Impact of Body Mass Index on Static Postural Control in Adults With and Without Diabetes: A Cross-Sectional Study

AimThe objective of this research was to determine the static postural control differences measured from a force platform in Type 2 diabetes mellitus (T2DM) and healthy control groups with different levels of body mass index (BMI), and detect the static postural control difference between T2DM and healthy control groups stratified by different BMI category. This research also explored the relationship of BMI and static postural performance.MethodsWe recruited 706 participants with T2DM and 692 healthy controls who were sufficiently matched for age, gender, and BMI in this cross-sectional study. The participants were stratified into three groups by BMI: normal weight, overweight, and obesity. All participants performed two-legged static stance postural control assessment on a firm force platform. The Center of Pressure (CoP) parameters were collected under eyes-open and eyes-closed conditions. Mann–Whitney U test was used to compare the static postural control parameters within each BMI category in both groups. The static postural control parameters among different weight groups were compared by Kruskal–Wallis test, post hoc pair-wise comparison were conducted. Generalized linear model was conducted to examine the association between BMI and static postural control parameters while controlling for confounding factors.ResultsHealthy control group had statistical difference in most CoP parameters compared to T2DM group based on all BMI categories. Normal weight participants presented significant difference compared with overweight and/or obesity for total track length (TTL) and velocity of CoP displacements in Y direction (V-Y) under eyes-open condition, and for most CoP parameters under eyes-closed condition in both groups. There were statistically significant correlations between BMI and most static postural control parameters under only eyes-closed condition according to the result of generalized linear model.ConclusionT2DM patients had impaired static postural control performance compared to healthy controls at all BMI categories. The findings also indicated the association between BMI and static postural control, where higher BMI individuals showed more static postural instability in both T2DM and healthy controls.

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Influence of Visual Information and Sex on Postural Control in Children Aged 6–12 Years Assessed with Accelerometric Technology

Diagnostics ◽

10.3390/diagnostics11040637 ◽

2021 ◽

Vol 11 (4) ◽

pp. 637

Author(s):

Jesús García-Liñeira ◽

Raquel Leirós-Rodríguez ◽

José Luis Chinchilla-Minguet ◽

José Luis García-Soidán

Keyword(s):

Postural Control ◽

Visual Information ◽

Cross Sectional Study ◽

Cross Sectional ◽

Sensory Stimuli ◽

Eyes Closed ◽

Visual Inputs ◽

Eyes Open ◽

Three Body ◽

Muscular Activation

The performance of postural control is believed to be linked to how children use available sensory stimuli to produce adequate muscular activation. Therefore, the aim of the present study was to thoroughly explore postural stability under normal conditions and without visual information in postural control in children aged 6–12 years during static single-leg support. A descriptive cross-sectional study was conducted with 316 children (girls = 158). The analyzed variables were the mean and maximum values obtained in each of the three body axes and their root mean square during two static single-leg support tests: one with eyes open and one with eyes closed. Girls showed lower magnitudes in the recorded accelerations at all ages and in all the variables of both tests. Accelerations during the tests showed progressively lower values from 6 to 12 years of age. The sex had a significant influence on the magnitude obtained in the accelerations recorded during the tests. Improvements in balance with increasing age were greater with visual information than without visual information. The tests of single-leg support showed preferential sensorimotor strategies in boys and girls: boys tend to rely more on visual inputs, and girls process somesthetic information in a preferential way.

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Comparison and Association of Neck Extensor Muscles’ Endurance and Postural Function in Subjects with and without Chronic Neck Pain – A Cross-Sectional Study

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1395-1050 ◽

2021 ◽

Author(s):

Praveen Kumar Kandakurti ◽

Ravi Shankar Reddy ◽

Venkata Nagaraj Kakarparthy ◽

Kanagaraj Rengaramanujam ◽

Jaya Shanker Tedla ◽

...

