Objective evidence of impairment

Exercise capacity and muscle function

Exercise testing has confirmed poor performance and also abnormal physiological responses to exercise. While the majority of studies have concluded that muscle function is normal, there is some evidence that many patients suffer from physiological deconditioning secondary to inactivity. (1.2,) The ability to exercise is also reduced in patients suffering from depression, although other, as yet undefined, pathophysiological processes may be operating in a subgroup of patients with CFS.

Cognitive functioning

Although some studies have found no objective impairment of cognitive functioning, others have suggested subtle deficits in information processing. However, similar deficits have been found in patients suffering from depression, and the specificity of this observation remains uncertain. (13>

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