1. CHRONIC FATIGUE SYNDROME Danielle Lafferty, EXS 486

2. What is Chronic Fatigue Syndrome(CFS) ?  Complicated disorder characterized by extreme fatigue  Cannot be explained by underlying medical condition  Does not improve with rest  May worsen with physical or mental activity

3. Epidemiology of CFS  Up to 4 million US citizens meet CDC criteria for the disorder  85% of US citizens with CFS remain undiagnosed  It is 3 to 5 times more likely in women than men  Affects individuals of all racial and ethnic backgrounds

4. How does CFS occur?  No known cause  Several theories  Viral infection: herpes 6, Epstein-Barr, measles  Hormonal Imbalance  Immune System Abnormality

5. Effects of CFS  Hypotension and tachycardia often occur with CFS  Those with CFS experience symptoms such as  Fatigue  Sore throat  Loss of memory and concentration  Muscle pain  Enlarged lymph nodes  headache  Exhaustion lasting longer than 24 hours after activity

6. Diagnosis of CFS  Diagnosis is challenging for CFS  No lab test can be done for diagnosis  Diagnosis occurs if there is significant reduction in the individual’s ability to perform daily activities  Diagnosis requires fatigue of 6 months or more in adults and at least 3 months in children

7. Management and Medication  No cure or prescription drugs specifically for CFS  Individuals can take medicine to relieve symptoms  Pain relievers and anti-inflammatory drugs such as Advil and Ibuprofin  Prescription drugs such as anticonvulsants (used to treat pain and for sleep problems), and narcotics when over the counter medicine does not relieve pain

8. Risk Factors for CFS  Age: can occur at any age but most common in 40s and 50s  Sex: women diagnosed more than men  Stress: difficulty managing stress could contribute to development of CFS

9. Exercise and Chronic Fatigue Syndrome  CFS can result in reduced participation in daily activities  Most patients have post- exertion malaise ( intensifying of symptoms following 12-48 hours after exertion/activity)  Extremes should be avoided  daily activities and chores may need to be broken down into shorter, less intense pieces  Important not to avoid exercise altogether

10. Case study  Patient is 30 year old female with CFS  BMI of 20 kg/m^2  Has been sedentary for the past 20 years  No family history of CV history  FBG=90mg/dl, TC=180mg/dl, LDL=120mg/dl, HDL=40 mg/dl  Blood pressure= 80/60 mmhg  Non- smoker  Has muscle pain and low energy level

11. Risk Stratification of Client  Only risk factor is her sedentary lifestyle  she does have hypotension  Although not a risk factor, need to be careful of lightheadedness during exercise  According to ACSM she would be placed in the low risk category because she only has one risk factor

12. Goal for Client  Main goal is just to improve health  No need for vigorous exercise  Appropriate balance between rest and exercise  Activity will improve emotional and psychological factors

13. Exercise Program  All exercise should be performed in a activity/rest ratio of 1:3  Aerobic activity:  40-60% max HR  30 minutes a day  3 times per week  Walking/biking/elliptical  Can be broken up into 3 sets of 10 minutes at a time if needed or 2 sets of 15

14. Exercise Program  Resistance Training  2 times per week  30-60% of max effort  15 minutes at a time  Body weight exercises: pushups(modified),sit ups, crunches

15. Conclusion  Client is suffering through a variety of symptoms  Rest is extremely important while exercising  Need to be careful of post exertion malaise  Remind client why exercise is important for them

16. References Allen, Peggy (2008). Chronic Fatigue Syndrome: Implications for Women and their Health Care Providers During the Childbearing Years. Journal of Midwifery and Women’s Health, 53(4). Centers for Disease Control and Prevention. (2014). Managing Activities and Exercise. Retrieved from CDC.gov: http://www.cdc.gov/cfs/management/managing- activities.html MayoClinic.(2014).Chronic Fatigue Syndrome. Retrieved from mayoclinic.org: http://www.mayoclinic.org/diseases-conditions/chronic-fatigue- syndrome/basics/symptoms/con-20022009 MedlinePlus.(2014). Chronic Fatigue Syndrome. Retrieved from nlm.nih.gov:http://www.nlm.nih.gov/medlineplus/chronicfatiguesyndrome.html