Journal of IiME Volume 4 Issue 1 www.investinme.org Definition of Recovery in Chronic Fatigue Syndrome (continued) Appendix I: Bell Ability Scale (Ref: Bell DS. The Doctor's Guide to Chronic Fatigue Syndrome. Perseus Books, Reading, MA; 1993) 100. No symptoms at rest or with exercise; normal overall activity; able to work or do house/home work full time without difficulty. 90. No symptoms at rest; mild symptoms with vigorous activity; normal overall activity level; able to work full time without difficulty. 80. Mild symptoms at rest; symptoms worsened by exertion; minimal activity restriction for activities requiring exertion; able to work full time with difficulty in jobs requiring prolonged standing or exertion. 70. Mild symptoms at rest; some daily activity limitation noted; overall functioning close to 90% of expected except for activities requiring exertion; able to work full time. 60. Mild to moderate symptoms at rest; daily activity limitation clearly noted; overall functioning 70% to 90%; able to work full time in light activity if hours flexible. 50. Moderate symptoms at rest; moderate to severe symptoms with exercise or activity; overall activity level reduced to 70% of expected; unable to perform strenuous activities but able to perform light duties or desk work 4 to 5 hours a day, but requires rest periods. 40. Moderate symptoms at rest; overall activity 50% to 70% of previous normal; able to go out of the house for short excursions; unable to perform strenuous activities; able to work sitting down at home 3 to 4 hours per day, but requires rest periods. 30. Moderate to severe symptoms at rest; severe symptoms with exercise; overall activity reduced to 50% of expected; usually confined to house; able to perform light activity (desk work) 2 to 3 hours per day but requires rest periods. 20. Moderate to severe symptoms at rest; unable to perform strenuous activity; overall activity 30-50% of expected; able to leave house only rarely; confined to bed or couch most of day; unable to concentrate more than 1 hour per day. 10. 0. Severe symptoms at rest; bedridden the majority of the time; rare travel outside the house; marked cognitive symptoms preventing concentration. Severe symptoms on a continuous basis; bedriddren; unable to care for self. ME Fact Clustering of combined gene data in CFS/ME patients for this and our previous study (n=117 CFS/ME patients) revealed genomic subtypes with distinct differences in SF-36 scores, clinical phenotypes, severity and geographical distribution. Antibody testing for Epstein-Barr virus (EBV), enterovirus, Coxiella burnetii and parvovirus B19 revealed subtype-specific relationships for EBV and enterovirus, the two most common infectious triggers of CFS/ME. Kerr et al. J Clin Pathol doi:10.1136/jcp.2009.072561 Invest in ME (Charity Nr. 1114035) Page 27/56

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