CFS & Exercise -Loss of capacity to Recover

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http://www.ncbi.nlm.nih.gov/pubmed/21749371

Eur J Clin Invest. 2011 Jun 10. doi:

10.1111/j.1365-2362.2011.02567.x.

Loss of capacity to recover from

acidosis on repeat exercise in

chronic fatigue syndrome: a

case-control study

DE, Hollingsworth KG,

Jakovljevic DG, Fattakhova G, Pairman

J, Blamire AM, Trenell MI, Newton JL.

Institute of Cellular Medicine Newcastle

Magnetic Resonance Centre Institute for

Ageing and Health The UK NIHR Biomedical

Research Centre in Ageing and Age

Related Diseases Newcastle Centre for

Brain Ageing and Vitality, Newcastle

University, Newcastle, UK.

Eur J Clin Invest 2011

ABSTRACT:

Background

Chronic fatigue syndrome (CFS) patients

frequently describe difficulties with repeat

exercise.

Here, we explore muscle bioenergetic

function in response to three bouts of

exercise.

Methods

A total of 18 CFS (CDC 1994) patients

and 12 sedentary controls underwent

assessment of maximal voluntary

contraction (MVC), repeat exercise with

magnetic resonance spectroscopy and

cardio-respiratory fitness test to

determine anaerobic threshold.

Results

Chronic fatigue syndrome patients

undertaking MVC fell into two distinct

groups:

8 (45%) showed normal PCr depletion in

response to exercise at 35% of MVC (PCr

depletion >33%; lower 95% CI for

controls);

10 CFS patients had low PCr depletion

(generating abnormally low MVC values).

The CFS whole group exhibited

significantly reduced anaerobic threshold,

heart rate, VO(2) , VO(2) peak and peak

work compared to controls.

Resting muscle pH was similar in controls

and both CFS patient groups.

However, the CFS group achieving normal

PCr depletion values showed increased

intramuscular acidosis compared to

controls after similar work after each of

the three exercise periods with no

apparent reduction in acidosis with repeat

exercise of the type reported in normal

subjects.

This CFS group also exhibited significant

prolongation (almost 4-fold) of the time

taken for pH to recover to baseline.

Conclusion

When exercising to comparable levels to

normal controls, CFS patients exhibit

profound abnormality in bioenergetic

function and response to it.

Although exercise intervention is the

logical treatment for patients showing

acidosis, any trial must exclude subjects

who do not initiate exercise as they will

not benefit.

This potentially explains previous mixed

results in CFS exercise trials.

© 2011 The Authors. European Journal of

Clinical Investigation © 2011 Stichting

European Society for Clinical Investigation

Journal Foundation.

PMID: 21749371 [PubMed - as supplied by

publisher]