Exercise therapy for chronic fatigue syndrome

Larun, Lillebeth; Brurberg, Kjetil Gundro; Odgaard‐Jensen, Jan; Price, Jonathan

doi:10.1002/14651858.cd003200.pub8

Cited by 70 publications

(44 citation statements)

References 77 publications

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“…It has been proven that properly selected exercises improve the physical and mental condition in patients with chronic fatigue syndrome (CFS) and are often implemented together with the other forms of therapy [ 56 , 57 , 58 , 59 , 60 , 61 ]. However, some researches question the clinical efficacy of graded-exercise-related therapy (GET) [ 62 ], while other sources even report deterioration after GET [ 63 , 64 ]. Among several patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), the post-exertional “malaise” (PEM) was observed, which can be defined as a ‘pathological inability to produce sufficient energy on demand’.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Fatigue and Physical Activity in a Polish Cohort of Multiple Sclerosis Patients

et al. 2020

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Background and objectives: Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). It can be defined as a subjective lack of physical and mental energy. The aim of this study was to evaluate the frequency and severity of fatigue in patients with MS and its relationship with overall physical activity and disease-related disability. Materials and Methods: The study included 100 patients with a clinical relapsing-remitting form of MS. Patients with severe depression were excluded. Neurological impairment was rated using the Expanded Disability Status Scale (EDSS). Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS), with FSS scores greater than 36 indicating patients with fatigue. Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) and categorized on three levels: low, moderate, and high, using standard metabolic equivalents (MET). Results: The average FSS and MFIS scores were (mean ± SD) 31.3 ± 15.2 and 30.1 ± 17.0, respectively. The mean EDSS score was 2.5 ± 1.5. 42%. Patients were classified as fatigued based on FSS. Fatigued patients had higher mean EDSS scores than non-fatigued (3.0 ± 1.6 vs. 2.2 ± 1.4, respectively, p = 0.002). Low, moderate, and high levels of physical activity were reported in 35%, 20%, and 45% of patients, respectively. Higher scores of fatigue in FSS and MFIS were inversely correlated with the intensity of physical activity (r = −0.38, p < 0.001 and r = −0.33, p < 0.001, respectively). Conclusions: In patients with MS, fatigue is a common symptom. Patients with lower physical activity and greater MS-related disability have a higher severity of fatigue, which negatively affects cognitive, psychosocial, and physical functioning.

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Section: Discussionmentioning

confidence: 99%

Relationship between Fatigue and Physical Activity in a Polish Cohort of Multiple Sclerosis Patients

et al. 2020

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“…peak oxygen uptake, heart rate, rating of perceived exertion (RPE) and blood lactate) is reported for the purpose of characterizing the test and describing the sub-study participants. Borg's RPE scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) [29] was administered according to published instructions [30]. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

Section: Laboratory Visitmentioning

confidence: 99%

“…The chronic nature of CRF in some cancer survivors has led to a comparison with ME/CFS [12]. Exercise appears to exert a moderate effect on fatigue in people with CFS in the short term [17]. However, following a reanalysis of an influential study [18,19] and subsequent controversy [20,21], the CDC no longer recommends graded exercise (progressive aerobic activity) as a recommended therapy in ME/CFS [14].…”

Section: Introductionmentioning

confidence: 99%

“…[24]). Considering inadequate reporting of adverse reactions to exercise in previous studies of ME/CFS [17,25], and the lack of data on PEM in people with chronic CRF, caution may be warranted. PEM is inadequately documented in the literature on chronic CRF and requires further investigation considering the potential implications for exercise prescription.…”

Section: Introductionmentioning

confidence: 99%

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Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Twomey

Yeung

Wrightson³

et al. 2019

Preprint

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Context: Cancer-related fatigue (CRF) is a distressing and persistent sense of tiredness or exhaustion that interferes with usual functioning. Chronic CRF continues for months after curative cancer treatment is complete. Post-exertional malaise (PEM) is a worsening of symptoms after physical or mental activity, with limited investigations in people with chronic CRF. Objectives: The purpose of this study was to identify and describe self-reported incidences of PEM in people with chronic CRF. Methods: Participants (n=18) were eligible if they scored ≤34 on the Functional Assessment of Chronic Illness Therapy-Fatigue scale and had a cancer-related onset of fatigue. Participants completed a brief questionnaire to assess PEM over a 6-month time-frame (the DePaul Symptom Questionnaire - Post-Exertional Malaise; DSQ-PEM). In addition, a maximal exercise test was used to investigate self-reported symptom exacerbation (via an open-ended questionnaire) after strenuous physical exertion. Results: On the DSQ-PEM, three participants met previously defined scoring criteria, which included experiencing moderate to very severe symptoms at least half of the time, worsening of fatigue after minimal effort, plus a recovery duration of >24 h. Content analysis of responses to open-ended questionnaires identified five people who experienced a delayed recovery and symptoms of PEM after maximal exercise. Conclusion: A subset of people with chronic CRF (up to 33% in this sample) may experience PEM. Exercise specialists and health care professionals working with people with chronic CRF must be aware that PEM may be an issue. Symptom exacerbation after exercise should be monitored, and exercise should be tailored and adapted to limit the potential for harm.

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“… 23 A recent study in FSHD patients found that either aerobic exercise training or cognitive behavioral therapy can reduce chronic fatigue. 24 Exercise training also has been evaluated as a non-pharmacological therapy for chronic fatigue in patients with chronic fatigue syndrome/myalgic encephalomyelitis 25 and multiple sclerosis, 26 and in cancer survivors. 27 The effect of exercise therapy on fatigue in DM1 patients is unknown.…”

Section: Introductionmentioning

confidence: 99%

Antisense oligonucleotide and adjuvant exercise therapy reverse fatigue in old mice with myotonic dystrophy

Kim

Antoury

et al. 2021

Molecular Therapy - Nucleic Acids

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Patients with myotonic dystrophy type 1 (DM1) identify chronic fatigue as the most debilitating symptom, which manifests in part as prolonged recovery after exercise. Clinical features of DM1 result from pathogenic gain-of-function activity of transcripts containing an expanded microsatellite CUG repeat (CUG exp ). In DM1 mice, therapies targeting the CUG exp transcripts correct the molecular phenotype, reverse myotonia, and improve muscle pathology. However, the effect of targeted molecular therapies on fatigue in DM1 is unknown. Here, we use two mouse models of DM1, age-matched wild-type controls, an exercise-activity assay, electrical impedance myography, and therapeutic antisense oligonucleotides (ASOs) to show that exaggerated exercise-induced fatigue progresses with age, is unrelated to muscle fiber size, and persists despite correction of the molecular phenotype for 3 months. In old DM1 mice, ASO treatment combined with an exercise training regimen consisting of treadmill walking 30 min per day 6 days per week for 3 months reverse all measures of fatigue. Exercise training without ASO therapy improves some measures of fatigue without correction of the molecular pathology. Our results highlight a key limitation of ASO monotherapy for this clinically important feature and support the development of moderate-intensity exercise as an adjuvant for targeted molecular therapies of DM1.

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Exercise therapy for chronic fatigue syndrome

Abstract: Exercise therapy for chronic fatigue syndrome.

Cited by 70 publications

References 77 publications

Relationship between Fatigue and Physical Activity in a Polish Cohort of Multiple Sclerosis Patients

Relationship between Fatigue and Physical Activity in a Polish Cohort of Multiple Sclerosis Patients

Post-Exertional Malaise in People with Chronic Cancer-Related Fatigue

Antisense oligonucleotide and adjuvant exercise therapy reverse fatigue in old mice with myotonic dystrophy

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