Orthostatic symptoms predict functional capacity in chronic fatigue syndrome: implications for management

QJM. 2010 Aug;103(8):589-95. doi: 10.1093/qjmed/hcq094. Epub 2010 Jun 9.

Abstract

Objectives: To establish the relationship between the functional impairment experienced by Chronic fatigue syndrome (CFS) patients and the symptoms frequently experienced by those with CFS; specifically cognitive impairment, fatigue and orthostatic symptoms.

Design: Cross sectional questionnaire survey.

Setting: Specialist CFS Clinical Service.

Subjects: Ninety-nine Fukuda diagnosed CFS and 64-matched controls.

Main outcome measures: Symptom and functional assessment tools completed and returned by post included; PROMIS HAQ (Patient-Reported Outcomes Measurement Information System, Health Assessment Questionnaire), CFQ (Cognitive Failures Questionnaire), FIS (Fatigue Impact Scale) and OGS (Orthostatic Grading Scale) assessment tools.

Results: CFS patients experience greater functional impairment than controls [mean (95% CI) PROMIS HAQ scores CFS 36 (31-42) vs. controls 6 (2-10); P < 0.0001], especially in the functional domains of activities and reach. Poorer functional ability impairment is significantly associated with greater cognitive impairment (P = 0.0002, r = 0.4), fatigue (P < 0.0001, r = 0.5) and orthostatic symptoms (P < 0.0001, r = 0.6). However, only orthostatic symptoms (OGS) independently associated with functional impairment (beta = 0.4, P = 0.01).

Conclusion: Treatment of orthostatic symptoms in CFS has the potential to improve functional capacity and so improve quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Case-Control Studies
  • Cross-Sectional Studies
  • Dizziness / etiology*
  • Fatigue Syndrome, Chronic / complications
  • Fatigue Syndrome, Chronic / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Severity of Illness Index*
  • Surveys and Questionnaires
  • United Kingdom