Costigan, A, Elliott, C, McDonald, C et al. · QJM : monthly journal of the Association of Physicians · 2010 · DOI
This study found that ME/CFS patients have much greater difficulty with daily activities compared to healthy people. Among ME/CFS patients, those who experience dizziness or lightheadedness when standing up (orthostatic symptoms) had the most trouble with physical functioning. The researchers suggest that treating these standing-related symptoms might help patients do more in their daily lives.
This study highlights orthostatic intolerance as a potentially modifiable factor affecting functional capacity in ME/CFS. Identifying orthostatic symptoms as an independent predictor of disability suggests that targeted management of this symptom could improve quality of life and functional outcomes in this severely disabled population.
This study cannot establish causation—it shows correlation between orthostatic symptoms and reduced function, but does not prove that orthostatic symptoms directly cause functional impairment. It also does not demonstrate whether treating orthostatic symptoms will actually improve function, only that a relationship exists. The cross-sectional design cannot determine temporal relationships.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Costigan, A, Elliott, C, McDonald, C, & Newton, J L (2010). Orthostatic symptoms predict functional capacity in chronic fatigue syndrome: implications for management.. QJM : monthly journal of the Association of Physicians. https://doi.org/10.1093/qjmed/hcq094
BibTeX
@article{mecfsatlas-costigan-2010-orthostatic-symptoms,
author = {Costigan, A and Elliott, C and McDonald, C and Newton, J L},
title = {Orthostatic symptoms predict functional capacity in chronic fatigue syndrome: implications for management.},
journal = {QJM : monthly journal of the Association of Physicians},
year = {2010},
doi = {10.1093/qjmed/hcq094},
note = {PubMed: 20534655},
url = {https://www.mecfsatlas.com/evidence/costigan-2010-orthostatic-symptoms},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/costigan-2010-orthostatic-symptoms
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