K. Ickmans, PT, MSc, Pain in Motion Research Group, Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion Research Group, Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College, Antwerp, Belgium; and Pain in Motion Research Group, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
Phys Ther. 2014 Apr;94(4):511-22. doi: 10.2522/ptj.20130367. Epub 2013 Dec 20.
Both good physical and cognitive functioning have a positive influence on the execution of activities of daily living. Patients with chronic fatigue syndrome (CFS) as well as patients with fibromyalgia have marked cognitive deficits. Furthermore, a good physical and functional health status may have a positive impact on a variety of cognitive skills-a link that has been observed in young and old individuals who are healthy, although evidence is limited in patients with CFS.
The purpose of this study was to examine whether recovery of upper limb muscle function could be a significant predictor of cognitive performance in patients with CFS and in patients with CFS and comorbid fibromyalgia. Furthermore, this study determined whether cognitive performance is different between these patient groups.
A case-control design was used.
Seventy-eight participants were included in the study: 18 patients with CFS only (CFS group), 30 patients with CFS and comorbid fibromyalgia (CFS+FM group), and 30 individuals who were healthy and inactive (control group) were studied. Participants first completed 3 performance-based cognitive tests designed to assess selective and sustained attention, cognitive inhibition, and working memory capacity. Seven days later, they performed a fatiguing upper limb exercise test, with subsequent recovery measures.
Recovery of upper limb muscle function was found to be a significant predictor of cognitive performance in patients with CFS. Participants in the CFS+FM group but not those in the CFS group showed significantly decreased cognitive performance compared with the control group.
The cross-sectional nature of this study does not allow for inferences of causation.
The results suggest that better physical health status could predict better mental health in patients with CFS. Furthermore, they underline disease heterogeneity, suggesting that reducing this factor in future research is important to better understand and uncover mechanisms regarding the nature of diverse impairments in these patients.
良好的身体和认知功能都对日常生活活动的执行有积极影响。慢性疲劳综合征（CFS）患者和纤维肌痛患者都有明显的认知缺陷。此外，良好的身体和功能健康状况可能对各种认知技能产生积极影响——这种联系在健康的年轻人和老年人中都有观察到，尽管在 CFS 患者中的证据有限。
本研究的目的是检验上肢肌肉功能的恢复是否可以成为 CFS 患者和 CFS 合并纤维肌痛患者认知表现的重要预测指标。此外，本研究还确定了这些患者群体之间的认知表现是否存在差异。
采用病例对照设计。
本研究纳入了 78 名参与者：18 名单纯 CFS 患者（CFS 组）、30 名 CFS 合并纤维肌痛患者（CFS+FM 组）和 30 名健康不活跃的个体（对照组）。参与者首先完成了 3 项基于表现的认知测试，旨在评估选择性和持续性注意力、认知抑制和工作记忆能力。7 天后，他们进行了一项使人疲劳的上肢运动测试，并进行了后续的恢复测量。
上肢肌肉功能的恢复被发现是 CFS 患者认知表现的重要预测指标。与对照组相比，CFS+FM 组的参与者而非 CFS 组的参与者表现出明显的认知表现下降。
本研究的横断面性质不允许进行因果推论。
结果表明，更好的身体健康状况可以预测 CFS 患者的更好的心理健康。此外，它们强调了疾病的异质性，表明在未来的研究中减少这一因素对于更好地理解和揭示这些患者各种损伤的性质的机制非常重要。
