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Original article| Volume 93, ISSUE 11, P2035-2041, November 2012

Reliability and Validity of a Low Load Endurance Strength Test for Upper and Lower Extremities in Patients With Fibromyalgia

Published:February 27, 2012DOI:https://doi.org/10.1016/j.apmr.2012.02.007

      Abstract

      Munguía-Izquierdo D, Legaz-Arrese A. Reliability and validity of a low load endurance strength test for upper and lower extremities in patients with fibromyalgia.

      Objective

      To evaluate the reliability, standard error of the mean (SEM), clinical significant change, and known group validity of 2 assessments of endurance strength to low loads in patients with fibromyalgia syndrome (FS).

      Design

      Cross-sectional reliability and comparative study.

      Setting

      University Pablo de Olavide, Seville, Spain.

      Participants

      Middle-aged women with FS (n=95) and healthy women (n=64) matched for age, weight, and body mass index (BMI) were recruited for the study.

      Interventions

      Not applicable.

      Main Outcome Measures

      The endurance strength to low loads tests of the upper and lower extremities and anthropometric measures (BMI) were used for the evaluations. The differences between the readings (tests 1 and 2) and the SDs of the differences, intraclass correlation coefficient (ICC) model (2,1), 95% confidence interval for the ICC, coefficient of repeatability, intrapatient SD, SEM, Wilcoxon signed-rank test, and Bland-Altman plots were used to examine reliability. A Mann-Whitney U test was used to analyze the differences in test values between the patient group and the control group. We hypothesized that patients with FS would have an endurance strength to low loads performance in lower and upper extremities at least twice as low as that of the healthy controls.

      Results

      Satisfactory test-retest reliability and SEMs were found for the lower extremity, dominant arm, and nondominant arm tests (ICC=.973–.979; P<.001; SEMs=1.44–1.66 repetitions). The differences in the mean between the test and retest were lower than the SEM for all performed tests, varying from −.10 to .29 repetitions. No significant differences were found between the test and retest (P>.05 for all). The Bland-Altman plots showed 95% limits of agreement for the lower extremity (4.7 to –4.5), dominant arm (3.8 to –4.4), and nondominant arm (3.9 to –4.1) tests. The endurance strength to low loads test scores for the patients with FS were 4-fold lower than for the controls in all performed tests (P<.001 for all).

      Conclusions

      The endurance strength to low loads tests showed good reliability and known group validity and can be recommended for evaluating endurance strength to low loads in patients with FS. For individual evaluation, however, an improved score of at least 4 and 5 repetitions for the upper and lower extremities, respectively, was required for the differences to be considered as substantial clinical change. Patients with FS showed impaired endurance strength to low loads performance when compared with the general population.

      Key Words

      List of Abbreviations:

      BMI (body mass index), CI (confidence interval), ICC (intraclass correlation coefficient), FS (fibromyalgia syndrome), SEM (standard error of the mean)
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