• J Pain Symptom Manage · Feb 2015

    Randomized Controlled Trial

    The role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial.

    • Hetty Prinsen, Johannes P van Dijk, Machiel J Zwarts, Jan Willem H Leer, Gijs Bleijenberg, and Hanneke W M van Laarhoven.
    • Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Hetty.Prinsen@radboudumc.nl.
    • J Pain Symptom Manage. 2015 Feb 1;49(2):173-82.

    ContextPostcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle fatigue.ObjectivesThe aims of this study were to examine whether central and peripheral muscle fatigue differ between fatigued and non-fatigued cancer survivors and to examine the effect of cognitive behavioral therapy (CBT) on peripheral and central muscle fatigue of fatigued cancer survivors in a randomized controlled trial.MethodsSixteen fatigued patients in the intervention group (CBT) and eight fatigued patients in the waiting list group were successfully assessed at baseline and six months later. Baseline measurements of 20 fatigued patients were compared with 20 non-fatigued patients. A twitch interpolation technique and surface electromyography were applied, respectively, during sustained contraction of the biceps brachii muscle.ResultsMuscle fiber conduction velocity (MFCV) and central activation failure (CAF) were not significantly different between fatigued and non-fatigued patients. Change scores of MFCV and CAF were not significantly different between patients in the CBT and waiting list groups. Patients in the CBT group reported a significantly larger decrease in fatigue scores than patients in the waiting list group.ConclusionPostcancer fatigue is neither characterized by abnormally high central muscle fatigue nor by low peripheral muscle fatigue. These findings suggest a difference in the underlying physiological mechanism of postcancer fatigue vs. other fatigue syndromes.Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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