A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia

• Type of Material: Article
• Authors: Susan T. Tran, DePaul University; Staci Thomas, Cincinnati Children’s Hospital Medical Center; Christopher DiCesare, Cincinnati Children’s Hospital Medical Center; Megan Pfeiffer, Cincinnati Children’s Hospital Medical Center; Soumitri Sil, Emory University; Tracy V. Ting, Cincinnati Children’s Hospital Medical Center; Sara E. Williams, Cincinnati Children’s Hospital Medical Center; Gregory D. Myer, Cincinnati Children’s Hospital Medical Center; Susmita Kashikar-Zuck, Cincinnati Children’s Hospital Medical Center
• Language: English
• Date: 2016-07-22
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2016 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12969-016-0103-7
• Title of Journal or Parent Work: Pediatric Rheumatology
• ISSN: 1546-0096
• Volume: 14
• Issue: 1
• Start Page: 43
• End Page: 43
• Grant/Funding Information: This study was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)/NIH Grants K24AR056687 and R21AR063412 to the last author (SKZ).
• Keywords: CRUCIATE LIGAMENT INJURY; CHRONIC PAIN; Science & Technology; LOWER-EXTREMITY KINEMATICS; JOINT HYPERMOBILITY; Pediatrics; COGNITIVE-BEHAVIORAL THERAPY; Rheumatology; Biomechanical assessment; NEUROMUSCULAR CONTROL; DYNAMIC POSTURAL CONTROL; BASIC GAIT PARAMETERS; Juvenile fibromyalgia; PHYSICAL-ACTIVITY; Life Sciences & Biomedicine; Chronic pain; Adolescents; CLINICAL-TRIAL; Physical activity
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery; Psychology, Behavioral

Abstract

Background: Adolescents with juvenile fibromyalgia (JFM) tend to be very sedentary and avoid participation in physical activity. A prior study suggested that JFM patients show altered biomechanics compared to healthy adolescents which may make them more prone to pain/injury during exercise. A new intervention combining well established cognitive behavioral therapy (CBT) techniques with specialized neuromuscular exercise -Fibromyalgia Integrative Training for Teens (FIT Teens) was developed and shown to be promising in improving functioning in adolescents with JFM. In contrast to traditional exercise programs such as aerobic or resistance training, neuromuscular training is a tailored approach which targets gait, posture, balance and movement mechanics which form the foundation for safe exercise participation with reduced risk for injury or pain (and hence more tolerable by JFM patients). The aim of this pilot feasibility study was to establish whether objective biomechanical assessment including sophisticated 3-D motion analysis would be useful in measuring improvements in strength, balance, gait, and functional performance after participation in the 8-week FIT Teens program. Methods: Eleven female participants with JFM (ages 12-18 years) completed pre- and post-treatment assessments of biomechanics, including walking gait analysis, lower extremity strength assessment, functional performance, and dynamic postural stability. Results: Descriptive data indicated that mechanics of walking gait and functional performance appeared to improve after treatment. Hip abduction strength and dynamic postural control also demonstrated improvements bilaterally. Conclusions: Overall, the results of this pilot study offer initial evidence for the utility of biomechanical assessment to objectively demonstrate observable changes in biomechanical performance after an integrated training intervention for youth with JFM. If replicated in larger controlled studies, findings would suggest that through the FIT Teens intervention, adolescents with JFM can progress towards normalized strength and biomechanics, which may enhance their ability to engage in physical exercise.