Assessing current functioning as a measure of significant reduction in activity level

Thorpe, T.W.; McManimen, Stephanie; Gleason, Kristen D; Stoothoff, Jamie; Newton, Julia L.; Strand, Elin Bolle; Jason, Leonard A.

doi:10.1080/21641846.2016.1206176

Cited by 8 publications

(10 citation statements)

References 27 publications

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“…A decrease in activity level is a cardinal feature of many proposed definitions of CFS/ME, which produces a substantial reduction or impairment in the ability to carry out daily activities of life. In fact, a reduction in activity level of at least 50% below premorbid levels has been reported [ 2 ] Using actigraphy, activity levels during the day were found to be lower in patients than in controls, as has already been reported [ 24 ]. Our results confirm these differences and add that between 12h and 14h, activity did not differ between the groups.…”

Section: Discussionsupporting

confidence: 56%

“…During the course of the illness, CFS/ME patients also experience relapses and partial remissions of the common features which include pathological dysregulation of the neuro-endocrine, immunological, gastrointestinal, autonomic systems with cellular energy metabolism/ion transport impairments of varying onset, duration, frequency and severity, reviewed in [ 1 ]. Symptoms can persist for years, and few patients regain their premorbid level of health or functioning [ 2 ]. The duration of CFS/ME and the potentially debilitating consequences of its symptoms significantly increase the economic burden and establish the condition as a top-level health problem in today’s society [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

et al. 2018

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Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) patients frequently show autonomic symptoms which may be associated with a hypothalamic dysfunction. This study aimed to explore circadian rhythm patterns in rest and activity and distal skin temperature (DST) and their association with self-reported outcome measures, in CFS/ME patients and healthy controls at two different times of year. Ten women who met both the 1994 CDC/Fukuda definition and 2003 Canadian criteria for CFS/ME were included in the study, along with ten healthy controls matched for age, sex and body mass index. Self-reported measures were used to assess fatigue, sleep quality, anxiety and depression, autonomic function and health-related quality of life. The ActTrust actigraph was used to record activity, DST and light intensity, with data intervals of one minute over seven consecutive days. Sleep variables were obtained through actigraphic analysis and from subjective sleep diary. The circadian variables and the spectral analysis of the rhythms were calculated. Linear regression analysis was used to evaluate the relationship between the rhythmic variables and clinical features. Recordings were taken in the same subjects in winter and summer. Results showed no differences in rhythm stability, sleep latency or number of awakenings between groups as measured with the actigraph. However, daily activity, the relative amplitude and the stability of the activity rhythm were lower in CFS/ME patients than in controls. DST was sensitive to environmental temperature and showed lower nocturnal values in CFS/ME patients than controls only in winter. A spectral analysis showed no differences in phase or amplitude of the 24h rhythm, but the power of the second harmonic (12h), revealed differences between groups (controls showed a post-lunch dip in activity and peak in DST, while CFS/ME patients did not) and correlated with clinical features. These findings suggest that circadian regulation and skin vasodilator responses may play a role in CFS/ME.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

et al. 2018

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“…All mean measurements during the re-evaluation showed a significant deterioration (P < 0.0001) in comparison to the initial evaluation. Phys F: Physical Functioning scale of the SF-36 questionnaire; %peak VO 2 : peak VO 2 oxygen uptake relative to controls [37]; No of steps: number of steps per day functioning scale of 0.91 [44], suggesting that the use of the physical functioning score is valid with an acceptable sensitivity and specificity. Several studies have shown a decreased peak VO 2 in ME/CFS patients [45].…”

Section: Discussionmentioning

confidence: 99%

Physical activity measures in patients with myalgic encephalomyelitis/chronic fatigue syndrome: correlations between peak oxygen consumption, the physical functioning scale of the SF-36 questionnaire, and the number of steps from an activity meter

et al. 2020

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Background: Most studies to assess effort intolerance in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have used questionnaires. Few studies have compared questionnaires with objective measures like an actometer or an exercise test. This study compared three measures of physical activity in ME/CFS patients: the physical functioning scale (PFS) of the SF-36, the number of steps/day (Steps) using an actometer, and the %peak VO 2 of a cardiopulmonary stress test. Methods: Female ME/CFS patients were selected from a clinical database if the three types of measurements were available, and the interval between measurements was ≤ 3 months. Data from the three measures were compared by linear regression. Results: In 99 female patients the three different measures were linearly, significantly, and positively correlated (PFS vs Steps, PFS vs %peak VO 2 and Steps vs %peak VO 2 : all P < 0.001). Subgroup analysis showed that the relations between the three measures were not different in patients with versus without fibromyalgia and with versus without a maximal exercise effort (RER ≥ 1.1). In 20 patients re-evaluated for symptom worsening, the mean of all three measures was significantly lower (P < 0.0001), strengthening the observation of the relations between them. Despite the close correlation, we observed a large variation between the three measures in individual patients. Conclusions: Given the large variation in ME/CFS patients, the use of only one type of measurement is inadequate. Integrating the three modalities may be useful for patient care by detecting overt discrepancies in activity and may inform studies that compare methods of improving exercise capacity.

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“…In the community-based sample the AUC of the physical functioning scale was 0.84 and in the tertiary care sample 0.87. However, another study found an AUC for assessing substantial reductions of the physical functioning scale of 0.91 [45], suggesting that the use of the physical functioning score is valid with an acceptable sensitivity and speci city.…”

Section: Discussionmentioning

confidence: 99%

Physical activity measures in patients with myalgic encephalomyelitis/chronic fatigue syndrome: correlations between peak oxygen consumption, the physical functioning scale of the SF-36 questionnaire, and the number of steps from an activity meter

Campen¹,

Rowe

Verheugt

et al. 2020

Preprint

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Background most studies to assess effort intolerance in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have used questionnaires. Few studies have compared questionnaires with objective measures like an actometer or an exercise test. Therefore three measures of physical activity in ME/CFS patients, being the physical functioning scale (PFS) of the SF-36, the number of steps/day (Steps) of an actometer and the %peak VO 2 of a cardiopulmonary stress test were compared. Methods female ME/CFS patients were selected from a clinical database if the three types of measurements were available, and the interval between measurements was ≤ three months. Data of the three measures were compared by linear regression. Results in 99 female patients the three different measures were linearly, significantly and positively correlated (PFS vs Steps, PFS vs %peak VO 2 and Steps vs %peak VO 2 : all P<0.001). Subgroup analysis showed that the relations between the three measures were not different in patients with versus without fibromyalgia and with versus without a maximal exercise effort (RER≥1.1). In 20 patients re-evaluated for symptom worsening, the mean of all three measures was significantly lower (P<0.0001), strengthening the observation of the relations between them. Despite the close correlation a large variation was observed between the three measures in individual patients. Conclusions given the large variation in ME/CFS patients, the use of only one type of measurement is inadequate. Integrating the three modalities may be useful for patient care by detecting overt discrepancies and may aid study designs aimed at improving exercise capacity.

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Assessing current functioning as a measure of significant reduction in activity level

Cited by 8 publications

References 27 publications

Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Physical activity measures in patients with myalgic encephalomyelitis/chronic fatigue syndrome: correlations between peak oxygen consumption, the physical functioning scale of the SF-36 questionnaire, and the number of steps from an activity meter

Physical activity measures in patients with myalgic encephalomyelitis/chronic fatigue syndrome: correlations between peak oxygen consumption, the physical functioning scale of the SF-36 questionnaire, and the number of steps from an activity meter

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