Clinically accessible tools for documenting the impact of orthostatic intolerance on symptoms and function in ME/CFS, 2020, Jihyun et al

[Andy]

BACKGROUND: Clinical observations have indicated that hours of upright activity (HUA) reported by Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients correlated with orthostatic symptoms and impaired physical function. This study examined the relationship between HUA and orthostatic intolerance (OI).

METHODS: Twenty-five female ME/CFS subjects and 25 age and race matched female healthy controls (HCs) were enrolled. Subjects reported HUA (defined as hours per day spent with feet on the floor) and completed questionnaires to assess the impact of OI on daily activities and symptoms. ME/CFS patients were categorized into those with <5 HUA and ≥5 HUA and analyzed by employment status. Data analysis used one-way ANOVA.

RESULTS: ME/CFS patients had fewer HUA, worse symptoms and greater interference with daily activities due to OI than HCs. The <5 HUA ME/CFS subjects had more severe OI related symptoms than ≥5 HUA ME/CFS subjects even though OI interfered with daily activities similarly. Only 33% of ME/CFS subjects were employed and all were ≥5 HUA ME/CFS subjects with an average HUA of 8.

CONCLUSIONS: ME/CFS subjects experienced more frequent and severe OI symptoms, higher interference with daily activities, and reduced ability to work than HCs. Reported HUA and assessment of OI using standardized instruments may be useful clinical tools for physicians in the diagnosis, treatment and management of ME/CFS patients.

Paywall, https://content.iospress.com/articles/work/wor203169
Sci hub, https://sci-hub.tw/10.3233/WOR-203169

 

[rvallee]

However it ends up being called, dysautonomia is very prevalent in COVID-19 symptoms. Many people have experienced it for a short period, meaning there should be a window to be able to observe changes, essentially a reverse control where the recovered patient is their own control. Certainly one of the most disabling. So there should be a lot of attention in the near future.

I really hope this makes it an acceptable respected thing. Even if ME in general remains a puzzle, this is clearly something that can be studied with objectivity and lead to some treatments.

It may even all by itself force major changes to medicine, as this is almost always dismissed as anxiety. At least if it leads to some recognition that defaulting to anxiety has been disastrous in blocking access to effective treatments to millions for decades.

 

[Dolphin]

This is now open access