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ME/CFS Part 1: Introduction and Identification

presented by Todd E. Davenport, PT, DPT, MPH, OCS, Staci Stevens, MA, and Mark VanNess, PhD

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Disclosure Statement:

Financial: Todd Davenport, Mark VanNess, and Staci Stevens receive compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Todd Davenport, Mark VanNess, and Staci Stevens have no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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This lesson is part one of a two-course series. Proceed to Part Two after completing this course.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) causes severely disabling fatigue within the context of a constellation of unusual signs and symptoms, which are associated with over-exertion. Because people with ME/CFS present with a whole host of clinical findings, there are multiple reasons for entry into medical and rehabilitation settings. The multifactorial clinical presentation of ME/CFS emphasizes the need for clinicians to recognize ME/CFS, in order to advocate for patients/clients with possible ME/CFS and to direct its appropriate management. The pathoetiology of ME/CFS is becoming better understood, and there is emerging evidence based on this pathoetiological evidence to support best practices in analeptic management strategies for people with ME/CFS.
This two-part course series provides the opportunity for attendees to receive the latest information in recognition, etiology, and analeptic management of patients with ME/CFS from a panel of established researchers and clinicians. In this session, the presenters will (i) summarize the clinical features ME/CFS with respect to optimal identification and differential diagnosis; (ii) describe the pathoetiology underlying the clinical features of ME/CFS; and (iii) provide an actionable framework for optimal analeptic management of individuals with ME/CFS that is based on current scientific evidence.

Meet Your Instructors

Todd E. Davenport, PT, DPT, MPH, OCS

Todd serves as professor and vice-chair of the Department of Physical Therapy in the School of Health Sciences at the University of the Pacific in Stockton, California, where he teaches in the Doctor of Physical Therapy (DPT) program. Todd is a graduate of the University of Southern California's DPT and Orthopedic Physical Therapy Residency programs.…

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Staci Stevens, MA

Staci Stevens holds a bachelor's degree in Sports Medicine and a master's degree in Exercise Physiology from the University of the Pacific in Stockton, California. Ms. Stevens, in conjunction with Workwell Foundation's research team, pioneered the use of two-day cardiopulmonary exercise testing (CPET) in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) to document the hallmark clinical feature…

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Mark VanNess, PhD

J. Mark VanNess, PhD, is a cardiovascular biologist and Distinguished Professor in the department of Health and Exercise Science at the University of the Pacific. He studied biology, chemistry, and exercise science as an undergraduate student and exercise physiology for his master's degree. He received his doctoral degree from the program in Neuroscience at Florida…

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Chapters & Learning Objectives

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1. What's in a Name and Why Does it Matter?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is identified on the basis of case definition criteria. Over time, several sets of case definition criteria have been developed. The purpose of this section is to describe the epidemiological background of case definition criteria, present the common contemporary case definition criteria for ME/CFS for use in the clinic, and discuss the relative utility of contemporary case definition criteria to identify ME/CFS.

2. Objective Evidence of Post-Exertional Malaise and Exercise Impairment in ME/CFS

The provocation of symptoms and signs in ME/CFS in response to exertion suggests the presence of measurable physiological deficits in the post-exertional state. A 2-day maximal cardiopulmonary exercise test (CPET) paradigm was devised, which has revealed a whole host of cardiac, pulmonary, metabolic, and symptomatic differences between people with ME/CFS and sedentary people after an initial bout of exertion. The purposes of this chapter are to acquaint the learner with the 2-day maximal CPET paradigm and to describe the scientific research it has generated regarding the physiological basis of post-exertional malaise.

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