Proprioception in patients with fibromyalgia and chronic fatigue syndrome: A systematic review

Abstract

Background. Previous research found impairments in postural balance and interoception in individuals with fibromyalgia (FM) and chronic fatigue syndrome (CFS). Both constructs can be associated with proprioception, making the latter an interesting topic for further research. Moreover, an understanding of the extent and nature of proprioceptive impairments in FM and CFS is needed to identify target points for rehabilitation. Objectives. To investigate the evidence for impairments in proprioception in individuals with FM and CFS and analyse differences with healthy controls. Methods. Observational case-control studies that compared proprioception between patients with FM or CFS and healthy controls were selected (databases: PubMed, MEDLINE, and Web of Science). Six studies (n = 422 participants) met the criteria. Data were extracted for population characteristics, diagnostics, and proprioceptive outcome measures, including study results. Results. All studies applied a limb or trunk repositioning task and reported the mean positioning error as the outcome of proprioceptive performance. FM patients showed impairments in trunk-related proprioception (p < .005), but not in knee, shoulder, or upper limb reposition sense compared to healthy controls. Conclusion. Evidence suggests trunk-related impairments may be present and relevant to the frequently reported postural imbalances in this population. However, the overall body of evidence after applying the GRADE approach was very low and further research using higher quality designs and procedures would be needed to establish strong data-based conclusions. Until then, professionals should consider the assessment of trunk-related posture and proprioception when working with this population.

Key Words: Fibromyalgia, Chronic Fatigue Syndrome, proprioception, postural balance.