Abstract
BackgroundMyalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex and debilitating disease accompanied by muscular fatigue and pain. A functional measure to assess muscle fatigability of ME/CFS patients is, however, not established in clinical routine. The aim of this study is to evaluate by assessing repeat maximum handgrip strength (HGS), muscle fatigability as a diagnostic tool and its correlation with clinical parameters.MethodsWe assessed the HGS of 105 patients with ME/CFS, 18 patients with Cancer related fatigue (CRF) and 66 healthy controls (HC) using an electric dynamometer assessing maximal (Fmax) and mean force (Fmean) of ten repetitive measurements. Results were correlated with clinical parameters, creatinine kinase (CK) and lactate dehydrogenase (LDH). Further, maximum isometric quadriceps strength measurement was conducted in eight ME/CFS patients and eight HC.ResultsME/CFS patients have a significantly lower Fmax and Fmean HGS compared to HC (p < 0.0001). Further, Fatigue Ratio assessing decline in strength during repeat maximal HGS measurement (Fmax/Fmean) was higher (p ≤ 0.0012). The Recovery Ratio after an identical second testing 60 min later was significantly lower in ME/CFS compared to HC (Fmean2/Fmean1; p ≤ 0.0020). Lower HGS parameters correlated with severity of disease, post-exertional malaise and muscle pain and with higher CK and LDH levels after exertion.ConclusionRepeat HGS assessment is a sensitive diagnostic test to assess muscular fatigue and fatigability and an objective measure to assess disease severity in ME/CFS.
Highlights
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/Chronic fatigue syndrome (CFS)) is a complex and debilitating disease accompanied by muscular fatigue and pain
Study population 105 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients were enrolled for handgrip strength (HGS) measurement
In our study we show that patients with ME/CFS have reduced Fmax and Fmean HGS compared to healthy controls (HC)
Summary
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex and debilitating disease accompanied by muscular fatigue and pain. A functional measure to assess muscle fatigability of ME/CFS patients is, not established in clinical routine. The aim of this study is to evaluate by assessing repeat maximum handgrip strength (HGS), muscle fatigability as a diagnostic tool and its correlation with clinical parameters. Chronic Fatigue Syndrome ( known as Myalgic Encephalomyelitis, ME/CFS), is a complex disease with persistent mental and physical fatigue causing severe impairment of quality of life. Jäkel et al J Transl Med (2021) 19:159 of ME/CFS is challenging for patients and physicians due to many unspecific symptoms, the broad differential diagnosis of chronic fatigue and the lack of an established biomarker. As objective measure to assess exertion intolerance in ME/CFS a repeat cardiopulmonary exercise test (CPET) is recommended by the National Institute of Health (NIH). The repeated exercise tests frequently lead to severe PEM and cannot be recommended for most patients [8]
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