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

Lookup NU author(s): Alison Costigan, Catherine Elliott, Dr Claire McDonald, Emerita Professor Julia Newton


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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 (β = 0.4, P = 0.01). Conclusions: Treatment of orthostatic symptoms in CFS has the potential to improve functional capacity and so improve quality of life. © The Author 2010. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.

Publication metadata

Author(s): Costigan A, Elliott C, McDonald C, Newton J

Publication type: Article

Publication status: Published

Journal: QJM

Year: 2010

Volume: 103

Issue: 8

Pages: 589-595

Print publication date: 09/06/2010

ISSN (print): 1460-2725

ISSN (electronic): 1460-2393

Publisher: Oxford University Press


DOI: 10.1093/qjmed/hcq094


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