Physical fatigability & exercise capacity in Chronic Fatigue Syndrome (CFS): association with disability, somatization & psychopathology

Physical fatigability and avoidance of physically demanding tasks in
chronic fatigue syndrome (CFS) were assessed by the
achievement or nonachievement of 85% of age-predicted maximal
heart rate (target heart rate, THR) during incremental
exercise. The association with functional status impairment,
somatization, and psychopathology was examined. A
statistically significant association was demonstrated between
this physical fatigability variable and impairment, and a
trend was found for an association with somatization. No
association was demonstrated with psychopathology. These
results are in accordance with the cognitive-behavioral model
of CFS, suggesting a major contribution of avoidance behavior
to functional status impairment; however, neither anxiety nor
depression seem to be involved in the avoidance behavior.
Aerobic work capacity was compared between CFS and healthy
controls achieving THR. Physical deconditioning with early
involvement of anaerobic metabolism was demonstrated in this
CFS subgroup. Half of the CFS patients who did not achieve THR
did not reach the anaerobic threshold. This finding argues
against an association in CFS between avoidance of physically
demanding tasks and early anaerobic metabolism during effort.

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