Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia

Authors: Anette Larsson, Annie Palstam, Jan Bjersing, Monika Löfgren, Malin Ernberg, Eva Kosek, Björn Gerdle, Kaisa Mannerkorpi

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Login to get access

Abstract

Background

Health and physical capacity are commonly associated with disease, age, and socioeconomic factors. The primary objective of this study was to investigate the degree to which physical capacity, defined as muscle strength and walking ability, is decreased in women with fibromyalgia (FM), as compared to healthy women, who are matched for age and level of education. The secondary aim was to investigate whether muscle strength and walking ability are associated with age, symptom duration, activity limitations and, Body Mass Index (BMI) in women with FM and control subjects.

Methods

This controlled, cross-sectional, multi-center study comprised 118 women with FM and 93 age- and education-level-matched healthy women. The outcome measures were isometric knee-extension force, isometric elbow-flexion force, isometric hand-grip force, and walking ability. Differences between the groups were calculated, and for the women with FM analyses of correlations between the measures of physical capacity and variables were performed.

Results

The women with FM showed 20% (p < 0.001) lower isometric knee-extension force, 36% (p < 0.001) lower isometric elbow-flexion force, 34% (p < 0.001) lower isometric hand-grip force, and 16% lower walking ability (p < 0.001), as compared to the healthy controls. All measures of muscle strength in women with FM showed significant weak to moderate relationship to symptom duration (rs = − 0.23–0.32) and walking ability (rs = 0.25–0.36). Isometric knee-extension force correlated with activity limitations, as measured using the SF-36 Physical function subscale (rs=0.23, p = 0.011).

Conclusions

Physical capacity was considerably decreased in the women with FM, as compared to the age- and education-level-matched control group. All measures of physical capacity showed a significant association with symptom duration. Knee-extension force and walking ability were significantly associated with activity limitations, age, and BMI. It seems important to address this problem and to target interventions to prevent decline in muscle strength. Assessments of muscle strength and walking ability are easy to administer and should be routinely carried out in the clinical setting for women with FM.

