Fibromyalgia: Hannonen P

Mäkinen H, Hannonen P. · No affiliation provided · J Rheumatol. · Pubmed #19208530 No free full text.

This publication has no abstract.

Hannonen P, Mikkelsson M. · Keski-Suomen keskussairaala 40620 Jyväskylä. · Duodecim. · Pubmed #15065519 No free full text.

This publication has no abstract.

Valkeinen H, Häkkinen K, Pakarinen A, Hannonen P, Häkkinen A, Airaksinen O, Niemitukia L, Kraemer WJ, Alén M. · Department of Health Sciences, University of Jyväskylä, Jyväskylä, FIN-40 014, Finland. · Scand J Rheumatol. · Pubmed #16195165 No free full text.

Abstract: OBJECTIVE: To examine the effects of strength training on maximal force, cross-sectional area (CSA), and electromyographic (EMG) activity of muscles and serum hormone concentrations in elderly females with fibromyalgia (FM). METHODS: Twenty-six patients with FM were randomly assigned to a training (FMT; n = 13; mean age 60 years) or a control (FMC; n = 13; 59 years) group. FMT performed progressive strength training twice a week for 21 weeks. The measurements included maximal isometric and concentric leg extension forces, EMG activity of the vastus lateralis and medialis, CSA of the quadriceps femoris, and serum concentrations of testosterone (T), free testosterone (FT), growth hormone (GH), insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulfate (DHEAS), and cortisol. Subjectively perceived symptoms of FM were also assessed. RESULTS: All patients were able to complete the training. In FMT strength training led to increases of 36% (p<0.001) and 33% (p<0.001) in maximal isometric and concentric forces, respectively. The CSA increased by 5% (p<0.001) and the EMG activity in isometric action by 47% (p<0.001) and in concentric action by 57% (p<0.001). Basal serum hormone concentrations remained unaltered during strength training. The subjective perceived symptoms showed a minor decreasing tendency (ns). No statistically significant changes occurred in any of these parameters in FMC. CONCLUSION: Progressive strength training increases strength, CSA, and voluntary activation of the trained muscles in elderly women with FM, while the measured basal serum hormone concentrations remain unaltered. Strength training benefits the overall physical fitness of the patients without adverse effects or any exacerbation of symptoms and should be included in the rehabilitation programmes of elderly patients with FM.

Häkkinen K, Pakarinen A, Hannonen P, Häkkinen A, Airaksinen O, Valkeinen H, Alen M. · Neuromuscular Research Center and Department of Biology of Physical Activity, University of Jyväskylä, Finland. · J Rheumatol. · Pubmed #12064848 No free full text.

Abstract: OBJECTIVE: To examine the effects of strength training on basal concentrations and acute responses of serum hormones, and their possible interrelationships with training induced muscle hypertrophy and strength gains of the knee extensor muscles in women with fibromyalgia (FM) and healthy controls. METHODS: Twenty-one premenopausal women with FM were randomized to 21 week strength training (FMT; n = 11) or control (FMC; n = 10) groups. Twelve premenopausal sedentary healthy women served as controls (HC). Surface electromyographic (EMG) activity, maximal unilateral isometric force of the right knee extensors, and muscle cross-sectional area (CSA) of the quadriceps femoris throughout the lengths of 3/12 to 12/15 of the femur (Lf) were measured. Serum concentrations of total and free testosterone and growth hormone (GH) were analyzed at rest and in pre- and post-exercise conditions, while levels of insulin-like growth factor and dehydroepiandrosterone sulfate were measured at rest only. RESULTS: Mean (SD) maximal force increased by 18% (10%) (p < 0.001) in the FMT group, and by 22% (12%) (p < 0.001) in the HC, while in the FMC it remained unchanged. Maximum integrated EMG of the agonists (VL + VM/2) increased in HC by 22% (p < 0.05) and in the FMT by 19% (p < 0.05). Significant increases in the CSA of the QF were observed at 5 to 12/15 Lf in FMT (p < 0.05-0.01) and at 3 to 12/15 Lf in HC (p < 0.05-0.001), while in FMC the CSA remained unchanged. No training induced changes occurred in the basal concentrations of serum hormones examined. A significant acute increase took place in the mean concentration of GH at pre-training in HC (p < 0.01) and in the FMT (p < 0.05), while at post-training the elevations after the loading (p < 0.001 and 0.05) remained elevated up to 15 min (p < 0.05) in HC and up to 30 min (p < 0.01) post-loading in the FMT. CONCLUSION: Both the magnitude and time course of adaptations of the neuromuscular system to resistance training in women with FM were completely comparable to those taking place in healthy women. Basal levels of the anabolic hormones seem to be similar in women with FM compared to age matched healthy women. Observations recorded during the acute loading conditions might be considered an indication of the training induced adaptation of the endocrine system, showing that the acute GH response may become systematic after strength training in both women with FM and controls.

