Document Type


Date of Degree

Fall 2013

Degree Name

PhD (Doctor of Philosophy)

Degree In

Physical Rehabilitation Science

First Advisor

Sluka, Kathleen A

First Committee Member

Rakel, Barbara A

Second Committee Member

Frey Law, Laura A

Third Committee Member

Morton, Susanne M

Fourth Committee Member

Keffala, Valerie J


The American College of Rheumatology (ACR) 1990 criterion classifies fibromyalgia as a clinical syndrome characterized by chronic widespread muscular pain and tenderness with hyperalgesia to pressure over 11/18 tender points of at least 3 months duration. Fibromyalgia is characterized by chronic widespread musculoskeletal pain and is associated with fatigue and cognitive dysfunction. The cause of fibromyalgia is unknown, but it has been shown to demonstrate sensitization of the central nervous system pain pathways by demonstrating lower pain pressure thresholds and reduced conditioned pain modulation (CPM).

Pain and fatigue associated with fibromyalgia can interfere with daily function, work, and social activities. Without greater understanding of the interaction of pain, fatigue and function, we are limited in our ability to improve these symptoms for individuals with fibromyalgia. We designed three experiments to examine the relationship of pain, fatigue and function in individuals with fibromyalgia.

Regression analyses demonstrated significant models that included pain, fatigue and fear of movement for prediction of function and quality of life in individuals with fibromyalgia and healthy controls. The fatigue study (cognitive fatigue, physical fatigue and dual fatigue task) demonstrated that people with fibromyalgia show enhanced pain and fatigue to both cognitive and physical fatigue tasks and reduced function in the physical fatigue task in comparison to healthy controls. Our final study showed active TENS restores CPM, decreases deep tissue pressure pain, decreases pain and fatigue during movement for individuals with fibromyalgia.


Chronic Pain, Fatigue, Fibromyalgia, Function, TENS


xii, 137 pages


Includes bibliographical references (pages 118-137).


Copyright 2013 Dana Leigh Dailey