Can exercise limits prevent post-exertional malaise in chronic fatigue syndrome? An uncontrolled clinical trial.
OBJECTIVE
It was hypothesized that the use of exercise limits prevents symptom increases and worsening of their health status following a walking exercise in people with chronic fatigue syndrome.


METHODS
An uncontrolled clinical trial (semi-experimental design).


METHODS
Outpatient clinic of a university department.


METHODS
Twenty-four patients with chronic fatigue syndrome.


METHODS
Subjects undertook a walking test with the two concurrent exercise limits. Each subject walked at an intensity where the maximum heart rate was determined by heart rate corresponding to the respiratory exchange ratio = 1.0 derived from a previous submaximal exercise test and for a duration calculated from how long each patient felt they were able to walk.


METHODS
The Short Form 36 Health Survey or SF-36, the Chronic Fatigue Syndrome Symptom List, and the Chronic Fatigue Syndrome -Activities and Participation Questionnaire were filled in prior to, immediately after and 24 hours after exercise.


RESULTS
The fatigue increase observed immediately post-exercise (P= 0.006) returned to pre-exercise levels 24 hours post-exercise. The increase in pain observed immediately post-exercise was retained at 24 hours post-exercise (P=0.03). Fourteen of the 24 subjects experienced a clinically meaningful change in bodily pain (change of SF-36 bodily pain score > or =10); 6 indicated that the exercise bout had slightly worsened their health status, and 2 had a clinically meaningful decrease in vitality (change of SF-36 vitality score > or =20). There was no change in activity limitations/participation restrictions.


CONCLUSIONS
It was shown that the use of exercise limits (limiting both the intensity and duration of exercise) prevents important health status changes following a walking exercise in people with chronic fatigue syndrome, but was unable to prevent short-term symptom increases.
Nijs
Jo
J
Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium. j.nijs@ha.be
Almond
Freya
F
De Becker
Pascale
P
Truijen
Steven
S
Paul
Lorna
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D017079:Exercise Tolerance; D015673:Fatigue Syndrome, Chronic / Q000534:rehabilitation / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking