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Tender point scores and their relations to signs of mobility, symptoms, and disability in female home care personnel and the prevalence of fibromyalgia syndrome
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
2002 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 29, no 3, 603-613 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: In this study of female home care personnel employed in a municipality (n = 643; participation rate 94%) we investigated (1) the prevalence of tender points and fibromyalgia (FM); (2) the relationships between tender point score and other signs and symptoms; (3) if subgroups based on the tender point score differed with respect to signs, symptoms, disability, and health related quality of life; and (4) signs that showed the strongest intercorrelations with disability and health.

METHODS: The following variables were registered: (1) Signs: joint mobility, spinal posture and mobility, tender points, and segmental mobility and pain provocation at L4-S1 levels of the low back. (2) Symptoms: pain and pain intensity and other symptoms. (3) Disability (i.e., self-rated reduced capacity for everyday activities and employment) and health: 3 indices and sick leave.

RESULTS: The tender point score correlated with the number of pain regions and the pain intensities, and the amount of other symptoms, sick leave, and disability. Tender point score was the strongest regressor of the investigated signs in regression of the 2 disability indices. Segmental pain showed the strongest correlation with tender point score. Three subgroups identified by tender point score showed significant differences in segmental pain, prevalence and intensity of different symptoms, disability, and health related quality of life. The prevalence of FM was 2.0%.

CONCLUSION: Tender point score together with different symptoms showed relatively strong correlations with disability. A relatively high prevalence of FM was found in occupationally active female home care personnel.

Place, publisher, year, edition, pages
2002. Vol. 29, no 3, 603-613 p.
Keyword [en]
fibromyalgia, home care, musculoskeletal, pain, tender point, women
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-48946OAI: oai:DiVA.org:liu-48946DiVA: diva2:269842
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Signs, symptoms, and disability related to the musculo-skeletal system: studies of home care personnel and patients with fibromyalgia
Open this publication in new window or tab >>Signs, symptoms, and disability related to the musculo-skeletal system: studies of home care personnel and patients with fibromyalgia
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Low back pain (LBP) and neck/shoulder pain are the major reasons for sickness absence and disability pensions in Sweden. The working situation of home care personnel in Sweden frequently requires heavy lifting and forward bending and workers report high prevalences of work-related musculo-skeletal pain and high frequencies of work accidents, especially lower back injuries. Most back pain patients are treated with non-surgical methods such as physical therapy, which includes manipulation, training of posture and co-ordination, lifting techniques, etc. There is limited scientific evidence with respect to clinical signs used in physical medicine. The clinical relevance of these signs with respect to symptoms and disability is unclear.

In Nyköping, Sweden, 607 home care personnel women were examined regarding pain prevalence and intensity in 9 body regions, other common symptoms, and disability. A clinical examination (conducted by 3 physiotherapists) investigated the following conditions: posture and sagittal spinal mobility (using kyphometer); joint laxity (Beighton score); segmental mobility and segmental pain from T10 down to L5-S1; and tender point (TP) palpation on 60 sites including the 18 ACR-criteria spots. In addition, a reliability study of 150 subjects was performed by two of the physiotherapists.

The 7-day prevalence of LBP was 48%. The reliability of manually investigated segmental mobility and pain was good, especially in L4-S 1 (kappa ≈o. 7). There was a positive correlation between segmental and total sagittal mobility (kyphometry) indicating criterion validity of the former. Sagittal hypomobility, segmental pain, hyper- and hypomobility, and tender point score correlated positively to pain intensity and many disability parameters. Neck-shoulder pain was more often combined with pain in other body regions and more strongly correlated to tender point score. The prevalence of fibromyalgia (FS) was 2%. There are many causes of FS. Central sensitisation is very likely essential and psychological factors and stress are discussed.

The personality profile of 33 female FS patients (FS-group) and 31 female controls (C-group) with local but not widespread pain was investigated, using MMPI and the Defence Mechanism Technique modified (DMTm). We found no sigos of serious personality abermtions in either group. A higher vulnerability for threatening experiences was found in the FS-group. Both symptoms and TP-score correlated positively to disability in both groups. The results of MMPI and DMTm indicate that cognitive coping strategies are suitable for FS patients. Because symptoms and sigos correlated to disability, the overall conclusion was that a multidisciplinary approach is appropriate in future investigations of pain problems.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 69 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 718
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28057 (URN)12820 (Local ID)91-7373-160-9 (ISBN)12820 (Archive number)12820 (OAI)
Public defence
2002-03-01, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-17Bibliographically approved

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Lundberg, GunnarGerdle, Björn

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