Keyword(s):

Neck Pain ◽

Postural Control ◽

Chronic Neck Pain ◽

Cross Sectional Study ◽

Control Measures ◽

Endurance Capacity ◽

Control Parameters ◽

Sectional Study ◽

Cross Sectional ◽

Velocity Moment

Abstract Purpose Neck extensor endurance (NEE) and position sense are vital for maintaining cervical spine function and defects in these processes may be associated with impaired postural control in chronic neck pain (CNP) subjects. The study’s objectives are 1) to compare the cervical extensor endurance capability and postural control of CNP subjects with those of asymptomatic controls; 2) to investigate the association between NEE and postural control. Materials and Methods Sixty-four participants (38 asymptomatic, 38 with CNP) participated in this cross-sectional study. NEE was assessed using a clinical extensor endurance test. Under open and closed eyes conditions, postural control measures were tested with the Good Balance system. The postural control parameters were AP-velocity (mm/s), ML-velocity (mm/s) and Velocity moment (mm2). NEE capacity and postural control parameters were compared and correlated between asymptomatic and CNP subjects. Results and Discussion CNP subjects showed lower NEE capacity (p<0.001) and significantly larger AP-velocity (p<0.001), ML-velocity (p<0.001) and Velocity moment (p<0.001) than asymptomatic participants. NEE negatively correlated with AP-velocity (r=−0.51, p=0.001), ML-velocity (r=0.46, p=0.003) and velocity moment (r=0.38, p=0.020) in asymptomatic subjects in eyes open condition and no correlations in subjects with CNP. CNP subjects showed increased postural sway velocities and lowered extensor endurance capacity compared to asymptomatic participants. No correlations existed between NEE and postural control parameters in CNP subjects.

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Low Level of Serum Sclerostin in Adult Patients with Tumor-induced Osteomalacia Comparing with X-linked Hypophosphatemia

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab579 ◽

2021 ◽

Author(s):

Xiaolin Ni ◽

Qi Zhang ◽

Xiang Li ◽

Qianqian Pang ◽

Yiyi Gong ◽

...

Keyword(s):

Bone Mass ◽

Cross Sectional Study ◽

Healthy Controls ◽

Cross Sectional ◽

Significant Difference ◽

Healthy Control ◽

Premenopausal Patients ◽

Male Patients ◽

Sclerostin Level ◽

Sclerostin Antibody

Abstract Context Sclerostin is an inhibitor of Wnt-β-catenin signaling to regulate bone formation. Circulating sclerostin levels were reported to be elevated in patients with X-linked hypophosphatemia (XLH), and sclerostin antibody (Scl-Ab) has been shown to increase bone mass and normalize circulating phosphate levels in Hyp mice. However, circulating sclerostin level in acquired hypophosphatemic patients with tumor-induced osteomalacia (TIO) remains rare reported. Objectives This study was designed to evaluate serum sclerostin levels in TIO patients comparing them with age-, sex- matched healthy controls and XLH patients, and analyze correlation of circulating sclerostin with BMD and laboratory parameters. Design, Setting and Participants 190 individuals including 83 adult TIO patients, 83 adult healthy controls and 24 adult XLH patients were enrolled in this cross-sectional study. Main outcome measures Serum sclerostin levels were determined in TIO patients, healthy controls and XLH patients. Results TIO patients (43 male and 40 female) aged 44.3 ± 8.7 (mean ± SD) years had lower levels of circulating sclerostin than healthy controls (94.2 ± 45.8 vs 108.4 ± 42.3 pg/mL, p = 0.01) with adjustment for age, gender, BMI and diabetes rate. Sclerostin levels were positively associated with age (r = 0.238, p = 0.030). Male patients had higher sclerostin level than female patients (104.7 ± 47.3 vs 83.0 ± 41.8 pg/mL, p = 0.014) and postmenopausal patients had higher tendency of sclerostin level than premenopausal patients (98.4 ± 48.8 vs 71.6 ± 32.3 ng/ml, p = 0.05). Sclerostin levels were positively associated with BMD of L1-4 (r = 0.255, p = 0.028), femoral neck (r = 0.242, p = 0.039) and serum calcium (r = 0.231, p = 0.043). TIO subgroup patients (n=24, 35.9 ± 7.3 years old) comparing with age-, sex-matched adult XLH patients and healthy controls revealed significant difference of sclerostin levels (XLH, TIO and healthy control were 132.0 ± 68.8, 68.4 ± 31.3 and 98.6 ± 41.1 pg/mL, respectively, p < 0.001). Conclusions Circulating sclerostin levels were decreased in TIO patients but increased in XLH patients, which might be result of histological abnormality and bone mass.

