University researchers lead new study, published in BMJ Open, into the diagnosis of Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME)
New research published in BMJ Open, has demonstrated that a simple, physical examination centred around the presence of five symptoms (known as The Perrin Technique), is quicker and more accurate at aiding the diagnosis of CFS / ME than current methods.
The research was funded by the F.O.R.M.E charity and led by the University of Central Lancashire in association with Wrightington, Wigan & Leigh NHS Foundation Trust and Salford Royal NHS Foundation Trust. The findings, published on Tuesday, 14 November 2017, could transform the way in which CFS / ME patients are assessed for the condition and diagnosed.
There is currently no universally accepted method of diagnosing CFS / ME, with diagnosis being completed via process of elimination of other conditions. ‘NICE recognises the heterogeneity of the condition, advising that diagnosis of CFS / ME should be made possible after other possible diagnoses have been excluded’ – BMJ Open (p.2). This means that for many patients the diagnosis of CFS / ME can be a very lengthy process.
In the first study of its kind, involving 94 participants*, Allied Health Professionals (AHP) using The Perrin Technique successfully diagnosed 86% of individuals with CFS / ME. Participants were assessed for five physical symptoms with no prior discussion about the patient’s condition or experiences.
When assessed by an experienced doctor using the standard clinical neurological and rheumatological examination, only 44% of sufferers were correctly diagnosed with the condition.
The Perrin Technique is a system of manual diagnosis around five physical symptoms, and is based on the theory that CFS / ME is a disorder of the lymphatic drainage system. This disorder can be caused by different factors including: allergies, stress and infections, which can lead to a build-up of toxins in the fluid around the brain and spinal cord. The five physical symptoms that were explored in this included: postural defects, tender points around the spine, chest and lymph nodes, skin rashes or eruptions and abnormal breast tenderness and varicosities.
The study demonstrated that The Perrin Technique can be utilised by newly trained Allied Health Professionals with no prior experience of the technique or condition, and when comparing the accuracy in diagnoses with that of an experienced AHP (86%), the newly trained AHP successfully diagnosed 77% of cases. “Examining for physical signs is both quick and simple for the AHP and may be used as an efficient screening tool for CFS / ME” - BMJ Open (p.1). For this study, the newly trained AHP underwent a few days of training in The Perrin Technique for diagnosis.
Once diagnosed, subsequent treatment using The Perrin Technique is focussed on stimulating the fluid motion around the brain and spinal cord to aid drainage of these toxins, and this has been found to significantly help sufferers: ‘techniques to stimulate the drainage of toxins in the lymph nodes have been shown to lead to symptom improvement in patients with CFS / ME’ – BMJ Open (p.2).
It is estimated there are 250,000 CFS / ME sufferers in the UK**. The condition is characterised by severe, disabling fatigue and a combination of other symptoms including muscular pain, concentration problems and intolerance to exercise. The effects vary for sufferers, with many individuals lives changed drastically. Education can be severely disrupted in young people and for many adults employment becomes impossible. For all, social life and family life become restricted and in some cases severely strained. Sufferers may be housebound or confined to bed for months or years***.
Professor Jim Richards, Lead for the Allied Health Research unit at University of Central Lancashire, said: “It appears that using physical symptoms to diagnose CFS / ME has the potential to speed up the diagnostic process and improve the accuracy of identifying the condition. Although we would recommend carrying out further research amongst the larger population for validation, this certainly shows exciting potential for sufferers of CFS / ME and the way the condition may be identified.”
Bev McDonald, Trustee at charity F.O.R.M.E added: “These findings are really promising. CFS / ME sufferers often have to endure months of unexplained symptoms before being a given a diagnosis, and this technique has the potential to speed up the process and thus facilitate quicker diagnosis and treatment. We hope the research helps to raise awareness amongst both patients and medical professionals.”
Dr Raymond Perrin, DO, PhD said: “Obtaining a diagnosis for CFS / ME is often a lengthy and stressful process for sufferers. This research shows that a simple examination could offer an aid to diagnosing CFS / ME for all doctors and primary health care workers dealing with CFS / ME. This could speed up the diagnostic procedure and help with the overall care of hundreds of thousands of sufferers in the UK alone. The quicker the diagnosis, the better the outcome for patients.”
* The 94 participants were aged between 18-60 and 52 patients were diagnosed with CFS / ME whilst 42 non-ME controls were selected.
** Statistics taken from: Webarchive
***Details taken from: http://www.forme-cfs.org.uk/
- The full study has been published by BMJ Open.