[The latest Julia Newton paper who has published interesting biomedical studies in recent years e.g. "Impaired cardiovascular response to standing in Chronic Fatigue Syndrome" http://www.imet.ie/imet_documents/Impaired CV responses to standing in CFS.pdf ]
QJM Advance Access published online on June 9, 2010 QJM, doi:10.1093/qjmed/hcq094
Orthostatic symptoms predict functional capacity in chronic fatigue
syndrome: implications for management
A. Costigan, C. Elliott, C. McDonald and J.L. Newton From the NIHR Biomedical Research Centre in Ageing-Cardiovascular Theme, Newcastle University, Newcastle, UK
Address correspondence to J.L. Newton, Institute for Ageing and Health,
Medical School, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, UK. email:
Received 9 April 2010 and in revised form 20 May 2010
Objectives: To establish the relationship between the functional impairment
experienced by Chronic fatigue syndrome (CFS) patients and the symptoms
frequently experienced by those with CFS; specifically cognitive impairment,
fatigue and orthostatic symptoms.
Design: Cross sectional questionnaire survey.
Setting: Specialist CFS Clinical Service.
Subjects: Ninety-nine Fukuda diagnosed CFS and 64-matched controls.
Main outcome measures: Symptom and functional assessment tools completed and
returned by post included; PROMIS HAQ (Patient-Reported Outcomes Measurement
Information System, Health Assessment Questionnaire), CFQ (Cognitive
Failures Questionnaire), FIS (Fatigue Impact Scale) and OGS (Orthostatic
Grading Scale) assessment tools.
Results: CFS patients experience greater functional impairment than controls
[mean (95% CI) PROMIS HAQ scores CFS 36 (31-42) vs. controls 6 (2-10); P <
0.0001], especially in the functional domains of activities and reach.
Poorer functional ability impairment is significantly associated with
greater cognitive impairment (P = 0.0002, r = 0.4), fatigue (P < 0.0001, r =
0.5) and orthostatic symptoms (P < 0.0001, r = 0.6). However, only
orthostatic symptoms (OGS) independently associated with functional
impairment (β = 0.4, P = 0.01).
Conclusions: Treatment of orthostatic symptoms in CFS has the potential to
improve functional capacity and so improve quality of life.