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At least 19 recordsLinked to original sources

PubMed1995

Chronic fatigue and the chronic fatigue syndrome: prevalence in a Pacific Northwest health care system.

OBJECTIVES: To investigate the point prevalence of the chronic fatigue syndrome and unexplained debilitating chronic fatigue in a community-based sample of persons and to describe demographic, clinical, and psychosocial differences among those with the chronic fatigue syndrome, those with chronic fatigue, and healthy controls. DESIGN: Prospective cohort study. SETTING: A health maintenance organization in Seattle, Washington. PARTICIPANTS: A random sample of 4000 members of the health maintenance organization was surveyed by mail for the presence of chronic fatigue. MEASUREMENTS: Persons with chronic fatigue were evaluated using a questionnaire that requested information about medical history and fatigue and related symptoms; validated measures of functional status and psychological distress; a physical examination; and standardized blood tests. A structured psychiatric interview was done in persons who appeared to meet the original Centers for Disease Control and Prevention (CDC) criteria for the chronic fatigue syndrome. Participants completed self-report measures at 12 and 24 months. Those with chronic fatigue were reevaluated in person 1 year after study enrollment. RESULTS: 3066 (77%) of the 4000 members surveyed responded. Chronic fatigue was reported by 590 persons (19%). Of these, 388 (66%) had a medical or psychiatric condition that could account for the fatigue. Of the 74 persons (37%) with chronic fatigue who were enrolled in the study, only 3 met the CDC criteria for the chronic fatigue syndrome. The remaining 71 persons were designated as having chronic fatigue alone. Seventy-four healthy, age- and sex-matched controls who were drawn from the same sample but who denied having chronic fatigue were also studied. Demographic characteristics were similar in persons with the chronic fatigue syndrome, persons with chronic fatigue alone, and controls. Those with the chronic fatigue syndrome or chronic fatigue alone had more frequent cervical and axillary adenopathy, poorer functional status, and greater psychological distress than controls. Women and minorities were not overrepresented among cases with chronic fatigue. CONCLUSIONS: Using different assumptions about the likelihood that persons who did not participate in the study had the chronic fatigue syndrome, the estimated crude point prevalence of the syndrome in this community ranged from 75 to 267 cases per 100,000 persons. The point prevalence of chronic fatigue alone was strikingly higher; it ranged from 1775 to 6321 cases per 100,000 persons.

Adult↗

PubMed1994

The prevalence and correlates of fatigue in patients receiving treatment with chemotherapy and radiotherapy. A comparison with the fatigue experienced by healthy individuals.

Fatigue can be a prevalent and serious problem for the individual with cancer and can negatively impact on the individual's quality of life. Little is known about the prevalence of clinical fatigue among patients with cancer and how the fatigue cancer patient's experience compares with the fatigue people experience as a function of their normal daily activities. This study, which utilized a control group, investigated the prevalence of fatigue among patients receiving treatment with radiotherapy (n = 54) and chemotherapy (n =47) over two measurement points. The level of fatigue experienced by cancer patients was compared with the level of fatigue experienced by apparently healthy auxiliary staff (n = 53) working at three cancer treatment facilities. There were no differences in the mean level of fatigue experienced by cancer patients and the mean level experienced by healthy controls before the start of cancer treatment. However, cancer patients experienced a significant increase in fatigue over a 5- or 6-week course of radiotherapy and 14 days after treatment with chemotherapy, and these increases were significantly greater than the fatigue reported by healthy control subjects. The midpoint of the Pearson Byars Fatigue Feeling Checklist was accepted as a crude measure of clinical fatigue and was found to be significantly different from the mean level of fatigue reported by healthy controls. The prevalence of fatigue among patients after undergoing cancer treatment was determined to be 61%. Fatigue in cancer patients was found to covary with weight, symptom distress, mood disturbance, and alterations in usual functional activities. The best predictors of fatigue in the patient sample were their symptom distress and mood disturbance. Symptom distress and fatigue were significant predictors of impairment in functional activities related to illness. Implications for practice and future research are discussed.

