Article

Is physical deconditioning a perpetuting factor in chronic fatigue syndrome? A controlled study on maximal exercise performance and relations with fatigue, impairment, and physical activity

Department of Medical Psychology, University of Nijmegen, The Netherlands.
Psychological Medicine (Impact Factor: 5.94). 02/2001; 31(1):107-14. DOI: 10.1017/S0033291799003189
Source: PubMed

ABSTRACT

Chronic fatigue syndrome (CFS) patients often complain that physical exertion produces an increase of complaints, leading to a greater need for rest and more time spent in bed. It has been suggested that this is due to a bad physical fitness and that physical deconditioning is a perpetuating factor in CFS. Until now, studies on physical deconditioning in CFS have shown inconsistent results.
Twenty CFS patients and 20 matched neighbourhood controls performed a maximal exercise test with incremental load. Heart rate, blood pressure, respiratory tidal volume, O2 saturation, O2 consumption, CO2 production, and blood-gas values of arterialized capillary blood were measured. Physical fitness was quantified as the difference between the actual and predicted ratios of maximal workload versus increase of heart rate. Fatigue, impairment and physical activity were assessed to study its relationship with physical fitness.
There were no statistically significant differences in physical fitness between CFS patients and their controls. Nine CFS patients had a better fitness than their control. A negative relationship between physical fitness and fatigue was found in both groups. For CFS patients a negative correlation between fitness and impairment and a positive correlation between fitness and physical activity was found as well. Finally, it was found that more CFS patients than controls did not achieve a physiological limitation at maximal exercise.
Physical deconditioning does not seem a perpetuating factor in CFS.

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    • "Symptom exacerbation (i.e., PEM) related to even mild exercise has been reported to occur in greater than 95% of CFS patients.[2] In the literature, the patient reactions associated with PEM have included increased symptoms of pain and fatigue,[3] [4] [5] abnormal cardiopulmonary responses to exercise,[2] [6] [7] decreases in physical activity behaviors,[4] [8] [9] changes in cognitive function,[10] [11] and up-regulation of numerous biological variables.[12] [13] Although a number of studies have been conducted, consistent results and/or replication of findings have been rare.[14] "
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    • "From previous studies in patients with CFS compared to healthy controls we know that groups of at least 10, preferably 20 patients per condition are sufficient to detect significant differences in (neuro)physiological parameters measured with sEMG, MRI, and exercise testing.[21,28,50,51] To identify (neuro)physiological characteristics of fatigue, a comparison of baseline measurements with an age, sex, and previous cancer treatment matched group of 20 non-fatigued patients is sufficient. "
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    • "Felitti and colleagues (1998) associated negative health outcomes of adverse childhood experiences with adult health behaviors, including increased levels of smoking and alcohol use, physical inactivity, and obesity in adulthood (see alsoAnda et al., 2006;Dube et al., 2003). In FSS, obesity has been associated with Fm, although not etiologically (Yunus, Arslan, & Aldag, 2002), and research on exercise tolerance and CFS has been mixed (Bazelmans, Bleijenberg, Van Der Meer, & Folgering, 2001;Fischler et al., 1997). Other studies have reported inverse relationships between adverse adult health behaviors such as alcohol and drug use and CFS, Fm, and MCS, and between positive health behaviors such as exercise, and CFS (Harvey, Wadsworth, Wessely, & Hotopf, 2008;Hausteiner et al., 2006;Shaver, Wilbur, Robinson, Wang, & Buntin, 2006;Woolley, Allen, & Wessely, 2004). "
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