Normal paraspinal muscle electromyographic fatigue characteristics in patients with primary fibromyalgia

Paraspinal muscle fatigue mechanisms were compared in 14 primary fibromyalgia patients and 14 age and sex matched normal subjects using a standardized 60-s isometric endurance test of the paraspinal muscles, during which surface integrated electromyographic (IEMG) activity was recorded. Fatigue-induced IEMG increases were similar for both groups during the initial 40 s (up to 112 +/- 20% and 111 +/- 6% of initial values in patients and normal subjects respectively). Thereafter, IEMG fell significantly in patients (P < 0.05) but only slightly in controls, so that at 58 s IEMG was 102 +/- 13% in patients and 109 +/- 12% in controls. If patients were divided according to body mass index (BMI, range 19-25 in controls) those with a BMI < 26 (n = 5) showed IEMG changes similar to those of control subjects throughout the test, while obese patients with BMI > 26 (n = 9) showed greater IEMG declines after 40 s than either normal subjects or in the fibromyalgia group as a whole. Paraspinal muscle fatigue mechanisms appear normal in primary fibromyalgia patients. Isometric force maintenance in overweight patients, despite IEMG declines, illustrates the action of intrinsic fatigue resistance mechanisms which were presumably utilized to a greater extent in these patients to cope with the extra load.