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 IJCM  Vol.9 No.5 , May 2018
Quantification of the Beneficial Effects of Compression Stockings on Symptoms of Exercise and Orthostatic Intolerance in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients
Abstract: Chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME) are, amongst others, characterized by exercise intolerance, pain, post exertional malaise and orthostatic intolerance. It has been shown in venous disease and sport participation that compression stockings may improve exercise performance and reduce post exercise muscle soreness. Moreover, its use is advocated in orthostatic hypotension. Therefore, it was hypothesized that compression stockings may reduce symptomatology in CFS/ME patients. Methods: 100 patients used compression stockings class II for minimally 3 weeks and thereafter filled in a questionnaire, based on the Rand 36 physical activity questions (n = 9), whether compression stockings changed perceived symptoms or not. Moreover, 7 questions referring to prolonged standing and sitting, to recovery post exercise, muscle pain during or immediately post exercise, and to dizziness/light-headedness during or immediately post exercise, while standing and during prolonged sitting were added. Questions were scored as 1: able to perform activity much less while wearing the stockings, 2: perform activity somewhat less, 3: no perceived change in activity, 4: perform activity slightly better, 5: able to perform activity much better while wearing the stockings. Results: In patients able to answer the question, all mean scores per activity were significantly higher than 3, being no perceived change in activity while wearing the stockings. Subgroup analysis showed that patients with orthostatic intolerance reported higher effects than patients without orthostatic intolerance. Conclusion: This pilot study suggests that compression stockings may be useful to reduce symptomatology of physical activities in CFS/ME patients, especially in patients with orthostatic intolerance. Larger prospective studies with hard endpoints are warranted.
Cite this paper: van Campen, C. , Verheugt, F. and Visser, F. (2018) Quantification of the Beneficial Effects of Compression Stockings on Symptoms of Exercise and Orthostatic Intolerance in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients. International Journal of Clinical Medicine, 9, 367-376. doi: 10.4236/ijcm.2018.95032.
References

[1]   Carruthers, B.M., et al. (2011) Myalgic Encephalomyelitis: International Consensus Criteria. Journal of Internal Medicine, 270, 327-338.
https://doi.org/10.1111/j.1365-2796.2011.02428.x

[2]   Clayton, E.W. (2015) Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An IOM Report on Redefining an Illness. JAMA, 313, 1101-1102.
https://doi.org/10.1001/jama.2015.1346

[3]   Jason, L.A., et al. (2015) Problems in Defining Post-Exertional Malaise. Journal of Prevention & Intervention in the Community, 43, 20-31.
https://doi.org/10.1080/10852352.2014.973239

[4]   Loy, B.D., O’Connor, P.J. and Dishman, R.K. (2016) Effect of Acute Exercise on Fatigue in People with ME/CFS/SEID: A Meta-Analysis. Medicine & Science in Sports & Exercise, 48, 2003-2012.
https://doi.org/10.1249/MSS.0000000000000990

[5]   IOM. (2015) Beyond Mayalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. The National Academies Press, Washington DC.
https://doi.org/10.1186/1741-7015-11-205

[6]   Morris, G. and Maes, M. (2013) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Encephalomyelitis Disseminata/Multiple Sclerosis Show Remarkable Levels of Similarity in Phenomenology and Neuroimmune Characteristics. BMC Medicine, 11, 205.
https://doi.org/10.1186/1741-7015-11-205

[7]   Fukuda, K., et al. (1994) The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine, 121, 953-959.
https://doi.org/10.7326/0003-4819-121-12-199412150-00009

[8]   Bou-Holaigah, I., et al. (1995) The Relationship between Neurally Mediated Hypotension and the Chronic Fatigue Syndrome. JAMA, 274, 961-967.
https://doi.org/10.1001/jama.1995.03530120053041

[9]   De Lorenzo, F., Hargreaves, J. and Kakkar, V.V. (1997) Pathogenesis and Management of Delayed Orthostatic Hypotension in Patients with Chronic Fatigue Syndrome. Clinical Autonomic Research, 7, 185-190.
https://doi.org/10.1007/BF02267980

[10]   Roerink, M.E., et al. (2017) Postural Orthostatic Tachycardia Is Not a Useful Diagnostic marker for Chronic Fatigue Syndrome. Journal of Internal Medicine, 281, 179-188.
https://doi.org/10.1111/joim.12564

[11]   Miwa, K. (2016) Variability of Postural Orthostatic Tachycardia in Patients with Myalgic Encephalomyelitis and Orthostatic Intolerance. Heart Vessels, 31, 1522-1528.
https://doi.org/10.1007/s00380-015-0744-3

[12]   Razumovsky, A.Y., et al. (2003) Cerebral and Systemic Hemodynamics Changes during Upright Tilt in Chronic Fatigue Syndrome. Journal of Neuroimaging, 13, 57-67.
https://doi.org/10.1111/j.1552-6569.2003.tb00158.x

[13]   Hoad, A., et al. (2008) Postural Orthostatic Tachycardia Syndrome Is an Under-Recognized Condition in Chronic Fatigue Syndrome. QJM, 101, 961-965.
https://doi.org/10.1093/qjmed/hcn123

[14]   Lewis, I., et al. (2013) Clinical Characteristics of a Novel Subgroup of Chronic Fatigue Syndrome Patients with Postural Orthostatic Tachycardia Syndrome. Journal of Internal Medicine, 273, 501-510.
https://doi.org/10.1111/joim.12022

[15]   Reynolds, G.K., et al. (2014) Comorbidity of Postural Orthostatic Tachycardia Syndrome and Chronic Fatigue Syndrome in an Australian Cohort. Journal of Internal Medicine, 275, 409-417.
https://doi.org/10.1111/joim.12161

