ABSTRACT
Current approaches to the diagnosis and assessment of Chronic Fatigue Syndrome (CFS) rely primarily on scales that measure only the occurrence of various symptoms related to CFS. Such approaches do not provide information on either the severity of symptoms or on fluctuations in symptom severity and activity level that occur over time. As a result, these measures do not reflect the complexities and the interrelations among symptoms. By obscuring the fluctuating nature of CFS and its high variability, current assessment procedures may prevent health care professionals from understanding the complexities of this disease. The present study provides two CFS case studies to illustrate the advantages of using self-reporting rating scales in combination with a device used to measure the frequency and intensity of activity. The implications of this assessment system, which captures the symptom dynamics and variability involved in CFS, are discussed.
Subject(s)
Fatigue Syndrome, Chronic/diagnosis , Health Status , Monitoring, Physiologic/statistics & numerical data , Motor Activity/physiology , Analysis of Variance , Circadian Rhythm/physiology , Fatigue Syndrome, Chronic/psychology , Female , Humans , Male , Middle Aged , Monitoring, Physiologic/instrumentation , Personality Inventory/statistics & numerical data , Psychometrics , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
A retrospective review of 202 patients with acute injury to knee ligaments was carried out by chart review, scored questionnaire and scored physical examination. Of 62 patients with complete midsubstance injury to the anterior cruciate ligament, repair was attempted in 46, while 16 had complete excision of the ligament without replacement or augmentation. Computer analysis revealed that these groups were similar with respect to mean age of the patients, sex distribution, incidence of meniscectomy and distribution of associated injuries. At 4-year follow-up, there was no advantage of primary repair over excision for these injuries. In fact, repair seemed to be subjectively and objectively worse than excision, being associated with increased pain and decreased range of motion. The high rate of signs and symptoms of deterioration in both groups suggests a need for better alternatives in the acute phase of anterior cruciate ligament injury.
