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Löfgren et al: Fibromyalgia Syndrome or CFS/ME and Factors Influencing Work Disability in Women

Discussion in 'Latest ME/CFS Research' started by mango, Oct 15, 2016.

  1. mango

    mango Senior Member

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    Fibromyalgia Syndrome or Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Factors Influencing Work Disability in Women

    Monika Löfgren (5), Marie-Louise Schult (5), Ann Öhman (6), Per Julin (5), Jan Ekholm (5)

    Author Affiliations

    5. Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, Bldg 39, Floor 3, Stockholm, 182 88, Sweden
    6. Department of Epidemiology and Global health, Umeå Centre for Gender Studies, Umeå University, Umeå, 901 85, Sweden

    Handbook of Return to Work: From Research to Practice (2016), pp 459-480
    Volume 1 of the series Handbooks in Health, Work, and Disability
    DOI: 10.1007/978-1-4899-7627-7_26

    Abstract
    Fibromyalgia is a complex chronic pain syndrome characterized by widespread muscle pain, tenderness, and fatigue. Women with fibromyalgia report that symptoms limiting their work ability include pain, tiredness, muscle weakness, and memory and concentration difficulties.

    Work tasks perceived as “difficult” for women with fibromyalgia are repetitive movements, static muscle work as when holding, standing, or sitting in the same positions for fairly long periods, heavy work, working above shoulder level, power gripping, and frequent carrying and lifting. These difficulties reflect the fibromyalgia pathophysiology.

    To be able to remain at work, women with fibromyalgia need workplaces, which are flexible and adjustable. They need to be able to change and alternate positions and tasks, take short breaks, and, in many cases, reduce working hours.

    With appropriate support and adaptation, most are able to continue working to some extent.

    The prognosis for post-viral fatigue chronic fatigue syndrome/myalgic encephalomyelitis is considered poor if untreated. Many women with chronic fatigue syndrome/myalgic encephalomyelitis have low work capacity and are not in work.

    One problem in reviewing studies assessing their likelihood of return to work is the variability in the criteria for inclusion. Thus, the proportion of patients with stress-related chronic fatigue in chronic fatigue syndrome/myalgic encephalomyelitis studies is bound to affect the return-to-work rates.

    Recent research has strengthened the view that there could be a clinically and scientifically meaningful distinction between chronic fatigue syndrome/myalgic encephalomyelitis, usually with acute onset after infection and hypothetically a neuroimmunological disorder and, on the other hand, stress-related chronic fatigue.

    Current evidence for activity improvements and work resumption after rehabilitation is reviewed for patients with chronic fatigue syndrome/myalgic encephalomyelitis.

    http://link.springer.com/chapter/10.1007/978-1-4899-7627-7_26
     
    Hutan, AndyPR, Valentijn and 2 others like this.
  2. Valentijn

    Valentijn The Diabolic Logic

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  3. Sean

    Sean Senior Member

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    And every other outcome measure.
     
    mango likes this.
  4. Valentijn

    Valentijn The Diabolic Logic

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    I'm getting the impression that they don't know much about ME/CFS, but have done thorough research. However, they don't distinguish between shit research and quality research, so everything is given equal credibility. On the one hand, they describe ME as a neurological disease, and seem to give prominence to CCC over Fukuda, but they also say 30% of patients recover after CBT/GET.

    They don't understand that SMC was a control group in PACE, so don't subtract those "recovered" from the GET/CBT+SMC "recovered". And no mention of null long-term followup. They also treat APT like it's a real treatment, instead of something manufactured solely for PACE.

    As usual for these types of papers, it's a confusing mess which probably had good intentions, but severely suffers from a lack of understanding regarding the subject.
     
    TiredSam, Hutan, mango and 4 others like this.
  5. mango

    mango Senior Member

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    Dr Per Julin is one of the main doctors at the (biomedical) ME/CFS centre at Stora Sköndal in Sweden, does some research as well. He's very appreciated by his patients, and I would say that he's very knowledgeable about ME/CFS in general.

    But he should know better re: PACE and CBT/GET... he's definitely aware of Tuller's criticism, the long-term followup results and the reanalysis etc etc etc. And from his own experience of working with ME/CFS patients for many years. I'm not sure what happened there... :confused:
     
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  6. Valentijn

    Valentijn The Diabolic Logic

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    Is one of the authors a student, perhaps?
     
  7. mango

    mango Senior Member

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    I don't know. I haven't had the time yet to look up who the other people are, I'm not familiar with any of the names.
     
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  8. Effi

    Effi Senior Member

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    Europe
    This kind of literature review studies is sometimes written solely for the technical purpose of getting funding from somewhere, i.e. written in order to support their specific case for funding. I'm not saying this is what happened here, cause I don't know the authors involved, but if it were that would explain a lot. Especially because, as @mango says, this Dr Per Julin should know better.
     
    L'engle likes this.

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