Abstract
Purpose
The aim of this study was to determine the local and systemic effects of isometric and concentric muscle contractions on experimental pain and performance fatigability in people with and without fibromyalgia.
Methods
Forty-seven fibromyalgia (FM: 51.3 ± 12.3 year) and 47 control (CON: 52.5 ± 14.7 year) participants performed submaximal isometric and concentric exercise for 10 min with the right elbow flexors. Assessments before and after exercise included pressure pain thresholds (PPT) of the biceps and quadriceps, central pain summation, self-reported exercising arm and whole-body pain, and maximal voluntary isometric contraction (MVIC) of the right elbow flexors and left handgrip.
Results
People with FM experienced greater reductions in local fatigue (right elbow flexor MVIC: CON: − 4.0 ± 6.7%, FM: − 9.8 ± 13.8%; p = 0.013) and similar reductions in systemic fatigue (left handgrip MVIC: − 6.5 ± 10.2%; p < 0.001) as CON participants, which were not different by contraction type nor related to baseline clinical pain, perceived fatigue, or reported pain with exercise. Following exercise both groups reported an increase in PPTs at the biceps (pre: 205.5 ± 100.3 kPa, post: 219.0 ± 109.3 kPa, p = 0.004) only and a decrease in central pain summation (pre: 6.8 ± 2.9, post: 6.5 ± 2.9; p = 0.013). FM reported greater exercising arm pain following exercise (CON: 0.7 ± 1.3, FM: 2.9 ± 2.3; p < 0.001), and both groups reported greater arm pain following concentric (isometric: 1.4 ± 2.0, concentric: 2.2 ± 2.9; p = 0.001) than isometric exercise. Neither group reported an increase in whole-body pain following exercise.
Conclusion
People with FM experienced greater performance fatigability in the exercising muscle compared to CON that was not related to central mechanisms of fatigue or pain. These results suggest changes in performance fatigability in FM may be due to differences occurring at the muscular level.
Trial registration #
NCT #: NCT03778385, December 19, 2018, retrospectively registered. IRB#: HR-3035.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- ACR:
-
2010 American College of Rheumatology Modified Diagnostic Criteria for Fibromyalgia
- BMI:
-
Body mass index
- CON:
-
Control
- Conc:
-
Concentric
- DXA:
-
Dual-energy X-ray absorptiometry
- FIQR:
-
Revised Fibromyalgia Impact Questionnaire
- FM:
-
Fibromyalgia
- Iso:
-
Isometric
- MVIC:
-
Maximal voluntary isometric contraction
- NRS:
-
Numerical rating scale
- PAAT:
-
Physical Activity Assessment Tool
- PPT:
-
Pressure pain threshold
- PROMIS Fatigue:
-
PROMIS Short Form v1.0—Fatigue 7a
- RPE:
-
Rating of perceived exertion
- VAS:
-
Visual analogue scale
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Funding
This research was supported by the National Center for Advancing Translational Sciences and National Institutes of Health through award number TL1TR001437 [GB/MHB]; Promotion of Doctoral Studies-I Scholarship from the Foundation for Physical Therapy Research [GB]; Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number R15HD090265 [MHB].
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GB, and MHB. The first draft of the manuscript was written by GB and MHB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Berardi, G., Senefeld, J.W., Hunter, S.K. et al. Impact of isometric and concentric resistance exercise on pain and fatigue in fibromyalgia. Eur J Appl Physiol 121, 1389–1404 (2021). https://doi.org/10.1007/s00421-021-04600-z
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DOI: https://doi.org/10.1007/s00421-021-04600-z