scholarly journals Assessment of systemic joint laxity in the clinical context: Relevance and replicability of the Beighton score in chronic fatigue

2021 ◽  
pp. 1-8
Author(s):  
Gabriella Bernhoff ◽  
Helena Huhmar ◽  
Lina Bunketorp Käll
Keyword(s):  
Interrater Reliability ◽  
Chronic Fatigue ◽  
Criterion Validity ◽  
Joint Laxity ◽  
Clinical Context ◽  
Beighton Score ◽  
Persistent Symptoms ◽  
Fatigue Syndrome ◽  
The Common ◽  
Measuring Tool

BACKGROUND: Persistent symptoms in patients with systemic joint laxity (SJL) are often equivalent with complications. Screening for SJL is an important part of the assessment of musculoskeletal phenotype. The common measuring tool, the Beighton score (BS), still has unclear evidence. OBJECTIVE: To assess the Beighton score in a clinical context for (1) ability to classify SJL as absent or present (criterion validity), and (2) interrater reliability (physician-physiotherapist), for a dichotomous cut-off (yes/no), as well as for interpretation in categories (no, some, clear SJL). METHODS: This real-world observational study included 149 consecutive patients seeking secondary care for investigation of possible myalgic encephalomyelitis/chronic fatigue syndrome. Assessment was done during a routine examination. Data were evaluated with Cohen’s kappa and Spearman’s rho. RESULTS: BS criterion validity showed poor agreement with the assessment of SJL: percentage agreement was 74 % and kappa 0.39 (3-cut level), 73 % and kappa 0.39/0.45 (4-/5-cut level). The best interrater reliability was moderate (rho 0.66) for interpretation in categories. CONCLUSIONS: The BS alone was not a reliable proxy for SJL and should be supplemented with a targeted history. Nevertheless, its interrater reliability was acceptable, and the categorised score appears to have greater clinical relevance than the dichotomous score.

A Systematic Review of Acupuncture and Moxibustion Treatment for Chronic Fatigue Syndrome in China

2008 ◽  
Vol 36 (01) ◽  
pp. 1-24 ◽  
Author(s):  
Tianfang Wang ◽  
Qunhao Zhang ◽  
Xiaolin Xue ◽  
Albert Yeung
Keyword(s):  
Systematic Review ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Future Studies ◽  
Acupuncture And Moxibustion ◽  
Fatigue Syndrome ◽  
Collective Experience ◽  
Rigorous Study ◽  
The Common ◽  
Study Designs

Studies on the treatment of chronic fatigue syndrome (CFS) with acupuncture and moxibustion in China were reviewed. All studies concluded the treatments were effective, with response rates ranging from 78.95% to 100%. However, the qualities of the studies were generally poor, and none of them used a RCT design. The common acupoints/sites used in the treatment of CFS, which may reflect the collective experience of acupuncturists in China based on Traditional Chinese Medicine theories can be used to evaluate the effectiveness of acupuncture for the treatment of CFS in future studies using more scientifically rigorous study designs.

Chronic Fatigue Syndrome: A Way Forward

1994 ◽  
Vol 57 (10) ◽  
pp. 381-383 ◽  
Author(s):  
Susan Pemberton ◽  
Simon Hatcher ◽  
Philip Stanley ◽  
Allan House
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
The Common

Chronic fatigue syndrome (CFS) is a condition surrounded by uncertainty and controversy; for example, over whether its cause is physical, psychological or psychosomatic. No doubt this is one reason for the lack of simple rehabilitation programmes to help patients with the syndrome. This article outlines the approach to treating CFS which has been developed at the Fatigue Clinic in Leeds. It is not based upon a particular theory of CFS, but is designed to help patients overcome the common personal and social dysfunctions associated with their condition. As a result it should prove acceptable in wider use, regardless of patients' or therapists' views on the cause of CFS.