Activities of Daily Living↗

PubMed1994

Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.

Estimates of the percentage of patients with postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis who experience fatigue range from approximately 75% to 100%. In this study we describe the severity of fatigue and its impact on subjects with these three diagnoses. The Fatigue Severity Scale, the Human Activity Profile, and the Nottingham Health Profile were used to measure fatigue, activity, and health status respectively of each diagnostic group as well as a control group. Using a Kruskal-Wallis one-way analysis of variance followed by a Bonferroni-adjusted Mann Whitney U test all diagnostic groups reported significantly higher levels (p = .0000 to p = .002) of fatigue and lower perceived health status than the control group. Subjects with chronic fatigue and multiple sclerosis also had significantly reduced activity levels (p = .002 to p = .01) compared with the control group. Further attention should be directed toward understanding the relationship between fatigue and ability to engage in activities as well as strategies for remediation and/or compensation of the fatigue.

Adult↗

PubMed1993

Fatigue, depression, and social adjustment in chronic fatigue syndrome.

The aims of this study were to determine the characteristics and perceived levels of fatigue and the prevalence of depression in children with chronic fatigue syndrome and to assess the effects of illness on schooling and social functioning. Twelve children with chronic fatigue syndrome were compared with a matched group of children with cystic fibrosis and matched healthy controls. Levels of fatigue (fatigue questionnaire), depression (children's depression inventory), and social adjustment (semistructured interview with parents) were compared between groups. Children with chronic fatigue syndrome had significantly higher median scores for physical and mental fatigue and depressive symptomatology than either comparison group and five children scored as depressed on the children's depression inventory. Schooling and social functioning were seriously disrupted. Children with chronic fatigue syndrome reported high levels of fatigue affecting both physical and mental functioning, the association with depression found in adult studies was confirmed, and social adjustment was poor.

Absenteeism↗

PubMed1989

Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders.

Patients (n = 47) presenting to a neurological centre with unexplained chronic "postviral" fatigue (CFS) were studied prospectively. Controls were patients with peripheral fatiguing neuromuscular diseases and inpatients with major depression in a psychiatric hospital. Seventy-two percent of the CFS patients were cases of psychiatric disorder, using criteria that excluded fatigue as a symptom, compared with 36% of the neuromuscular group. There was no difference in subjective complaints of physical fatigue between all groups. Mental fatigue and fatigability was equally common in CFS and affective patients, but only occurred in those neuromuscular patients who were also cases of psychiatric disorder. Overall, the CFS patients more closely resembled the affective than the neuromuscular patients. Attribution of symptoms to physical rather than psychological causes was the principal difference between matched CFS and psychiatric controls. The symptoms of "postviral" fatigue had little ability to discriminate between CFS and affective disorder. The fatigue in CFS appeared central in origin, suggesting it is not primarily a neuromuscular illness. The implications for research and treatment of chronic fatigue are discussed.

Adult↗

PubMed1995

The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue.

The Multidimensional Fatigue Inventory (MFI) is a 20-item self-report instrument designed to measure fatigue. It covers the following dimensions: General Fatigue, Physical Fatigue, Mental Fatigue, Reduced Motivation and Reduced Activity. This new instrument was tested for its psychometric properties in cancer patients receiving radiotherapy, patients with the chronic fatigue syndrome, psychology students, medical students, army recruits and junior physicians. We determined the dimensional structure using confirmatory factor analyses (LISREL's unweighted least squares method). The hypothesized five-factor model appeared to fit the data in all samples tested (AGFIs > 0.93). The instrument was found to have good internal consistency, with an average Cronbach's alpha coefficient of 0.84. Construct validity was established after comparisons between and within groups, assuming differences in fatigue based on differences in circumstances and/or activity level. Convergent validity was investigated by correlating the MFI-scales with a Visual Analogue Scale measuring fatigue (0.22 < r < 0.78). Results, by and large, support the validity of the MFI.