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Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2015-0326 ◽

2016 ◽

Vol 0 (0) ◽

Cited By ~ 8

Author(s):

Vichit Supornsilchai ◽

Chutima Jantarat ◽

Wichit Nosoognoen ◽

Sopon Pornkunwilai ◽

Suttipong Wacharasindhu ◽

...

Keyword(s):

Bisphenol A ◽

Estrogenic Activity ◽

Age At Onset ◽

Ultra Performance Liquid Chromatography ◽

Cross Sectional Study ◽

Normal Weight ◽

Control Groups ◽

Limit Of Quantification ◽

Cross Sectional ◽

Liquid Chromatography Tandem Mass

AbstractReports on the secular trend of pubertal onset indicate a recent earlier start especially in girls. Bisphenol A (BPA), which posses estrogenic activity, might be a cause of advanced puberty. The objective of the study was to determine the association between BPA and advanced puberty.A cross-sectional study was conducted in patients with advanced puberty (n=41) compared to age-matched controls (n=47). Anthropometric measurements, estradiol, basal and gonadotropin releasing hormone (GnRH)-stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, uterine sizes, ovarian diameters and bone ages were obtained. Urinary BPA concentrations were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC/MSMS) with the lower limit of quantification (LLOQ) of 0.05 ng/mL.The median adjust-BPA concentration in advanced puberty group was higher than in control groups [1.44 vs. 0.59 μg/g creatinine (Cr): p<0.05]. We also found that the median adjust-BPA concentration in girls with advanced puberty who were overweight/obese, was greater than in the normal pubertal overweight/obese girls (1.74 vs. 0.59 μg/g Cr: p<0.05), and was in the same trend among normal weight girls with advanced and normal puberty (0.83 vs. 0.49 μg/g Cr: p=0.09), but not statistically significant.The present findings suggest that BPA exposure appears to be related to an earlier age at onset of puberty especially in obese girls.

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Does Dual Motor Tasks Provokes Posture Adaptations in Healthy Young Adults? A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49048.15374 ◽

2021 ◽

Author(s):

Carley Bowman ◽

Aleena Jose ◽

Martin G Rosario

Keyword(s):

Young Adults ◽

Postural Stability ◽

Cross Sectional Study ◽

P Value ◽

Motor Tasks ◽

Anova Analysis ◽

Dual Tasks ◽

Cross Sectional ◽

Eyes Closed ◽

Eyes Open

Introduction: Most studies on postural deviations during single and dual tasks have been extensively studied in neuromuscular and older adult populations. Nevertheless, further research is warranted to identify whether such tasks can impose postural adaptations in young, healthy adults without sensory impairments. Aim: To assess postural stability modifications in young adults during single tasks and dual motor tasks (holding a cup filled with water) while concomitantly challenging the sensory systems. Materials and Methods: This was the cross-sectional study on 82 young adults (18-45 years old) from Texas Woman’s University (TWU) Health Science Center in Dallas, Texas, and surrounding areas. Standing postural control was measured by collecting total sway, direction of sway and velocity in the Anterior-Posterior (AP) and Medial-Lateral (ML) directions during different balance tasks. For single and dual tasks, the tests were performed with a bipedal stance on foam involving challenging the sensory input via Eyes Open (EO), Eyes Closed (EC), and head movements with eyes open (EO HUD) and closed (EC HUD). The dual motor tasks were similar to the single tasks with the addition of holding a cup full of water to split attention. Data were placed into the Statistical Package for Social Sciences (SPSS) Data Analysis 25.0 system and were analysed for repeated measures Analysis of Variance (ANOVA) analysis. Results: Eighty-two healthy young adults participated in this study (mean age of 24.6±2.7 years, 13 males and 69 females). An ANOVA analysis revealed that postural stability was considerably altered during motor tasks. Sway in the Antero-Posterior (AP) direction, and velocity of sway increased as the complexity of the tasks intensified. A substantial difference in total sway during single tasks when eyes were closed compared to eyes open (p-value <0.01) was noted. There was a significant difference in total sway (AP and ML) during eyes open (EOM) to eyes closed (ECM) and during eyes open with head moving up and down (EOM HUD) (p-value 0.001). There were significant differences in mean AP velocity during EO (0.11±0.12) compared to EC HUD (0.19±0.15), and when comparing EOM (0.07±0.04) to ECM HUD (0.13±0.08) (p=0.01) Conclusion: This study identified postural changes when comparing single and dual tasks in healthy young adults, and the outcomes of this study showed definite distinctions in postural responses during single and dual motor tasks.