Trial registration

ClinicalTrials.gov identification number: NCT01226784, Oct 21, 2010.
Literature
1.
go back to reference Gran JT. The epidemiology of chronic generalized musculoskeletal pain. Best Pract Res Clin Rheumatol. 2003;17(4):547–61.CrossRefPubMed Gran JT. The epidemiology of chronic generalized musculoskeletal pain. Best Pract Res Clin Rheumatol. 2003;17(4):547–61.CrossRefPubMed
2.
go back to reference Lindell L, Bergman S, Petersson IF, Jacobsson LT, Herrstrom P. Prevalence of fibromyalgia and chronic widespread pain. Scand J Prim Health Care. 2000;18(3):149–53.CrossRefPubMed Lindell L, Bergman S, Petersson IF, Jacobsson LT, Herrstrom P. Prevalence of fibromyalgia and chronic widespread pain. Scand J Prim Health Care. 2000;18(3):149–53.CrossRefPubMed
3.
go back to reference Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum. 1990;33(2):160–72.CrossRefPubMed Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum. 1990;33(2):160–72.CrossRefPubMed
4.
go back to reference Mannerkorpi K, Burckhardt CS, Bjelle A. Physical performance characteristics of women with fibromyalgia. Arthritis Care Res. 1994;7(3):123–9.CrossRefPubMed Mannerkorpi K, Burckhardt CS, Bjelle A. Physical performance characteristics of women with fibromyalgia. Arthritis Care Res. 1994;7(3):123–9.CrossRefPubMed
5.
go back to reference Henriksen M, Lund H, Christensen R, Jespersen A, Dreyer L, Bennett RM, Danneskiold-Samsoe B, Bliddal H. Relationships between the fibromyalgia impact questionnaire, tender point count, and muscle strength in female patients with fibromyalgia: a cohort study. Arthritis Rheum. 2009;61(6):732–9.CrossRefPubMed Henriksen M, Lund H, Christensen R, Jespersen A, Dreyer L, Bennett RM, Danneskiold-Samsoe B, Bliddal H. Relationships between the fibromyalgia impact questionnaire, tender point count, and muscle strength in female patients with fibromyalgia: a cohort study. Arthritis Rheum. 2009;61(6):732–9.CrossRefPubMed
6.
go back to reference Góes SM, Leite N, Shay BL, Homann D, Stefanello JMF, Rodacki ALF. Functional capacity, muscle strength and falls in women with fibromyalgia. Clin Biomech. 2012;27:578.CrossRef Góes SM, Leite N, Shay BL, Homann D, Stefanello JMF, Rodacki ALF. Functional capacity, muscle strength and falls in women with fibromyalgia. Clin Biomech. 2012;27:578.CrossRef
7.
go back to reference Henriksson C, Gundmark I, Bengtsson A, Ek AC. Living with fibromyalgia. Consequences for everyday life. Clin J Pain. 1992;8(2):138–44.CrossRefPubMed Henriksson C, Gundmark I, Bengtsson A, Ek AC. Living with fibromyalgia. Consequences for everyday life. Clin J Pain. 1992;8(2):138–44.CrossRefPubMed
8.
go back to reference Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19–28.CrossRefPubMed Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19–28.CrossRefPubMed
9.
go back to reference Lannersten L, Kosek E. Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain. 2010;151(1):77–86.CrossRefPubMed Lannersten L, Kosek E. Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain. 2010;151(1):77–86.CrossRefPubMed
10.
go back to reference Gerdle B, Söderberg K, Puigvert LS, Rosendal L, Larsson B. Increased interstitial concentrations of pyruvate and lactate in the trapezius muscle of patients with fibromyalgia: a microdialysis study. J Rehabil Med. 2010;42(7):679–87.CrossRefPubMed Gerdle B, Söderberg K, Puigvert LS, Rosendal L, Larsson B. Increased interstitial concentrations of pyruvate and lactate in the trapezius muscle of patients with fibromyalgia: a microdialysis study. J Rehabil Med. 2010;42(7):679–87.CrossRefPubMed
11.
go back to reference World Health Organization. ICF: International Classification of Functioning, Disability and Health. Geneva: WHO; 2001. World Health Organization. ICF: International Classification of Functioning, Disability and Health. Geneva: WHO; 2001.
12.
go back to reference Norregaard J, Bulow PM, Vestergaard-Poulsen P, Thomsen C, Danneskiold-Samoe B. Muscle strength, voluntary activation and cross-sectional muscle area in patients with fibromyalgia. Br J Rheumatol. 1995;34(10):925–31.CrossRefPubMed Norregaard J, Bulow PM, Vestergaard-Poulsen P, Thomsen C, Danneskiold-Samoe B. Muscle strength, voluntary activation and cross-sectional muscle area in patients with fibromyalgia. Br J Rheumatol. 1995;34(10):925–31.CrossRefPubMed
