Category: Alternative Treatments

Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations?

Abstract:

OBJECTIVES: To assess the dietary habits and food avoidance-behavior in patients with Chronic Fatigue Syndrome (CFS).

METHODS: Cross-sectional pilot study with 28 patients diagnosed with severe CFS. Eating habits were assessed with a food frequency questionnaire and 3-day food records. We analyzed variables related to dietary restrictions induced by symptoms or external information.

RESULTS: The most prevalent restrictions were for dairy products and gluten-containing grains, with 22 and 15 restricting patients, respectively. Patients reported different digestive symptoms, which did not improve with the use of exclusion diets. Thirteen patients had received information against the intake of certain foods through different sources. Six cases of grains restriction and 11 of dairy were compatible with a counseling-induced pattern of exclusion.

CONCLUSIONS: There is not a homogeneous pattern of food avoidance. Dietary restrictions should be based on a proven food allergy or intolerance. Dietary counseling should be based on sound nutritional knowledge.

 

Source: Trabal J, Leyes P, Fernández-Solá J, Forga M, Fernández-Huerta J. Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations? Nutr Hosp. 2012 Mar-Apr;27(2):659-62. doi: 10.1590/S0212-16112012000200046. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000200046&lng=en&nrm=iso&tlng=en (Full article)

 

Effects of tuina on the mechanical properties of skeletal muscles of four limbs in patients with chronic fatigue syndrome

Abstract:

OBJECTIVE: To study the effects of tuina on the mechanical properties of skeletal muscles of four limbs in patients with chronic fatigue syndrome (CFS).

METHODS: Thirty CFS patients were recruited as the test group, while another 30 healthy volunteers were recruited as the healthy control group. Patients in the test group received tuina therapy, 30 min each time, once every other day, for totally 10 times. Isokinetic testing technology was used to compare peak torque (PT), total watt (TW), average power (AP), and flexor/extensor (F/E) ratio in the elbow and knee muscles of CFS patients before and after treatment. The Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale was used to evaluate the fatigue degree before and after treatment, and compared with the healthy control group.

RESULTS: After treatment the FACIT fatigue scale score decreased significantly in the test group when compared with before treatment (27.5 +/- 9.1 vs 42.5 +/- 11.2), showing statistical difference (P < 0.05). The pre-treatment PT, TW, AP, and F/E ratio in the skeletal muscle were all lower in the test group than in the healthy control group. Compared with before treatment in the test group, patients’ elbow 60 degrees/s angular velocity values during exercise extensor PT and TW, knee 60 degrees/s and 180 degrees/s angular velocity values during exercise flexor PT and TW increased significantly; elbow extensor and knee extensor, flexor AP was significantly elevated; knee in 180 degrees/s angular velocity of movement F/E ratio significantly increased, and all the differences were statistically significant (P < 0.05). The improvement of the fatigue degree in CFS patients and elbow in 60 degrees/s angular velocity values under the flexor and extensor TW, and flexor AP value of the degree of improvement were negatively correlated (r = -0.282, -0.482, -0.285, P < 0.05, P < 0.01). Meanwhile, the muscles with the knee in 180 degrees/s angular velocity was negatively correlated with the F/E ratio of the degree of improvement (r = -0. 330, P < 0.05).

CONCLUSIONS: CFS patients have lowered mechanical properties of four limbs. Tuina therapy can improve the biomechanical properties of limb skeletal muscle and reduce the overall degree of fatigue in patients. The changes of limb skeletal muscle and mechanical properties can provide objective reference for the clinical diagnosis and assessment of CFS.

 

Source: Liu KP, Fang M, Jiang SY. Effects of tuina on the mechanical properties of skeletal muscles of four limbs in patients with chronic fatigue syndrome. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 May;32(5):599-602. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22679716

 

Effect of acupuncture on serum malonaldehyde content, superoxide dismutase and glutathione peroxidase activity in chronic fatigue syndrome rats

Abstract:

OBJECTIVE: To study the effect of acupuncture on blood oxygen free radical metabolism in rats with chronic fatigue syndrome (CFS).

