Pamela
S. Johnson¹ M.S./P.T., Helen Bourke-Taylor¹ O.T.R./L., Dan s. Heffez¹
M.D., Daniel G. Malone² M.D., Ruth E. Ross¹ Ph.D. and James W. Robertson¹
B.S. (Sponsored by Daniel
Malone) ¹Chicago Institute of Neurosurgery and Neuroresearch, Chicago,
IL 60614 and ²University of Wisconsin at Madison, Madison, WI 53706
OBJECTIVE:
An association has been proposed between fibromyalgia and cervical myelopathy. As
part of an investigation of a possible neurological etiology of fibromyalgia,
42 consecutive patients with fibromyalgia were evaluated using a series
of standardized tests of neurological function. We
assessed upper extremity function including coordination and dexterity
(Jebsen-Taylor Hand Test and nine-hole peg test) and strength (Jamar dynamometer
and pinch gauge). Mobility
and static and dynamic balances were assessed using the Berg Balance Scale
and timed measures of ambulation. The
median age of patients was 44 years. Patients
carried the diagnosis of fibromyalgia for a median of 6 years. Eighty-seven
percent of patients were female.
METHODS:
Data analysis indicated that 68% of patients had balance deficits as shown
by the Berg Balance Scale, including impaired functional reach (31%),
tandem stance (24%) and single limb stance (26%). The
sample size allowed for the analysis of the Jebsen-Taylor hand test of
dexterity only for the 30 right-handed females; a statistically significant
slowing as compared to accepted standard of normal was identified in 6
of 7 subtests (p<.01). Forty-six
percent and 33% of patients fell below the 25th percentile on nine-hole
peg testing of the dominant and non-dominant hands, respectively. Tests of grip strength and dexterity showed a lack of the normal
dominance pattern in 60% of patients.
CONCLUSION:
We conclude that some patients with fibromyalgia have neurological dysfunction
that can be objectively quantified. This
database will allow for prospective objective analysis of the response of
fibromyalgia to the treatment of cervical myelopathy. Presented
at the National Fibromyalgia Research Association's Subgroups in Fibromyalgia
Symposium, September 26-27, 1999, in Portland, Oregon.
For
Appointment Information Contact:
Dan Heffez, MD
Milwaukee Neurological Institute
4550
2350 W. Villard Ave
Milwaukee
WI 53209
(414)
438-6500