13.
go back to reference Maquet D, Croisier JL, Renard C, Crielaard JM. Muscle performance in patients with fibromyalgia. Joint Bone Spine. 2002;69(3):293–9.CrossRefPubMed Maquet D, Croisier JL, Renard C, Crielaard JM. Muscle performance in patients with fibromyalgia. Joint Bone Spine. 2002;69(3):293–9.CrossRefPubMed
14.
go back to reference Cardoso FS, Curtolo M, Natour J, Lombardi Júnior I. Assessment of quality of life, muscle strength and functional capacity in women with fibromyalgia. Rev Bras Reumatol. 2011;51(4):344–50.CrossRef Cardoso FS, Curtolo M, Natour J, Lombardi Júnior I. Assessment of quality of life, muscle strength and functional capacity in women with fibromyalgia. Rev Bras Reumatol. 2011;51(4):344–50.CrossRef
15.
go back to reference Nørregaard J, Bülow P, Lykkegaard J, Mehlsen J, Danneskiold-Samsøoe B. Muscle strength, working capacity and effort in patients with fibromyalgia. Scand J Rehabil Med. 1997;29(2):97–102.PubMed Nørregaard J, Bülow P, Lykkegaard J, Mehlsen J, Danneskiold-Samsøoe B. Muscle strength, working capacity and effort in patients with fibromyalgia. Scand J Rehabil Med. 1997;29(2):97–102.PubMed
16.
go back to reference Bengtsson A. The muscle in fibromyalgia. Rheumatology (Oxford). 2002;41(7):721–4.CrossRef Bengtsson A. The muscle in fibromyalgia. Rheumatology (Oxford). 2002;41(7):721–4.CrossRef
17.
go back to reference Elvin A, Siösteen AK, Nilsson A, Kosek E. Decreased muscle blood flow in fibromyalgia patients during standardised muscle exercise: a contrast media enhanced colour Doppler study. Eur J Pain. 2006;10(2):137.CrossRefPubMed Elvin A, Siösteen AK, Nilsson A, Kosek E. Decreased muscle blood flow in fibromyalgia patients during standardised muscle exercise: a contrast media enhanced colour Doppler study. Eur J Pain. 2006;10(2):137.CrossRefPubMed
18.
go back to reference Bennett RM. Adult growth hormone deficiency in patients with fibromyalgia. Curr Rheumatol Rep. 2002;4(4):306–12.CrossRefPubMed Bennett RM. Adult growth hormone deficiency in patients with fibromyalgia. Curr Rheumatol Rep. 2002;4(4):306–12.CrossRefPubMed
19.
go back to reference Gerdle B, Grönlund C, Karlsson SJ, Holtermann A, Roeleveld K. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia. BMC Musculoskelet Disord. 2010;11(1):42.CrossRefPubMedPubMedCentral Gerdle B, Grönlund C, Karlsson SJ, Holtermann A, Roeleveld K. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia. BMC Musculoskelet Disord. 2010;11(1):42.CrossRefPubMedPubMedCentral
20.
go back to reference McLoughlin MJ, Colbert LH, Stegner AJ, Cook DB. Are women with fibromyalgia less physically active than healthy women? Med Sci Sports Exerc. 2011;43(5):905–12.CrossRefPubMedPubMedCentral McLoughlin MJ, Colbert LH, Stegner AJ, Cook DB. Are women with fibromyalgia less physically active than healthy women? Med Sci Sports Exerc. 2011;43(5):905–12.CrossRefPubMedPubMedCentral
21.
go back to reference Kop WJ, Lyden A, Berlin AA, Ambrose K, Olsen C, Gracely RH, Williams DA, Clauw DJ. Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome. Arthritis Rheum. 2005;52(1):296–303.CrossRefPubMed Kop WJ, Lyden A, Berlin AA, Ambrose K, Olsen C, Gracely RH, Williams DA, Clauw DJ. Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome. Arthritis Rheum. 2005;52(1):296–303.CrossRefPubMed
22.
go back to reference Soriano-Maldonado A, Ruiz JR, Aparicio VA, Estévez-López F, Segura-Jiménez V, Álvarez-Gallardo IC, Carbonell-Baeza A, Delgado-Fernández M, Ortega FB. Association of Physical Fitness with pain in women with fibromyalgia: the al-Ándalus project. Arthritis Care Res. 2015;67:1561.CrossRef Soriano-Maldonado A, Ruiz JR, Aparicio VA, Estévez-López F, Segura-Jiménez V, Álvarez-Gallardo IC, Carbonell-Baeza A, Delgado-Fernández M, Ortega FB. Association of Physical Fitness with pain in women with fibromyalgia: the al-Ándalus project. Arthritis Care Res. 2015;67:1561.CrossRef
23.
go back to reference Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, van Kan GA, Andrieu S, Bauer J, Breuille D. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249–56.CrossRefPubMed Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, van Kan GA, Andrieu S, Bauer J, Breuille D. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249–56.CrossRefPubMed