Häkkinen A, Häkkinen K, Hannonen P, Alen M. · Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland. · Ann Rheum Dis. · Pubmed #11114277 links to  free full text

Abstract: OBJECTIVE: To investigate the effects of 21 weeks' progressive strength training on neuromuscular function and subjectively perceived symptoms in premenopausal women with fibromyalgia (FM). METHODS: Twenty one women with FM were randomly assigned to experimental (FM(T)) or control (FM(C)) groups. Twelve healthy women served as training controls (H(T)). The FM(T) and H(T) groups carried out progressive strength training twice a week for 21 weeks. The major outcome measures were muscle strength and electromyographic (EMG) recordings. Secondary outcome measures were pain, sleep, fatigue, physical function capacity (Stanford Health Assessment Questionnaire), and mood (short version of Beck's depression index). RESULTS: Female FM(T) subjects increased their maximal and explosive strength and EMG activity to the same extent as the H(T) group. Moreover, the progressive strength training showed immediate benefits on subjectively perceived fatigue, depression, and neck pain of training patients with FM. CONCLUSIONS: The strength training data indicate comparable trainability of the neuromuscular system of women with FM and healthy women. Progressive strength training can safely be used in the treatment of FM to decrease the impact of the syndrome on the neuromuscular system, perceived symptoms, and functional capacity. These results confirm the opinion that FM syndrome has a central rather than a peripheral or muscular basis.

Hannonen P. · Keski-Suomen keskussairaala, sisätautien vastuualue, Keskussairaalantie 19, 40620 Jyväskylä. · Duodecim. · Pubmed #19385341 No free full text.

Abstract: Fibromyalgia is a controversial pain syndrome with chronic widespread pain (occurring on both sides of the body as well as axially below and above the waist) and unexplained fatigue as the predominating features. Fibromyalgia involves lots of symptoms focusing on different organ systems. In sensory examination the most significant finding is general allodynia. The widespread chronic pain and tender points at certain locations as reported by the patient differentiate fibromyalgia patients from those suffering from other diseases of the musculoskeletal system.

Auvinen S, Suominen T, Hannonen P, Bachinski LL, Krahe R, Udd B. · Jyväskylä Central Hospital, Jyväskylä, Finland. · Arthritis Rheum. · Pubmed #18975316 links to  free full text

Abstract: Because of its high prevalence, fibromyalgia (FM) is a major general health issue. Myotonic dystrophy type 2 (DM2) is a recently described autosomal-dominant multisystem disorder. Besides variable proximal muscle weakness, myotonia, and precocious cataracts, muscle pain and stiffness are prominent presenting features of DM2. After noting that several of our mutation-positive DM2 patients had a previous diagnosis of FM, suggesting that DM2 may be misdiagnosed as FM, we invited 90 randomly selected patients diagnosed as having FM to undergo genetic testing for DM2. Of the 63 patients who agreed to participate, 2 (3.2%) tested positive for the DM2 mutation. Their cases are described herein. DM2 was not found in any of 200 asymptomatic controls. We therefore suggest that the presence of DM2 should be investigated in a large sample of subjects diagnosed as having FM, and clinicians should be aware of overlap in the clinical presentation of these 2 distinct disorders.

