Monday, February 8, 2010

Post-Exertional Malaise and CFS

  'Postexertional Malaise in Women with Chronic Fatigue Syndrome'
  Vanness JM, Stevens SR, Bateman L, Stiles TL, Snell CR.
  Pacific Fatigue Laboratory, University of the Pacific , Stockton,
  J Womens Health (Larchmt). 2010 Jan 24

  Objective: Postexertional malaise (PEM) is a defining characteristic
  of chronic fatigue syndrome (CFS) that remains a source of some
  controversy. The purpose of this study was to explore the effects of
  an exercise challenge on CFS symptoms from a patient perspective.

  Methods: This study included 25 female CFS patients and 23 age-matched
  sedentary controls. All participants underwent a maximal
  cardiopulmonary exercise test. Subjects completed a health and
  well-being survey (SF-36) 7 days postexercise. Subjects also provided,
  approximately 7 days after testing, written answers to open-ended
  questions pertaining to physical and cognitive responses to the test
  and length of recovery. SF-36 data were compared using multivariate
  analyses. Written questionnaire responses were used to determine
  recovery time as well as number and type of symptoms experienced.

  Results: Written questionnaires revealed that within 24 hours of the
  test, 85% of controls indicated full recovery, in contrast to 0 CFS
  patients. The remaining 15% of controls recovered within 48 hours of
  the test. In contrast, only 1 CFS patient recovered within 48 hours.
  Symptoms reported after the exercise test included fatigue,
  light-headedness, muscular/joint pain, cognitive dysfunction,
  headache, nausea, physical weakness, trembling/instability, insomnia,
  and sore throat/glands.
A significant multivariate effect for the
  SF-36 responses (p < 0.001) indicated lower functioning among the CFS
  patients, which was most pronounced for items measuring physiological

  Conclusions: The results of this study suggest that PEM is both a real and an incapacitating condition for women with CFS and that their responses to exercise are distinctively different from those of sedentary controls.

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