24.
go back to reference Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8(1):1.CrossRef Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8(1):1.CrossRef
25.
go back to reference Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions. Clin Rheumatol. 2009;28(4):475–8.CrossRefPubMedPubMedCentral Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms, and functions. Clin Rheumatol. 2009;28(4):475–8.CrossRefPubMedPubMedCentral
26.
go back to reference Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag health study. Arthritis Care Res. 2010;62(5):611–7.CrossRef Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag health study. Arthritis Care Res. 2010;62(5):611–7.CrossRef
27.
go back to reference Ross CE, Wu C-l. American Sociological Review. 1995;60(5):719–745. Ross CE, Wu C-l. American Sociological Review. 1995;60(5):719–745.
28.
go back to reference White KP, Speechley M, Harth M, Ostbye T. The London fibromyalgia epidemiology study: the prevalence of fibromyalgia syndrome in London, Ontario. J Rheumatol. 1999;26(7):1570–6.PubMed White KP, Speechley M, Harth M, Ostbye T. The London fibromyalgia epidemiology study: the prevalence of fibromyalgia syndrome in London, Ontario. J Rheumatol. 1999;26(7):1570–6.PubMed
29.
go back to reference Larsson A, Palstam A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K. Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia—a randomized controlled trial. Arthritis Res Ther. 2015;17(1):1–15.CrossRef Larsson A, Palstam A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, Gerdle B, Kosek E, Mannerkorpi K. Resistance exercise improves muscle strength, health status and pain intensity in fibromyalgia—a randomized controlled trial. Arthritis Res Ther. 2015;17(1):1–15.CrossRef
30.
go back to reference Hedin PJ, Hamne M, Burckhardt CS, Engstrom-Laurent A. The fibromyalgia impact questionnaire, a Swedish translation of a new tool for evaluation of the fibromyalgia patient. Scand J Rheumatol. 1995;24(2):69–75.CrossRefPubMed Hedin PJ, Hamne M, Burckhardt CS, Engstrom-Laurent A. The fibromyalgia impact questionnaire, a Swedish translation of a new tool for evaluation of the fibromyalgia patient. Scand J Rheumatol. 1995;24(2):69–75.CrossRefPubMed
31.
go back to reference Mannerkorpi K, Hernelid C. Leisure time physical activity instrument and physical activity at home and work instrument. Development, face validity, construct validity and test-retest reliability for subjects with fibromyalgia. Disabil Rehabil. 2005;27(12):695–701.CrossRefPubMed Mannerkorpi K, Hernelid C. Leisure time physical activity instrument and physical activity at home and work instrument. Development, face validity, construct validity and test-retest reliability for subjects with fibromyalgia. Disabil Rehabil. 2005;27(12):695–701.CrossRefPubMed
32.
go back to reference Schaufelberger M, Eriksson B, Grimby G, Held P, Swedberg K. Skeletal muscle alterations in patients with chronic heart failure. Eur Heart J. 1997;18(6):971–80.CrossRefPubMed Schaufelberger M, Eriksson B, Grimby G, Held P, Swedberg K. Skeletal muscle alterations in patients with chronic heart failure. Eur Heart J. 1997;18(6):971–80.CrossRefPubMed
33.
go back to reference Brodin E, Ljungman S, Sunnerhagen KS. Rising from a chair: a simple screening test for physical function in predialysis patients. Scand J Urol Nephrol. 2008;42(3):293–300.CrossRefPubMed Brodin E, Ljungman S, Sunnerhagen KS. Rising from a chair: a simple screening test for physical function in predialysis patients. Scand J Urol Nephrol. 2008;42(3):293–300.CrossRefPubMed
34.
go back to reference Leggin BG, Neuman RM, Iannotti JP, Williams GR, Thompson EC. Intrarater and interrater reliability of three isometric dynamometers in assessing shoulder strength. J Shoulder Elb Surg. 1996;5(1):18–24.CrossRef Leggin BG, Neuman RM, Iannotti JP, Williams GR, Thompson EC. Intrarater and interrater reliability of three isometric dynamometers in assessing shoulder strength. J Shoulder Elb Surg. 1996;5(1):18–24.CrossRef
35.