Valkeinen H, Alén M, Häkkinen A, Hannonen P, Kukkonen-Harjula K, Häkkinen K. · Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. · Arch Phys Med Rehabil. · Pubmed #18675392 No free full text.

Abstract: OBJECTIVE: To examine the effectiveness of concurrent strength and endurance training on muscle strength, aerobic and functional performance, and symptoms in postmenopausal women with fibromyalgia (FM). DESIGN: Randomized controlled trial. SETTING: Local gym and university research laboratory. PARTICIPANTS: Twenty-six women with FM. INTERVENTION: Progressive and supervised 21-week concurrent strength and endurance training. MAIN OUTCOME MEASURES: Muscle strength of leg extensors, upper extremities, and trunk; peak oxygen uptake (Vo(2)peak), maximal workload (Wmax), and work time; 10-m walking and 10-step stair-climbing time and self-reported functional capacity (Health Assessment Questionnaire); and symptoms of FM. RESULTS: After concurrent strength and endurance training, the groups differed significantly in Wmax (P=.001), work time (P=.001), concentric leg extension force (P=.043), walking (P=.001) and stair-climbing (P<.001) time, and fatigue (P=.038). The training led to an increase of 10% (P=.004) in Wmax and 13% (P=.004) in work time on the bicycle but no change in Vo(2)peak. CONCLUSIONS: Concurrent strength and endurance training in low to moderate volume improves the muscle strength of leg extensors, Wmax, work time, and functional performance as well as perceived symptoms, fatigue in particular. Concurrent strength and endurance training is beneficial to postmenopausal women with FM without adversities, but more extensive studies are needed to confirm the results.

Valkeinen H, Häkkinen A, Alen M, Hannonen P, Kukkonen-Harjula K, Häkkinen K. · Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. · Int J Sports Med. · Pubmed #17960505 No free full text.

Abstract: The purpose of this study was to compare physical fitness and health-related quality-of-life between twenty-three postmenopausal women with fibromyalgia (age 58 +/- 3 years) and eleven healthy women (58 +/- 5 years). Aerobic fitness and isometric force of different muscle groups were measured. Functional performance was assessed by walking and stair-climbing times. Symptoms were assessed by visual analog scale and quality-of-life by RAND-36 questionnaire. Women with fibromyalgia had significantly lower isometric force in bilateral leg extensors (1285 vs. 1898 N), unilateral knee extensors (414 vs. 502 N) and flexors (197 vs. 235 N) than healthy women, but no differences were observed in forces of the trunk and upper extremities. Maximal workload in the aerobic test (130 vs. 151 W), functional performance and quality-of-life were lower in women with fibromyalgia and they reported more symptoms than healthy subjects, while maximal oxygen uptake did not differ between the groups. A lower maximal load in the aerobic test suggests the patients' unsatisfactory ability to stand physical loading and resist overall fatigue. Moreover, fatigue rather than pain was the main factor to decrease the quality-of-life in women with fibromyalgia. Additional efforts should be addressed to strength training, when planning health promotion and rehabilitation programs in fibromyalgia.

Valkeinen H, Häkkinen A, Hannonen P, Häkkinen K, Alén M. · Department of Health Sciences, University of Jyväskylä, Central Hospital, Finland. · Arthritis Rheum. · Pubmed #16575859 links to  free full text

Abstract: OBJECTIVE: To examine heavy-resistance exercise-induced acute neuromuscular fatigue, blood lactate concentration, and muscle pain in elderly women with fibromyalgia (FM) and in healthy controls before and after a period of strength training. METHODS: Thirteen elderly women with FM (mean+/-SD age 60+/-2 years) and 10 healthy women (mean+/-SD age 64+/-3 years) performed a heavy-resistance fatiguing protocol (5 sets of leg presses with 10 repetitions maximum) before and after a 21-week strength training period. Maximal isometric force and electromyography (EMG) activity of leg extensors and blood lactate concentration were measured during the loading. Pain was assessed by visual analog scale. RESULTS: The strength training led to large increases in maximal force and EMG activity of the muscles and contributed to the improvement in loading performance (average load/set) at week 21. The fatiguing loading sessions typically applied in strength training before and after the experimental period caused remarkable and comparable acute decreases in maximal force and increases in blood lactate concentration in both groups. Acute exercise-induced muscle pain increased similarly in both groups, and the pain level in women with FM was lowered after the 21-week training period. CONCLUSION: The increased strength in women with FM improved high-load performance and also seemed to attenuate perceived pain. Acute exercise-induced neuromuscular changes and the time course of muscle pain in women with FM were comparable with findings in healthy controls, which suggests a typical fatiguing process and a similar trainability of the muscles in elderly women with FM.