David Arthur John Tyrrell. 19 June 1925 — 2 May 2005

2007 ◽  
Vol 53 ◽  
pp. 349-363 ◽  
Author(s):  
J. R. Kerr ◽  
D. Taylor-Robinson
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Bovine Spongiform Encephalopathy ◽  
Common Cold ◽  
Chronic Fatigue ◽  
Spongiform Encephalopathy ◽  
Human Suffering ◽  
Fatigue Syndrome ◽  
The Common

David Tyrrell is remembered by physicians and scientists principally for his discovery of the common cold viruses and elucidation of their pathogenesis, but also for his work in various other areas, including influenza, bovine spongiform encephalopathy (BSE) and chronic fatigue syndrome (CFS). David possessed a deep humanity, honesty, perseverance and a vision of collaboration as a means of making discoveries that would contribute meaningfully to the alleviation of human suffering. He also had a warmth and a mischievous sense of humour that was frequently directed at bureaucracy, which he thoroughly disliked.

scholarly journals Chronic fatigue syndrome: a hypothesis focusing on the autonomic nervous system

1999 ◽  
Vol 96 (1) ◽  
pp. 117-125 ◽  
Author(s):  
Massimo PAGANI ◽  
Daniela LUCINI
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Systolic Arterial Pressure ◽  
Chronic Fatigue ◽  
Autonomic Nervous ◽  
Fatigue Syndrome ◽  
Sympathetic Modulation ◽  
Autonomic Activation ◽  
The Common

Chronic fatigue syndrome is a debilitating illness of unknown aetiology, with estimated levels of prevalence of up to about 8.7/100 000 in the U.S.A. Like pain fatigue it is a personal, emotionally rich experience, which may originate from peripheral or central sites (or both). The nature of the symptoms is complex and reflects the interaction of the patient with the environment and cultural milieu. Accordingly the common use of the same terminology for different types of fatigue may be misleading. Autonomic activation is a key component of both real and simulated physical exercise. Alterations in autonomic nervous system activity are a key component of several physiopathological conditions. In chronic fatigue syndrome disturbances in autonomic activity, and in other homoeostatic mechanisms, such as the hormonal and immune systems, have been reported recently. In this review we followed the hypothesis that in chronic fatigue syndrome the paradoxical condition of disturbing somatic symptoms in the absence of organic evidence of disease might be addressed by focusing on attending functional correlates. In particular we addressed possible alterations in cardiovascular autonomic control, as can be assessed by spectral analysis of R–R interval and systolic arterial pressure variability. With this approach, in subjects complaining of unexplained fatigue, we obtained data suggesting a condition of prevailing sympathetic modulation of the sino-atrial node at rest, and reduced responsiveness to excitatory stimuli. Far from considering the issue resolved, we propose that in the context of the multiple physiological and psychological interactions involved in the perception and self-reporting of symptoms, attendant changes in physiological equivalents might furnish a convenient assessment independent from subjective components. Indices of sympathetic modulation could, accordingly, provide quantifiable signs of the interaction between subject's efforts and environmental demands, independently of self descriptions, which could provide convenient measurable outcomes, both for diagnosis and treatment titration in chronic fatigue syndrome.

scholarly journals Socialization to the Model: The Active Component in the Therapeutic Alliance? A Preliminary Study

2010 ◽  
Vol 39 (2) ◽  
pp. 221-227 ◽  
Author(s):  
Jo Daniels ◽  
Alison J. Wearden
Keyword(s):  
Therapeutic Alliance ◽  
Chronic Fatigue ◽  
Coding System ◽  
Active Components ◽  
Fatigue Syndrome ◽  
Specific Factors ◽  
The Common ◽  
Preliminary Study ◽  
The Relationship ◽  
Detailed Picture

Background: Therapeutic alliance has been found to be a significant predictor of outcome in psychotherapy yet what constitutes therapeutic alliance remains unclear. Examining the common constructs of therapeutic alliance, it is possible that there may be a conceptual overlap between active components of therapeutic alliance and socialization to the treatment model. Aim: To investigate the relationship between socialization to the model and therapeutic alliance. Method: Participants (N = 43) were taken from the active treatment arm in a RCT for the treatment of chronic fatigue syndrome (CFS/ME). Therapeutic alliance was measured using a 5-item questionnaire (brief CALPAS) and socialization to the model was extracted from therapy tapes using a novel coding system. Results: Key findings were that when patients and therapists agreed about goals of treatment, there were higher levels of concordance, less evidence of applying principles incongruent to the model, and less resistance during the treatment sessions. Conclusions: The outcome of this preliminary study contributes to the potential understanding of active components in the therapeutic alliance, and supports further research to achieve a more detailed picture of “non-specific” factors in therapy, including the active process of socialization in therapeutic alliance.

scholarly journals Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
Amy D. Proal ◽  
Michael B. VanElzakker
Keyword(s):  
Molecular Mimicry ◽  
Chronic Fatigue ◽  
The Novel ◽  
Biological Factors ◽  
Host Proteins ◽  
Manage Care ◽  
Persistent Symptoms ◽  
Multiple Organs ◽  
Fatigue Syndrome ◽  
Wide Range

The novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic of coronavirus disease 2019 (COVID-19). Across the globe, a subset of patients who sustain an acute SARS-CoV-2 infection are developing a wide range of persistent symptoms that do not resolve over the course of many months. These patients are being given the diagnosis Long COVID or Post-acute sequelae of COVID-19 (PASC). It is likely that individual patients with a PASC diagnosis have different underlying biological factors driving their symptoms, none of which are mutually exclusive. This paper details mechanisms by which RNA viruses beyond just SARS-CoV-2 have be connected to long-term health consequences. It also reviews literature on acute COVID-19 and other virus-initiated chronic syndromes such as post-Ebola syndrome or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) to discuss different scenarios for PASC symptom development. Potential contributors to PASC symptoms include consequences from acute SARS-CoV-2 injury to one or multiple organs, persistent reservoirs of SARS-CoV-2 in certain tissues, re-activation of neurotrophic pathogens such as herpesviruses under conditions of COVID-19 immune dysregulation, SARS-CoV-2 interactions with host microbiome/virome communities, clotting/coagulation issues, dysfunctional brainstem/vagus nerve signaling, ongoing activity of primed immune cells, and autoimmunity due to molecular mimicry between pathogen and host proteins. The individualized nature of PASC symptoms suggests that different therapeutic approaches may be required to best manage care for specific patients with the diagnosis.

scholarly journals Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: Application of the common sense model

2019 ◽  
Vol 24 (3) ◽  
pp. 546-563 ◽  
Author(s):  
Cara Haines ◽  
Maria Loades ◽  
Cara Davis
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Physical Health ◽  
Common Sense ◽  
Illness Perceptions ◽  
Chronic Fatigue ◽  
Health Conditions ◽  
Common Sense Model ◽  
Fatigue Syndrome ◽  
The Common ◽  
Sense Model

Background: The common sense model (CSM) proposes that illness perceptions guide coping and illness management, which subsequently affects outcomes. Chronic fatigue syndrome (CFS) is associated with severe functional impairment. CFS is distinct from other physical health conditions in that individuals can experience high levels of uncertainty, stigma and disbelief from others. This study aimed to compare illness perceptions in adolescents with CFS with other physical health conditions, using a cross-sectional, between-groups design. Methods: Adolescents (aged 11–18) with CFS ( n = 49), type 1 diabetes ( n = 52) and juvenile idiopathic arthritis ( n = 42) were recruited through National Health Service (NHS) clinics and online, and completed a series of questionnaires. Results: Adolescents with CFS differed on the perceived consequences, timeline, personal control, treatment control, identity and understanding dimensions of illness perceptions. Except for identity, these dimensions were predicted by health condition even when accounting for age, gender, fatigue, physical functioning, anxiety and depression. Conclusions: Results offer preliminary evidence for the applicability of the CSM in adolescents, with implications for supporting adolescents with physical health conditions. Results suggest that psychological interventions targeting perceived control, understanding and identity may have particular utility for adolescents with CFS.

scholarly journals Cytokines across the Night in Chronic Fatigue Syndrome with and without Fibromyalgia

2010 ◽  
Vol 17 (4) ◽  
pp. 582-587 ◽  
Author(s):  
Toru Nakamura ◽  
Stephan K. Schwander ◽  
Robert Donnelly ◽  
Felix Ortega ◽  
Fumiharu Togo ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Interleukin 10 ◽  
Peripheral Blood Lymphocytes ◽  
Fatigue Syndrome ◽  
The Common ◽  
Cytokine Dysregulation ◽  
And Function ◽  
Anti Inflammatory Cytokine ◽  
Better Than

ABSTRACT The symptoms of chronic fatigue syndrome (CFS) are consistent with cytokine dysregulation. This has led to the hypothesis of immune dysregulation as the cause of this illness. To further test this hypothesis, we did repeated blood sampling for cytokines while patients and matched healthy controls slept in the sleep lab. Because no one method for assaying cytokines is acknowledged to be better than another, we assayed for protein in serum, message in peripheral blood lymphocytes (PBLs), and function in resting and stimulated PBLs. We found no evidence of proinflammatory cytokine upregulation. Instead, in line with some of our earlier studies, we did find some evidence to support a role for an increase in interleukin-10, an anti-inflammatory cytokine. Although the changes were small, they may contribute to the common complaint in CFS patients of disrupted sleep.

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