METHODS: Thirty male SD rats were randomly divided into control group (n = 10), model group (n = 10) and acupuncture group (n = 10). CFS model was established by repeated suspension (1.0-2.5 h) and forced cold water swimming (7 min), once daily continuously for 12 days. For rats in the acupuncture group, bilateral “Zusanli” (ST 36) and “Sanyinjiao” (SP 6) were stimulated by manipulating the acupuncture needles intermittently for 20 min, once daily, and with 7 days being a treatment course. The treatment was conducted for three courses with an interval of 3 days between two courses. Serum malonaldehyde (MDA) content, superoxide dismutase (SOD) activity, and glutathione peroxidase (GSH-PX) activity were detected by thiobarbituric acid chromatometry (TBA), xanthine oxidase (XOD) and dithio-bis-nitrobenzoic acid (DTNB), respectively.

RESULTS: In comparison with the control group, serum MDA content was up-regulated significantly, while serum SOD activity and GSH-PX activity were decreased considerably in the model group (P < 0.01). Compared with the model group, serum MDA level was down-regulated apparently, and serum SOD activity and GSH-PX activity were up-regulated remarkably in the acupuncture group (P < 0.01).

CONCLUSION: Acupuncture can adjust metabolism of serum oxygen free radicals in CFS rats, which probably contributes to its effect in relieving CFS in clinic.

 

Source: Liu CZ, Lei B. Effect of acupuncture on serum malonaldehyde content, superoxide dismutase and glutathione peroxidase activity in chronic fatigue syndrome rats. Zhen Ci Yan Jiu. 2012 Feb;37(1):38-40, 58. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22574567

 

Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back

Abstract:

OBJECTIVE: To compare the differences of therapeutic effect of chronic fatigue syndrome treated with the combined therapy of coiling dragon needling and cupping on back and the western medicine therapy with Prednisone.

METHODS: Seventy-two cases were randomly divided into an acupuncture and cupping group (37 cases) and a Prednisone group (35 cases). In acupuncture and cupping group, Jiaji (EX-B 2) points of T1–L5 were applied with coiling dragon needling (once a day), combined with moving cupping on back (once every two days); in Prednisone group, Prednisone tablets were orally taken for 10 mg at 8:00 am. Seven days made one course, and 2 courses were carried on totally. FS-14 scale and BELL’s chronic fatigue syndrome integral table were applied to evaluate the fatigue degree of patients before and after treatment, and the therapeutic effects of both groups were compared.

RESULTS: After one course of treatment, the BELL’s scores of both groups were obviously improved (both P < 0.01), but there was no significant difference between groups (P > 0.05); after two courses of treatment, the BELL’s score in acupuncture and cupping group improved more obviously than that in Prednisone group, and the total effective rate of 91.9% (34/37) in acupuncture and cupping group was superior to that of 71.4% (25/35) in Prednisone group (P < 0.05).

CONCLUSION: The therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back is positive, superior to that of Prednisone with oral administration.

 

Source: Xu W, Zhou RH, Li L, Jiang MW. Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back. Zhongguo Zhen Jiu. 2012 Mar;32(3):205-8. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22471128

 

Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients

Abstract:

OBJECTIVE: To observe the therapeutic effect and safety of acupuncture of Back-shu points [Xinshu (BL 15), Pishu (BL 20), etc.] in the treatment of chronic fatigue syndrome (CFS).

METHODS: A total of 120 CFS patients were equally randomized Into acupuncture and control groups. Acupuncture needles were inserted into bilateral Xinshu (BL 15), Pishu (BL 20), and Gaohuang (BL 43) points, once daily for 4 weeks except weekends. For patients of the control group, acupuncture needles were inserted into the shallow layer of the non-acupoints (two mid-points of the horizon lines passing through the crossing-points of the 1st and 2nd branches of the Gallbladder Meridian and the crests of 4th, 5th and 11th thoracic vertebrae). General health scale (SF-20) and Chalder fatigue scale were used to measure the CFS patients’ degree of general health. A follow-up survey was carried out 3 months after the last treatment.

RESULTS: In comparison with pre-treatment, the scores of Chalder fatigue scale were decreased significantly in both treatment and control groups (P < 0.01), while the scores of physiological function (PF) and general health (GH) of SF-20 in both acupuncture groups and those of the role function (RF), social function (SF), mental health (MH) and pain sensation (PS) in the treatment group were increased apparently after the treatment (P < 0.05, P < 0.01). The scores of Chalder Scale and PF, RF, SF, GH, MH, PS and the CFS patients’ satisfication degrees 4 weeks (64.4% and 36.7%) and 3 months (62.3% and 32%) after the treatment in the treatment group were significantly superior to those of the control group (P < 0.05).

