PDF(Pubmed)
Abstract：
BACKGROUND: Fibromyalgia syndrome (FMS) is associated with central alterations, but controversies exist regarding the presence and role of peripheral factors. Microdialysis (MD) can be used in vivo to study muscle alterations in FMS. Furthermore for chronic pain conditions such as FMS, the mechanisms for the positive effects of exercise are unclear. This study investigates the interstitial concentrations of algesics and metabolites in the vastus lateralis muscle of 29 women with FMS and 28 healthy women before and after an exercise intervention.
METHODS: All the participants went through a clinical examination and completed a questionnaire. In addition, their pressure pain thresholds (PPTs) in their upper and lower extremities were determined. For both groups, MD was conducted in the vastus lateralis muscle before and after a 15-week exercise intervention of mainly resistance training of the lower limbs. Muscle blood flow and interstitial muscle concentrations of lactate, pyruvate, glutamate, glucose, and glycerol were determined.
RESULTS: FMS was associated with significantly increased interstitial concentrations of glutamate, pyruvate, and lactate. After the exercise intervention, the FMS group exhibited significant decreases in pain intensity and in mean interstitial concentrations of glutamate, pyruvate, and glucose. The decrease in pain intensity in FMS correlated significantly with the decreases in pyruvate and glucose. In addition, the FMS group increased their strength and endurance.
CONCLUSIONS: This study supports the suggestion that peripheral metabolic and algesic muscle alterations are present in FMS patients and that these alterations contribute to pain. After an exercise intervention, alterations normalized, pain intensity decreased (but not abolished), and strength and endurance improved, all findings that suggest the effects of exercise are partially peripheral.
METHODS: All the participants went through a clinical examination and completed a questionnaire. In addition, their pressure pain thresholds (PPTs) in their upper and lower extremities were determined. For both groups, MD was conducted in the vastus lateralis muscle before and after a 15-week exercise intervention of mainly resistance training of the lower limbs. Muscle blood flow and interstitial muscle concentrations of lactate, pyruvate, glutamate, glucose, and glycerol were determined.
RESULTS: FMS was associated with significantly increased interstitial concentrations of glutamate, pyruvate, and lactate. After the exercise intervention, the FMS group exhibited significant decreases in pain intensity and in mean interstitial concentrations of glutamate, pyruvate, and glucose. The decrease in pain intensity in FMS correlated significantly with the decreases in pyruvate and glucose. In addition, the FMS group increased their strength and endurance.
CONCLUSIONS: This study supports the suggestion that peripheral metabolic and algesic muscle alterations are present in FMS patients and that these alterations contribute to pain. After an exercise intervention, alterations normalized, pain intensity decreased (but not abolished), and strength and endurance improved, all findings that suggest the effects of exercise are partially peripheral.
摘要：
背景：纤维肌痛综合征（FMS）与中枢改变有关，但是关于外围因素的存在和作用存在争议。微透析（MD）可用于体内研究FMS中的肌肉变化。此外，对于FMS等慢性疼痛状况，运动的积极作用机制尚不清楚.这项研究调查了29名FMS女性和28名健康女性在运动干预前后股外侧肌中镇痛药和代谢物的间质浓度。
方法：所有参与者都进行了临床检查并完成了问卷调查。此外,确定了他们上肢和下肢的压力痛阈值(PPTs).对于这两个群体来说，在主要进行下肢阻力训练的15周运动干预之前和之后，在股外侧肌进行MD。肌肉血流量和间质肌肉乳酸浓度，丙酮酸,谷氨酸,葡萄糖，和甘油被测定。
结果：FMS与谷氨酸间质浓度显著增加有关，丙酮酸,和乳酸。运动干预后,FMS组的疼痛强度和谷氨酸的平均间质浓度显着降低，丙酮酸,和葡萄糖。FMS中疼痛强度的降低与丙酮酸和葡萄糖的降低显着相关。此外,FMS组增加了他们的力量和耐力。
结论：本研究支持FMS患者存在外周代谢和痛觉肌改变的建议，这些改变有助于疼痛。运动干预后，改变标准化，疼痛强度降低（但未消除），力量和耐力得到改善，所有表明运动影响的发现都部分是外围的。
方法：所有参与者都进行了临床检查并完成了问卷调查。此外,确定了他们上肢和下肢的压力痛阈值(PPTs).对于这两个群体来说，在主要进行下肢阻力训练的15周运动干预之前和之后，在股外侧肌进行MD。肌肉血流量和间质肌肉乳酸浓度，丙酮酸,谷氨酸,葡萄糖，和甘油被测定。
结果：FMS与谷氨酸间质浓度显著增加有关，丙酮酸,和乳酸。运动干预后,FMS组的疼痛强度和谷氨酸的平均间质浓度显着降低，丙酮酸,和葡萄糖。FMS中疼痛强度的降低与丙酮酸和葡萄糖的降低显着相关。此外,FMS组增加了他们的力量和耐力。
结论：本研究支持FMS患者存在外周代谢和痛觉肌改变的建议，这些改变有助于疼痛。运动干预后，改变标准化，疼痛强度降低（但未消除），力量和耐力得到改善，所有表明运动影响的发现都部分是外围的。
