Thursday, February 13, 2014

Postexertional Malaise in Chronic Fatigue Syndrome

To cite this article:
J. Mark VanNess, Staci R. Stevens, Lucinda Bateman, Travis L. Stiles, and Christopher R. Snell. Journal of Women's Health. February 2010, 19(2): 239-244. doi:10.1089/jwh.2009.1507.
Published in Volume: 19 Issue 2: February 19, 2010
Online Ahead of Print: January 24, 2010

J. Mark VanNessPh.D.Staci R. StevensM.A.Lucinda BatemanM.D.Travis L. StilesB.S., andChristopher R. SnellPh.D.
Pacific Fatigue Laboratory, University of the Pacific, Stockton, California.
Address correspondence to:
J. Mark VanNess, Ph.D.
Pacific Fatigue Laboratory
University of the Pacific
3601 Pacific Avenue
Stockton, CA 95211


Objective: Postexertional malaise (PEM) is a defining characteristic of chronic fatigue syndrome (CFS) that remains a source of some controversy. The purpose of this study was to explore the effects of an exercise challenge on CFS symptoms from a patient perspective.
Methods: This study included 25 female CFS patients and 23 age-matched sedentary controls. All participants underwent a maximal cardiopulmonary exercise test. Subjects completed a health and well-being survey (SF-36) 7 days postexercise. Subjects also provided, approximately 7 days after testing, written answers to open-ended questions pertaining to physical and cognitive responses to the test and length of recovery. SF-36 data were compared using multivariate analyses. Written questionnaire responses were used to determine recovery time as well as number and type of symptoms experienced.
Results: Written questionnaires revealed that within 24 hours of the test, 85% of controls indicated full recovery, in contrast to 0 CFS patients. The remaining 15% of controls recovered within 48 hours of the test. In contrast, only 1 CFS patient recovered within 48 hours. Symptoms reported after the exercise test included fatigue, light-headedness, muscular/joint pain, cognitive dysfunction, headache, nausea, physical weakness, trembling/instability, insomnia, and sore throat/glands. A significant multivariate effect for the SF-36 responses (p < 0.001) indicated lower functioning among the CFS patients, which was most pronounced for items measuring physiological function.
Conclusions: The results of this study suggest that PEM is both a real and an incapacitating condition for women with CFS and that their responses to exercise are distinctively different from those of sedentary controls.

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