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Review
. 2021 Jan 15;11(1):127.
doi: 10.3390/diagnostics11010127.

Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis

David Núñez-Fuentes  1 , Esteban Obrero-Gaitán  1 , Noelia Zagalaz-Anula  1 , Alfonso Javier Ibáñez-Vera  1 , Alexander Achalandabaso-Ochoa  1 , María Del Carmen López-Ruiz  1 , Daniel Rodríguez-Almagro  1 , Rafael Lomas-Vega  1
Affiliations
Review

Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis

David Núñez-Fuentes et al. Diagnostics (Basel). .

Abstract

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.

Keywords: central sensitization; chronic fatigue syndrome; fibromyalgia; meta-analysis; postural balance; sensory organization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow chart.
Figure 2
Figure 2
Forest plot of the meta-analysis of functional balance. Std diff, Standardized difference; CI, Confidence interval.
Figure 3
Figure 3
Forest plot of the meta-analysis of balance confidence. Std diff, Standardized difference; CI, Confidence interval.
Figure 4
Figure 4
Forest plot of the meta-analysis of static balance. Std diff, Standardized difference; CI, Confidence interval.
Figure 5
Figure 5
Forest plot of the meta-analysis of dynamic balance. Std diff, Standardized difference; CI, Confidence interval.
Figure 6
Figure 6
Forest plot of the meta-analysis of Sensory Organization Test. Std diff, Standardized difference; CI, Confidence interval.
Figure 7
Figure 7
Forest plot of posturographical parameters of Postural Stability in Bipedal Stance. Std diff, Standardized difference; CI, Confidence interval.
See this image and copyright information in PMC

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