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Are Ultrasound Findings Similar in Patients with Axial Spondyloarthritis and in Athlete Entheses?

The Journal of Rheumatology ◽

10.3899/jrheum.160715 ◽

2017 ◽

Vol 44 (5) ◽

pp. 609-612 ◽

Cited By ~ 7

Author(s):

Marie-Alix Lanfranchi ◽

Olivier Leluc ◽

Alice Tavano ◽

Cécile Wormser ◽

Sophie Morange ◽

...

Keyword(s):

Physical Activity ◽

Healthy Subjects ◽

Axial Spondyloarthritis ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Control Groups ◽

Cross Sectional ◽

Ultrasound Findings ◽

Us Findings

Objective.Enthesitis is the spondyloarthritis (SpA) landmark, but can also be seen after entheses overuse, such as during intensive sport.Methods.We aimed to compare entheses ultrasound (US) findings in a prospective cross-sectional study of 30 axial SpA cases, 30 athletes, and 29 controls.Results.Mean (SD) MAdrid Sonographic Enthesis Index (MASEI) score was 26.3 (13), 12.2 (7), and 10.4 (6) in patients with SpA, athletes, and non-athlete control groups, respectively (p < 0.0001).Conclusion.The MASEI score was significantly higher in patients with SpA compared with healthy controls, athletes, and non-athletes, and can be of value to distinguish SpA from healthy subjects, whatever their physical activity.

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Incidence of headache after COVID-19 vaccination in patients with history of headache: A cross-sectional study

Cephalalgia ◽

10.1177/03331024211038654 ◽

2021 ◽

pp. 033310242110386

Author(s):

Koji Sekiguchi ◽

Narumi Watanabe ◽

Naoki Miyazaki ◽

Kei Ishizuchi ◽

Chisato Iba ◽

...

Keyword(s):

Adverse Event ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Cross Sectional ◽

Healthy Control ◽

History Of ◽

Baseline Characteristics ◽

Migrainous Headache ◽

Headache Patients

Background Headache is an adverse event of coronavirus 2019 (COVID-19) vaccination. Whether patients with history of headache suffer more from vaccination-induced headaches is unknown. We aimed to uncover if headache patients develop more headaches after COVID-19 mRNA vaccination than healthy controls. Methods We performed a questionnaire survey for nursing staff in our hospital from April to May 2021. Based on baseline characteristics, we divided the participants into migraine, non-migrainous headache, and healthy control, and examined the occurrence and features of headache after COVID-19 vaccinations. Results We included 171 participants (15.2% migraine and 24.6% non-migrainous headache). Headache incidence after vaccinations was significantly higher in the migraine (69.2%) and non-migrainous headache (71.4%) groups than in the healthy control (37.9%) group. The incidence of headaches was significantly higher after the second dose compared to the first (45.6% vs. 20.5%). Conclusion Migraineurs and non-migrainous headache participants developed more headaches compared to the healthy controls after COVID-19 vaccination.

