The former head of the National Institute of Health’s Chronic Fatigue Syndrome (CFS) research center in New Jersey, Dr. Natelson, has been looking into the issue of how CFS and fibromyalgia (FMS) affect the ability of the afflicted to exercise. Dr. Natelson’s latest work involves the use of a measure called peak oxygen consumption (VO2 max). VO2 max gives an accurate indication of an individual’s fitness. This measure is the volume of oxygen used when an individual exercises according to his maximum ability. VO2 gives the maximum milliliters of oxygen used during one minute per kilogram of body weight. Those who are in good physical shape will have higher values of VO2 and can work out with greater intensity than those in poor physical condition.
The rate at which one can release energy through aerobic exercise is dependent on two issues:
- The chemical makeup of the muscles’ cell tissue system which affects the ability to employ oxygen as a means of burning body fuel.
- The twinned abilities of the lungs and the heart to bring oxygen to the muscles’ tissue system.
Natelson has found that a patient can be expected to function at a comfortable level at around 50-60% of their VO2 max. To illustrate the implications of this formula as it relates to fibromyalgia patients, a person who has a VO2 max of 35 ml/min/kg, is unable to do much more than sedentary desk work. VO2 values are helpful in suggesting an assessment of a patient’s overall function. If values are monitored with regularity, a patient can be assessed in terms of how his function has improved or declined with the passing of time. This monitoring process can be important for a patient who is trying to obtain disability payments, for instance, but the main function of such a monitoring process is to give a patient’s physician some idea of how the patient’s case is progressing.
There are different methods of obtaining VO2 max values. One study employed the used of treadmill tests. But a simple pedometer can give an accurate sense of VO2 max. Pedometers can be found for under $5.00 in stores such as Wal-Mart, but of course, fancy versions exist, some costing as much as $30.00. The high-end versions of the device allow for some patient input, such as stride length. This type of input aids the device in calculating how many miles have been covered or how many calories have been burned. This is useful in monitoring a slow increase in the level of a patient’s functioning.
In the drug trials for Ampligen, researchers found that patients’ VO2 levels dropped before patient questionnaires showed any sign of a decline in function. Physicians who are sold on VO2 max as a means of monitoring patient function feel that this is a very sensitive indicator of how the patient is responding to treatment.