Chronic Fatigue Syndrome (CFS)

1
Chronic Fatigue Syndrome (CFS)

• Jonathan Cooke 0311284
• Kevin Repay 0275542
• Tara Ruberto 0306015

2
What is CFS?

• A condition characterized by persistent
  debilitating fatigue, not relieved by rest and
  not accounted for by any specifically identified
  medical or psychiatric condition.
• The cause of CFS is unknown and therefore
  defined primarily by its symptoms

3
Common Symptoms of Chronic Fatigue Syndrome

• Frequent sore throats
• Painful lymph nodes
• Headaches
• Difficulty with concentration and memory
• Low-grade fever

4
Signs and SymptomsMajor Criteria

• New onset of persistent or relapsing fatigue, not
  resolving with bed rest, and severe enough to
  reproduce or impair average daily activities
  below 50 of previous levels for at least six
  months
• Other clinical conditions that could cause
  similar symptoms must be excluded by appropriate
  medical evaluation. These other conditions
  include, but are not limited to, malignancy,
  autoimmune disease, localized infection, chronic
  bacterial or parasite disease, endocrine
  disorder, and other chronic disease

5
Signs and SymptomsMinor Criteria

• Mild fever
• Sore throat
• Painful lymph nodes in neck or underarm region
• Generalized muscle weakness
• Muscle discomfort or myalgia
• Prolonged generalized fatigue after levels of
  exercise that were previously well tolerated
• Generalized headache
• Mygratory arthralgia
• Neuropsychologic complaints
• Sleep disturbance
• History of symptom complex having begun acutely
  following viral infection

6
Signs and SymptomsPhysical Criteria

• Low grade fever
• Non-exudative pharyngitis
• Palpable tender lymph nodes in neck
• To meet the case definition, clients must meet
  both major criteria and a total of eight other
  symptom criterias, or six symptom criteria and
  two physical criteria.

7
Contraindicators for exercise with CFS

• Cold/humid weather
• Insuffiecient sleep
• Fatigue
• Excessive vigorous phsyical activity or
  inactivity
• Anxiety
• Stress
• Strenuous strength training exercises

8
Exercise Suggestions for Clients with CFS

• Aim for no more than three exercise sessions per
  week.
• Experiment to find the type of exercise that
  works best for the client. Choose from a range of
  gentle activities such as stretching, yoga, Tai
  Chi, walking and light weight training.
• Stretching seems to be well tolerated by people
  with CFS. Clients may prefer to perform your
  stretching program while lying down in bed.
• Aerobic exercise seems to cause relapses for many
  people with CFS. If this is true for the client,
  try non-aerobic forms of exercise like weight
  training with light weights.
• Learn from past relapses. For example, if walking
  for 20 minutes worsened the clients symptoms,
  try walking for five minutes and see how that
  goes. It may be helpful to keep a diary to keep
  track of what works and what doesnt for the
  client.

9
Exercise Suggestions for Clients with CFS cont.

• Stop the physical activity well before the client
  feels tired. Pacing is very important.
• Remember that the clients exercise tolerance
  will differ from one day to the next.
• Listen to your body if the client doesnt feel
  up to exercising on a particular day, dont.
• Only slowly increase the intensity, time spent or
  frequency of exercise when the client knows he or
  she can cope with it. For example, if the client
  can exercise for five minutes without suffering a
  relapse, try for six minutes.

10
Recommendations for Exercise Programming Cont

• Strength training exercises should be based on
  preservation of levels of strength
• Progression of exercise activity should focus
  primarily on increasing the duration of moderate
  intensity activities instead of increasing
  exercise intensity
• Emphasize use of motivational cues social and
  extrinsic
• Avoid eccentric or upper extremity overhead
  loading
• Supervise and control with follow up support
• Avoid early morning exercise
• Ensure adequate time and attention for client

11
Special Considerations

• Depression may accompany condition as lifestyle
  changes occur due to persistent symptoms
• Often clients will express frustration as people
  are not sympathetic to their condition
• Clients tend to cope with symptoms by planning
  acivities to budget their energy

12
References

• Mondell, D. L. (c2005.). Living with chronic
  fatigue syndrome 4 steps to manage pain and lead
  a fulfilling life / (1st ed. ed.). New York
  McGraw-Hill,.
• Sietsema, K. E. (1997). Chronic Fatigue Syndrome.
  In J.L. Durstine G.E. Moore (Eds.), American
  College of Sports Medicine Exercise Management
  for Persons with Chronic Diseases and
  Disabilities. (pp.141-145). Windsor Human
  Kinetics
• Wallace, Daniel J. (Daniel Jeffrey),1949-.
  (2002.). All about chronic fatigue syndrome.
  Oxford New York Oxford University Press,.