Severe ME Day of Understanding and Remembrance: Aug. 8, 2017
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Symptom variability following acute exercise in ME-CFS: a perspective on measuring PEM

Discussion in 'Latest ME/CFS Research' started by Dolphin, Aug 3, 2017.

  1. Dolphin

    Dolphin Senior Member

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    http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1321166

     
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  2. Dolphin

    Dolphin Senior Member

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  3. Dolphin

    Dolphin Senior Member

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  4. Dolphin

    Dolphin Senior Member

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  5. Dolphin

    Dolphin Senior Member

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    The basic data is in Tables 2 & 4 and Figures 1 & 2
     
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  6. Valentijn

    Valentijn Senior Member

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    I wish they'd asked more about physical symptoms, and less about mood and fatigue.
     
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  7. Dolphin

    Dolphin Senior Member

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    The small sample sizes reduce the chances of getting statistically significant average differences. But still study shows that it can be hard to define the illness based on the subjective response to a single exercise test in individuals.
     
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  8. Dolphin

    Dolphin Senior Member

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    Data on the CDC symptoms is included in the supplemental files.
     
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  9. Dolphin

    Dolphin Senior Member

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    Vigor goes in the opposite direction i.e. more is better so changes are in the expected direction in both Table 2 and Table 4.
     
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  10. Dolphin

    Dolphin Senior Member

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    Other studies are also discussed
     
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  11. slysaint

    slysaint Senior Member

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    Wish they'd stop using that blasted Chalder Fatigue scale.
     
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  12. Dolphin

    Dolphin Senior Member

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    Only one of the 18 changes is statistically significant different [MPQ = McGill Pain Questionnaire]. However all 18 are in the expected direction.
     
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  13. trishrhymes

    trishrhymes Senior Member

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    I've only read the abstract posted here, but that struck me too.

    My PEM involves amplification of all my ME symptoms, pain, weakness, nausea, headaches, dizziness, generally feeling too ill to get out of bed, and brain fog, which for me really only impacts badly during PEM. Any mood change is a direct result of the symptoms, though being unable to think straight, being in acute pain all over, and hoping not to vomit kind of overrides any registering of finer points of mood.

    I'm not sure I could have filled all that in on a questionnaire, the Chalder Fatigue Scale would evoke the sounds of paper ripping and me throwing up, not a serious attempt to fill in that pile of crap.

    Edit - I really should read a whole paper before I comment.
     
    Last edited: Aug 3, 2017
  14. JaimeS

    JaimeS Senior Member

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    Wish in general there would be less "ME is fatigue" going around.
     
  15. lnester7

    lnester7 Seven

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    We should demand to measure lactate levels, Oxygen vs DO. Metabolites....
    I mean sport science is not new, I don't understand why CFS is like just ask questions instead of using common sense testing.
     
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  16. duncan

    duncan Senior Member

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    This study may be limited in that it only attempts to parse down on overtly obvious physical exertion. Although this is clearly relevant and important, it seems to exclude other forms of exertion, including cognitive and emotional exertion.

    We know that each of us is individual in which form of exertion triggers PEM. As many reservations as I have relative to the NIH ME/CFS study, I was pleased to see an exertional study in the form of a mathematics exercise.

    Point being: different forms of exertion may be at play, and to research differently may risk excluding ME/CFS subgroups.
     
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  17. Dolphin

    Dolphin Senior Member

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    Just to be clear to anyone reading this: the Chalder fatigue scale wasn't used in this study, just in one it discusses.
     
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  18. Dolphin

    Dolphin Senior Member

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    Other things were measured in study two just not discussed in this paper. This paper is one that discusses that
    I think there are others also.
     
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  19. hixxy

    hixxy Senior Member

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    My mood can alter drastically when I crash and not just because I'm unhappy about the crash and symptoms. I get lowered mood, OCD like behaviours with frustration, agitation, anxiety, insomnia and a lot of neuro sensory problems. I also get a lot of worsening of physical symptoms too.
     
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  20. Murph

    Murph :)

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    1. I like this approach. We all know me/cfs patients can appear normal-ish when rested (especially the mild/moderates who are likely to sign up for studies). Attempts to measure PEM are the future of research!

    2. The problem seems to be that these patients are broken even before the exercise and we don't see much of an effect from it.

    Screen Shot 2017-08-04 at 9.08.27 AM.png
    Screen Shot 2017-08-04 at 9.09.17 AM.png
    3. While it is not prominent in the abstract they did enquire about physical symptoms.

    Screen Shot 2017-08-04 at 9.10.03 AM.png



    I like the dot plots - much more transparent than just measures of means and standard deviations. But I still wish they'd mark p values on the charts so we can see if any of this might be more than just random.
     

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