Exercise helps Chronic Fatigue Syndrome (CFS)

Exercise, the last thing on the mind for many with CFS, seems to improve physical functioning according to a new study.

Researchers in the UK set out to measure strength, aerobic exercise capacity, and functional incapacity in patients with CFS. One of the criteria for being in the study was not having a current psychiatric disorder.

Published in the Journal of Neurology, Neurosurgery and Psychiatry, the researchers found that people with CFS were indeed weaker than people in the control group who were either depressed or who led sedentary lives. They also found that the low exercise capacity in CFS patients was related to weakness in the thigh muscles, (quadriceps) as well as overall low physical fitness, and body mass ratio (an index for estimating obesity.)

Another point made in the study was that compared with the sedentary controls, CFS patients perceived greater effort during exercise as well as greater physical fatigue.

The authors conclude that physical weakness helps to maintain physical disability in people with CFS, and that treatment designed to reverse this deconditioning helps improve physical functioning.

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Strength and physiological response to exercise in patients with chronic fatigue syndrome.

OBJECTIVE: To measure strength, aerobic exercise capacity and efficiency, and functional incapacity in patients with chronic fatigue syndrome (CFS) who do not have a current psychiatric disorder.

METHODS: Sixty six patients with CFS without a current psychiatric disorder, 30 healthy but sedentary controls, and 15 patients with a current major depressive disorder were recruited into the study. Exercise capacity and efficiency were assessed by monitoring peak and submaximal oxygen uptake, heart rate, blood lactate, duration of exercise, and perceived exertion during a treadmill walking test. Strength was measured using twitch interpolated voluntary isometric quadriceps contractions. Symptomatic measures included physical and mental fatigue, mood, sleep, somatic amplification, and functional incapacity.

RESULTS: Compared with sedentary controls, patients with CFS were physically weaker, had a significantly reduced exercise capacity, and perceived greater effort during exercise, but were equally unfit. Compared with depressed controls, patients with CFS had significantly higher submaximal oxygen uptakes during exercise, were weaker, and perceived greater physical fatigue and incapacity. Multiple regression models suggested that exercise incapacity in CFS was related to quadriceps muscle weakness, increased cardiovascular response to exercise, and body mass index. The best model of the increased exercise capacity found after graded exercise therapy consisted of a reduction in submaximal heart rate response to exercise.

CONCLUSIONS: Patients with CFS were weaker than sedentary and depressed controls and as unfit as sedentary controls. Low exercise capacity in patients with CFS was related to quadriceps muscle weakness, low physical fitness, and a high body mass ratio. Improved physical fitness after treatment was associated with increased exercise capacity. These data imply that physical deconditioning helps to maintain physical disability in CFS and that a treatment designed to reverse deconditioning helps to improve physical function.

Originally published in: J Neurol Neurosurg Psychiatry 2000 Sep;69(3):302-307 Related Articles, Books, LinkOut

Authors: Fulcher KY, White PD

National Sports Medicine Institute, St Bartholomew’s and the Royal London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK.

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