Adult↗

PubMedDate not supplied

Psychobehavioral and immunological characteristics of adult people with chronic fatigue and patients with chronic fatigue syndrome.

The psychobehavioral responses and cellular immune function were investigated in healthy people (control, N = 21), adult people with chronic fatigue (fatigue-non-CFS group, N = 24), and patients with chronic fatigue syndrome (CFS, N = 10). Based on psychobehavioral responses, the fatigue-non-CFS group had low general activity levels (p < .05) and slightly depressive tendencies (p < .01) compared with the control. They had many life event stresses (p < .05) and sleep disturbances (p < .01), and they could not cope appropriately with stresses. The fatigue-non-CFS group also showed significantly lower natural killer (NK) cell activity (p < .01) and decreased numbers of CD16+ and CD56+ cells (p < .05). Compared with the fatigue-non-CFS group, patients with CFS had higher degrees of physical fatigue (p < .01) and more life event stresses (p < .05). They had lower general activity levels and social introversion. They were also in a depressive state. NK cell activity and the numbers of CD16+ and CD56+ cells were significantly reduced in patients with CFS (p < .01). These findings suggest that adult people with chronic fatigue may be in an intermediate state between the healthy control and patients with CFS in terms of psychobehavioral responses and low NK cell activity. We observed three cases in such an intermediate state in whom CFS subsequently developed.

Adaptation, Psychological↗

PubMed1988

The frequency of the chronic fatigue syndrome in patients with symptoms of persistent fatigue.

STUDY OBJECTIVE: To determine the frequency of the chronic fatigue syndrome among patients with symptoms of fatigue. DESIGN: Prospective, cohort study. SETTING: Referral clinic, based in a primary care general internal medicine faculty practice of a university medical center. PATIENTS: Consecutive sample of 135 patients (53 men, 82 women) with 6 months or more of debilitating fatigue. INTERVENTIONS: All patients had a complete history taken, had a physical examination and a comprehensive battery of blood tests, and were given the Diagnostic Interview Schedule of the National Institute of Mental Health, a highly-structured 260-item instrument designed to enable accurate psychiatric diagnoses. Other diagnostic studies (for example, sleep studies and electroencephalography) were ordered if necessary for individual patients. MEASUREMENTS AND MAIN RESULTS: Six of the one hundred thirty-five patients met criteria for chronic fatigue syndrome (95% CI, 0 to 10). Ninety-one (67%) patients (CI, 56 to 78) had clinically active psychiatric disorders and 4 (3%) patients (CI, 0 to 8) had medical disorders that were considered a major cause of their fatigue. Thirty-four (25%) patients (CI, 14 to 36) had insufficient symptoms or objective findings of the chronic fatigue syndrome. CONCLUSION: The chronic fatigue syndrome is rare among patients with symptoms of persistent fatigue. Most of these patients have psychiatric disorders.

Adult↗

PubMed1986

[Fatigue in women conducting work with predominantly dynamic effort. I. Work demands and type of signs of fatigue].

In evaluation of fatigue by the working day and evaluation of chronic fatigue subjective methods have been applied. The fatigue due to the working day was tested twice during a work shift--in the 2nd and 8th working hour. Two professional groups of women were covered by the investigation: knitters (94) and sorters (44). It was a sufficient sample. The fatigue was found to be relatively low--it did not surpass the value of 2 points. Only some symptoms occurred with greater intensity, e.g. tiredness of legs and whole body. This results from the type of work performed by the women. The correlation between the type of fatigue symptoms and type of work is also confirmed by differences in evaluation of knitters and sorters. The evaluation of fatigue in both professional groups did not differ from the results of studies of the fatigue after the working day. Only somatic disturbances were evaluated higher; the differences between sorters and knitters in this group of symptoms possibly being affected by the differences in the workers' age. The obtained results indicate that despite the differences in the type of work, the type and magnitude of fatigue were similar at both workplaces.

