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Symptom fluctuations and daily physical activity in CFS (Meeus et al, 2011)

Discussion in 'Latest ME/CFS Research' started by Dolphin, Nov 9, 2011.

  1. Dolphin

    Dolphin Senior Member

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    I read the full text of this today. I'll post some comments below.

  2. Dolphin

    Dolphin Senior Member

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    Two extracts from introduction

    From introduction:

    - patients can't win! :(

  3. Dolphin

    Dolphin Senior Member

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    Control group

    Control group:
    "professionally active" = in employment (I presume)
  4. Dolphin

    Dolphin Senior Member

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    They are also in contrast to
    The amount of time sedentary in the two studies is hugely different:
    versus
    Definition of sedentary in Meeus:
    I think sedentary in Newton might include anything under 3 METs; alternatively, they use a fancier technique:
    For light activity in Meeus, the controls did more of it:
    If on adds the two types of activity together:

    CFS Weekday: 1325.35 Week end day: 1313.26
    CON Weekday: 1280.36 Week end day: 1279.72

    one sees results which are not that different for sedentary in the Newton group:
    Note: judging by the minutes in both studies, sleep time is counted within the total minutes (I have seen other studies that excluded it). So for example if people with CFS simply slept longer, that could potentially explain the difference in sedentary time between the CFS patients and controls.
  5. Dolphin

    Dolphin Senior Member

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    CFS activity levels don't fluctuate any more than controls within a day or day-to-day

    "during the day" means within any one day.

    Note, van der Werf found something similar on daily changes:
    This is interesting because part of the rationale of many behavioural interventions in CFS patients is said to be to reduce "boom and bust" (Deary & Chalder). However, it may be the case that the frequency of this activity pattern in CFS has been exaggerated. [ref: Deary V, Chalder T: Chapter 11, "Conceptualisation in Chronic Fatigue Syndrome" in Formulation and Treatment in Clinical Health Psychology Edited by Ana V. Nikcevic, Andrzej R. Kuczmierczyk, Michael Bruch]
  6. Dolphin

    Dolphin Senior Member

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    Here's a bit more (trying not to copy and paste too much):

    This is interesting:
    A lot of psychs would give the management approach required would be fairly straightforward.

  7. livingwithcfids

    livingwithcfids

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    Dolphin, nothing against you but this study sucks in that nothing was accomplished; just repetitive information known for the last 30 years. This study seemed like it could have been done in 2001, not 2011. I like how they used ALL females in the study with no explanation as to why.

    Of course patients with CFS were less active
    CONCLUSIONS:
    The more patients with CFS are sedentary and the better activity is dispersed, the fewer symptoms and variations they experience on the same and next day.
    Inversely, more symptoms and variability is experienced when patients were more active that day or the previous day."

    They can't be serious. Exercise induces symptoms? Who would have guessed? Brainless Belgians!
  8. oceanblue

    oceanblue Senior Member

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    Thanks for the helpful analysis, Dolphin. I only had the energy to skim it but you've highlighted some very important findings:
    Maybe the tide is finally turning.


    This is odd though:
    I would expect CFS patients to have less high-intensity activity (unless peak was defined relative to each participant's average activity) and this anomaly might cast doubt on some of the other findings.
  9. taniaaust1

    taniaaust1 Senior Member

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    I havent been able to read this whole thread or whole first post but I certainly agree with what they come up with here. It supports what most of us say about pacing ourselves. Pacing is the only way I think we have any chance of getting stability with our illness.

  10. Dolphin

    Dolphin Senior Member

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    I think this bit relates to length of very vigorous activity. Neither group did very much of this.

    So there was a numerical difference, with the length of time more than double during the week and triple at week ends, on average, but there was a big variation (SD) in the control values meaning it wasn't statistically significant.

    Perhaps if there were male controls rather sedentary female controls, there would be a difference.

    So don't think the study would/should be dismissed for this finding.
  11. oceanblue

    oceanblue Senior Member

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    I'm reassured. There wasn't really enough data to draw any conclusion on vigorous activity levels at all (encouraging though that patients were numercially less active) so it seems reasonable to ignore it.
  12. Esther12

    Esther12 Senior Member

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    Just posting to mark this thread for future reading... it looks interesting, but I've not had a chance today. Ta.
  13. Dolphin

    Dolphin Senior Member

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    I'm not sure what system you use - not sure if you know that under "thread tools" you can subscribe to a thread. I sometimes do that for some threads where I have read them but not posted a message.
  14. BEG

    BEG Senior Member

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    I am appreciative, Dolphin, that you posted this article. Not only that, you posted it in a manner that made it easy to read and understand (for those of us whose fatigue can be measured also in brain activity.) Personally, I don't think this type of information can ever be overdone. We're fighting a very ignorant public . . . still. Lazy 'n crazy anyone?

    A take away point for me: An exacerbation of symptoms with even light activity is not something to dismiss. It can be harmful. Who needs more oxidative stress?

    I like that the authors used METS to define activity level. I believe that term is underused. During cardiopulmonary excercise terting, I learned the number of METS I can't exceed without symptoms. Believe me when I say that I shouldn't put my book down and get out of a chair, and a stroll around a mall is out of the question.

    So thanks again, for painstakingly presenting this article, to reinforce what we already know, and to inform those who don't know.
  15. Dolphin

    Dolphin Senior Member

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    Cheers Brown-eyed Girl. An earlier poster did say it was nothing against me personally so I didn't take it personally as post really directed at the whole research project rather than what I wrote. But useful to know somebody found it useful also. I partly write things like this for myself and my goldfish memory.
  16. Snow Leopard

    Snow Leopard Senior Member

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    Hi Dolphin, I appreciate your analysis too, because you tend to report things in a similar way to what I'd think is important. So reading your analyses saves me a lot of time!
    SOC, WillowJ and Dolphin like this.
  17. WillowJ

    WillowJ Senior Member

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    Thanks for this, Dolphin.

    Archives of Physical Medicine and Rehabilitation... so the normal audience would be a journal for, occupational therapists, physical therapists, and the like, yes? that would be a good audience to educate. maybe also, social services might read it? would that be too much to hope for?
  18. barbc56

    barbc56 Senior Member

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    What does subscribe to post mean? I usually bookmark things but sometimes on boards it will only save the front page of the board.

    Obviously, not computer literate here. :>)
  19. Esther12

    Esther12 Senior Member

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    I've got to admit - I'm not sure either. I had assumed it e-mailed you about updates, but this could be totally wrong. We could always just click on it, and find out!
    Dolphin likes this.
  20. Dolphin

    Dolphin Senior Member

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    Yes, you get updates. Some people may not like getting updates. I have updates sent to my E-mail* (but it doesn't have to be like that).

    *Unless it's urgent, I then copy them in to a particular E-mail folder I have and follow the link when it suits better (well, that's the theory - I can't always restrain myself!).

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