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DIFFERENCES IN HIP MUSCLE STRENGTH AND STATIC BALANCE IN PATIENTS WITH TRANSFEMORAL AMPUTATIONS CLASSIFIED AT DIFFERENT K-LEVELS: A PRELIMINARY CROSS-SECTIONAL STUDY

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v5i1.37456 ◽

2022 ◽

Vol 5 (1) ◽

Author(s):

Stefanie John ◽

Katja Orlowski ◽

Kai-Uwe Mrkor ◽

Jürgen Edelmann-Nusser ◽

Kerstin Witte

Keyword(s):

Muscle Strength ◽

Cross Sectional Study ◽

Static Balance ◽

Residual Limb ◽

Sectional Study ◽

Cross Sectional ◽

Hip Strength ◽

Eyes Closed ◽

Hip Muscle ◽

Eyes Open

BACKGROUND: Following amputation, patients with lower limb amputations (LLA) are classified into different functional mobility levels (K-levels) ranging from K0 (lowest) to K4 (highest). However, K-level classification is often based on subjective criteria. Objective measures that are able to differentiate between K-levels can help to enhance the objectivity of K-level classification. OBJECTIVE(S): The goal of this preliminary cross-sectional study was to investigate whether differences in hip muscle strength and balance parameters exist among patients with transfemoral amputations (TFA) assigned to different K-levels. METHODOLOGY: Twenty-two participants with unilateral TFA were recruited for this study, with four participants assigned to K1 or K2, six assigned to K3 and twelve assigned to K4. Maximum isometric hip strength of the residual limb was assessed in hip flexion, abduction, extension, and adduction using a custom-made diagnostic device. Static balance was investigated in the bipedal stance on a force plate in eyes open (EO) and eyes closed (EC) conditions. Kruskal-Wallis tests were used to evaluate differences between K-level groups. FINDINGS: Statistical analyses revealed no significant differences in the parameters between the three K-level groups (p>0.05). Descriptive analysis showed that all hip strength parameters differed among K-level groups showing an increase in maximum hip torque from K1/2-classified participants to those classified as K4. Group differences were also present in all balance parameters. Increased sway was observed in the K1/2 group compared to the K4 group, especially for the EC condition. CONCLUSION: Although not statistically significant, the magnitude of the differences indicates a distinction between K-level groups. These results suggest that residual limb strength and balance parameters may have the potential to be used as objective measures to assist K-level assignment for patients with TFA. This potential needs to be confirmed in future studies with a larger number of participants. Layman's Abstract Patients with lower limb amputation (LLA) are classified into different mobility levels, so-called K-levels, which are ranging from K0 (lowest) to K4 (highest). K-level classification is relevant for the patients as it determines the type of prosthetic components available. However, K-level can vary greatly based on the clinician or orthopedic technician individual assessment. Objective data from physical performance tests can help to improve K-level classification. Therefore, muscle strength tests of the amputation stump as well as balance tests were performed in this study to determine whether these parameters have the potential to support K-level classification. Twenty-two participants with a thigh amputation participated in the study (four K1/2-, six K3- and twelve K4-participants). Hip muscle strength on the amputation side was assessed as well as static balance in the double leg stance with eyes open and eyes closed. Analysis of the data showed that all hip strength parameters differed between the K-level groups, with maximum strength increasing from the K1/2 group to the K4 group. Group differences were also seen in the balance parameters with greater body sway for the K1/2 group when compared to the K4 group, especially when participants had their eyes closed. These results show that muscle strength tests of the residual limb and static balance tests may serve as additional measures to improve K-level assignment for patients with LLA. This was only an initial study and further studies with a larger number of participants are required to confirm these results. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37456/28905 How To Cite: John S, Orlowski K, Mrkor K.U, Edelmann-Nusser J, Witte K. Differences in hip muscle strength and static balance in patients with transfemoral amputations classified at different K-levels: A preliminary cross-sectional study. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.5. https://doi.org/10.33137/cpoj.v5i1.37456 Corresponding Author: Stefanie John,Department of Sports Science, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany.E-Mail: [email protected] ID: https://orcid.org/0000-0001-6722-7195

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Variability in Postural Control With and Without Balance-Based Torso- Weighting in People With Multiple Sclerosis and Healthy Controls

Physical Therapy ◽

10.2522/ptj.20130288 ◽

2014 ◽

Vol 94 (10) ◽

pp. 1489-1498 ◽

Cited By ~ 10

Author(s):

