Smith Wayne R, White Peter D, Buchwald Dedra
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
BMC Psychiatry. 2006 Nov 13;6:53. doi: 10.1186/1471-244X-6-53.
Patients with chronic fatigue syndrome typically report high levels of physical activity before becoming ill. Few studies have examined premorbid and current activity levels in chronically fatigued patients.
In a case-control study, 33 patients with chronic, unexplained, disabling fatigue attending a university-based clinic specializing in fatigue were compared to 33 healthy, age- and sex-matched controls. Patients rated their activity levels before their illness and currently, using scales designed for this purpose. Controls reported their level of activity of 2 years previously and currently. Chi-square analyses, Student's t tests, and Wilcoxon signed rank tests were used in pair matched analyses.
Compared to healthy controls, patients with chronic, unexplained fatigue rated themselves as more active before their illness (p < or = 0.001) and less active currently (p < or = 0.001). The patients also reported they currently stood or walked less than the controls (median [inter-quartile range] = 4 2345 versus 9 [7.5-12] hours, p < or = 0.001), and spent more time reclining (median [inter-quartile range] = 12 10111213141516 versus 8 [8-9.5] hours, p < or = 0.001). These differences remained significant for the subset of patients who met strict criteria for chronic fatigue syndrome or fibromyalgia.
Patients with chronic, unexplained, disabling fatigue reported being more active before becoming ill than healthy controls. This finding could be explained by greater premorbid activity levels that could predispose to illness, or by an overestimation of previous activity. Either possibility could influence patients' perceptions of their current activity levels and their judgments of recovery. Perceived activity should be addressed as part of management of the illness.
慢性疲劳综合征患者通常报告在患病前有较高的身体活动水平。很少有研究调查慢性疲劳患者病前和当前的活动水平。
在一项病例对照研究中,将33名在一家专门治疗疲劳的大学诊所就诊的患有慢性、不明原因、致残性疲劳的患者与33名年龄和性别匹配的健康对照者进行比较。患者使用为此目的设计的量表对他们患病前和当前的活动水平进行评分。对照者报告他们两年前和当前的活动水平。在配对分析中使用卡方分析、学生t检验和威尔科克森符号秩检验。
与健康对照者相比,患有慢性、不明原因疲劳的患者认为自己在患病前更活跃(p≤0.001),而目前则较不活跃(p≤0.001)。患者还报告说,他们目前站立或行走的时间比对照者少(中位数[四分位间距]=4[2 - 3 - 4 - 5]小时对9[7.5 - 12]小时,p≤0.001),且躺卧的时间更多(中位数[四分位间距]=12[10 - 11 - 12 - 13 - 14 - 15 - 16]小时对8[8 - 9.5]小时,p≤0.001)。对于符合慢性疲劳综合征或纤维肌痛严格标准的患者亚组,这些差异仍然显著。
患有慢性、不明原因、致残性疲劳的患者报告在患病前比健康对照者更活跃。这一发现可以用可能易患疾病的更高病前活动水平来解释,或者用对先前活动的高估来解释。这两种可能性都可能影响患者对其当前活动水平的认知及其恢复判断。应将感知到的活动作为疾病管理的一部分加以处理。