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Published on: March 21, 2013
Orthostatic symptoms predict functional capacity in chronic fatigue syndrome: implications for management
A Costigan1, C Elliott, C McDonald
1NIHR Biomedical Research Centre in Ageing-Cardiovascular Theme, Newcastle University, Newcastle, UK.
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.
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