European journal of neurology, 1999, 6, 63 - 69.
One of the main differences between ME and most cases of CFS is the phenomenon of prolonged muscle fatigue after minimal exertion. However, the research on muscle function during and after exercise as been far from illuminating. Some studies (on patients with CFS) have found an abnormality during exertion but most have not. Moreover, none have detected an obvious problem during the recovery phase. On the basis of this research, psychiatrists claimed that the vast majority of fatigued patients don't have anything wrong with their muscles and that exercise when tired was therefore safe. However, it is now generally accepted that CFS covers a number of disorders, so what is safe for one fatigue syndrome may not be safe for another.
The following study illustrates this point. Researchers from Glasgow recently assessed muscle strength during a series of strenuous tests and up to 24 hours afterwards. The subjects included 10 patients with 'CFS' (diagnosed using criteria consistent with ME) and 10 sedentary controls. The results revealed that the patients with CFS/ME were weaker at the beginning of the tests compared to the controls although the decline in muscle power during the exercise was the same. However, the most interesting finding was that the CFS/ME patients showed a further decline in muscle strength during the recovery phase when the muscles of the controls were getting stronger. The difference between the groups was particularly marked at 24 hour post-exercise.
The are a number of explanations for the abnormalities but given the results were compared to sedentary controls, deconditioning isn't one of them. While we speculate, it may be wise to think again about the advice to exercise beyond fatigue, at least for people with ME.
A comparison of the cognitive deficits seen in Myalgic encephalomyelitis
to Alzheimer's Disease.
Proceedings of the British psychological society 1999, Jan 12.
Another symptom which is characteristic of ME is impaired cognitive functioning (e.g. poor memory ect). Early reports revealed major deficits but these were forgotten when the research found only subtle changes in CFS. The following study is noteworthy because it focused exclusively on people with ME (London criteria).
Tests were done on 20 patients and it was found that their performance was significantly inferior to that of healthy controls. Moreover, when the results were compared to those from 782 patients with Alzheimer's Disease (AD), the ME group fell between mild and moderate Alzheimer's patients on most tasks. "The extent as well as the range of the impairments... confirms the severe nature of ME."
These findings deserve to be taken seriously because they were
reported by one of Britain's leading experts in the field. The results not only
support anecdotal reports from the patients but they underline once again that
generalisations about CFS may not apply to the various subgroups.
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