Abstract
Chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME) are, amongst others, characterized by exercise intolerance, pain, post exertional malaise and orthostatic intolerance. It has been shown in venous disease and sport participation that compression stockings may improve exercise performance and reduce post exercise muscle soreness. Moreover, its use is advocated in orthostatic hypotension. Therefore, it was hypothesized that compression stockings may reduce symptomatology in CFS/ME patients. Methods: 100 patients used compression stockings class II for minimally 3 weeks and thereafter filled in a questionnaire, based on the Rand 36 physical activity questions (n = 9), whether compression stockings changed perceived symptoms or not. Moreover, 7 questions referring to prolonged standing and sitting, to recovery post exercise, muscle pain during or immediately post exercise, and to dizziness/light-headedness during or immediately post exercise, while standing and during prolonged sitting were added. Questions were scored as 1: able to perform activity much less while wearing the stockings, 2: perform activity somewhat less, 3: no perceived change in activity, 4: perform activity slightly better, 5: able to perform activity much better while wearing the stockings. Results: In patients able to answer the question, all mean scores per activity were significantly higher than 3, being no perceived change in activity while wearing the stockings. Subgroup analysis showed that patients with orthostatic intolerance reported higher effects than patients without orthostatic intolerance. Conclusion: This pilot study suggests that compression stockings may be useful to reduce symptomatology of physical activities in CFS/ME patients, especially in patients with orthostatic intolerance. Larger prospective studies with hard endpoints are warranted.
Highlights
The terms chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME) describe a complex physical illness characterized by debilitating fatigue, post-exertional malaise (PEM), orthostatic intolerance, pain, cognitive problems, sleep dysfunction and an array of other immune, neurological and autonomic symptoms
In the recent American syncope guidelines the use of compression garments were advocated in patients with orthostatic hypotension [25], where the OI − Patients OI + Patients P value between groups
Post exertional malaise and orthostatic intolerance are main complaints in Chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME) patients, and as scientific data are missing in this patient group, a pilot study was performed to assess its use in daily practice
Summary
The terms chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME) describe a complex physical illness characterized by debilitating fatigue, post-exertional malaise (PEM), orthostatic intolerance, pain, cognitive problems, sleep dysfunction and an array of other immune, neurological and autonomic symptoms. Rest and sleep produce only modest relief of fatigue/PEM and the other symptoms. The disease severity ranges from mild to severe. In the most severe cases, the patient is bedridden all of the time [1]. Signs and symptoms have been described in a recent extensive review of literature by the American Institute of Medicine (IoM) and in other scientific journals [2] [3] [4] [5]. A host of abnormalities have been identified in CFS/ME, and in almost any organ, the exact pathophysiology remains at present unclear [2] [6]
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