Postexertional Malaise in Chronic Fatigue Syndrome

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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

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J. Mark VanNess, Ph.D., Staci R. Stevens, M.A., Lucinda Bateman, M.D., Travis L. Stiles, B.S., andChristopher R. Snell, Ph.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

E-mail: mvanness@pacific.edu

ABSTRACT

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.