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Jo Nijs
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==Tracking the activities of ME/CFS-patients == ===The Chronic fatigue syndrome activities and participation questionnaire (CFS-APQ) === In his PhD, Nijs took on the task of devising a new activities questionnaire for ME/CFS. Many of the surveys that were used at the time such as the Short Form 36-Item Health Survey [[Short Form 36-Item Health Survey|(SF-36]]), Karnofsky scores and the Symptom Checklist (SCL-90) were not specific to this illness, so they might overlook important aspects of ME/CFS-disability. By analyzing various questionnaires retrospectively,<ref name="Activity Limitations, 2002" /> Nijs came up with 26 new questions that map out the particular limitations ME/CFS-patients face (e.g. making the bed, preparing meals, reading etc.). The questionnaire, called the 'Chronic Fatigue Syndrome Activities and Participation Questionnaire' (CFS-APQ), showed good construct validity and internal consistency<ref name="NijsCV2004" /> but was unable to differentiate between ME/CFS and fibromyalgia patients.<ref name="Nijs, 2003" /> ===Daily physical activity in ME/CFS=== Nijs has researched how a reliable measurement of the daily activities of ME/CFS patients could be obtained. He has agued that the 'International Physical activity questionnaire-short form' (IPAQ-sf) might be inappropriate since it focused mostly on strenuous efforts and vigorous activities, which are hardly performed by ME/CFS patients.<ref name="IPAQ2011" /> As an alternative, Nijs proposes to use more direct measures such as an accelerometer that tracks step counts and an activity diary. In a 2011 study, Nijs used these techniques to follow up on the activities of 67 ME/CFS patients and 66 healthy controls.<ref name="Fluct2011" /> Patients were significantly less active compared to sedentary controls. The study was however unable to confirm the fluctuating activity pattern of ME/CFS patients; they did not concentrate their activities more in peaks, as was suggested by [[Leonard Jason]].<ref name="Jason1999">{{Cite journal | last = Jason | first = L.A. | authorlink = Leonard Jason | last2 = King | first2 = C.P. | authorlink2 = | last3 = Frankenberry | first3 = E.L. | author-link3 = | last4 = Jordan | first4 = K.M. | authorlink4 = Karen Jordan | last5 = Tryon | first5 = W.W. | authorlink5 = | last6 = Rademaker | first6 = F. | last7 = Huang | first7 = C.F. | date = Apr 1999 | title = Chronic fatigue syndrome: assessing symptoms and activity level | url = https://www.ncbi.nlm.nih.gov/pubmed/10348404|journal=Journal of Clinical Psychology|volume=55|issue=4 | pages = 411–424|issn=0021-9762|pmid=10348404|quote=|via=}}</ref> Nijs’ study showed a correlation between time spent being more active on the one hand and pain, fatigue and concentration difficulties on the other hand. According to the authors "this can be interpreted as more physical activity resulting in more complaints and more fluctuations in the fatigue." A 2013 study by Nijs' research group showed that there was no significant correlation between activity levels and cognitive performance in 31 ME/CFS patients.<ref name="IckmansCog2013" /> Another study suggested increased physical activity to have beneficial effects on sleep quality in ME/CFS.<ref name="Aerenhouts2015">{{Cite journal | title = Sleep characteristics, exercise capacity and physical activity in patients with chronic fatigue syndrome | date = 2015 | url=https://pubmed.ncbi.nlm.nih.gov/25512240/|journal=Disability and Rehabilitation|volume=37|issue=22 | pages = 2044–2050 | last = Aerenhouts | first = Dirk | authorlink = | last2 = Ickmans | first2 = Kelly | authorlink2 = Kelly Ickmans | last3 = Clarys | first3 = Peter | authorlink3 = | last4 = Zinzen | first4 = Evert | authorlink4 = | last5 = Meersdom | first5 = Geert | authorlink5 = | last6 = Lambrecht | first6 = Luc | authorlink6 = | last7 = Nijs | first7 = Jo | authorlink7 = Jo Nijs|doi=10.3109/09638288.2014.993093|pmc=|pmid=25512240|access-date=|issn=1464-5165|quote=|via=}}</ref> ===The value of exercise testing in ME/CFS=== Nijs has worked on the issue of exercise testing in ME/CFS. Because of [[post-exertional malaise]], it is not always possible for ME/CFS-patients to reach their [[VO2 Max]]. Based on the exercise testing of more than 200 ME/CFS-patients, Nijs demonstrated (in succession to Mullis et al.<ref name="Mullis1999">{{Cite journal | title = Prediction of peak oxygen uptake in chronic fatigue syndrome. | date = 1999-10-01 | url = https://bjsm.bmj.com/content/33/5/352|journal=British Journal of Sports Medicine|volume=33|issue=5 | pages = 352–356 | last = Mullis | first = R. | last2 = Campbell | first2 = I.T. | last3 = Wearden | first3 = A.J. | last4 = Morriss | first4 = R.K. | last5 = Pearson | first5 =D.J. | language=en|doi=10.1136/bjsm.33.5.352|pmid=10522640|issn=0306-3674}}</ref>) that other values such as [[peak workload]] or VO2 submax can be used to correctly predict VO2 Max.<ref name="peak2004" /><ref name="Submaximal2007" /> In a review of exercise testing in ME/CFS, Nijs concluded that despite some conflicting studies, “the weighted available evidence points towards a reduced physiological exercise capacity in CFS".<ref name="Inactive2011" /> The authors concluded that a lack of uniformity in diagnostic criteria, could explain for the differences between studies. Yet, while ME/CFS patients showed a reduced physiological exercise capacity, there was only a minor correlation between exercise test results and employment rate, suggesting this might not be a reliable measure to assess disability.<ref name="Employment2005" />
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