Symptom fluctuations and daily physical activity in patients with chronic fatigue syndrome: a case-control study, Nijs et al (2011)

Hoopoe

Hoopoe

Senior Member (Voting Rights)
A study that is of interest because it measured activity levels with an accelerometer.
OBJECTIVES:
To compare the activity pattern of patients with chronic fatigue syndrome (CFS) with healthy sedentary subjects and examine the relationship between the different parameters of performed activity (registered by an accelerometer device) and symptom severity and fluctuation (registered by questionnaires) in patients with CFS.

DESIGN:
Case-control study. Participants were asked to wear an accelerometer device on the nondominant hand for 6 consecutive days. Every morning, afternoon, and evening patients scored the intensity of their pain, fatigue, and concentration difficulties on a visual analog scale.

SETTING:
Patients were recruited from a specialized chronic fatigue clinic in the university hospital, where all subjects were invited for 2 appointments (for questionnaire and accelerometer adjustments). In between, activity data were collected in the subject's normal home environment.

PARTICIPANTS:
Female patients (n=67) with CFS and female age-matched healthy sedentary controls.

INTERVENTIONS:
Not applicable.

MAIN OUTCOME MEASURES:
Accelerometry (average activity counts, peak activity counts, ratio peak/average, minutes spent per activity category) and symptom severity (intensity of pain, fatigue, and concentration difficulties).

RESULTS:
Patients with CFS were less active, spent more time sedentary, and less time lightly active (P<.05). The course of the activity level during the registration period (P interaction>.05), peak activity, and the staggering of activities (ratio peak/average) on 1 day were not different between groups (P>.05). Negative correlations (-.242 varying to -.307) were observed for sedentary activity and the ratio with symptom severity and variation on the same and the next day. Light, moderate, and vigorous, as well as the average activity and the peak activity, were positively correlated (.242 varying to .421) with symptom severity and variation.

CONCLUSIONS:
The more patients with CFS are sedentary and the better activity is dispersed, the fewer symptoms and variations they experience on the same and next day. Inversely, more symptoms and variability is experienced when patients were more active that day or the previous day. The direction of these relations cannot be determined in a cross-sectional study and requires further study.
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https://www.ncbi.nlm.nih.gov/pubmed/22032215

Unfortunately the authors did not investigate further to find out the "direction of these relations".
 
strategist said:
Unfortunately the authors did not investigate further to find out the "direction of these relations".
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Probably because that would have required time travel to see if increased symptoms the next day could lead to more activity the previous day... I think I've just confused myself... :confused:

This, however, I do understand. What they're saying here is that pacing works.
The more patients with CFS are sedentary and the better activity is dispersed, the fewer symptoms and variations they experience on the same and next day. Inversely, more symptoms and variability is experienced when patients were more active that day or the previous day.
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It doesn't require time travel, it just requires cloning, of many identical people with ME.

And a few decades, so possibly some form of technology to keep people asleep without ageing for 30 or so years would be needed. To stop them getting bored waiting for the research to start.

Maybe that doesn't exist yet but possibly easier than time travel.

Maybe.

Fairly sure that's considered unethical for some reason.

...and yes, pacing works, sort of.
 
Am I correct in understanding that a difference between the CFS group and the sedentary controls is that the CFS group were in general either active or resting, whereas the sedentary controls pottered more?

Does this mean that CFS group are seeking to maximise what they can do, ie pacing themselves, whereas the healthy but sedentary controls did not have a need structure what they did when? I suppose the big question is then, does this separating into distinct spells of activity and of rest increase what an individual with ME is able to do overall? Unfortunately not a question this experimental set up can answer.
 
Peter Trewhitt said:
I suppose the big question is then, does this separating into distinct spells of activity and of rest increase what an individual with ME is able to do overall?
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I think it does.

When I stop in time and rest (or doing something different, lighter) , after some time I can go on with the task I was doing. Sadly after every rest I have to stop sooner and in the end I have to stop all together and lay down.
 
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