[16]   LaManca, J.J., et al. (1999) Cardiovascular Response during Head-Up Tilt in Chronic Fatigue Syndrome. Clinical Physiology, 19, 111-120.
https://doi.org/10.1046/j.1365-2281.1999.00154.x

[17]   Jones, J.F., et al. (2005) Orthostatic Instability in a Population-Based Study of Chronic Fatigue Syndrome. American Journal of Medicine, 118, 1415.
https://doi.org/10.1016/j.amjmed.2005.06.013

[18]   Blockmans, D., et al. (2003) Combination Therapy with Hydrocortisone and Fludrocortisone Does Not Improve Symptoms in Chronic Fatigue Syndrome: A Randomized, Placebo-Controlled, Double-Blind, Crossover Study. American Journal of Medicine, 114, 736-741.
https://doi.org/10.1016/S0002-9343(03)00182-7

[19]   Peterson, P.K., et al. (1998) A Preliminary Placebo-Controlled Crossover Trial of Fludrocortisone for Chronic Fatigue Syndrome. Archives of Internal Medicine, 158, 908-914.
https://doi.org/10.1001/archinte.158.8.908

[20]   Rowe, P.C., et al. (2001) Fludrocortisone Acetate to Treat Neurally Mediated Hypotension in Chronic Fatigue Syndrome: A Randomized Controlled Trial. JAMA, 285, 52-59.
https://doi.org/10.1001/jama.285.1.52

[21]   Naschitz, J., et al. (2004) Midodrine Treatment for Chronic Fatigue Syndrome. Postgraduate Medical Journal, 80, 230-232.
https://doi.org/10.1136/pgmj.2003.011429

[22]   Kawamura, Y., et al. (2003) Efficacy of a Half Dose of Oral Pyridostigmine in the Treatment of Chronic Fatigue Syndrome: Three Case Reports. Pathophysiology, 9, 189-194.
https://doi.org/10.1016/S0928-4680(03)00007-5

[23]   Miwa, K. (2017) Down-Regulation of Renin-Aldosterone and Antidiuretic Hormone Systems in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal of Cardiology, 69, 684-688.
https://doi.org/10.1016/j.jjcc.2016.06.003

[24]   McDonald, C., et al. (2014) Postural Tachycardia Syndrome Is Associated with Significant Symptoms and Functional Impairment Predominantly Affecting Young Women: A UK Perspective. BMJ Open, 4, e004127.
https://doi.org/10.1136/bmjopen-2013-004127

[25]   Shen, W.K., et al. (2017) 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 70, 620-663.
https://doi.org/10.1016/j.jacc.2017.03.002

[26]   Podoleanu, C., et al. (2006) Lower Limb and Abdominal Compression Bandages Prevent Progressive Orthostatic Hypotension in Elderly Persons: A Randomized Single-Blind Controlled Study. Journal of the American College of Cardiology, 48, 1425-1432.
https://doi.org/10.1016/j.jacc.2006.06.052

[27]   Beliard, S., et al. (2015) Compression Garments and Exercise: No Influence of Pressure Applied. Journal of Sports Science and Medicine, 14, 75-83.

[28]   Rabe, E., et al. (2018) Indications for Medical Compression Stockings in Venous and Lymphatic Disorders: An Evidence-Based Consensus Statement. Phlebology, 33, 163-184.
https://doi.org/10.1177/0268355516689631

[29]   Murdock, K.W., et al. (2017) The Utility of Patient-Reported Outcome Measures among Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Quality of Life Research, 26, 913-921.
https://doi.org/10.1007/s11136-016-1406-3

[30]   Haywood, K.L., Staniszewska, S. and Chapman, S. (2012) Quality and Acceptability of Patient-Reported Outcome Measures Used in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): A Systematic Review. Quality of Life Research, 21, 35-52.
https://doi.org/10.1007/s11136-011-9921-8

[31]   Motykie, G.D., et al. (1999) Evaluation of Therapeutic Compression Stockings in the Treatment of Chronic Venous Insufficiency. Dermatologic Surgery, 25, 116-120.
https://doi.org/10.1046/j.1524-4725.1999.08095.x

[32]   Moffatt, C. (2008) Variability of Pressure Provided by Sustained Compression. International Wound Journal, 5, 259-265.
https://doi.org/10.1111/j.1742-481X.2008.00470.x

[33]   Agu, O., Baker, D. and Seifalian, A.M. (2004) Effect of Graduated Compression Stockings on Limb Oxygenation and Venous Function during Exercise in Patients with Venous Insufficiency. Vascular, 12, 69-76.
https://doi.org/10.1258/rsmvasc.12.1.69

[34]   Beidler, S.K., et al. (2009) Inflammatory Cytokine Levels in Chronic Venous Insufficiency Ulcer Tissue before and after Compression Therapy. Journal of Vascular Surgery, 49, 1013-1020.
https://doi.org/10.1016/j.jvs.2008.11.049

[35]   Mann, S., et al. (2016) The Effects of Compression Socks on Arterial Blood Flow and Arterial Reserves in Amateur Sportsmen. Development in Sports Science, 1, 1-9.

[36]   Okamoto, T., et al. (2013) Acute Effect of Brisk Walking with Graduated Compression Stockings on Vascular Endothelial Function and Oxidative Stress. Clinical Physiology and Functional Imaging, 33, 455-462.
https://doi.org/10.1111/cpf.12052

[37]   Streeten, D.H., Thomas, D. and Bell, D.S. (2000) The Roles of Orthostatic Hypotension, Orthostatic Tachycardia, and Subnormal Erythrocyte Volume in the Pathogenesis of the Chronic Fatigue Syndrome. The American Journal of the Medical Sciences, 320, 1-8.
https://doi.org/10.1097/00000441-200007000-00001

 
 
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