Postexertional Malaise in Women with Chronic Fatigue Syndrome – Source: Journal of Women’s Health, Jan 24, 2009

Abstract 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 postexertional malaise 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.

Source: Journal of Women’s Health, Jan 24, 2009. PMID: 20095909, by VanNess JM, Stevens SR, Bateman L, Stiles TL, Snell CR. Pacific Fatigue Laboratory, University of the Pacific, Stockton, California. [E-mail:]

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