Subgrouping

Possibly the biggest aspect of fibromyalgia that gets doctors scratching their heads is the incredible variety of fibromyalgia patients.  As Auvinet et al (see library – soon) say, fibromyalgia patients “do not constitute a homogeneous group.”  Like I’ve said before, what works for one patient may not work for another.  What works for one patient one day may not work the next week for the same patient.  It’s very frustrating for both doctors and patients, so doctors tend to look at ways to classify patients, to identify subgroups in order to be able to treat more people more effectively and to create some standardization in treatment options to avoid unnecessary and possible harmful treatments.  All well and good, but every study trying to identify subgroups has used different criteria.  It seems like they need to decide on the most proper criteria before identifying the subgroups.  It’s just a mishmash of non-information out there.

The latest that I read (Auvinet et al) used gait markers (the way patients walked) to identify subgroups, looking at stride frequency, stride regularity, and cranio-caudal power, which is how they look at “kinesia,” which simply means movement, as far as I can tell.  And they did identify a few subgroups by looking at the way patients walk.  Looking at stride regularity, they found a set of patients who had lower functionality and coping mechanisms, and higher tendency to catastrophization and mood disorders.  Looking at stride frequency they identified another group with normal stride frequency, low pain, and although higher in terms of activity, a tendency for hyperkinesia (which I think is muscle spasms rather than hyperactivity).  Looking at the cranio-caudal power, this group correlated to pain.  Actually these are only a few subsets they identified.  I’m not sure how useful these subsets have proven to be, especially since the article is from 2011 and I’m not finding a lot relating gait with fibromyalgia.  However, Auvinet et al did note that improving gait in one of the subsets then improved symptoms.  That seems pretty relevant.  Again, nothing about it since (so far – still looking).

There is another study (Goes et al) that looked at the gait characteristics in middle aged women with fibromyalgia and compared them to elderly women without fibromyalgia.  Yep, you guessed it.  We walk like old women.  Our stride length, walking speed, and range of motion in our legs, hips, etc, are similar to elderly women.  They identified it as a “premature aging pattern.”  I’ve never fought getting older, but it would be nice to age at the right rate!  Golly!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s