CONCLUSION: Acupuncture at Back-shu point has a good therapeutic effect (including immediate and midterm effect) in the treatment of chronic fatigue syndrome patients.

 

Source: Zhang W, Liu ZS, Xu HR, Liu YS. Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients. Zhen Ci Yan Jiu. 2011 Dec;36(6):437-41, 448. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22379791

 

Cervical neuro-muscular syndrome: discovery of a new disease group caused by abnormalities in the cervical muscles

Abstract:

Our previous study of whiplash injury found that abnormalities in the cervical muscles cause autonomic dystonia. Further research has found that abnormalities in the cervical muscles cause headache, chronic fatigue syndrome, vertigo, and dizziness. We named this group of diseases cervical neuro-muscular syndrome. Patients treated within a 2-year period from April 1, 2002 to March 31, 2004 reported good outcomes in 83.8% for headache, 88.4% for vertigo and dizziness, 84.5% for chronic fatigue syndrome, 88.0% for autonomic dystonia, and 83.7% for whiplash-associated disorder. A large number of outpatients present with general malaise, including many general physical complaints without identifiable cause. We propose that treatment of the cervical muscle is effective for general malaise.

 

Source: Matsui T, Ii K, Hojo S, Sano K. Cervical neuro-muscular syndrome: discovery of a new disease group caused by abnormalities in the cervical muscles. Neurol Med Chir (Tokyo). 2012;52(2):75-80. https://www.jstage.jst.go.jp/article/nmc/52/2/52_2_75/_pdf (Full article)

 

Role of Lactobacillus acidophilus loaded floating beads in chronic fatigue syndrome: behavioral and biochemical evidences

Abstract:

BACKGROUND: In recent years the interface between neuropsychiatry and gastroenterology has converged in to a new discipline referred to as enteric neuroscience. Implications of brain-gut communication in the pathogenesis of psychiatric disorders indicate a possible role of suitably packaged/delivered probiotics as newer therapeutic options. In the present study probable role of per-oral administration of free Lactobacillus acidophilus (LAB) and LAB loaded alginate beads in attenuation of the symptoms associated with chronic fatigue syndrome (CFS) were evaluated.

METHODS: Chronic fatigue syndrome following physical fatigue was induced in rats by forcing them to swim (forced swim test; FST) in water till exhaustion, after weighing them down with 10% their body weight, daily for 28 days. Immobility (I) and postswim fatigue time (PSF) were taken as suitable markers. Free LAB and LAB loaded floating beads (FBs) were administered, from 21 to 28 days.

KEY RESULTS: Immobility and PSF were found to increase considerably in FST rats (665 ± 22 s and 196 ± 6 s) as compared with the naïve (32 ± 7 s and 22 ± 2 s) at 20 days, establishing severe fatigue like behavior. FST control group exhibited significant (P < 0.05) hypertrophy of spleen, hypotrophy of thymus, and increased oxido-nitrosative stress in brain and tumor necrosis factor-α (TNF-α) levels in serum. Treatment with LAB and LAB FBs significantly decreased I and PSF and attenuated (P < 0.05) oxido-nitrosative stress and TNF-α levels. Spleen and thymus were also restored to their original size in this group.

CONCLUSIONS & INFERENCES: The findings suggest a valuable therapeutic role of LAB especially when incorporated into alginate beads for the treatment of CFS.

© 2012 Blackwell Publishing Ltd.

 

Source: Singh PK, Chopra K, Kuhad A, Kaur IP. Role of Lactobacillus acidophilus loaded floating beads in chronic fatigue syndrome: behavioral and biochemical evidences. Neurogastroenterol Motil. 2012 Apr;24(4):366-e170. doi: 10.1111/j.1365-2982.2011.01861.x. Epub 2012 Feb 1. https://www.ncbi.nlm.nih.gov/pubmed/22296294

 

A study of median frequencies of skeletal muscle undergoing Tuina intervention in patients with chronic fatigue syndrome

Abstract:

OBJECTIVE: To study the changes in median frequency (MF) from a surface electromyogram of skeletal muscles and functional assessment of chronic illness therapy (FACIT) figure scale scores for patients with chronic fatigue syndrome (CFS) before and after Tuina treatment.

