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How to exercise people with chronic fatigue syndrome: Evidence based practice guidelines
Deborah Van Cauwenbergh, Margot De Kooning, Kelly Ickmans, Jo Nijs.
DOI: 10.1111/j.1365-2362.2012.02701.x
European Journal of Clinical Investigation
Vol. 42 Issue 6
Accepted manuscript online: 25 MAY 2012 10:10AM EST
Received Date : 22-Feb-2012 , Accepted Date : 18-May-2012
Abstract:
Introduction: Despite of the large number of studies emphasizing the effectiveness of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for people with chronic fatigue syndrome (CFS), clinicians are left wondering how exactly applying exercise therapy to their patients with CFS. The aim of this literature review is to identify the appropriate exercise modalities (i.e. exercise duration, mode, number of treatment sessions, session length, duration of treatment, exercise intensity and whether or not applying home exercise program) for people with CFS.
Method: All studies that were identified through electronic databases (PubMed and PEDro) were assessed for methodological quality by using selection criteria (Delphi score).
Results: In this literature review 12 studies fulfilled all study requirements. One study had a low methodological quality. The parameters used in the GET and CBT interventions were divided into subgroups: (1) time or symptom contingent, (2) exercise frequency and (3) exercise modality.
Discussion: The lack of uniformity in outcome measures and CFS diagnostic criteria make it difficult to compare the findings across studies.
Conclusion: Based on the available evidence, exercise therapy for people with CFS should be aerobic, and must comprise of 10 to 11 sessions spread over a period of 4-5 months. A time-contingent approach is preferred over a symptom-contingent way of exercising. In addition, people with CFS can perform home exercises 5 times a week with an initial duration of 5 to 15 minutes per exercise session. The exercise duration can be gradually increased up to 30 minutes.
http://onlinelibrary.wiley.com/doi/...doi/10.1111/j.1365-2362.2012.02701.x/abstract
Can they? I have not seen the full text yet, but the conclusions are concerning if they are based on 12 CBT and GET studies which generally do not demonstrate compliance from patients and just assume patients are exercising. This is one of the reasons the PACE conclusions are so dangerous, they concluded that CBT and GET, with the rationale that patients should challenge their self-imposed boundaries and increase activity, is "safe", yet without published evidence that patients were actually increasing activity as presumed.