Recovery of upper limb muscle function in cfs with and without fibro.

[Firestormm]

Recovery of upper limb muscle function in chronic fatigue syndrome with and without fibromyalgia

1. Kelly Ickmans1,2,3,
2. Mira Meeus2,4,5,
3. Margot De Kooning1,3,6,
4. Luc Lambrecht7,
5. Jo Nijs1,3,*

Article first published online: 9 DEC 2013

Abstract


Background

Chronic fatigue syndrome (CFS) patients frequently complain of muscle fatigue and abnormally slow recovery, especially of the upper limb muscles during and after activities of daily living. Furthermore, disease heterogeneity has not yet been studied in relation to recovery of muscle function in CFS. Here, we examine recovery of upper limb muscle function from a fatiguing exercise in CFS patients with (CFS+FM) and without (CFS-only) comorbid fibromyalgia and compare their results with a matched inactive control group.


Design

In this case–control study, 18 CFS-only patients, 30 CFS+FM patients and 30 healthy inactive controls performed a fatiguing upper limb exercise test with subsequent recovery measures.


Results

There was no significant difference among the three groups for maximal handgrip strength of the non-dominant hand. A significant worse recovery of upper limb muscle function was found in the CFS+FM, but not in de CFS-only group compared with the controls (P < 0·05).


Conclusions

This study reveals, for the first time, delayed recovery of upper limb muscle function in CFS+FM, but not in CFS-only patients. The results underline that CFS is a heterogeneous disorder suggesting that reducing the heterogeneity of the disorder in future research is important to make progress towards a better understanding and uncovering of mechanisms regarding the nature of divers impairments in these patients.

Full paper available - link in title above.

 

[Dufresne]

I used to work as a personal trainer before PEM made this impossible. The onset of this symptom was slow to develop and up until last year I was still able to do light exercises on my muscles if I kept it under a certain threshold of exertion. One thing I discovered was that I was able to do more if I exercised one side at a time. For instance, push ups against the wall using one hand at a time. This is too strenuous for me now but I guess I could still figure a way of exercising somewhat if I can further lighten the exertion. I've just been too discouraged after PEM's when I've even tried to do the pitiful exercises I was doing up until a year ago.

 

[MeSci]

Inability to hold my arms up for long was one the first things that made me realise something was wrong. I had difficulty hanging out the washing and wondered what the £"*& was the matter. I still have this difficulty, like today when I was browsing clothes on a high rail in a charity shop. I have to keep putting my arms down again for a few seconds to rest them.

Hmmm...so they found that only the ones with FM as well had the problem they tested for. I don't think I have FM.

 

[Marco]

That's interesting.

I hadn't connected with these findings at all until I read the comments.

The first inkling (sic) I had of having any problems with exercise was during warm up exercises in Ju Jitsu training that were with arms at or above shoulder height. I fainted and went down like a sack of spuds.

Since then I can't tolerate anything requiring repeated use of my arms at or above shoulder height. Very rapidly the arm muscles begin to ache and feel like lead and I have to drop them for a while to recover strength. Fitting a new lightbulb can be murder for me.

Strange thing is I've just bought a set of weights and can do several reps with the bar from shoulder height to arms straight and back again with none of the same problems. The problem seems to be holding the arms in the same place while raised.

Don't know what that means.

PS - I don't have fibro and any pains I have tend to be in the legs.

 

[minkeygirl]

I don't have FM and my arms are really weak, especially from the elbows up. Using my arms in general is exhausting.

I was just looking into a new microwave and there is no way I could get one for over the stove. I'd be constantly worried that I would drop something.

 

[SOC]

I suspect that the CFS-only subset was too small relative to the size of the other sample sets to safely draw the conclusion that CFS-only patients don't have recovery problems while CFS+FM patients do. I'd want to see some statistics... maybe some calculations of error...?

And, as always, the fuzziness of diagnosis raises questions about the accuracy of subset-specific conclusions. For example, how did they decide whether patients have comorbid FM? There's no objective measure for FM or CFS. If they included all "CFS" patients who had muscle pain in the CFS+FM group and only non-pain "CFS" patients in the CFS-only group, then it's possible the 18 CFS-only patients don't even have ME/CFS as we know it. Maybe they are depression or hypothyroid or goodness-knows-what-fatiguing-illness patients.

I've had some ME/CFS specialists say I have comorbid FM, and others say I don't. My GP diagnosed me with FM, but I honestly don't think he knew that there's a difference between FM and ME/CFS. Frankly, I don't believe I have comorbid FM at least in part because my pain appears to be of an entirely different nature than that described by FM patients, but who knows for sure?

IMO, the diagnoses are far, far too unclear to be drawing any conclusions about CFS-only vs CFS+FM.