Symptom variability following acute exercise in myalgic encephalomyelitis/chronic fatigue syndrome: a perspective on measuring post-exertion malaise

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Date
2017-01-01
Authors
Lindheimer, Jacob
Meyer, Jacob
Meyer, Jacob
Stegner, Aaron
Dougherty, Ryan
Van Riper, Stephanie
Shields, Morgan
Reisner, Amanda
Shukla, Sanjay
Light, Alan
Yale, Steven
Cook, Dane
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Kinesiology
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Kinesiology
Abstract

Background: Consensus for an operational definition of post-exertion malaise (PEM) and which symptoms best characterize PEM has not been established and may be due to variability within and between studies.

Purpose: Determine the magnitude of the effect of maximal and submaximal physical exertion on multiple myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms that are associated with PEM and explore variability among two studies in which mood, fatigue, and pain symptoms were measured before and after exercise.

Methods: Symptoms were measured before, and 48 and 72 hours after exercise in study 1 (ME/CFS = 13; Controls = 11) and before and 24 hours after exercise in study 2 (ME/CFS = 15, Controls = 15). Between-study variability was examined by comparing Hedges d effect sizes (95% CI) from studies 1 and 2. Within-patient group variability was examined via inspection of dot density plots.

Results: In study 1, large increases in general fatigue (Δ = 1.05), reduced motivation (Δ = 0.93), feelings of fatigue (Δ = 0.90), feelings of confusion (Δ = 0.93), and total mood disturbance (Δ = 0.90) were found at 72 hours. In study 2, a large increase in affective/sensory pain (Δ = 0.79) was found at 24 hours. Dot density plots in both studies revealed substantial variability among people with ME/CFS relative to healthy control participants.

Conclusions: PEM symptoms are variable among people with ME/CFS and several gaps in the literature need to be addressed before guidelines for measuring PEM in the clinical or research setting can be established.

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This article is published as Lindheimer J, Meyer J, Stegner A, Rougherty R, Van Riper S, Shields M, Reisner A, Shukla S, Light A, Yale S, Cook D (2017). Symptom variability following acute exercise in ME/CFS: A perspective on measuring post-exertion malaise. Fatigue: Biomedicine, Health & Behavior, 5(2); 69-88. doi: 10.1080/21641846.2017.1321166.

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