Exercise as it relates to Disease/The effect of chronic fatigue on a women’s capacity to exercise

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This is a critique of the article: De Becker P, Roeykens J, Reynders M, McGregor N, De Meirleir K. Exercise capacity in chronic fatigue syndrome. Archives of internal medicine. 2000;160(21):3270-7. [1]

What is the background to this research?[edit]

Chronic fatigue syndrome (CFS) is a condition in which the patient suffers from debilitating fatigue [2][3][4]. The study defined CFS based on Centre for Disease Control and Prevention definition from 1994: the participants must have unexplained fatigue for more than six months, that is not due to continuing exertion and is not resolved by rest, they must also have 4 or more of the 8 symptoms following; sore throat, tender lymph nodes, memory and concentration problems, joint pain, headaches of a new type, unrefreshing sleep, and post-exertional malaise lasting more than 24 hours [5]. Half the general population reports feeling fatigued on a regular basis in surveys [2]. Fatigue effects motivation and mood[2]. If individuals are not wanting to exercise due to their CFS their fatigue, general health and wellbeing could get worse[3]. This then creates a downward spiral [4]. This study was looking at the exercise capacity of females with chronic fatigue compared to the exercise capacity of female sedentary individuals.

Where is the research from?[edit]

This investigation was published in the Archives of Internal Medicine, a highly respected source of peer reviewed original work. The study took place mainly in the University of Brussels, Brussels, Belgium in their Human Performance laboratory and Department of Internal Medicine with assistance from the Collaborative Pain Research Unit, Department of Biological Science in the University of Newcastle, Callaghan, New South Wales, Australia. The Archives of Internal Medicine is a publication from The Journal of the American Medical Association which is overseen by the American Medical Association. The Archives of internal medicine focus on research and studies that relate to; cardiovascular disease, geriatrics, infectious disease, gastroenterology, endocrinology, allergy, and immunology [6]. It is a well-regarded source of peer reviewed articles about internal medicine.

What kind of research was this?[edit]

The research was comparing females from two groups one who had CFS the control group consisted of age-matched individuals, all participants were female. There were 427 CFS participants and 204 participants in the control group. The limitations of this study come down to how well the participants matched. Were the participants from the same socioeconomic class? how many times a week do they eat take out? What was there relationship with a healthy lifestyle as they grew up? And what effect do these variables have on the results? These are all factors that were not taken into consideration and can have a large impact on a person’s belief [7]

What did the research involve?[edit]

450 participants that had CFS were enrolled in the study. Of those participant 127 did not meet the Centre for disease and infection control criteria for CFS stated in 1988 or 1994, therefore their results were not included in the final data. The control group was 204 age matched participants that lead a sedentary lifestyle. All participants did the same trial until exhaustion in the same weather conditions [1].

What were the basic results?[edit]

The results show that the population without CFS performed much better than the population with CFS in the assessment.

Table 3. Prevalence of CFS and control Female subjects who attained the maximal exercise parameters*
Group CFS Control
All subjects 427 (100) 204 (100)
Target heat rate > 85% 174 (41) 174 (85)
Respitory Quotient > 1.0 342 (80) 192 (94)
Target heat rate > 85% and Respitory Quotient > 1.0 157 (37) 163 (80)
  • Data given as numbers (percentage of participants)

What conclusions can we take from this research?[edit]

Individuals with CFS have a higher resting heart rate and a lower peak maximum heart rate. And can also contract post-acute viral status post exercise which takes them longer to recover post-exercise due to their CFS. As this study was the first large study evaluating CFS patients (n=427) with sedentary control group (n=204) due to the large number of participants (n= 631) the results become more reliable. However, the maximal heart rate was the only aspect that was assessed. This is one of many aspects of physical activity and to health, though this is a useful tool for establishing an individual’s physical capacity with relative ease [1].

Practical advice[edit]

If you have CFS your exercise capacity is most likely lower than it would be if you did not have CFS. Take this into consideration when exercising and make sure to let your body adapt as you get fitter and do not exceed your limits or push too hard.

Further information/resources[edit]

Below is a list of resources that go into further detail about CFS and what exercise may be beneficial for a patient with CFS. It is worth noting that these websites do not come from a reputable location they are merely here to provide some additional general information about CFS and some ideas for types of exercise that may be easier for patients suffering with CFS. This does not substitute for medical advice or advice from an accredited physiotherapist of exercise psychologist. If you have any concerns about your condition, contact your chosen health professional. [Chronic fatigue syndrome (CFS) - Better Health Channel] [Recommended Exercise programs for CFS patients] [How to exercise right with CFS]

References[edit]

  1. a b c [De Becker P, Roeykens J, Reynders M, McGregor N, De Meirleir K. Exercise capacity in chronic fatigue syndrome. Archives of internal medicine. 2000;160(21):3270-7.]
  2. a b c [Afari N, Buchwald D. Chronic fatigue syndrome: a review. American Journal of Psychiatry. 2003;160(2):221-36.]
  3. a b [Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, et al. Chronic fatigue syndrome: a working case definition. Annals of internal medicine. 1988;108(3):387-9.]
  4. a b [Wessely S. Chronic fatigue: symptom and syndrome. Annals of internal medicine. 2001;134(9_Part_2):838-43.]
  5. [Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of internal medicine. 1994;121(12):953-9.]
  6. [Jamanetwork.com. For Authors | JAMA Internal Medicine | JAMA Network 2020 [Available from: https://jamanetwork.com/journals/jamainternalmedicine/pages/for-authors#fa-about.]
  7. [ Cohen S, Janicki‐Deverts D, Chen E, Matthews KA. Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences. 2010;1186(1):37-55.]