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"Fatigue in Healthy and Diseased Individuals" (Finsterer & Mahjoub, 2013)

Dolphin

Senior Member
Messages
17,567
CFS only gets a few minor references in this. Interventions mentioned (briefly) are not novel. But perhaps of interest to the odd person interested in a more thorough dissection of the topic.

Fatigue in Healthy and Diseased Individuals.

Am J Hosp Palliat Care. 2013 Jul 26. [Epub ahead of print]

Finsterer J, Mahjoub SZ.

Source

1Krankenanstalt Rudolfstiftung, Vienna, Austria.

Abstract

Objectives:Although fatigue is experienced by everyone, its definition and classification remains under debate.

METHODS:

A review of the previously published data on fatigue.

RESULTS:

Fatigue is influenced by age, gender, physical condition, type of food, latency to last meal, mental status, psychological conditions, personality type, life experience, and the health status of an individual.

Fatigue may not only be a symptom but also a measurable and quantifiable dimension, also known as fatigability.

Additionally, it may be classified as a condition occurring at rest or under exercise or stress, as physiologic reaction or pathologic condition, as spontaneous phenomenon or triggerable state, as resistant or irresistant to preconditioning, training, or attitude, as prominent or collateral experience, and as accessible or inaccessible to any type of treatment or intervention.

Fatigue may be the sole symptom of a disease or one among others. It may be also classified as acute or chronic.

Quantification of fatigability is achievable by fatigue scores, force measurement, electromyography, or other means.

Fatigue and fatigability need to be delineated from conditions such as sleepiness, apathy, exhaustion, exercise intolerance, lack of vigor, weakness, inertia, or tiredness.

Among neurological disorders, the prevalence of fatigue is particularly increased in multiple sclerosis, amyotrophic lateral sclerosis, Parkinson disease, traumatic brain injury, stroke, and bleeding and also in neuromuscular disorders.

Fatigue may be influenced by training, mental preconditioning, or drugs.

CONCLUSIONS:

Fatigue needs to be recognized as an important condition that is not only a symptom but may also be quantified and can be modified by various measures depending on the underlying cause.

KEYWORDS:

fatigability, fatigue, muscle performance, review, tiredness

PMID: 23892338 [PubMed - as supplied by publisher]
 

Dolphin

Senior Member
Messages
17,567
Some of the many issues involved in measuring fatigue and fatiguability:

Often, it is critical to include multiple measures to assess perception of fatigue or fatigability. In a study of patients with PD, the combination of objective and perceptual measures was necessary to determine that fatigue perception is related to cognition and homeostatic or psychological factors but not to fatigability or motor cortex excitability.3 Perception of fatigue and fatigability was also independent of each other in a study on patients with PD who showed objective decrement in motor performance, which did not correlate with perceived fatigue.109 Measuring fatigue perception needs effort to be normalized, as patients may restrict their effort level in an attempt to normalize or minimize experiencing fatigue.110 The sense of effort can be viewed as a ‘‘central governor,’’ which avoids catastrophic muscle damage.111 Sense of effort is strongly dependent on the psychological status of a proband. Rating of perceived exertion is higher in patients with anxiety, depression, or neuroticism and lower among those with an extroverted personality.112 As fatigue progresses to task failure, a progressive overmatching of force and increased sense of force exerted occurs.113-115

3. Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013;80(4):409-416.

109. Lou JS, Kearns G, Benice T, Oken B, Sexton G, Nutt J. Levodopa improves physical fatigue in Parkinson’s disease: a double-blind, placebo-controlled, crossover study. Mov Disord. 2003;18(10):1108-1114.

110. Eldadah BA. Fatigue and fatigability in older adults. PMR. 2010; 2(5):406-413.

111. Crewe H, Tucker R, Noakes TD. The rate of increase in rating of perceived exertion predicts the duration of exercise to fatigue at a fixed power output in different environmental conditions. Eur J Appl Physiol. 2008;103(5):569-577.

112. Morgan WP. Psychological components of effort sense. Med Sci Sports Exerc. 1994;26(9):1071-1077.

113. Westerblad H, Allen DG, Bruton JD, Andrade FH, La¨nnergren J. Mechanisms underlying the reduction of isometric force in skeletal muscle fatigue. Acta Physiol Scand. 1998;162(3): 253-260.

114. Jones LA. Perception of force and weight: theory and research. Psychol Bull. 1986;100(1):29-42.

115. Cafarelli E, Layton-Wood J. Effect of vibration on force sensation in fatigued muscle. Med Sci Sports Exerc. 1986;18(5):516-521.