The Pacific Fatigue Lab
Could a small lab in the Central Valley of California shake the CFS research field with a quake of epic proportions? Change how the disease is viewed? How it’s defined? Legitimize the disease once and for all? It’s possible that given enough resources the Pacific Fatigue Lab at the University of the Pacific in Stockton, California may do all of these.
Run by three exercise physiologists, Dr. Christopher. Snell (Ph.D), Dr. MarkVan Ness (Ph.D) and Staci Stevens (M.A.), a former grad student and now a researcher with chronic fatigue syndrome (ME/CFS), the lab focuses on a very basic and still very misunderstood aspect of CFS – why patients have so much trouble with exercise.
Staci Stevens, the founding Executive Director of the Pacific Fatigue Lab explained. “Many researchers look at ME/CFS patients when they’re at rest- at baseline. But as any ME/CFS patient knows, the real problems occur when their systems are under stress due to too much activity. We’re taking a close look the physiology of CFS patients as they undertake the most stressful activity of all – exercise.”
Since oxygen plays a key role in energy production, exercise physiologists use oxygen consumption during exercise to tell how much energy a person’s body is capable of producing. Having people pedal a stationary bicycle until they can pedal no more tells researchers how much air their lungs can take in (Ventilation Max) and therefore how much oxygen they use to produce energy (VO2 Max) at their peak level of effort. Since oxygen plays a key role in the energy production process this test effectively tells researchers how much energy is being produced.
Given the fatigue and post-exertional problems often noted in ME/CFS one would think aerobic exercise tests would have played a key role in legitimizing this disease, but instead they’ve given rise to further skepticism. The ability of many patients to pass them has added to confusion about a disease characterized by the word fatigue. How could CFS patients be so fatigued if they’re able to generate normal amounts of energy?
A New Approach. The Pacific Fatigue Lab researchers realized, however, that while researchers may have been asking the right questions they were asking them in the wrong way. Many ME/CFS patients can, after all, get through a single ‘workout’ or a single day or single afternoon at work okay only to ‘crash’ afterwords. Until now, though, no one’s taken a close look at the ME/CFS patient’s ability to produce energy when they’re in a crash – an odd oversight in a disease whose symptoms are so tied to activity. (Indeed, study after study is showing that many variables which test out normal or near normal when ME/CFS patients are at rest are abnormal when their systems are put under stress). With the Pacific Fatigue Lab doing a new exercise testing regime, two exercise tests two days in a row and other tests (now known as the Stevens’ Protocol) they’ve given the post-exertional problems ME/CFS patients have reported for so many years a chance to show up – and they have.
Their results are both profound and disturbing. About half of the ME/CFS patients they’ve tested do, in fact, ‘fail’ or significantly under perform in the first single exercise test – they cannot generate normal amounts of energy even when they’re ‘rested’. It’s the rest of the patients that are so intriguing, though. When you give these patients a second test a day later many of them will fail as well--and fail spectacularly.