Kent Jonsson: Evaluation of respiratory function in women with fibromyalgia

Abstract

Aim: This thesis aims to investigate respiratory function in women with fibromyalgia (FM) and how this can affect clinical outcomes that may be targeted by specific treatments.

Method: All four articles were cross-sectional case-control studies comprising of women with FM and healthy controls matched for age and BMI. In study I, the primary outcome was forced expiration and the secondary outcomes were thoracic mobility and pain on palpation. In study II, blood gases were evaluated using a stepwise analysis to determine chronic respiratory dysfunction. In study III, breathing pattern was explored by investigating respiratory rate and tidal volume and calculating formed minute ventilation as the primary outcomes. In study IV, prediction of physical performance through six-minute walking test and chair stand test was analyzed with breathing pattern and thorax mobility as potential mediators. 

Results: Study I showed decreased forced exhalation and reduced thoracic mobility in women with FM compared to healthy controls. A subgroup of women with FM showed signs of chronic hyperventilation (Study II). This was in accordance with the breathing pattern found in women with FM (Study III) containing significantly lower tidal volume, higher respiratory rate and higher minute volume. This may be driven by both stress and reduced thoracic mobility. Breathing pattern and thoracic mobility may be a mediating factor for aerobic fatigue in women with FM (Study IV).

Conclusion: Dysfunctional breathing may be present in some women with FM affecting physical function. Thorax mobility and perceived stress can be contributing factors to such dysfunction. This can have clinical importance regarding management and for optimizing treatment. Measuring thorax mobility may be a cost-effective way to identify these patients.