Charlotte M. Hunt ◽

Gail Widener ◽

Diane D. Allen

Keyword(s):

Multiple Sclerosis ◽

Postural Control ◽

Repeated Measures ◽

Center Of Pressure ◽

Quiet Standing ◽

Healthy Controls ◽

Movement Variability ◽

Lateral Direction ◽

Eyes Closed ◽

Eyes Open

Background People with multiple sclerosis (MS) have diminished postural control, and center of pressure (COP) displacement varies more in this population than in healthy controls. Balance-based torso-weighting (BBTW) can improve clinical balance and mobility in people with MS, and exploration using both linear and nonlinear measures of COP may help determine whether BBTW optimizes movement variability. Objective The aim of this study was to investigate the effects of BBTW on people with MS and healthy controls during quiet standing. Design This was a quasi-experimental study comparing COP variability between groups, between eye closure conditions, and between weighting conditions in the anterior-posterior and medial-lateral directions. Methods Twenty participants with MS and 18 healthy controls stood on a forceplate in 4 conditions: eyes open and closed and with and without BBTW. Linear measures of COP displacement included range and root mean square (RMS). Nonlinear measures included approximate entropy (ApEn) and Lyapunov exponent (LyE). Three-way repeated-measures analyses of variance compared measures across groups and conditions. The association between weighting response and baseline nonlinear variables was examined. When significant associations were found, MS subgroups were created and compared. Results The MS and control groups had significantly different range, RMS, and ApEn values. The eyes-open and eyes-closed conditions had significantly different range and RMS values. Change with weighting correlated with LyE (r=−.70) and ApEn (r=−.59). Two MS subgroups, with low and high baseline LyE values, responded to BBTW in opposite directions, with a significant main effect for weighting condition for the LyE variable in the medial-lateral direction. Limitations The small samples and no identification of impairments related to LyE at baseline were limitations of the study. Conclusions The LyE may help differentiate subgroups who respond differently to BBTW. In both subgroups, LyE values moved toward the average of healthy controls, suggesting that BBTW may help optimize movement variability in people with MS.

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Impact of Fibromyalgia on Alpha-2 EEG Power Spectrum in the Resting Condition: A Descriptive Correlational Study

BioMed Research International ◽

10.1155/2019/7851047 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Santos Villafaina ◽

Daniel Collado-Mateo ◽

Juan P. Fuentes-García ◽

Ricardo Cano-Plasencia ◽

Narcís Gusi

Keyword(s):

Cross Sectional Study ◽

Healthy Controls ◽

Analog Scale ◽

Brain Areas ◽

Cross Sectional ◽

Eyes Closed ◽

Pain Scores ◽

Subjective Pain ◽

Eeg Power ◽

Resting Period

Objective. The objective of this prospective cross-sectional study was to analyze the differences between patients with fibromyalgia and non-pain controls in terms of EEG power in the eyes-closed resting state. This study also aims to evaluate potential correlations between EEG power and subjective pain.Methods. The fibromyalgia patients were recruited by the Extremadura Association of Fibromyalgia (AFIBROEX) in Cáceres, Spain. Age- and sex-matched healthy controls (1:1 ratio) were recruited from university facilities and people close to the AFIBROEX by public calls. All underwent EEG during a 1-minute resting period with their eyes closed. The theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3 frequency bands were analyzed by using EEGLAB. Self-reported visual analog scale pain scores were determined just prior to EEG.Results. A total of 62 women participated in the study, 31 of them diagnosed with fibromyalgia and 31 healthy controls. Fibromyalgia group exhibited a significantly lower alpha-2 in C4, T3, P4, Pz, and O2 compared to the healthy controls. Interestingly, pain correlated negatively with alpha-2 in Cz, P4, and Pz only in the fibromyalgia group.Conclusion. The fibromyalgia group exhibited decrease alpha-2 power in central, temporoparietal, and occipital brain areas. Furthermore, higher values of pain correlated with lower level of alpha-2 power in Cz, P4, and Pz. These findings may point the importance of alpha-2 power in pain in women with fibromyalgia.

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