Neuromuscular Strain in ME/CFS – Research Study Conclusion

peterA new study, partially funded by Solve ME/CFS Initiative (SMCI), published by Dr. Peter Rowe of Johns Hopkins and colleagues in the journal PLoS One supports previous observations by the group that increased mechanical sensitivity may be a contributor to the onset of ME/CFS symptoms.

In earlier studies, this research group noted that ME/CFS symptoms could be provoked by the application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In the current study, the investigative team measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with ME/CFS and healthy controls. They randomly assigned 60 individuals with ME/CFS and 20 healthy controls to either a 15-minute period of passive, supine straight leg raise (meaning individuals raised and held up their legs while laying on their backs)—causing true neuromuscular strain—or a 15-minute period of a sham leg raise that did not, in fact, cause strain.

The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver when compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually, and a representative composite symptom score was also created from these individual measures.

In brief, the results showed that, compared to individuals with ME/CFS in the sham strain group, those with ME/CFS in the true strain group reported significant increased body pain and concentration difficulties as well as increased composite symptom scores during the maneuver. “Healthcare practitioners should think long and hard about the practical implication of this study before recommending therapies involving neuromuscular strain like graded exercise therapy (GET) to their patients,” said Dr. Nahle, vice president for research and scientific programs at SMCI. “This work makes it clear that such strain does increase symptom intensity in chronic fatigue syndrome.”

Dr. Rowe is a member of the SMCI Research Advisory Council and a professor of pediatrics at the Johns Hopkins Children’s Center in Baltimore, MD. To read the PLoS One study in its entirety, visit


SOURCE: Rowe PC, Fontaine KR, Lauver M, Jasion SE, Marden CL, Moni M, Thompson CB, Violand RL. Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome. PLoS One. 2016 Jul 18;11(7). DOI: 10.1371/journal.pone.0159386.