Valkeinen H, Alen M, Hannonen P, Häkkinen A, Airaksinen O, Häkkinen K. · Department of Health Sciences, University of Jyväsklä, Jyväsklä, Finland. · Rheumatology (Oxford). · Pubmed #13130154 links to  free full text

Abstract: OBJECTIVE: To investigate the effects of strength training on neuromuscular functions in elderly females with fibromyalgia (FM). METHODS: Thirteen females with fibromyalgia [group FMt; mean age (s.d.) 60.2 (2.5) years] and 11 healthy controls [group HCt; 64.2 (2.7) yr] carried out supervised strength training twice a week for 21 weeks. Thirteen FM patients [group FMc; 59.1 (3.5) yr] served as non-training controls. Maximal isometric force and electromyographic (EMG) activity of the right quadriceps femoris in knee extension and flexion actions, maximal 10-m walking speed, and 10-step stair-climbing time were measured. Tender points were assessed by palpation, subjectively perceived symptoms with a visual analogue scale, and the self-reported physical function capacity by Health Assessment Questionnaire (HAQ). RESULTS: The mean (s.d.) increases in maximal extension force during the training period in groups FMt and in HCt were 32 (33)% (P < 0.001) and 24 (12)% (P < 0.001) respectively and those of flexion were 13 (20)% (P < 0.05) and 24 (17)% (P < 0.01). Explosive force of the extensors increased in both FMt and in HCt. The integrated EMGs of the vastus lateralis and medialis muscles increased in both FMt and HCt. Muscle forces and EMGs in group FMc remained at the basal level. Walking speed, stair-climbing time and the HAQ index improved in group FMt. The changes in the number of tender points and in perceived symptoms were in favour of the training group FMt. CONCLUSIONS: The data support the hypothesis that elderly female FM patients have normal neuromuscular function. Supervised strength training also suits elderly FM patients, has positive effects on perceived symptoms and improves functional capacity without complications.

Häkkinen A, Häkkinen K, Hannonen P, Alen M. · Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä. · J Rheumatol. · Pubmed #10813301 No free full text.

Abstract: OBJECTIVE: To compare the maximal and explosive strength characteristics of the leg muscles in premenopausal women with fibromyalgia (FM) with those of healthy female controls (HC) and to examine acute neuromuscular fatigue during heavy resistance loading and short term recovery from fatigue in these 2 groups. METHODS: Subjects were 11 women with FM, 38.6 (5.8) years old, and 12 healthy female controls, 37.3 (6.1) years old. The following were recorded before, during, and after a fatiguing loading session: maximal bilateral concentric and isometric force, isometric force-time curves and relaxation-time curves with agonist-antagonist neural activation (by EMG) of the leg muscles, muscle pain, and blood lactate concentrations. RESULTS: At baseline all the measured muscle strength characteristics were comparable between the study groups. The heavy fatiguing loading led to considerable and comparable acute fatigue found in both muscle strength characteristics and agonist-antagonist electromyography in both groups. The respective changes in blood lactate concentration and subjectively perceived muscular pain in the loaded muscles during strenuous resistance loading and recovery from fatigue were similar in both groups. CONCLUSION: Premenopausal women with FM do not demonstrate lower dynamic or isometric muscle strength characteristics compared to matched healthy controls. Second, the similar neuromuscular responses recorded during and after the fatiguing loading strongly support the hypothesis of normal muscle structure and neuromuscular function in patients with FM.