Adult↗

PubMed1994

Quadriceps femoris muscle resistance to fatigue using an electrically elicited fatigue test following intense endurance exercise training.

BACKGROUND AND PURPOSE: Electrical stimulation has been used to assess skeletal muscle resistance to fatigue. The purpose of this study was to test the hypothesis that 12 weeks of intense endurance exercise training on a bicycle ergometer would reduce the percentage of decline in quadriceps femoris muscle torque during an electrically elicited fatigue test. SUBJECTS AND METHODS: Eleven nondisabled subjects performed 12 weeks of high-intensity endurance exercise training, and 6 subjects served as controls and did not exercise. Two electrically elicited fatigue tests, one with and one without prior voluntary fatiguing exercise, were administered to each subject before and after the 12-week training period. RESULTS: The percentage of decline in peak torque of the quadriceps femoris muscle over 50 electrically elicited muscle contractions did not change as a result of endurance exercise training, despite significant improvements in maximal oxygen consumption and quadriceps femoris muscle endurance. The recovery of maximal isometric torque immediately after exhausting voluntary exercise followed by electrical stimulation was significantly greater after 12 weeks of intense exercise training. CONCLUSION AND DISCUSSION: The percentage of decline in peak torque during an electrically elicited fatigue test does not detect improvements in quadriceps femoris muscle endurance induced by endurance exercise training. The percentage of initial torque recovered immediately after fatiguing exercise, however, is improved by endurance training. [Sinacore Dr, Jacobson RB, Delitto A. Quadriceps femoris muscle resistance to fatigue using an electrically elicited fatigue test following intense endurance exercise training.

Adult↗

PubMed1991

Human quadriceps strength and fatiguability in patients with post viral fatigue.

Quadriceps isometric strength, activation and fatiguability were measured in 11 patients with symptoms of fatigue three months after glandular fever or a glandular fever-like illness. Predicted normal and lower limits of normal muscle strength were calculated from height and age. These measures and the fatigue index were compared with a group of healthy students of similar age. Two of the patients were unable to activate fully their muscles. After allowing for this inhibition the group mean (SD) strength was 104 (22%) of predicted. Although there was no significant difference in the fatigue index between the patients and the control group, there was a trend for the patients to show less fatigue than controls. There was no difference in the muscle results for those patients who were found to have Epstein-Barr virus infections and those who did not. The feelings of weakness and fatigue experienced by the patients could not be explained by either physiological muscle fatigue or lack of effort.

Adolescent↗

PubMedDate not supplied

Prevalence of chronic fatigue syndrome in Italian patients with persistent fatigue.

Our study was carried out to determine the prevalence of chronic fatigue syndrome (CFS) within a selected population of patients suffering from persistent fatigue. We studied subjects with recurrent or persistent fatigue lasting 6 months and fulfilling at least four minor Center for Disease Control (CDC) criteria for the diagnosis of CFS. Evaluation included both clinical examination and laboratory testing. All subjects filled out a questionnaire specifically designed to gain information about the length and severity of symptoms, and patients with a previously diagnosed illness associated with fatigue were excluded. The study was carried out at the Fatigue Clinic of an internal medicine unit (Clinica Medica I) of the University of Rome "La Sapienza". Sixty-three subjects, residents of the Lazio region (central Italy), completed the diagnostic assessment. Alternative diagnoses were established in 37 (59%) of the 63 patients. A diagnosis of CFS based on the CDC criteria was established in only 6 cases. In 2 subjects, CFS had appeared following infectious mononucleosis, and no definitive diagnosis could be formulated for 18 patients. In Italy, CFS seems to be an infrequent cause of severe and persistent fatigue in a selected population. Numerous morbid conditions may be responsible for a clinical picture closely resembling CFS. We recommend that patients suffering from fatigue be thoroughly evaluated.

