Influence of Symptom Expectancies on Stair-Climbing Performance in Chronic Fatigue Syndrome: Effect of Study Context

  • Marianne Heins
  • Hans Knoop
  • Jo Nijs
  • Remco Feskens
  • Mira Meeus
  • Greta Moorkens
  • Gijs Bleijenberg
Article

Abstract

Background

In patients with chronic fatigue syndrome (CFS), performance of physical activities may be affected by an anticipated increase in symptoms after these activities. Nijs et al. previously studied the influence of symptom expectancies and related psychological processes on the performance of an isolated physical activity [Nijs J, Meeus M, Heins M, Knoop H, Moorkens G, Bleijenberg G. Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study. Disabil Rehabil 2012. doi:10.3109/09638288.2011.641661.].

Purpose

We aimed to validate the previous findings in a larger group of patients in a different setting. We also extended the possible underlying psychological processes studied.

Method

In 49 CFS patients, we measured performance (duration and increase in heart rate) during self-paced climbing and descending of two floors of stairs. Before this task, patients rated experienced fatigue and anticipated fatigue after stair climbing. In addition, kinesiophobia, catastrophising and focusing on bodily symptoms were measured. Using correlational and regression analyses, we tested whether performance during stair climbing could be explained by experienced and anticipated fatigue and psychological factors.

Results

Longer duration of stair climbing correlated with higher anticipated fatigue, independently of sex, age, body mass index and fatigue before stair climbing. Focusing on bodily symptoms and fatigue-related catastrophising were related to anticipated fatigue.

Conclusion

Symptom expectations affect the performance of physical activity in CFS patients, possibly through focusing on bodily symptoms and catastrophising. These findings partially contradict the findings of the previous study, which stresses the importance of study context in conducting this type of experiments (i.e., patient characteristics, instructions).

Keywords

Chronic fatigue syndrome Symptom expectancies Physical performance Focusing on symptoms Catastrophising 

