RESEARCH ARTICLE
Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome
Peter C. Rowe
, Kevin R. Fontaine
, Megan Lauver
, Samantha E. Jasion
, Colleen L. Marden
, Malini Moni
, Carol B. Thompson
,Richard L. Violand
* Abstract*
Chronic fatigue syndrome (CFS) is a complex, multisystem disorder that can be disabling. CFS symptoms can be provoked by increased physical or cognitive activity, and by orthostatic stress. In preliminary work, we noted that CFS symptoms also could be provoked by application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In this study we measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with CFS and healthy controls. We randomly assigned 60 individuals with CFS and 20 healthy controls to either a 15 minute period of passive supine straight leg raise (true neuromuscular strain) or a sham straight leg raise. The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually on a 0–10 scale, and summed to create a composite symptom score. Compared to individuals with CFS in the sham strain group, those with CFS in the true strain group reported significantly increased body pain (P = 0.04) and concentration difficulties (P = 0.02) as well as increased composite symptom scores (all P = 0.03) during the maneuver. After 24 hours, the symptom intensity differences were significantly greater for the CFS true strain group for the individual symptom of lightheadedness (P = 0.001) and for the composite symptom score (P = 0.005). During and 24 hours after the exposure to the true strain maneuver, those with CFS had significantly higher individual and composite symptom intensity changes compared to the healthy controls.
We conclude that a longitudinal strain applied to the nerves and soft tissues of the lower limb is capable of increasing symptom intensity in individuals with CFS for up to 24 hours.
These findings support our preliminary observations that increased mechanical sensitivity may be a contributor to the provocation of symptoms in this disorder.
Citation: Rowe PC, Fontaine KR, Lauver M, Jasion SE, Marden CL, Moni M, et al. (2016) Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome. PLoS ONE 11(7): e0159386. doi:10.1371/journal.pone.0159386
Editor: Ute Vollmer-Conna, University of New South Wales, AUSTRALIA
Received: March 17, 2016; Accepted: July 3, 2016; Published: July 18, 2016
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What a ghastly waste of scarce resources. Is this criminal negligence?
ReplyDeleteThe cfs patients were all selected using fukuda 1994. Now it is July, 2016. There is plenty of valid research published, to facilitate differentiating this wastebasket fatigue group cleanly from patients suffering from acute, infectious onset ME, defined by Ramsey, Hyde.
References
1. Fukuda K, Straus SE, Hickie I, Sharpe M, Dobbins JG, Komaroff A, et al. Chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Int Med. 1994;121: 953–959. pmid:7978722 doi: 10.1300/j092v01n02_06 View Article
Disappointed,
Hope