Influence of Codiagnosis of CFS & Habitual Physical Exercise on the Psychological Status and Quality of Life of Patients with Fibromyalgia 2022 Ortega

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Influence of Codiagnosis of Chronic Fatigue Syndrome and Habitual Physical Exercise on the Psychological Status and Quality of Life of Patients with Fibromyalgia

Abstract
Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are two diseases that are frequently codiagnosed and present many similarities, such as poor tolerance to physical exercise. Although exercise is recommended in their daily routine to improve quality of life, little is known about how CFS codiagnosis affects that.

Using scientifically validated questionnaires, we evaluated the psychological state and quality of life of patients with FM (n = 70) and how habitual physical exercise (HPE) reported by patients with only FM (FM-only n = 38) or codiagnosed with CFS (FM + CFS, n = 32) influences those aspects. An age-matched reference group of “healthy” women without FM (RG, n = 70) was used. The FM-only group presented a worse psychological state and quality of life compared to RG, with no influence of CFS codiagnosis.

The patients of the FM-only and FM + CFS groups who perform HPE presented better levels of stress and state anxiety, but with no differences between them. Depression and trait anxiety improved only in women with just FM. CFS codiagnosis does not worsen the psychological and quality of life impairment of FM patients and does not have a great influence on the positive effect of HPE.

https://www.mdpi.com/2077-0383/11/19/5735

peer review record
https://www.mdpi.com/2077-0383/11/19/5735/review_report
 
The authors appear to be clueless about CFS.
Here's a section from the introduction (my bolding):

CFS is characterized by disabling fatigue lasting more than 3 months, which further worsens the course and development of the disease and makes it even more difficult to acquire routines that include exercise. For people with CFS, exercise also seems to significantly improve health status, physical fitness, and quality of life, thus having a direct impact in fatigue, but literature is still scarce in this regard. People with CFS tend to have an aversion to exercise to avoid symptom aggravation. Because of this, they do not (attempt to) engage in physical activities and become completely sedentary [9].
 
The paper said:
Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are two diseases that are frequently codiagnosed
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Beginning with a lie. They are, in fact, usually not diagnosed. Present, yes, but the vast majority of those are told they're not going to be "labeled" with those since "there's nothing I can can do to help you anyway". Diagnosis is not a symbolic thing, it doesn't happen in the mind of the clinician, it's a process that ends up in a record. When it's not recorded, that means it's not diagnosed.
The paper said:
poor tolerance to physical exercise. Although exercise is recommended in their daily routine to improve quality of life
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This reads like dehydrated homeopathy. Words and their meaning, such a difficult thing to master.
The paper said:
CFS is characterized by disabling fatigue lasting more than 3 months, which further worsens the course and development of the disease and makes it even more difficult to acquire routines that include exercise.
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I'm sorry, the disease... worsens the course of the disease? I'm really not sure they understand why people even use words. And we have difficult "acquiring" routines? That's just weird as hell.
For people with CFS, exercise also seems to significantly improve health status, physical fitness, and quality of life, thus having a direct impact in fatigue, but literature is still scarce in this regard
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Trust us, we're experts? The power of evidence-based medicine in a nutshell: it's evidence-based, but we can't find any. It's amazing that they don't realize they are doing exactly the same thing as people who are annoyed that they can't find any scientific evidence for Flat Earth and other nonsense. Literally the same.
The paper said:
Because of this, they do not (attempt to) engage in physical activities and become completely sedentary
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When you have absolutely zero basic knowledge about the topic you are "studying". And: screw up, "do not attempt to". You know nothing about us, GTFOH.

I don't even understand what conclusion they were trying to squeeze out of that stone. The idea that research devoid of any quality or basic knowledge about the issue they are researching amounts to real work is plain bizarre. This is not real work.
 
Trish said:
The authors appear to be clueless about CFS.
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from reading the reviewers comments (which are quite critical, particularly reviewer 3) they are also unfamiliar with CFS, but at least had the common sense to look up the diagnosis, although it was hardly the most widely used/up-to-date version.
Round 2

Reviewer 3 Report

1. I'm afraid that there is a serious issue regarding to the definition of "co-diagnosis of chronic fatigue syndrome and fibromyalgia". Since the authors did not provide their diagnostic criteria of chronic fatigue syndrome, I've checked it in the literature, which is defined as "a complicated disorder characterized by extreme fatigue that lasts for at least six months and that can't be explained by an underlying medical condition." Since it is the prerequisite criteria that chronic fatigue syndrome can't be explained by an underlying medical condition, how could the authors had a "co-diagnosis of FM and CFS"?
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The paper claims:
For people with CFS, exercise also seems to significantly improve health status, physical fitness, and quality of life, thus having a direct impact in fatigue, but literature is still scarce in this regard. People with CFS tend to have an aversion to exercise to avoid symptom aggravation. Because of this, they do not (attempt to) engage in physical activities and become completely sedentary [9].
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It's interesting to follow the citation to see where they get this claim. It's from this paper: Training Individuals With Chronic Fatigue Syndrome, which is equally bad. The authors seem to have no ME expertise, they also get everything wrong, the paper is just their opinion (it's not an experiment), and it's from 2008.

It's very strange that they cited this paper rather than something newer. This was before even the PACE trial. There's a ton of research on GET that's more rigorous than (essentially) the opinion of two people. Thinking about this further...I wonder if the authors are so clueless or out of touch that they don't even have a modern BPS view. They seem to demonstrate little familiarity of GET--their paper never mentions it. A lot of the research they cite is fairly old. I skimmed their citations, and they only cited two papers about GET: The Cochrane review and this one.
 
It took me about ten minutes just to understand the title, being unsure whether Habitual Physical Exercise was a diagnosis. I think I see what they are trying to say, but it would help if the first sentence were lucid. After that, reading the text seemed unlikely to be profitable.
 
I'd love to know why they feel the need to state that they are using 'scientifically validated' measurement tools.

One would hope they are in a science paper.
 
This is pretty common language to use an a research paper. It's not related to the paper's poor quality.
 
Arnie Pye said:
I'd love to know how questionnaires are scientifically validated.
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Honestly, I doubt it's anything beyond: scientists did it, they validated it. I'm not even sure what other option there can be for this.

And, yes, I'm aware of the practice where "scientists" take a new-but-identical dowsing rod and compare it to other dowsing rods they use often and declare all of them calibrated on the basis of meeting expectations. That's just performative nonsense.

If you're not actually measuring real properties of the universe, it ain't science. That's the difference between 5C, 15C and 45C and cold, lukewarm and warm. Only one those scales is useful when doing science.
 
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