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Sandler et al: Fatigue Exacerbation by Interval or Continuous Exercise in CFS

Discussion in 'Latest ME/CFS Research' started by mango, Jun 4, 2016.

  1. mango

    mango Senior Member

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    Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome

    Sandler CX1, Lloyd AR, Barry BK.

    Author information
    1 Fatigue Clinic, Lifestyle Clinic, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia;
    2 Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia;
    3 Neuroscience Research Australia, University of New South Wales, Sydney, Australia.

    Med Sci Sports Exerc. 2016 May 13. [Epub ahead of print]

    Abstract

    PURPOSE:
    To determine if the typical exacerbation of symptoms in patients with chronic fatigue syndrome (CFS) following a bout of exercise differs between high-intensity interval training (HIIT) or continuous (CONT) aerobic exercise of the same duration and mechanical work.

    METHODS:
    Participants with specialist-diagnosed CFS performed two 20-minute bouts of cycling in a randomised crossover study. The bouts were either moderate-intensity-continuous (70% age predicted heart rate max (APHRM)) or high-intensity-interval exercise, separated by at least 2 weeks. Self-report questionnaires capturing fatigue and related symptoms, and actigraphy were collected across 2 days before and 4 days following the exercise. Comparisons between exercise bouts were made using paired sample t-tests.

    RESULTS:
    Fourteen moderately affected participants who were unable to work, but not bed bound, completed the study (9 female, 32 ± 10 years, 67 ± 11 kg). Mechanical work was matched successfully between the exercise bouts (HIIT 83,037 vs CONT 83,348 J, p=0.84). Mean heart rate (HIIT 76 ± 5 vs CONT 73 ± 6 %APHRM, p<0.05) and RPE (6-20) in the legs (HIIT 15.4 ± 1.4 vs CONT 13.2 ± 1.2, p<0.001) were higher for the interval compared to continuous exercise. Mean fatigue scores (0-10) were similar before each exercise challenge (HIIT 4.5 ± 1.8 vs CONT 4.1 ± 1.7, p=0.43). Participants reported an increase in fatigue scores following both challenges (Mean difference: HIIT 1.0 ± 1.3, p<0.01; CONT 1.5 ± 0.7, p<0.001), but these exacerbations in fatigue were not statistically or clinically different (p=0.20).

    CONCLUSIONS:
    High-intensity interval exercise did not exacerbate fatigue any more than continuous exercise of comparable workload. This finding supports evaluation of HIIT in graded exercise therapy interventions for patients with CFS.

    PMID: 27183124 [PubMed - as supplied by publisher]

    http://www.ncbi.nlm.nih.gov/pubmed/27183124/
     
  2. BurnA

    BurnA Senior Member

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    One word : Lloyd.
     
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  3. TiredSam

    TiredSam The wise nematode hibernates

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    If you say so. I must say a few other words occured to me.
     
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  4. eastcoast12

    eastcoast12 Senior Member

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    Long Island ny
    That was funny
     
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  5. alex3619

    alex3619 Senior Member

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    Logan, Queensland, Australia
    You might genuinely get these kinds of results under some protocols, and under other protocols get the opposite results. Study design is critical, and I would like to see the details of this one. This is both disappointing and entirely expected coming from Lloyd. Did they even review the exercise physiology studies before designing this one? I will be looking for that in the references and discussion in the paper.

    Perhaps someone should tell him that ME is mostly not about fatigue, nor is CFS for the most part. We need to get past studying miasma (swamp miasma causes disease) and blowing smoke up people's rectums (an old therapeutic technique, look it up). I really don't give a damn about fatigue by itself.
     
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  6. Sea

    Sea Senior Member

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    Anyone else notice they didn't say there was no exacerbation - it just wasn't any worse than their other intervention, so that's ok. :bang-head:
     
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  7. alex3619

    alex3619 Senior Member

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    Yes, but we only have an abstract. This claim is concerning though as it indicates the same kind of spin you see in other CBT/GET research. The kind like "patients didn't improve in fitness but we think this is swell" or "we proved the null hypothesis but isn't this so nice".
     
  8. Dolphin

    Dolphin Senior Member

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    This might be a biased of patients group of patients: people who were able to do a graded exercise therapy program already.
    ---
    Later date say:
    It would be somewhat unusual for no one within a group with CFS to have fibromyalgia also.

    ---

     
    Last edited: Aug 9, 2016
  9. Dolphin

    Dolphin Senior Member

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    Pain thresholds have decreased following exercise in in at least 2 CFS studies i.e. people have become more sensitive to pain. So it is (somewhat) unusual that they didn't find that here:

     
    Last edited: Aug 9, 2016
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  10. halcyon

    halcyon Senior Member

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    Nothing is unusual about inconsistent results between Fukuda studies.
     
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  11. Dolphin

    Dolphin Senior Member

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    It surprised me that the continuous exercise bout caused a bigger average deterioration in fatigue paired to the high-intensity interval training (1.5 vs 1.0 p<0.001)
     
  12. Dolphin

    Dolphin Senior Member

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    There wasn't a huge difference in the exercise intensities in terms of each predicted heart rate between the 2 exercise groups. That could possibly explain why there wasn't a deterioration in the high-intensity interval exercise group.
     
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  13. Dolphin

    Dolphin Senior Member

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    I found this a little interesting as sometimes there are discussions about whether the exacerbation following exercise or delayed. It varied in this group.
     
  14. Dolphin

    Dolphin Senior Member

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    I remember reading, I think it was in Dr Anne MacIntyre's book, of somebody with ME who relapsed badly and ended up in bed 3 months following running 100m (?) for the bus. I would certainly be cautious of high-intensity activity.
     
  15. Dolphin

    Dolphin Senior Member

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  16. Dolphin

    Dolphin Senior Member

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  17. Dolphin

    Dolphin Senior Member

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    Average BMI = 22.90 kg/m2
     
  18. Dolphin

    Dolphin Senior Member

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    One of the most consistent findings in CFS exercise studies is that the rating of perceived exertion in CFS patients is higher than controls for equivalent exercise levels.

    My vague recollection of previous CFS exercise studies is that higher RPE levels have very often been found in CFS studies i.e. that the exercise levels here weren't that intense perhaps.
     
  19. Dolphin

    Dolphin Senior Member

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  20. Dolphin

    Dolphin Senior Member

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    At one point they refer to:
    Different results might be found with a higher intensity problem.
     

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