Original article
Relationships Between Performance-Based Tests and Patients’ Ratings of Activity Limitations, Self-Efficacy, and Pain in Fibromyalgia

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Abstract

Mannerkorpi K, Svantesson U, Broberg C. Relationships between performance-based tests and patients’ ratings of activity limitations, self-efficacy, and pain in fibromyalgia.

Objective

To investigate the relationship between performance-based tests, ratings of activity limitations, self-efficacy, and pain in fibromyalgia.

Design

Descriptive.

Setting

University hospital.

Participants

Sixty-nine women with fibromyalgia (mean age, 45±7.8y).

Interventions

Not applicable.

Main Outcome Measures

The patients completed 4 performance-based tests focusing on muscle power function and 3 unloaded arm movements. The patients rated their activity limitations by means of the subscales of physical function (PF) and pain on the Fibromyalgia Impact Questionnaire (FIQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Arthritis Self-Efficacy Scale (ASES). Spearman correlation coefficient (ρ) and multivariate regression analysis were conducted.

Results

The highest correlations were found between the 6-minute walk test (6MWT) (ρ range, −.48 to .68) and the activity limitations and between hand grip strength (ρ range, −.34 to .57) and the activity limitations. The regression analysis indicated that hand grip strength explained 25% of the variation in the SF-36 PF scale. The 6MWT plus endurance of the shoulder muscles explained 24% of the variation in the FIQ PF scale and the 6MWT plus active abduction of the shoulder explained 48% of the variation in the ASES function scale. Correlations between the performance-based tests and the activity limitations tended to be higher than those between performance and pain.

Conclusions

The majority of the performance-based tests and the patients’ subjective ratings of activity limitations showed significant relationships. The 6MWT and hand grip strength, reflecting activity limitations in the SF-36, FIQ, and ASES, are recommended for use in clinical research and in the clinical examination when planning treatment for patients with fibromyalgia.

Section snippets

Population

Sixty-nine women with fibromyalgia1 were included in this study, which is a part of a larger treatment study reported elsewhere.6 We recruited the patients from primary health care and rheumatology clinics in the Göteborg, Sweden, region. Our criteria for inclusion were: women with a diagnosis of fibromyalgia and fulfillment of the America College of Rheumatology 1990 criteria for fibromyalgia.1 The criteria for exclusion were other rheumatic diseases and other severe somatic or psychiatric

Missing Values

The performance-based tests were performed by all 69 (100%) participants, apart from the 6MWT, which was not performed by a blind woman (completion rate, 99%). One missing value was found in the FIQ PF scale, the SF-36 PF scale, the ASES function scale, and the ASES pain scale, respectively (completion rate, 99%). Two missing values were found in the FIQ pain scale and the SF-36 bodily pain scale (completion rate, 97%).

Content of the Subscales Assessing Physical Function in SF-36, FIQ, and ASES

We found the items on the PF scales to be linked to 4 types of activity

Discussion

Significant relationships, ranging from fair to good, were found between the performance-based tests and the patients’ subjective ratings of their activity limitations. These relationships are of clinical importance for understanding activity limitations reported by patients with fibromyalgia and they are in line with studies of patients with LBP28, 29 and RA.30, 31 These results also indicate that body functions are important to assess when planning the rehabilitation of patients with

Conclusions

The performance-based tests assessing body functions showed significant relationships with activity limitations in patients with fibromyalgia. Interesting differences were found in the content of the rating scales assessing activity limitations. Most of the items on the SF-36 PF scale focus on the lower extremities and are related to exercise tolerance, while most of the items on the FIQ PF scale cover items related to lifting and carrying objects while walking around, without clear reference

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  • Cited by (0)

    Supported by the Swedish Research Council, the Swedish Rheumatism Association, the Länsförsäkringsbolagen Research Foundation, and the Vårdal Foundation.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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