Fatigue: A New Frontier

Article Outline

• Copyright

This issue represents a new chapter in delivering intellectually stimulating, cutting-edge educational content to the readership of PM&R. It is the first in a line of topics that span the academic and clinical interests of a majority of physiatrists, regardless of specific areas of sub-specialty practice or clinical research. The development and publication of these so-called “cross-cutting” topics represents an opportunity to not only educate, but to (figuratively) unite the overall community of physiatrists, and to hopefully stimulate ongoing discussion, analysis, and debate. Therefore, it is with much anticipation and pleasure that I introduce this “theme” issue of PM&R, Fatigue: A New Frontier.

Fatigue was chosen as the inaugural topic after consultation with many physiatrists representing clinical and academic medicine. Anecdotally, in 25 years of evaluating and treating patients, “excessive fatigue” has been one of the most frequently self-selected positive elements on general review of symptoms. And over the years, various discussions with my fellow physiatrists have led me to conclude that indeed, fatigue is ubiquitous in the patients that we treat in physiatry. This logically led to probing questions such as: is fatigue a disease or a symptom; how well defined is the scientific basis of fatigue; is fatigue one end of the spectrum of sleepiness; how do different physiatrists assess and treat fatigue; and is there a genetic predisposition to developing chronic fatigue.

To my great pleasure, Lynn Gerber, MD, graciously agreed to serve as the guest editor for this volume. Dr. Gerber is a University Professor at and the Director of the Center for the Study of Chronic Illness and Disability in the College of Health and Human Services at George Mason University in Fairfax, VA. With assistance from her colleague Ali Weinstein, MD, and with guidance from PM&R senior editor and current American Academy of Physical Medicine and Rehabilitation (AAPM&R) president, Betsy Sandel, MD, they have developed the contents of this issue and organized a group of extremely well respected academicians and clinicians to contribute their expertise to this subject. The result is a comprehensive presentation of basic science, clinical translation, and editorial content that is unmatched in the literature. The topics range from an understanding of central and peripheral fatigue, to a review of fatigue in various medical and neurological conditions (eg, cancer, multiple sclerosis, and fibromyalgia), assessment of fatigue in specific populations (eg, older adults and elite athletes), and current and future trends in the management of fatigue. It is an outstanding volume and I offer my sincerest “Thank you” to Drs. Gerber and Weinstein for their intense and unwavering efforts to bring this issue to fruition. I am certain that you will both enjoy and benefit from its content.

Finally, as I have previously stated, this is the first in a regular series of publications of “cross-cutting” topics to be published in PM&R, two volumes per year, either as theme issues or free-standing supplements. The next in line toward the latter part of 2010 is Neuroplasticity to be followed in 2011 by Biologics and Mild Traumatic Brain Injury. Each issue, starting with Fatigue, will offer SAE-P credits. Also, the intra-specialty bridging of these theme issues/supplements mirrors the evolving nature of the new AAPM&R council membership model and I hope that more and more members will participate in these projects through the council structure when called on. For now, good reading!

• † Disclosure: nothing to disclose