Núñez-Fuentes, David, Obrero-Gaitán, Esteban, Zagalaz-Anula, Noelia et al. · Diagnostics (Basel, Switzerland) · 2021 · DOI
This study reviewed 19 research papers involving 2,347 people (mostly women) to understand balance problems in fibromyalgia syndrome (FMS). The researchers found that FMS patients have significantly worse balance than healthy people, with particular difficulty standing still, moving around, and relying on their inner ear and vision for balance. The findings suggest that people with FMS may depend too heavily on feeling where their body is in space rather than using normal balance cues.
Balance impairment is a frequent but undercharacterized symptom in both FMS and ME/CFS, and understanding its sensory basis (vestibular, visual, somatosensory) has implications for rehabilitation. This evidence synthesis provides quantified effect sizes that validate patient-reported balance difficulties and suggest specific neurophysiological mechanisms—vestibular dysfunction and sensory dependence—that may be common across related conditions. The findings support the need for targeted balance assessments and rehabilitation in post-viral and chronic fatigue conditions.
This study does not prove causation or the specific mechanism causing balance problems in FMS, only that they exist and differ from controls. It does not establish whether balance dysfunction is primary (neurological) or secondary to other FMS symptoms like pain and fatigue. Additionally, because the studies reviewed were observational and tested only baseline (non-exertional) balance, results do not address whether balance worsens with post-exertional malaise or activity, which is central to ME/CFS pathophysiology.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Núñez-Fuentes, David, Obrero-Gaitán, Esteban, Zagalaz-Anula, Noelia, Ibáñez-Vera, Alfonso Javier, Achalandabaso-Ochoa, Alexander, López-Ruiz, María Del Carmen, et al. (2021). Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics11010127
BibTeX
@article{mecfsatlas-nez-fuentes-2021-alteration-postural,
author = {Núñez-Fuentes, David and Obrero-Gaitán, Esteban and Zagalaz-Anula, Noelia and Ibáñez-Vera, Alfonso Javier and Achalandabaso-Ochoa, Alexander and López-Ruiz, María Del Carmen and Rodríguez-Almagro, Daniel and Lomas-Vega, Rafael},
title = {Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis.},
journal = {Diagnostics (Basel, Switzerland)},
year = {2021},
doi = {10.3390/diagnostics11010127},
note = {PubMed: 33467458},
url = {https://www.mecfsatlas.com/evidence/nez-fuentes-2021-alteration-postural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/nez-fuentes-2021-alteration-postural
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