Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome

Question 1

symptoms

Answer 1

• severe or prolonged fatigue; drop in activity level lasting 6 mo or longer
• post exertion malaise after physical or mental activity
• fatigue not alleviated by rest
• myalgia
• cognitive impairments; difficulty thinking, concentrating or with short term memory
• difficulty sleeping
• sore that that is frequent or recurring, tender lymph nodes
• headache
• athralgias
• dizziness and light headedness
• deconditioning, anxiety, depression

Question 2

Specific etiology

Answer 2

• unknown
• possible multiple triggers

Question 3

diagnosis

Answer 3

• based on medical history, physical and mental status examination
• no lab tests
• must have two major criteria: persistent or relapsing fatigue and reduced PA for at least 6 mo and four or more of the eight presenting factors

Question 4

More common

Answer 4

in women than men and in younger ages (20s and 30s)

Question 5

prognosis

Answer 5

symptoms may persist for months or years; limited recovery in 5-10% of cases

Question 6

PT examination

Answer 6

• examine exercise tolerance levels
• examine posture
• monitor activity levels and degree of fatigue
• examine for depression and degree of emotional support

Question 7

PT goals

Answer 7

• activity pacing; avoid push and crash cycles when pt has good day
• energy conservation

Question 8

exercise recommendations

Answer 8

• overall goal is to prevent reconditioning
• aerobic exercise prescription: low to mod levels of intensity (RPE 9-20) with gradual progression; distributed practice schedule
• maintain flexibility
• maintain or improve muscle strength
• avoid overexertion