References

  1. 1.
    Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121(12):953–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Bazelmans E, Bleijenberg G, Voeten MJ, van der Meer JW, Folgering H. Impact of a maximal exercise test on symptoms and activity in chronic fatigue syndrome. J Psychosom Res. 2005;59(4):201–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Lapp CW. Exercise limits in chronic fatigue syndrome. Am J Med. 1997;103(1):83–4.PubMedCrossRefGoogle Scholar
  4. 4.
    VanNess JM, Stevens SR, Bateman L, Stiles TL, Snell CR. Postexertional malaise in women with chronic fatigue syndrome. J Womens Health (Larchmt). 2002;19(2):239–44.CrossRefGoogle Scholar
  5. 5.
    Vercoulen JH, Bazelmans E, Swanink CM, et al. Physical activity in chronic fatigue syndrome: assessment and its role in fatigue. J Psychiat Res. 1997;31(6):661–73.PubMedCrossRefGoogle Scholar
  6. 6.
    Nijs J, Meeus M, Heins M, Knoop H, Moorkens G, Bleijenberg G. Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study. Disabil Rehabil. 2012;doi:10.3109/09638288.2011.641661.
  7. 7.
    Kori S, Miller R, Todd D. Kinesiophobia: a new view of chronic pain behavior. Pain Manage. 1990:35–43.Google Scholar
  8. 8.
    Nijs J, De Meirleir K, Duquet W. Kinesiophobia in chronic fatigue syndrome: assessment and associations with disability. Arch Phys Med Rehabil. 2004;85(10):1586–92.PubMedCrossRefGoogle Scholar
  9. 9.
    Nijs J, Vanherberghen K, Duquet W, De Meirleir K. Chronic fatigue syndrome: lack of association between pain-related fear of movement and exercise capacity and disability. Phys Ther. 2004;84(8):696–705.PubMedGoogle Scholar
  10. 10.
    Silver A, Haeney M, Vijayadurai P, Wilks D, Pattrick M, Main CJ. The role of fear of physical movement and activity in chronic fatigue syndrome. J Psychosom Res. 2002;52(6):485–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Petrie K, Moss-Morris R, Weinman J. The impact of catastrophic beliefs on functioning in chronic fatigue syndrome. J Psychosom Res. 1995;39(1):31–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Nijs J, Van de Putte K, Louckx F, Truijen S, De Meirleir K. Exercise performance and chronic pain in chronic fatigue syndrome: the role of pain catastrophizing. Pain Med. 2008;9(8):1164–72.PubMedCrossRefGoogle Scholar
  13. 13.
    Vercoulen JH, Swanink CM, Galama JM, et al. The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: development of a model. J Psychosom Res. 1998;45(6):507–17.PubMedCrossRefGoogle Scholar
  14. 14.
    Wiborg JF, Knoop H, Prins JB, Bleijenberg G. Does a decrease in avoidance behavior and focusing on fatigue mediate the effect of cognitive behavior therapy for chronic fatigue syndrome? J Psychosom Res. 2011;70(4):306–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS. The sickness impact profile: validation of a health status measure. Med Care. 1976;14(1):57–67.PubMedCrossRefGoogle Scholar
  16. 16.
    Jacobsen PB, Azzarello LM, Hann DM. Relation of catastrophizing to fatigue severity in women with breast cancer. Cancer Res Ther Contr. 1999;8:155–64.Google Scholar
  17. 17.
    Ray C, Weir W, Stewart D, Miller P, Hyde G. Ways of coping with chronic fatigue syndrome: development of an illness management questionnaire. Soc Sci Med. 1993;37(3):385–91.PubMedCrossRefGoogle Scholar
  18. 18.
    Vlaeyen JW, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012. doi:10.1016/j.pain.2011.12.009.
  19. 19.
    Wilson A, Hickie I, Hadzi-Pavlovic D, et al. What is chronic fatigue syndrome? Heterogeneity within an international multicentre study. Aust N Z J Psychiatry. 2001;35(4):520–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Cella M, Chalder T, White PD. Does the heterogeneity of chronic fatigue syndrome moderate the response to cognitive behaviour therapy? An exploratory study. Psychother Psychosom. 2011;80(6):353–8. doi:10.1159/000327582.PubMedCrossRefGoogle Scholar
  21. 21.
    Nisenbaum R, Reyes M, Unger ER, Reeves WC. Factor analysis of symptoms among subjects with unexplained chronic fatigue: what can we learn about chronic fatigue syndrome? J Psychosom Res. 2004;56(2):171–8. doi:10.1016/S0022-3999(03)00039-4.PubMedCrossRefGoogle Scholar
  22. 22.
    Baden DA, McLean TL, Tucker R, Noakes TD, St Clair Gibson A. Effect of anticipation during unknown or unexpected exercise duration on rating of perceived exertion, affect, and physiological function. Br J Sports Med. 2005;39(10):742–6. discussion -6.PubMedCrossRefGoogle Scholar
  23. 23.
    Stanley C, Pargman D, Tenenbaum G. The effect of attentional coping strategies on perceived exertion in a cycling task. J Appl Sport Psychol. 2007;19:352–63.CrossRefGoogle Scholar
  24. 24.
    Wiborg JF, Knoop H, Stulemeijer M, Prins JB, Bleijenberg G. How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity. Psychol Med.40(8):1281–7.Google Scholar
  25. 25.
    Moss-Morris R, Sharon C, Tobin R, Baldi JC. A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. J Health Psychol. 2005;10(2):245–59.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2012

Authors and Affiliations

  • Marianne Heins
    • 1
  • Hans Knoop
    • 1
  • Jo Nijs
    • 2
    • 3
  • Remco Feskens
    • 4
  • Mira Meeus
    • 2
    • 3
  • Greta Moorkens
    • 5
  • Gijs Bleijenberg
    • 1
  1. 1.Expert Centre for Chronic FatigueRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  2. 2.Department of Human Physiology, Faculty of Physical Education and PhysiotherapyVrije Universiteit BrusselBrusselsBelgium
  3. 3.Division of Musculoskeletal Physiotherapy, Department of Health Care SciencesArtesis University College AntwerpAntwerpBelgium
  4. 4.Department of Methods and StatisticsUtrecht UniversityUtrechtThe Netherlands
  5. 5.Reference Centre for Chronic Fatigue SyndromeUniversity of AntwerpAntwerpBelgium

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