Adolescent↗

PubMed1993

Prevalence of fatigue and chronic fatigue syndrome in a primary care practice.

BACKGROUND: Our goals were to determine the prevalence of unusual, debilitating fatigue and the frequency with which it was associated with the chronic fatigue syndrome (CFS) or other physical or psychological illness in an outpatient clinic population. METHODS: We prospectively evaluated a cohort of 1000 consecutive patients in a primary care clinic in an urban, hospital-based general medicine practice. The study protocol included a detailed history, physical examination, and laboratory and psychiatric testing. RESULTS: Five patients who came because of CFS studies were excluded. Of the remaining 995, 323 reported fatigue, and 271 (27%) complained of at least 6 months of unusual fatigue that interfered with their daily lives. Of the 271, self-report or record review revealed a medical or psychiatric condition that could have explained the fatigue in 186 (69%). Thus, 85 (8.5%) of 995 patients had a debilitating fatigue of at least 6 months' duration, without apparent cause. Of these patients, 48 refused further evaluation, and 11 were unavailable for follow-up; 26 completed the protocol. Three of the 26 were hypothyroid, and one had a major psychiatric disorder. Of the remaining 22 patients, three met Centers for Disease Control and Prevention criteria for CFS, four met British criteria, and 10 met the Australian case definition. The point prevalences of CFS were thus 0.3% (95% confidence interval [CI], 0% to 0.6%), 0.4% (95% CI, 0% to 0.8%), and 1.0% (95% CI, 0.4% to 1.6%) using the Centers for Disease Control and Prevention, British, and Australian case definitions, respectively. These estimates were conservative, because they assumed that none of the patients who refused evaluation or were unavailable for follow-up would meet criteria for CFS. CONCLUSIONS: While chronic, debilitating fatigue is common in medical outpatients, CFS is relatively uncommon. Prevalence depends substantially on the case definition used.

Adult↗

PubMed1994

Measuring the functional impact of fatigue: initial validation of the fatigue impact scale.

The fatigue impact scale (FIS) was developed to improve our understanding of the effects of fatigue on quality of life. The FIS examines patients' perceptions of the functional limitations that fatigue has caused over the past month. FIS items reflect perceived impact on cognitive, physical, and psychosocial functioning. This study compared 145 patients referred for investigation of chronic fatigue (ChF) with 105 patients with multiple sclerosis (MS) and 34 patients with mild hypertension (HT). Internal consistency for the FIS and its three subscales was > .87 for all analyses. Fatigue impact was highest for the ChF group although the MS group's reported fatigue also exceeded that of the HT group. Discriminant function analysis correctly classified 80.0% of the ChF group and 78.1% of the MS group when these groups were compared. This initial validation study indicates that the FIS has considerable merit as a measure of patient's attribution of functional limitations to symptoms of fatigue.

Adult↗

PubMed1993

Muscle fatigue: clinical implications for fatigue assessment and neuromuscular electrical stimulation.

Muscle fatigue can be defined as a decrease in the force-generating ability of a muscle that resulted from recent activity. Recent studies of muscle fatigue are reviewed that are relevant to two areas of interest to physical therapists: clinical assessment of muscle fatigue and neuromuscular electrical stimulation. Volitional and electrical tests have been used to quantify muscle fatigue. Several variations on each type of test are discussed, as are the possible sites in which fatigue might occur. The rate of fatigue during the therapeutic application of electrical stimulation of skeletal muscle is much greater than that seen during volitional contractions. Factors contributing to this phenomenon are examined. The unique requirements affecting how stimulus variables can be manipulated to minimize muscle fatigue in three specific therapeutic uses of neuromuscular electrical stimulation are addressed.

Electric Stimulation↗

PubMed1993

Changes in relations between surface electromyogram and fatigue level by repeating fatiguing static contractions.

