Sub-typing daily fatigue progression in chronic fatigue syndrome

[Ember]

Leonard A. Jason & Molly M. Brown
Center for Community Research, DePaul University, Chicago, IL, USA

Posted online on May 1, 2012.

http://informahealthcare.com/doi/abs/10.3109/09638237.2012.670879

Background
Activity logs involve patients writing down their activities and symptoms over 1 or more days.

Aims
This study sought to classify daily fatigue patterns among patients with chronic fatigue syndrome (CFS) using activity logs.

Method
Fatigue intensity was self-reported every 30 min in a sample of 90 patients with CFS over 1 day. A cluster analysis using fatigue intensity, variability and slope was conducted.

Results
Three clusters emerged involving patients with different trajectories. One group evidenced high fatigue intensity, low variability, and fatigue intensity stayed the same over time. A second group had moderate fatigue intensity, high variability, and fatigue intensity decreased over time. A third group had moderate fatigue intensity, high variability, but fatigue intensity increased over time. The three clusters of patients differed on measures of actigraphy, pain and immune functioning.

Conclusions
Activity logs can provide investigators and clinicians with valuable sources of data for understanding patterns of fatigue and activity among patients with CFS.

 

[roxie60]

nice to see they are at least trying to gather data. My hats off to those CFSers that volunteered to give herculian effort to report their symps.

 

[searcher]

I am curious to find out how the groups differed in immune functioning. In my first year with CFS I was in group 1 since I never had any obvious variation in the unrelenting fatigue, but I would now say that I am in group 2.

 

[taniaaust1]

When I was in my second stage of this illness (after this illness for 9-12mths) .. I certainly would of been group 1. Im curious if that group is more so early ME/CFS? .. I was then in that group 1 catagory for years.

I dont know where I fit now but not group one and I dont seem to fit in with those other groups either so Im going to propose a fourth group to which would fit me ..

-Low fatigue
-high variability with (symptoms) intensity (which may include fatigue but has other symptoms far outweighing the fatigue, so fatigue may not be noticed)
-with fatigue (and other symptoms) increasing over time or staying the same (depending one what had been done)

(over time with this study seens to be only a 1 day or week period)
Does anyone else here also not fit into the catagories looked at in that study and fit better into the one I just made up?

The three clusters of patients differed on measures of actigraphy, pain and immune functioning.

Im so glad they didnt just look at fatigue! I too are looking forward to reading about how the immune fuction varied.

 

[jimells]

I know I'm a relentless wet rag, but really, I can't imagine a more useless study. How much money did they waste on this? This strikes me as 1) Publish or Perish 2) Use the grant money or lose it 3) A student with no imagination working on their thesis

There is so much junk research out there, it's hard to believe. And it all ends with the same conclusion: "More research (and grant money) needed!"

Still, my hat's off to all those folks keeping the logs. I wonder how long it took them to recover from the study? Oh hey, let's study that!

 

[Dolphin]

Sub-typing daily fatigue progression in chronic fatigue syndrome.

Jason LA, Brown MM.

J Ment Health. 2012 May 1. [Epub ahead of print]

Source
Center for Community Research , DePaul University , Chicago, IL , USA.

Abstract*

Background:

Activity logs involve patients writing down their activities and symptoms over 1 or more days.

Aims:

This study sought to classify daily fatigue patterns among patients with chronic fatigue syndrome (CFS) using activity logs.

Method:

Fatigue intensity was self-reported every 30 min in a sample of 90 patients with CFS over 1 day.

A cluster analysis using fatigue intensity, variability and slope was conducted.

Results:

Three clusters emerged involving patients with different trajectories.

One group evidenced high fatigue intensity, low variability, and fatigue intensity stayed the same over time.

A second group had moderate fatigue intensity, high variability, and fatigue intensity decreased over time.

A third group had moderate fatigue intensity, high variability, but fatigue intensity increased over time.

The three clusters of patients differed on measures of actigraphy, pain and immune functioning.

Conclusions:

Activity logs can provide investigators and clinicians with valuable sources of data for understanding patterns of fatigue and activity among patients with CFS.

PMID: 22548385 [PubMed - as supplied by publisher]

* I've given each sentence it's own paragraph.

 

[Dolphin]

A couple of extracts

Potentially, single assessments for intensity might not reflect the patterns of fatigue that occur over a day.

(next, but thought I'd separate - lots of fatigue measures only use a single assessment)

Further, the amount of functional disability fatigue causes might not be represented in the fatigue patterns over a particular day. For example, a person might experience high levels of fatigue but continue to use all available energy to stay involved in work activities. Although this work activity might be necessary to survive economically and the level of functional impairment might not be evident, continuing to experience high levels of fatigue might result in later problems and impairments. Patients often talk about continuing to work for as long as possible until they are so functionally impaired that they can no longer maintain their employment.

Just looking at it. It's hard to try to post other points unless people have the paper. Probably far to say that nothing earth-shattering anyway.

 

[user9876]

I had always assumed a pattern of mornings being the worst and things gradually getting better through the day. Seems that this is just one class.

 

[Ember]

There was also a brief discussion of this article earlier here.

 

[Dolphin]

This paper was based on the baseline data from a non-pharmacological trial. Lots of papers (20? 30?) have been published on the data. The main purpose was to try out the effects of the four treatments and that's what they got the money for. So no major costs from doing this paper.