Pain-Related Post-Exertional Malaise in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: A Systematic Review and Three-Level Meta-Analysis
In: Pain Medicine, Jg. 23 (2021-10-20), S. 1144-1157
Online
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Zugriff:
Objective Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) are two debilitating, moderately comorbid illnesses in which chronic musculoskeletal pain symptoms are prevalent. These individuals can experience post-exertional malaise (PEM), a phenomenon in which symptom severity is worsened for 24 hours or longer after physical stress, but the pain-related component of PEM is not well characterized. Design Systematic review and meta-analysis. Methods Case–control studies involving adults with ME/CFS or FM and measuring pain symptoms before and after exposure to a standardized aerobic exercise test were included. Hedges’ d effect sizes were aggregated with random-effects models, and potential moderators were explored with meta-regression analysis. Results were adjusted for nesting effects with three-level modeling. Results Forty-five effects were extracted from 15 studies involving 306 patients and 292 healthy controls. After adjusting for nesting effects, we observed a small to moderate effect indicating higher post-exercise pain in patients than in controls (Hedges’ d = 0.42; 95% confidence interval [CI]: 0.16–0.67). The mean effect was significantly moderated by pain measurement time point (b = –0.19, z = –2.57, P = 0.01), such that studies measuring pain 8–72 hours after exercise showed larger effects (d = 0.71, 95% CI = 0.28–1.14) than did those measuring pain 0–2 hours after exercise (d = 0.32, 95% CI = 0.10–0.53). Conclusions People with ME/CFS and FM experience small to moderate increases in pain severity after exercise, which confirms pain as a component of PEM and emphasizes its debilitating impact in ME/CFS and FM. Future directions include determining mechanisms of pain-related PEM and developing exercise prescriptions that minimize symptom exacerbation in these illnesses.
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Pain-Related Post-Exertional Malaise in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: A Systematic Review and Three-Level Meta-Analysis
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Autor/in / Beteiligte Person: | Ellen E Barhorst ; Lindheimer, Jacob B. ; Boruch, Alexander E. ; Cook, Dane B. |
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Zeitschrift: | Pain Medicine, Jg. 23 (2021-10-20), S. 1144-1157 |
Veröffentlichung: | Oxford University Press (OUP), 2021 |
Medientyp: | unknown |
ISSN: | 1526-4637 (print) ; 1526-2375 (print) |
DOI: | 10.1093/pm/pnab308 |
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