Breathing and Chest Wall Mobility in People With Fibromyalgia.
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Observational

Summary: 
      The aim of this study is to examine differences between respiratory function in female
      fibromyalgia patients and healthy controls. The study will also examine differences in spine
      mobility and pain intensity.
    

Detailed description: 
      Fibromyalgia is characterized by persistent widespread pain and affects approximately 1-3% of
      the general population. Fibromyalgia is a multifactorial syndrome and much research has been
      done and several interesting facts discovered. Still, the etiology is unknown. The autonomic
      nervous system may be the cause of several symptoms of this condition and a pattern of
      abnormal autonomous functions has been described . Besides the autonomous nerve system the
      respiratory system has also potential to impact various body organs mainly by altered blood
      gas chemistry. Deviant respiratory function in local pain condition as in cervical and lumbar
      spine has been reported. Respiratory function in generalized pain as in people with
      fibromyalgia has not been given much consideration.

      This project is an observational cross sectional study with the purpose to examine
      respiratory function in a group of females with fibromyalgia and compare with age-matched
      controls. Peak expiratory flow (PEF), Chest mobility, spinal mobility and pain palpation
      where measured at the same visit. Data about smoking habits was registered and in patients
      also the duration of pain. Measurement of the subject's weight and height were recorded and
      the body mass index (BMI) was calculated. For evaluation of forced exhalation, a Wright peak
      expiratory flow meter was used. PEF was measured three times and the best result was
      recorded. Spinal mobility was measured by using the Cervico-thoracic ratio (CTR) method. The
      CTR measure was done in a sitting position with the subject instructed to sit in an upright
      posture and look straight in front of them. The spinous process of the seventh cervical
      vertebra (C7) was palpated as the referent point and a mark was made on the vertex followed
      by marks for each motion segment between C7 to the fifth thoracic vertebra (T5) by using a
      CTR measuring strip. Then the subjects were told to flex the chin and the trunk forward as
      much as possible. Again, the distance between C7 and T5 was measured and the difference
      between measurements in upright position and maximum flexed position was calculated in mm for
      each segment to a total sum for all segments from C7-T5. A tape measure was used to measure
      the mobility of the thorax at maximum inhalation and exhalation at the level of proc.
      Xiphoideus. Every measurement was performed three times and the best measurement was
      recorded. Manual palpation for pain was done over the upper thoracic spine in the same area
      as the spinal mobility was measured, with subjects lying prone on an examination table. A
      total of 20 locations were palpated from C7 to T5. First left side facets, and then left side
      costotransverse joints in the same segmental level. The same procedure was then used for the
      right side. Palpation was done with a force of approximately 4kg/sq cm (equating to blanching
      of the thumb or fingernail). After each point was palpated the subject estimated perceived
      pain on a visual analogue scale.

      A ratio was also constructed by PEF (l / min) / chest expansion (cm) called
      expiratory-inspiratory ratio.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Female patients with diagnosed fibromyalgia and female healthy subjects included as
        controls.
      
Keywords: Respiratory function; Spinal mobility; Chest expansion