Prediction of Discontinuation of Structured Exercise Programme in Chronic Fatigue Syndrome Patients

Abstract

Purpose: The purpose of this study was to assess differences in the physiological profiles of completers vs. non-completers following a structured exercise programme (SEP) and the ability to predict non-completers, which is currently unknown in this group. Methods: Sixty-nine patients met the Fukuda criteria. Patients completed baseline measures assessing fatigue, autonomic nervous system (ANS), cognitive, and cardiovascular function. Thirty-four patients completed a home-based SEP consisting of 10–40 min per day at between 30 and 80% actual HR max. Exercise intensity and time was increased gradually across the 16 weeks and baseline measures were repeated following the SEP. Results: Thirty-five patients discontinued, while 34 completed SEP. For every increase in sympathetic drive for blood pressure control as measured by the taskforce, completion of SEP decreased by a multiple of 0.1. For a 1 millisecond increase in reaction time for the simple reaction time (SRT), the probability for completion of SEP also decreases by a multiple of 0.01. For a one beat HRmax increase, there is a 4% increase in the odds of completing SEP. Conclusion: The more sympathetic drive in the control of blood vessels, the longer the reaction time on simple visual stimuli and the lower the HRmax during physical exercise, then the lower the chance of SEP completion in ME/CFS.

Relationship between Cardiopulmonary, Mitochondrial and Autonomic Nervous System Function Improvement after an Individualised Activity Programme upon Chronic Fatigue Syndrome Patients

“…In a previous study, we noted that CFS patients who completed the IAP showed improved visual attention both in terms of reaction time and correctness of responses and processing speed of simple visual stimuli [ 34 ]. It is important to note that there was a significant drop out rate of 51% with IAP [ 49 ]. The more sympathetic drive contributes to the control of blood vessels, the longer the reaction time with simple visual stimuli and the lower the HRmax during physical exercise, the chance of a CFS patient completing IAP was reduced [ 49 ].…”

“…It is important to note that there was a significant drop out rate of 51% with IAP [ 49 ]. The more sympathetic drive contributes to the control of blood vessels, the longer the reaction time with simple visual stimuli and the lower the HRmax during physical exercise, the chance of a CFS patient completing IAP was reduced [ 49 ]. Overall, it could be concluded that an aerobic activity programme characterised by a high frequency of weekly training sessions (5 times/week) and incremental progression of exercise intensity is not well tolerated by a significant number of CFS patients (51% of the patients in the current study).…”

Long Covid — Pathophysiology and Treatment

“…However, it should be underlined that physical exercise programme in ME/CFS might be deleterious to some patients. Fifty one percent of dropout rate was noted due to post-exertional malaise (PEM) perceived by CFS patients undergoing physical activity programme based on aerobic physical activity [35]. CFS patients with higher severity of disturbance in autonomic control over blood vessels, worse cognitive function and the lower the maximal Heart Rate during physical exercise had lower chance of completion of programme based on physical activity [35].…”

“…Fifty one percent of dropout rate was noted due to post-exertional malaise (PEM) perceived by CFS patients undergoing physical activity programme based on aerobic physical activity [35]. CFS patients with higher severity of disturbance in autonomic control over blood vessels, worse cognitive function and the lower the maximal Heart Rate during physical exercise had lower chance of completion of programme based on physical activity [35]. Therefore, If above described suggestions on parallels between pathophysiology of ME/CFS and long COVID would be confirmed in further researches, then reactions of long COVID patients on rehabilitation based on physical activity programmes should be closely monitored due to risk of PEM occurrence.…”

“…However, patients should be supported throughout rehabilitation process. Goals taken by patients should be realistic [35].…”