Home-based testing protocol to measure physiological responses to everyday activities in ME
Physios for ME and an exercise specialist have trialled a safe method of measuring the effect of everyday activities on people with ME/CFS.
CPET exercise testing in the lab has, in the past, shown abnormal reactions to exercise, but now a portable metabolic assessment system and a physiological stress monitor has shown people with ME/CFS also react abnormally to normal everyday activities such as:
- Lying for 5 min
- Sitting for 5 min
- Standing for up to 5 min
- Typical bathroom activities (e.g. washing, grooming, toileting) for up to 5 min
- Walking downstairs
- Typical kitchen activities (e.g. preparing breakfast, hot drinks) for up to 5 min
- Walking upstairs
- A formal cognitive activity (serial sevens test [31]) and other standardised mental arithmetic problems were performed while sitting for up to 5 min.
“All participants demonstrated some physiological abnormalities during testing, which supports preliminary success to further develop this home-based assessment approach.
However, there was no single activity that all participants could complete that caused roughly similar abnormal response(s) in all participants. Thus, future work to produce a standardised testing protocol that yields broadly informative findings on ME pathophysiology is likely to require additional study with larger samples.
Perhaps surprisingly, the activity that caused most participants to exceed their anaerobic threshold was the cognitive task, which all but one participant was able to complete.”
All participants were positive about the testing process and would recommend it to others. 11 showed signs of undiagnosed Orthostatic Intolerance, and the evidence of over doing it (i.e. exceeding anaerobic thresholds) suggested who might benefit from heart rate monitoring as part of an energy management strategy.
Home-based testing protocol to measure physiological responses to everyday activities in ME: a feasibility study, by Nicola Clague-Baker, Sarah Tyson, Karen Leslie, Helen Dawes, Michelle Bull & Natalie Hilliard in Fatigue: Biomedicine, Health & Behavior (2023) [DOI: 10.1080/21641846.2023.2245584]
Research abstract
Background and objectives
Individuals with Myalgic Encephalomyelitis (ME) have shown altered physiological responses during maximum cardiopulmonary exercise testing. However, maximal testing is not representative of the everyday activities reported to cause or increase symptoms in ME, and is not accessible for those with severe or very severe illness. The aim of this study was to assess the feasibility and acceptability of a home-based testing protocol to measure physiological responses in ME to everyday activity.
Methods
Researchers attended participants’ homes to collect data and provide equipment for independent testing. Adults with ME who met the International Consensus Criteria wore a portable metabolic assessment system and a physiological stress monitor. Blood pressure, heart rate, oxygen saturation and lactic acid were assessed during a range of everyday positions and activities in their own homes.
Results
Online recruitment yielded 70 volunteers in 24 h. 17 eligible individuals reflecting a range of illness severities were enrolled. All participants found the procedures acceptable with 12 (70%) subjects completing every listed activity. Apparent physiological abnormalities were identified in all participants.
Conclusion
Physiological measurement during everyday activities was feasible for our participants who represented a range of ME severities. Activities must be adapted for different levels of severity to avoid significant symptom exacerbation. Further research is needed to develop home-based assessment protocols to advance the biobehavioral understanding of ME.
