Predicting post-exertional malaise in Gulf War Illness based on acute exercise responses

Post-exertional malaise (PEM) is poorly understood in Gulf War Illness (GWI). Exercise challenges have emerged as stimuli to study PEM; however, little attention has been paid to unique cardiorespiratory and perceptual responses during exercise. This study tested whether select exercise parameters e...

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Bibliographic Details
Published in:Life sciences (1973) 2021-09, Vol.280, p.119701, Article 119701
Main Authors: Boruch, Alexander E., Lindheimer, Jacob B., Klein-Adams, Jacquelyn C., Stegner, Aaron J., Wylie, Glenn R., Ninneman, Jacob V., Alexander, Thomas, Gretzon, Nicholas P., Samy, Bishoy, Van Riper, Stephanie M., Falvo, Michael J., Cook, Dane B.
Format: Article
Language:English
Subjects:
Aged
Carbon dioxide
Cardiopulmonary
Chronic
Dependent variables
Exercise
Exercise Test
Exercise tests
Fatigue
Fatigue - complications
Fatigue - physiopathology
Fatigue syndrome
Female
Gulf War
Gulf War syndrome
Heart Rate
Humans
Illnesses
Independent variables
Leg
Male
Mathematical analysis
Mechanical ventilation
Middle Aged
Military personnel
Muscle pain
Muscles
Muscular fatigue
Myalgia - complications
Myalgia - physiopathology
Oxygen
Oxygen consumption
Pain
Parameters
Persian Gulf Syndrome - complications
Persian Gulf Syndrome - physiopathology
Persian Gulf War
Physical training
War
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Summary:Post-exertional malaise (PEM) is poorly understood in Gulf War Illness (GWI). Exercise challenges have emerged as stimuli to study PEM; however, little attention has been paid to unique cardiorespiratory and perceptual responses during exercise. This study tested whether select exercise parameters explained variability in PEM responses. Visual analog scale (0−100) versions of the Kansas questionnaire were used for daily symptom measurements one week before and one week after 30-min of cycling at 70% heart rate reserve in 43 Veterans with GWI and 31 Veteran controls (CON). Cardiopulmonary exercise testing (CPET) methods were used to measure oxygen (VO2), carbon dioxide (VCO2), ventilation (VE), heart rate, work rate, and leg muscle pain. Symptom changes and CPET parameters were compared between groups with independent samples t-tests. Linear regression (GLM) with VE/VCO2, cumulative work, leg muscle pain, and self-reported physical function treated as independent variables and peak symptom response as the dependent variable tested whether exercise responses predicted PEM. Compared to CON, Veterans with GWI had greater ventilatory equivalent for oxygen (VE/VO2), peak leg muscle pain, fatigue, and lower VCO2, VO2, power, and cumulative work during exercise (p 
ISSN:0024-3205
1879-0631
DOI:10.1016/j.lfs.2021.119701