De inspanningskapaciteit van ME/CVS-patiënten, gemeten m.b.v. een zogenaamde fietstest,
is, volgens een recente studie van Wienstein en kollega's, beduidend minder.
De mate waarin iemand aangeeft vermoeid te zijn/vermoeid te raken (subjektief!)
heeft echter geen duidelijke relatie met de harde cijfers uit de inspanningstest.
Het aktiviteitennivo is wel duidelijk gerelateerd aan de uitkomsten van de fietstest.
De uitkomsten van deze studie, alhoewel klein, heeft belangrijke implikaties:
- De mate van invaliditeit kan "geobjektiveerd" worden (m.b.v. een fietstest)
- De inspanningskapaciteit van ME/CVS-patiënten is aanzienlijk gereduceerd.
- Subjektieve diagnosekriteria hebben zeer weinig waarde:
het "vermoeidheidskriterium" voor "CVS" selekteert "chronisch vermoeide mensen".
Exploratory Analysis of the Relationships between Aerobic Capacity and Self-Reported Fatigue in Patients with Rheumatoid Arthritis, Polymyositis, and Chronic Fatigue Syndrome.
PM R. 2009 Jul;1(7):620-8.
Weinstein AA, Drinkard BM, Diao G, Furst G, Dale JK, Straus SE, Gerber LH.
OBJECTIVE:
To determine
if self-reported levels of
physical activity and fatigue
are related
to peak oxygen uptake (VO(2peak)) and
whether these relationships differ among the patient groups
(rheumatoid arthritis [RA],
polymyositis [PM], and
chronic fatigue syndrome [CFS]).
DESIGN:
Correlational investigation.
SETTING:
Two ambulatory research clinics
at the National Institutes of Health, Clinical Center, Bethesda, MD.
PARTICIPANTS:
There were
9 patients with PM,
10 with RA, and
10 with CFS.
All patients met case criteria for their respective diagnoses.
METHODS/MAIN OUTCOME MEASUREMENTS:
VO(2peak) during bicycle ergometry and
self-reported fatigability, fatigue, and physical activity.
VO(2peak) was used as
the criterion measurement of
physiological fatigue
with which the self-reported variables were compared.
RESULTS:
The Pearson r revealed that
self-reported physical activity
correlated with
VO(2peak)
(r = 61, P = .01).
However,
fatigability and fatigue
did not correlate with VO(2peak).
Linear regression analysis was performed
to assess the effects of diagnosis group,
self-reported activity level or fatigue, and
their interaction.
A trend in the data showed a
distinctive relationship
between fatigue/fatigability
within the 3 groups.
In addition,
when controlling for group status,
self-reported activity
predicted aerobic capacity
as measured by VO(2peak).
CONCLUSIONS:
This study confirms that
patients with chronic,
but stable RA, PM, or CFS
are fatigued and
have significantly decreased aerobic capacity.
Self-reports of physical activity
predicted VO(2peak), and
may be used as
an indicator of activity-based aerobic capacity.
Self-reports of fatigue, however, did not correlate with VO(2peak) and
hence are assessing
something other than
an index of aerobic capacity, and
provide additional information
about patients' perceptions,
which will require further investigation.
PMID: 19627955 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/19627955
http://www.pmrjournal.org/article/S1934-1482(09)00436-5/abstract#cor1
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