Several submax exercise tests r reliable, valid & acceptable in chronic pain, FMS or chronic fatigue

[Dolphin]

I read this. Although the research strategy seems reasonably thorough (although they didn't check Journal of CFS, for example), involving checking 2637 abstracts, none of the 18 studies involved chronic fatigue or CFS patients.

So not that much of interest to many/most here

Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review.

J Physiother. 2014 Jul 29. pii: S1836-9553(14)00079-4. doi: 10.1016/j.jphys.2014.06.011. [Epub ahead of print]

Ratter J1, Radlinger L2, Lucas C3.

Author information

Abstract

Question: Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders?

Design:

Systematic review of studies of the psychometric properties of exercise tests.

Participants:

People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders.

Intervention:

Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included.

Outcome measures:

Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates.

Results:

Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias.

The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test.

None of the studies assessed maximal exercise tests.

Where they had been tested, reliability and validity were generally high.

Dropout rates were generally acceptable.

The 2-km walk test was not recommended in fibromyalgia.

Conclusion:

Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue.

There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue. [Ratter J, Radlinger L, Lucas C (2014) Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review.Journal of Physiotherapy60:XXX-XXX.].

Copyright © 2014. Published by Elsevier B.V.

KEYWORDS:

Chronic pain; Exercise test; Fatigue syndrome (chronic); Fibromyalgia; Psychometrics; Review (publication type)

 

[anciendaze]

@Dolphin

How did they determine that a test was submaximal? I've been trying to find older research on anaerobic threshold in any illness to check if anyone had previously seen the the drop in anaerobic threshold reported by two recent studies of ME/CFS. So far I keep finding papers on repeatability which would not be valid if those researchers had seen this drop in one group of patients. I've also seen papers in which researchers simply assumed an exercise challenge was subanaerobic, based on results from healthy people.

Having seen actual data from a patient who hit anaerobic threshold at a power output of only 40 watts I have to wonder if some of the exercise challenges described here as submaximal were actually above anaerobic threshold, and into the range in which results resemble overtraining in athletes. Pushing into this range undermines desired repeatability of the test because performance will continue to decline unless the exercise challenge is reduced.

On a more positive note, if anyone has found a proxy measurement for anaerobic threshold I would dearly like to know what it is, not least so I could regulate my own exercise to avoid setbacks.