METHODS: A controlled clinical trial was adopted. Thirty-two patients suffering from CFS were enrolled according to the inclusion criteria from outpatient department of Shanghai Yueyang Hospital of Integrated Chinese and Western Medicine in China; thirty normal people whose gender, age, height and body mass were concordant with the CFS patients were selected as the normal group. Surface electromyography was used to detect the median frequency (MF) of biceps, quadriceps, and waist and back muscle before and after a 20-day course of treatment. CFS patients also were asked to fill out the figure scale of FACIT to evaluate the degree of fatigue.

RESULTS: There was no significant difference in surface electromyography MF of myoelectric signal of biceps and quadriceps between CFS and normal person; however, the waist and back muscle MF of the normal person was significantly lower than that of the CFS patients. Before and after treatment, there were no obvious changes in the MF of myoelectric signals of all muscles. Tuina significantly decreased the scale score of FACIT.

CONCLUSION: Tuina can improve the symptom of patients with CFS.

 

Source: Liu KP, Fang M, Dai DC, Jiang SY, Zuo YZ. A study of median frequencies of skeletal muscle undergoing Tuina intervention in patients with chronic fatigue syndrome. Zhong Xi Yi Jie He Xue Bao. 2011 Oct;9(10):1083-7. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22015189

 

Mindfulness-based cognitive therapy for people with chronic fatigue syndrome still experiencing excessive fatigue after cognitive behaviour therapy: a pilot randomized study

Abstract:

Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS; sometimes known as myalgic encephalomyelitis). However, only a minority of patients fully recover after CBT; thus, methods for improving treatment outcomes are required. This pilot study concerned a mindfulness-based cognitive therapy (MBCT) intervention adapted for people with CFS who were still experiencing excessive fatigue after CBT. The study aimed to investigate the acceptability of this new intervention and the feasibility of conducting a larger-scale randomized trial in the future. Preliminary efficacy analyses were also undertaken.

Participants were randomly allocated to MBCT or waiting list. Sixteen MBCT participants and 19 waiting-list participants completed the study, with the intervention being delivered in two separate groups. Acceptability, engagement and participant-rated helpfulness of the intervention were high. Analysis of covariance controlling for pre-treatment scores indicated that, at post-treatment, MBCT participants reported lower levels of fatigue (the primary clinical outcome) than the waiting-list group. Similarly, there were significant group differences in fatigue at 2-month follow-up, and when the MBCT group was followed up to 6 months post-treatment, these improvements were maintained.

The MBCT group also had superior outcomes on measures of impairment, depressed mood, catastrophic thinking about fatigue, all-or-nothing behavioural responses, unhelpful beliefs about emotions, mindfulness and self-compassion. In conclusion, MBCT is a promising and acceptable additional intervention for people still experiencing excessive fatigue after CBT for CFS, which should be investigated in a larger randomized controlled trial.

KEY PRACTITIONER MESSAGE: Only about 30% of people with chronic fatigue syndrome (CFS) recover after cognitive behaviour therapy (CBT); thus, methods for improving treatment outcomes are needed. This is the first pilot randomized study to demonstrate that a mindfulness-based intervention was associated with reduced fatigue and other benefits for people with CFS who were still experiencing excessive fatigue after a course of CBT. Levels of acceptability, engagement in the intervention and rated helpfulness were high. A larger-scale randomized controlled trial is required.

Copyright © 2011 John Wiley & Sons, Ltd.

Source: Rimes KA, Wingrove J. Mindfulness-based cognitive therapy for people with chronic fatigue syndrome still experiencing excessive fatigue after cognitive behaviour therapy: a pilot randomized study. Clin Psychol Psychother. 2013 Mar-Apr;20(2):107-17. doi: 10.1002/cpp.793. Epub 2011 Oct 9. https://www.ncbi.nlm.nih.gov/pubmed/21983916

Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review

Abstract:

BACKGROUND: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population.

METHODS: Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded.

RESULTS: A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium.

CONCLUSIONS: The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.

© 2011 Alraek et al; licensee BioMed Central Ltd.

 

Source: Alraek T, Lee MS, Choi TY, Cao H, Liu J. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complement Altern Med. 2011 Oct 7;11:87. doi: 10.1186/1472-6882-11-87. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201900/ (Full article)