Balance deficits in Chronic Fatigue Syndrome with and without fibromyalgia.

Ema

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NeuroRehabilitation. 2018;42(2):235-246. doi: 10.3233/NRE-172245.
Balance deficits in Chronic Fatigue Syndrome with and without fibromyalgia.
Serrador JM1,2,3, Quigley KS4,5, Zhao C2, Findley T2, Natelson BH6.
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Abstract
OBJECTIVE:
Chronic Fatigue Syndrome (CFS) is a disorder of unknown etiology associated with debilitating fatigue. One symptom commonly reported is disequilibrium. The goal of this study was to determine if CFS patients demonstrated verified balance deficits and if this was effected by comorbid fibromyalgia (FM).

METHODS:
Twenty-seven patients with CFS (12 with comorbid FM) and 22 age and gender matched controls performed posturography.

RESULTS:
Balance scores were significantly correlated with physical functional status in the CFS group (R2 = 0.43, P < 0.001), which was not found for mental functional status (R2 = 0.06, P > 0.5). CFS patients (regardless of FM) had significantly higher anxiety subscale of the vertigo symptom scale scores. CFS patients, regardless of FM status, demonstrated significantly lower overall composite balance scores (Controls - 78.8±1.5; CFS - 69.0±1.4, P < 0.005) even when controlling for anxiety and also had worse preference scores, indicating they relied on visual information preferentially even when visual information was incorrect. Interestingly, the CFS+FM group, not CFS only, demonstrated significantly worse vestibular scores (Controls - 70.2±2.4; CFS only - 67.9±3.8; CFS with FM - 55.4±4.6, P = 0.013).

INTERPRETATION:
The major findings are that poor balance may be associated with poorer self-reported physical health. In addition, CFS patients seemed to rely preferentially on visual inputs, regardless of whether it was correct. The finding that vestibular function may be impaired in patients with CFS+FM but not in those with CFS alone suggests that the pathophysiology of CFS+FM may differ as has been suggested by some.

KEYWORDS:
Chronic Fatigue Syndrome; fibromyalgia; posturography; vestibular function
 

Cort

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NeuroRehabilitation. 2018;42(2):235-246. doi: 10.3233/NRE-172245.
Balance deficits in Chronic Fatigue Syndrome with and without fibromyalgia.
Serrador JM1,2,3, Quigley KS4,5, Zhao C2, Findley T2, Natelson BH6.
Author information

Abstract
OBJECTIVE:
Chronic Fatigue Syndrome (CFS) is a disorder of unknown etiology associated with debilitating fatigue. One symptom commonly reported is disequilibrium. The goal of this study was to determine if CFS patients demonstrated verified balance deficits and if this was effected by comorbid fibromyalgia (FM).

METHODS:
Twenty-seven patients with CFS (12 with comorbid FM) and 22 age and gender matched controls performed posturography.

RESULTS:
Balance scores were significantly correlated with physical functional status in the CFS group (R2 = 0.43, P < 0.001), which was not found for mental functional status (R2 = 0.06, P > 0.5). CFS patients (regardless of FM) had significantly higher anxiety subscale of the vertigo symptom scale scores. CFS patients, regardless of FM status, demonstrated significantly lower overall composite balance scores (Controls - 78.8±1.5; CFS - 69.0±1.4, P < 0.005) even when controlling for anxiety and also had worse preference scores, indicating they relied on visual information preferentially even when visual information was incorrect. Interestingly, the CFS+FM group, not CFS only, demonstrated significantly worse vestibular scores (Controls - 70.2±2.4; CFS only - 67.9±3.8; CFS with FM - 55.4±4.6, P = 0.013).

INTERPRETATION:
The major findings are that poor balance may be associated with poorer self-reported physical health. In addition, CFS patients seemed to rely preferentially on visual inputs, regardless of whether it was correct. The finding that vestibular function may be impaired in patients with CFS+FM but not in those with CFS alone suggests that the pathophysiology of CFS+FM may differ as has been suggested by some.

KEYWORDS:
Chronic Fatigue Syndrome; fibromyalgia; posturography; vestibular function
I love it. Vestibular problems - I'm not surprised at all. Particularly after I exercise my balance is horrible.

upload_2018-3-25_10-41-35.jpeg

"The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders can result, and are often associated with one or more of these symptoms, among others: Vertigo and dizziness."

We rarely hear about gait but studies have found problems with gait in ME/CFS. I imagine that it all comes down to problems in the brain.

Reduced gait automaticity in female patients with chronic fatigue syndrome: Case-control study.Eyskens JB et al. J Rehabil Res Dev. (2015)

TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia.Rasouli O et al. Clin Biomech (Bristol, Avon). (2016)

Gait characteristics of subjects with chronic fatigue syndrome and controls at self-selected and matched velocities.Paul L et al. J Neuroeng Rehabil. (2008)
 

pattismith

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INTERPRETATION:
The major findings are that poor balance may be associated with poorer self-reported physical health. In addition, CFS patients seemed to rely preferentially on visual inputs, regardless of whether it was correct. The finding that vestibular function may be impaired in patients with CFS+FM but not in those with CFS alone suggests that the pathophysiology of CFS+FM may differ as has been suggested by some.
"Conclusion
In euthyroid HashimotoThyroiditis patients, a significant relationship between subclinical vestibular damage and the degree of TPO Ab titre was documented.
This finding suggests that circulating antithyroid autoantibodies may represent a risk factor for developing vestibular dysfunction. An accurate vestibular evaluation of HT patients with or without symptoms is therefore warranted."

it's a pity that TPO antibodies were not documented in the CFS/Fm study...:thumbdown: