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Lessons from ME/CFS: Finding Meaning in the Suffering
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Exercise Tolerance Testing in Adolescents with CFS and Recovered Controls after Mono

Discussion in 'Latest ME/CFS Research' started by shrewsbury, May 22, 2010.

  1. shrewsbury

    shrewsbury member

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    Tate Mitchell to CO-CURE May 8

    'Exercise Tolerance Testing in a Prospective Cohort of Adolescents
    with Chronic Fatigue Syndrome and Recovered Controls Following
    Infectious Mononucleosis'

    Katz BZ, Boas S, Shiraishi Y, Mears CJ, Taylor R.
    J Pediatr. 2010 May 5. [Epub ahead of print]

    Department of Pediatrics, Northwestern University, Feinberg School of
    Medicine and Children's Memorial Hospital, Chicago, IL.

    http://www.ncbi.nlm.nih.gov/pubmed/20447647


    Abstract

    OBJECTIVE: Six months after acute infectious mononucleosis (IM), 13%
    of adolescents meet criteria for chronic fatigue syndrome (CFS). We
    measured exercise tolerance in adolescents with CFS and control
    subjects 6 months after IM.

    STUDY DESIGN: Twenty-one adolescents with CFS 6 months after IM and 21
    recovered control subjects performed a maximal incremental exercise
    tolerance test with breath-by-breath gas analysis. Values expressed
    are mean +/- standard deviation.

    RESULTS: The adolescents diagnosed with CFS and control subjects did
    not differ in age, weight, body mass index, or peak work capacity.
    Lower oxygen consumption peak percent of predicted was seen in
    adolescents with CFS compared with control subjects (CFS 99.3 +/- 16.6
    vs control subject 110.7 +/- 19.9, P = .05). Peak oxygen pulse also
    was lower in adolescents with CFS compared with recovered control
    subjects (CFS 12.4 +/- 2.9 vs control subjects 14.9 +/- 4.3, P = .03).

    CONCLUSIONS: Adolescents with CFS 6 months after IM have a lower
    degree of fitness and efficiency of exercise than recovered
    adolescents. Whether these abnormal exercise findings are a cause or
    effect of CFS is unknown. IM can lead to both fatigue and measurable
    changes in exercise testing in a subset of adolescents.

    Copyright 2010 Mosby, Inc. All rights reserved.
  2. Hope123

    Hope123 Senior Member

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    It was a good idea to study to compare recovered and non-recovered mono patients but we know from prior studies that it's not so much a one time exercise tolerance test that distinguishes CFS vs. non-CFS groups but rather a repeat exercise test. That is, metabolic measure are similar in both groups after one test but after a second test, the CFS groups' measures decline even more rather than staying stable or improving like healthy controls or even controls with non-CFS chronic diseases (heart/ lung disease, e.g.)
    Tito likes this.
  3. Dolphin

    Dolphin Senior Member

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    I'd be betting on "effect".
  4. oceanblue

    oceanblue Senior Member

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    UK
    I wholeheartedly agree. This was a test of capability, not fatigability (as in chronic FATIGUE syndrome). You'd think that researchers would have worked this out by now. And also, you would surely expect the ill subjects to do worse than the recovered ones, so I'm not quite sure what the purpose of this study was.
  5. Dolphin

    Dolphin Senior Member

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    I just read the following paper. One thing not covered in the abstract is the following:
    --------------
    Although they didn't reach significance, these data might be of interest to somebody. I have a vague recollection of reading some CFS patients' cortisol levels dropped after exercising and the results here suggest it happened for some of the CFS patients.

  6. oceanblue

    oceanblue Senior Member

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    Full text inc tables available here

    Just wanted to pull out the deconditioning/fitness levels as VO2 max from the paper:


    VO2max, ml/min/kg
    CFS patients: 37.4
    Recovered: 40.9

    The differences were not statistically significant. Population norms for group of this age that is 85% female is around 40-49 so recovered patients (after 6 months) are scraping average while CFS patients are a bit below average, but by no means abnormal.
  7. Dolphin

    Dolphin Senior Member

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    Thanks.

    Probably not important but there's a slight discrepency with the PubMed Central file: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975670/pdf/nihms-191571.pdf . Recovered are down as 41.7 but still not statistically different from non-recovered.
    Simon likes this.

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