go back to reference Nordenskiold UM, Grimby G. Grip force in patients with rheumatoid arthritis and fibromyalgia and in healthy subjects. A study with the Grippit instrument. Scand J Rheumatol. 1993;22(1):14–9.CrossRefPubMed Nordenskiold UM, Grimby G. Grip force in patients with rheumatoid arthritis and fibromyalgia and in healthy subjects. A study with the Grippit instrument. Scand J Rheumatol. 1993;22(1):14–9.CrossRefPubMed
36.
go back to reference Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C. Tests of functional limitations in fibromyalgia syndrome: a reliability study. Arthritis Care Res. 1999;12(3):193–9.CrossRefPubMed Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C. Tests of functional limitations in fibromyalgia syndrome: a reliability study. Arthritis Care Res. 1999;12(3):193–9.CrossRefPubMed
37.
go back to reference Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed
38.
go back to reference Colton T. Statistics in medicine. Boston: Little, Brown and Company; 1974. p. 1. Colton T. Statistics in medicine. Boston: Little, Brown and Company; 1974. p. 1.
39.
go back to reference Jones CJ, Rutledge DN, Aquino J. Predictors of physical performance and functional ability in people 50+ with and without fibromyalgia. J Aging Phys Act. 2010;18(3):353–68.CrossRefPubMed Jones CJ, Rutledge DN, Aquino J. Predictors of physical performance and functional ability in people 50+ with and without fibromyalgia. J Aging Phys Act. 2010;18(3):353–68.CrossRefPubMed
40.
go back to reference Wu F, Callisaya M, Laslett L, Wills K, Zhou Y, Jones G, Winzenberg T. Lower limb muscle strength is associated with poor balance in middle-aged women: linear and nonlinear analyses. Osteoporos Int. 2016;27(7):2241–8.CrossRefPubMed Wu F, Callisaya M, Laslett L, Wills K, Zhou Y, Jones G, Winzenberg T. Lower limb muscle strength is associated with poor balance in middle-aged women: linear and nonlinear analyses. Osteoporos Int. 2016;27(7):2241–8.CrossRefPubMed
41.
go back to reference Persch LN, Ugrinowitsch C, Pereira G, Rodacki AL. Strength training improves fall-related gait kinematics in the elderly: a randomized controlled trial. Clin Biomech. 2009;24(10):819–25.CrossRef Persch LN, Ugrinowitsch C, Pereira G, Rodacki AL. Strength training improves fall-related gait kinematics in the elderly: a randomized controlled trial. Clin Biomech. 2009;24(10):819–25.CrossRef
42.
go back to reference Nordeman L, Gunnarsson R, Mannerkorpi K. Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study. Clin J Pain. 2014;30(5):391–8.PubMed Nordeman L, Gunnarsson R, Mannerkorpi K. Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study. Clin J Pain. 2014;30(5):391–8.PubMed
43.
go back to reference Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3–10.CrossRefPubMed Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3–10.CrossRefPubMed
44.
go back to reference Sayer AA, Kirkwood T. Grip strength and mortality: a biomarker of ageing? Lancet (London, England). 2015;386(9990):226.CrossRef Sayer AA, Kirkwood T. Grip strength and mortality: a biomarker of ageing? Lancet (London, England). 2015;386(9990):226.CrossRef
45.
go back to reference Bohannon RW, Magasi SR, Bubela DJ, Wang YC, Gershon RC. Grip and knee extension muscle strength reflect a common construct among adults. Muscle Nerve. 2012;46(4):555–8.CrossRefPubMedPubMedCentral Bohannon RW, Magasi SR, Bubela DJ, Wang YC, Gershon RC. Grip and knee extension muscle strength reflect a common construct among adults. Muscle Nerve. 2012;46(4):555–8.CrossRefPubMedPubMedCentral
46.
go back to reference Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094.CrossRefPubMed Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094.CrossRefPubMed
47.
go back to reference Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–30.CrossRefPubMed Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–30.CrossRefPubMed
Metadata
Title
Controlled, cross-sectional, multi-center study of physical capacity and associated factors in women with fibromyalgia
Authors
Anette Larsson
Annie Palstam
Jan Bjersing
Monika Löfgren
Malin Ernberg
Eva Kosek
Björn Gerdle
Kaisa Mannerkorpi
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2047-1

Other articles of this Issue 1/2018

BMC Musculoskeletal Disorders 1/2018 Go to the issue