CARDIOPULMONARY EXERCISE TEST PERFORMANCE IN MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME: SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
PURPOSE/HYPOTHESIS: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by a waxing and waning set of disabling symptoms that occur in response to physical activity. Symptomatology is thought to be associated with decremented performance on CPET, however study results have been mixed. The purpose of this systematic review and meta-analysis was to compare CPET performance between individuals with ME/CFS and matched control subjects. NUMBER OF SUBJECTS: Eighteen studies including n = 975 people who met clinical criteria for ME/CFS (eg, Oxford, Holmes, Fukuda, Canadian Consensus Criteria, and International Consensus Criteria) and n = 500 control subjects who were matched for sex and age. MATERIALS AND METHODS: Articles that reported CPET measurements at either peak exertion or ventilatory anaerobic threshold (VAT) were included in the quantitative analysis. Medline Complete, CINAHL, Academic Search Complete, SPORTDISCUS, and PsycINFO was searched on 5 December 2018 using keywords ((SU exercise tests) OR (exercise physiology) OR (cardiopulmonary system)) AND ((SU myalgic encephalomyelitis) OR (SU chronic fatigue syndrome)). Hand searches of the reference sections of identified papers were also completed. The systematic review revealed 18 articles that were included in the quantitative analysis. Measurements of volume of oxygen consumed (VO2), heart rate (HR), workload (WL), respiratory exchange ratio (RER) obtained during a single CPET were abstracted for maximal exertion and VAT. Standardized mean difference (d) and 95% confidence interval (95% CI) were calculated for each variable. Two-sample t test were conducted to assess the statistical significance of raw mean differences between groups. Statistical significance was determined at α ≤ 0.05. RESULTS: Clinical criteria used to identify ME/CFS and ramping protocols varied across studies. No significant difference in maximal RER was identified between groups (d: −.07; 95% CI: −0.20 to 0.06; P = .293). At maximal exertion, significant differences favoring the matched control subjects were identified for VO2 (d: −1.13; 95% CI: −2.16 to −1.01; P < .0001) HR (d: −1.65; 95% CI: −2.11 to −1.52; P < .0001), and WL (d: −4.26; 95% CI: −4.48 to −4.02; P < .0001). Subjects with ME/CFS had higher maximal RPE than matched control subjects (d: 0.93; 95% CI: .55 to 1.29; P < .0001). At VAT, significant differences favoring the matched control subjects were identified for VO2 (d: −1.53; 95% CI: −1.75 to −1.31; P < .0001), HR (d: −2.12; 95% CI: −2.28 to −1.96), and WL (d: −6.50; 95% CI: −6.84 to −6.18). CONCLUSIONS: People with ME/CFS demonstrated lower VO2, HR, and WL at maximal exertion and VAT compared to age and sex matched control subjects. The magnitude of differences between groups was greater at VAT than maximal exertion. CLINICAL RELEVANCE: People with ME/CFS demonstrate objectively verifiable impairments in VO2, HR, and WL on CPET, which may relate to observed functional disability.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».