Staci Stevens

Staci R. Stevens, MA in exercise physiology. Founder and Director of Workwell Foundation, Ripon, California, USA. She serves as Co-Vice President of the Board of Directors and Chair of the Membership Committee of the International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. She served a term on the Chronic Fatigue Syndrome Advisory Committee from 2003 - 2006.

Stevens had (in her own words) a very well-controlled case of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) for greater than 20 years, which motivates her high commitment to advancing understanding of the illness and helping other patients.

Stevens is one of the authors of the 2011 case definition, International Consensus Criteria.

Talks and Interviews

 * 2015, Video: Post-exertional malaise: How to do more with less, Staci Stevens, Vancouver BC Canada, May 2015
 * 2012, MECFS Alert Episode 32: Staci Stevens, Director of the Pacific Fatigue Lab
 * 2012, Top 10 Things You Should Know About Post-Exertional Relapse
 * 2011, "Effective Management of Activity Intolerance" - Staci R. Stevens, MA at the 10th International IACFSME Conference, Patient Agenda
 * 2010, Slide presentation to CFSAC
 * 2009, Staci Steven speaking to CFSAC meeting

Notable studies

 * 2013, Discriminative validity of metabolic and workload measurements to identify individuals with Chronic Fatigue Syndrome
 * 2012, A double-blind, placebo-controlled, randomized, clinical trial of the TLR-3 agonist rintatolimod in severe cases of chronic fatigue syndrome."Abstract: 'A Phase III prospective, double-blind, randomized, placebo-controlled trial comparing twice weekly IV rintatolimod versus placebo was conducted in 234 subjects with long-standing, debilitating CFS/ME at 12 sites. The primary endpoint was the intra-patient change from baseline at Week 40 in exercise tolerance (ET). Secondary endpoints included concomitant drug usage, the Karnofsky Performance Score (KPS), Activities of Daily Living (ADL), and Vitality Score (SF 36). Subjects receiving rintatolimod for 40 weeks improved intra-patient placebo-adjusted ET 21.3% (p = 0.047) from baseline in an intention-to-treat analysis. Correction for subjects with reduced dosing compliance increased placebo-adjusted ET improvement to 28% (p = 0.022). The improvement observed represents approximately twice the minimum considered medically significant by regulatory agencies. The rintatolimod cohort vs. placebo also reduced dependence on drugs commonly used by patients in an attempt to alleviate the symptoms of CFS/ME (p = 0.048). Placebo subjects crossed-over to receive rintatolimod demonstrated an intra-patient improvement in ET performance at 24 weeks of 39% (p = 0.04). Rintatolimod at 400 mg twice weekly was generally well-tolerated."
 * 2011, Diagnostic accuracy of symptoms characterising chronic fatigue syndrome
 * 2010, Post-exertional malaise in women with chronic fatigue syndrome
 * 2010, Conceptual model for physical therapist management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
 * 2007, Legal and Scientific Considerations of the Exercise Stress Test"'Abstract - This article examines the legal and scientific bases on which an exercise stress test can provide medically acceptable evidence of disability for the Chronic Fatigue Syndrome (CFS) patient. To qualify for disability benefits, a claimant must establish the existence of a serious medically determinable impairment (MDI) that causes the inability to work. The single stress test has been used to objectively establish whether a claimant can engage in “substantial gainful employment” and is an important determinant of the award or denial of benefits. A review of case law indicates problems associated with a single test protocol that may be remedied by a “test-retest” protocol. The results of a preliminary study employing this approach indicate that the test-retest protocol addresses problems inherent in a single test and therefore provides an assessment of CFS related disability consistent with both medical and legal considerations.'"
 * 2007, Diminished Cardiopulmonary Capacity During Post-Exertional Malaise"'Abstract - Reduced functional capacity and post-exertional malaise following physical activity are hallmark symptoms of Chronic Fatigue Syndrome (CFS). That these symptoms are often delayed may explain the equivocal results for clinical cardiopulmonary exercise testing with CFS patients. The reproducibility of VO2 max in healthy subjects is well documented. This may not be the case with CFS due to delayed recovery symptoms. Purpose: To compare results from repeated exercise tests as indicators of post-exertional malaise in CFS. Methods: Peak oxygen consumption (VO2 peak), percentage of predicted peak heart rate (HR%), and VO2 at anaerobic threshold (AT), were compared between six CFS patients and six control subjects for two maximal exercise tests separated by 24 hours. Results: Multivariate analysis showed no significant differences between control and CFS, respectively, for test 1: VO2 peak (28.4 ± 7.2 ml/ kg/min; 26.2 ± 4.9 ml/kg/min), AT (17.5 ± 4.8 ml/kg/min; 15.0 ± 4.9 ml/ kg/min) or HR% (87.0 ± 25.4%; 94.8 ± 8.8%). However, for test 2 the CFS patients achieved significantly lower values for both VO2 peak (28.9 ± 8.0 ml/kg/min; 20.5 ± 1.8 ml/kg/min, p = 0.031) and AT (18.0 ± 5.2 ml/kg/min; 11.0 ± 3.4 ml/kg/min, p = 0.021). HR% was not significantly different (97.6 ± 27.2%; 87.8 ± 9.3%, p = 0.07). A follow-up classification analysis differentiated between CFS patients and controls with an overall accuracy of 92%. Conclusion: In the absence of a second exercise test, the lack of any significant differences for the first test would appear to suggest no functional impairment in CFS patients. However, the results from the second test indicate the presence of a CFS related post-exertional malaise. It might be concluded then that a single exercise test is insufficient to demonstrate functional impairment in CFS patients. A second test may be necessary to document the atypical recovery response and protracted malaise unique to CFS.'"
 * 2005, Exercise capacity and immune function in male and female patients with Chronic Fatigue Syndrome (CFS)
 * 2001, Assessment of Functional Impairment by Cardiopulmonary Exercise Testing in Patients with Chronic Fatigue Syndrome"'Summary - Functional impairment in a population of patients with chronic fatigue syndrome (CFS) was determined by exercise testing. The criteria established by Weber and Janicki (1) were employed because impairment levels are based on maximal oxygen consumption. Oxygen consumption was obtained by cardiopulmonary exercise testing and was used to classify subjects according to the severity of impairment. All the subjects in this study met the CDC case definition (2) for CFS. All patients underwent at least two maximal graded exercise tests in which expired air was collected for assessment of V02max. Data are included for eighty-seven CFS patients, the highest V02 was used for determining impairment. Although all patients met the CDC case definition for CFS, only 35 (40%) would be classified as having greater than “Mild” functional impairment. The highest V02 of any of the patients in this study was 29.5 ml/kg/min, very close to what normative data predicts to be the average maximal value for the entire group. Without a sedentary control group it is unclear if the low V02 in this population is due to the pathology of CFS or results from the inactivity that accompanies the disease. However, use of maximal V02 during exercise can clearly discriminate between levels of functional impairment and may be efficacious for diagnosis of CFS. Additionally, in cases where cardiopulmonary analysis is unavailable, exercise duration on a standardized test may also be employed.'"
 * 2001, Chronic Fatigue Syndrome, Ampligen, and Quality of Life: A Phenomenological Perspective"'Summary - The purpose of this investigation was to identify significant quality-of-life issues for two women previously diagnosed with chronic fatigue syndrome (CFS), and their families. Both women were participants in a cost-recovery, clinical trial of the antiviral and immuno-modulatory drug, Ampligen. A qualitative, case study approach was adopted to access information not normally available from clinical trials. Specifically, semi-structured, in-depth interviews were conducted with the CFS patients, and their spouses, to discover if these families perceived any changes in their patterns of daily living contingent with participation in the Ampligen trial. Patient diaries were also analyzed for the purpose of triangulation. Content analysis of the interview transcripts and diary entries revealed a number of significant quality of life improvements for the women and their families, for which they perceived the drug therapy responsible. After an initial acclimation period, and with the exception of the day when the drug was administered, both women reported a reduction in pain, increased energy levels, and improved cognitive functioning. They each cited numerous cases to illustrate their improvement.'"