joyner, Michael Joseph; Hoskin, Tanya L.

In: PM and R, Vol. 8, No. 5, 01.05.2016, p. 425-435.

Research output: Contribution to journalArticle

@article{3c0f84c431254b968858eb075f29d3c6,
title = "Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction",
abstract = "Background: Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. Objective: To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Design: Cross-sectional, observational, controlled study. Setting: Community sample of patients with fibromyalgia and healthy controls. Participants: Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Methods: Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Main Outcome Measurements: Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Results: Autonomic function, as assessed by self-report, was significantly different between patients and controls (P <.0001); in contrast, the only difference between patients and controls on the Autonomic Reflex Screen was in the adrenergic domain (P = .022), and these abnormalities were mild. Self-reported physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Conclusions: Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of function have only modest objective measures of autonomic dysfunction. We recommend that the primary treatment goal should be focused on restoration of function, which may also ameliorate symptoms.",
author = "Ann Vincent and Whipple, {Mary O.} and Low, {Phillip Anson} and Joyner, {Michael Joseph} and Hoskin, {Tanya L.}",
year = "2016",
month = "5",
day = "1",
doi = "10.1016/j.pmrj.2015.08.008",
language = "English (US)",
volume = "8",
pages = "425--435",
journal = "PM and R",
issn = "1934-1482",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction

AU - Vincent, Ann

AU - Whipple, Mary O.

AU - Low, Phillip Anson

AU - Joyner, Michael Joseph

AU - Hoskin, Tanya L.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. Objective: To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Design: Cross-sectional, observational, controlled study. Setting: Community sample of patients with fibromyalgia and healthy controls. Participants: Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Methods: Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Main Outcome Measurements: Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Results: Autonomic function, as assessed by self-report, was significantly different between patients and controls (P <.0001); in contrast, the only difference between patients and controls on the Autonomic Reflex Screen was in the adrenergic domain (P = .022), and these abnormalities were mild. Self-reported physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Conclusions: Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of function have only modest objective measures of autonomic dysfunction. We recommend that the primary treatment goal should be focused on restoration of function, which may also ameliorate symptoms.

AB - Background: Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. Objective: To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Design: Cross-sectional, observational, controlled study. Setting: Community sample of patients with fibromyalgia and healthy controls. Participants: Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Methods: Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Main Outcome Measurements: Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Results: Autonomic function, as assessed by self-report, was significantly different between patients and controls (P <.0001); in contrast, the only difference between patients and controls on the Autonomic Reflex Screen was in the adrenergic domain (P = .022), and these abnormalities were mild. Self-reported physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Conclusions: Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of function have only modest objective measures of autonomic dysfunction. We recommend that the primary treatment goal should be focused on restoration of function, which may also ameliorate symptoms.

UR - http://www.scopus.com/inward/record.url?scp=84965168166&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965168166&partnerID=8YFLogxK

U2 - 10.1016/j.pmrj.2015.08.008

DO - 10.1016/j.pmrj.2015.08.008

M3 - Article

VL - 8

SP - 425

EP - 435

JO - PM and R

JF - PM and R

SN - 1934-1482

IS - 5

ER -