Brief reportCan Submaximal Exercise Variables Predict Peak Exercise Performance in Women with Chronic Fatigue Syndrome?
Introduction
Chronic fatigue syndrome (CFS) is a debilitating disorder characterized by debilitating fatigue, widespread musculoskeletal pain, sleep impairments, headache, and symptoms of poor concentration and memory (1). Maximal or peak exercise performance testing is widely used for the assessment of people with CFS, and it appears to be both reproducible and valid (2). Peak exercise capacity variables correlate with activity limitations and participation restrictions (3), supporting the clinical importance of peak exercise testing in individuals with CFS. However, the role of maximal exercise tests is limited in people whose performance may be limited because of pain or fatigue rather than exertion (4). In CFS, symptoms are typically made worse after a peak exercise stress test 5, 6, and a delayed recovery from exercise appears characteristic of the disorder (7). Therefore, a submaximal exercise test appropriate for CFS patients would have a number of advantages over a test performed until exhaustion: submaximal testing is likely to diminish symptom exacerbations following peak exercise testing (8) and consequently, decrease recovery time; it may encourage more severely disabled people with CFS to participate in research studies using exercise testing (8); and it has greater (clinical) applicability (for instance, to physical therapists) (4). The Aerobic Power Index Test has been used as a submaximal test in people with CFS: the test-retest reliability has been established (9), and it was the first submaximal test able to replicate previous findings of decreased exercise performance in CFS cases compared to healthy controls (8). However, there are currently no published data indicating that a submaximal exercise test is able to predict peak exercise performance in CFS patients. Prediction of peak aerobic capacity is one of the primary goals of submaximal exercise testing (4). Therefore, the present study aimed at examining whether physiological exercise data corresponding to a submaximal level, defined as 75% of the age-predicted target heart rate (8), are able to predict peak exercise performance in women with CFS.
Section snippets
Patient Recruitment and Research Design
The exercise capacity testing data of all women with CFS attending our university-based Chronic Fatigue Clinic between November 2003 and December 2005 were reanalyzed. The study focused on women to preclude bias originating from pooling of gender data (10). All participants fulfilled the Centers for Disease Control and Prevention criteria for CFS (1). Therefore, all patients underwent an extensive medical evaluation prior to exercise testing (for more details regarding the diagnostic strategies
Results
Of the 222 study participants, only 156 (71%) achieved the submaximal level (defined as 75% of the age-predicted target heart rate) and were used for further data analysis. The descriptive statistics of the exercise testing variables are presented in Table 1. In addition to the peak (p = 0.045) and submaximal work capacity attained (p = 0.025), all variables were normally distributed. The outcome of the correlation analysis is presented in Table 2. Oxygen uptake at the submaximal level (VO
Discussion
There is a need for standardized submaximal ergometer tests not only for patients with CFS but for people with various disorders that require close monitoring during exercise (4). Therefore, the present study aimed at examining whether a standardized submaximal ergometer test was able to predict peak exercise performance (including peak aerobic work capacity) in people with CFS. We utilized an exercise protocol (starting at 10 W with an increase of 10 W/min) that has previously been used for
Acknowledgments
The authors are grateful to Kenny De Meirleir for diagnosing the study participants.
References (17)
- et al.
Impact of a maximal exercise test on symptoms and activity in chronic fatigue syndrome
J Psychosom Res
(2005) - et al.
The Chronic Fatigue Syndrome, a comprehensive approach to its definition and study
Ann Intern Med
(1994) - et al.
Hypochondriasis influences quality-of-life outcomes in patients with chronic fatigue syndrome
Psychother Psychosom
(1996) - et al.
Disability evaluation in chronic fatigue syndrome: associations between exercise capacity and activity limitations/participation restrictions
Clin Rehabil
(2004) - et al.
Submaximal exercise testing: clinical application and interpretation
Phys Ther
(2000) Exercise limits in chronic fatigue syndrome
Am J Med
(1997)- et al.
Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome
Eur J Neurol
(1999) - et al.
Physiological responses during a submaximal cycle test in chronic fatigue syndrome
Med Sci Sports Exerc
(2004)
Cited by (14)
Effects of aerobic endurance, muscle strength, and motor control exercise on physical fitness and musculoskeletal injury rate in preprofessional dancers: An uncontrolled trial
2012, Journal of Manipulative and Physiological TherapeuticsCitation Excerpt :The Aerobic Power Index has been found to be an acceptable submaximal field test for evaluating aerobic capacity and predicting peak oxygen consumption in dancers.22 From the submaximal exercise test, the following data were gathered: aerobic power index (submaximal oxygen consumption per kilogram body mass), power output (W/kg body mass) and percentage of decrease of heart rate 1 minute after maximal heart rate during recuperation.21,23 The explosive strength of the lower limbs was evaluated using the “Standing Broad Jump” test.
Moderate Exercise Increases Expression for Sensory, Adrenergic, and Immune Genes in Chronic Fatigue Syndrome Patients But Not in Normal Subjects
2009, Journal of PainCitation Excerpt :Maximal exercise protocols have demonstrated few differences in cardiorespiratory and perceptual responses (RPE for example) between CFS patients and fitness-matched control subjects.10 However, it is notable that responses to submaximal exercise including VO2 do predict peak exercise performance in CFS patients.52 All blood processing and analyses were performed by personnel blinded to the subject's group.
A Systematic Review of Cardiorespiratory Fitness Tests Used in Dance
2023, Journal of Dance Medicine and ScienceA review of current exercise management practices for chronic fatigue syndrome
2014, Chronic Fatigue Syndrome: Risk Factors, Management and Impacts on Daily Life