Changes in relations between surface electromyogram (EMG) and fatigue level estimated by fatigue sensation were studied during repeated fatiguing static contractions. Six male subjects performed elbow flexion of 13-15%MVC. Contractions were repeated 5 times (C1, C2, C3, C4, C5) with 5 min intervals of rests. The contractions continued until the onset of fatigue sensation such as obvious pain or considerable tiredness. Bipolar surface EMGs were recorded from 6 synergists of elbow flexors. Mean amplitude (AEMG) and relative power spectrum (RPW) of EMG were calculated. Partial correlation coefficients between time, AEMG, and RPW during each contraction were calculated. AEMG increased with time. EMG spectrum shifted towards lower frequencies with time. The correlations between AEMG and RPW were negative below 60Hz. AEMG and RPW were compared between C1 and C2-C5 being related with fatigue sensations. The changes in AEMG and EMG spectrum with the repeated contractions were similar to those with the development of fatigue. The increases in AEMG with the repeats were seen in most synergists in 4 subjects. Though EMG roughly reflected the fatigue during work, the changes of EMG were thought to include active adaptation to work.

Adult↗

PubMed1994

[Evaluation of physical exercise and fatigue sensation by CFSI (Cumulative Fatigue Symptoms Index)].

Cumulative Fatigue Symptoms Index (CFSI) is used for workers' subjective assessment of feeling of fatigue and of symptoms. Until now, this index has been used in the analysis of members of the same occupation. The purpose of this study is to examine fatigue symptoms in workers and to assess by CFSI the effect of regular physical exercise. Study participants were an exercise group (n = 67) and a non-exercise group (n = 115) of older workers, aged from 30 to 69 years. The CFSI questionnaire was distributed to all participants and the former group (exercise) answered two descriptive questions concerning the aim and subjective effects of physical exercise. As a result, it was found that mental fatigue symptoms decreased in the exercise group even after considering the differences in managerial position, subjective senses on health and marital status which are related to degree of feelings of fatigue. Weakened vitality was significantly less in the exercise group than the non-exercise group. Therefore, we concluded that weakened vitality would be needed to be regarded on an assessment scale for effects caused by exercise. It has also been considered that we should investigate general fatigue in assessing physical fatigue relating to one's lifestyle.

Adult↗

PubMed1978

Metabolic correlates of fatigue and of recovery from fatigue in single frog muscle fibers.

Fatigue and recovery from fatigue were related to metabolism in single fibers of the frog semitendinosus muscle. The fibers were held at a sarcomere length of 2.3 microm in oxygenated Ringer solution at 15 degrees C and were stimulated for up to 150 s by a schedule of 10-s, 20-Hz tetanic trains that were interrupted by 1-s rest periods, after which they were rapidly frozen for biochemical analysis. Two kinds of fatigue were produced in relation to stimulus duration. A rapidly reversed fatigue occurred with stimulation for under 40 s and was evidenced by a decline in tetanic tension that could be overcome by 1 s of rest. A prolonged fatigue was caused by stimulation for 100-150 s. It was evidenced during stimulation by a fall in tetanic tension that could not be overcome by 1 s of rest, and after stimulation by a reduction, lasting for up to 82 min, in the peak tension of a 200-ms test tetanus. Fiber phosphocreatine (PCr) fell logarithmically in relation to stimulus duration, from a mean of 121 +/- 8 nmol/mg protein (SEM, n = 12) to 10% of this value after 150 s of stimulation. PCr returned to normal levels after 90-120 min of rest. Stimulation for 150 s did not significantly affect fiber glycogen and reduced fiber ATP by at most 15%. It is suggested that the prolonged fatigue caused by 100-150 s of tetanic stimulation was caused by long-lasting failure of excitation-contraction coupling, as it was not accompanied by depletion of energy stores in the form of ATP. One possibility is that H+ accumulated in fatigued fibers so as to interfere with the action of Ca2+ in the coupling process.

Adenosine Triphosphate↗