VanNess:

ME/CVS-patiŽnten

reageren slecht op inspanning

en "herstellen" zeer langzaam

 

 

 

 


 

Een onderzoek van VanNess en kollega's bevestigt opnieuw wat patiŽnten al jaren beweren:

de klachten nemen toe door inspanning en "herstel" van die inspanning duurt zeer lang.

 

Voor een verklaring van die verschijnselen verwijs ik U naar onze CGT/GET-review: klik hier.

 

Alhoewel de metingen subjektief (vragenlijstjes) en niet hard (bijv. verzuringsdrempel) zijn,

is dit de zoveelste studie die aantoont dat veel patiŽnten wel willen, maar niet kunnen...

 

Maar dat zullen stress-en-vermoeidheidsdeskundigen wel niet willen horen...

 

 


 

Citaten uit het uitgebreide studierapport:

 

 

Results

 

Recovery questions

 

Recovery time from the exercise test was

markedly different between the two groups.

 

Within 24 hours of the test,

none of the CFS patients indicated full recovery

in contrast to 20 controls (87%).

 

After 2 days, all control subjects reported full recovery from the test,

whereas only 1 CFS patient (4%) felt recovered by that time.

 

Notably, although the entire control group recovered within 2 days,

15 CFS patients (60%) reported that it took 5 days to fully recover from the test.

 

Some of them felt that even after the full week,

they had not yet recovered:

I felt the very worst 2 days after the test.

A full week after the test, and I still feel like Iím recovering.

 

In contrast to the experience of the CFS group,

of the 20 controls who indicated full recovery within 24 hours,

17 actually reported feeling an increased sense of well-being relative to before the test,

which they directly attributed to posttesting exercise effect:

A couple hours later, my legs were still tired but I felt great!

Energized and ready to go. [I felt] great, normal ready to do some more exercise.

 

At no point during the 7 days postexercise

did any of our CFS subjects report experiencing comparable benefit from the exercise bout.

 

 

Discussion

 

The results of this study suggest that

for a majority of CFS patients,

PEM represents a real and debilitating symptom complex

rather than the irrational fears

that have been hypothesized elsewhere.

 

With 60% of the patients in this study

taking >5 days to recover

from a single bout of physical activity,

there is strong support for the argument that

CFS patients exhibit abnormal, yet variable, responses to exercise.

 

Various reported effects were inconsistent with

what might normally be expected after exercise to exhaustion

from sedentary and deconditioned women.

 

...

 

For the majority of patients in this study,

the symptoms they experienced were wide-ranging,

possibly indicating diverse pathology.

 

It is interesting to note that despite patient heterogeneity

often proving the bane of CFS research,

numerous symptoms reported in this studywere shared by multiple participants.

 

Although the research literature is equivocal,

there are substantial data

implicating metabolic anomalies or autonomic dysfunction

as the source of decreased functional capacity in some CFS patients.

 

...

 

The debilitating effects of exercise

experienced by these patients

are difficult to conceive as purely psychological manifestations;

this assertion is supported by analysis of responses to the SF-36.

 

 


 

Postexertional malaise in women with chronic fatigue syndrome.

J Womens Health (Larchmt). 2010 Jan 24.

doi: 10.1089/jwh.2009.1507.

Vanness JM, Stevens SR, Bateman L, Stiles TL, Snell CR.

 

 

 

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 function.

 

 

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.

 

 

PMID: 20095909 [PubMed - as supplied by publisher]