Is it always possibly to do a tiny bit more?
Dr. Joe Fitzgibbon argues, based on research done on athletes, that some of the same principles apply to us as it does to these athletes. Athletes sometimes use a method of training where they increase speed, or length of training, just a little bit at a time, so that gradually over time they become better and faster. By doing it gradually it doesn't feel like a huge effort at any point in time, so it is easier in the long run to increase one’s stamina.
Dr. Joe Fitzgibbon seems to think that we can retrain ourselves using the same principles as athletes. So he argues that, no matter how bad we are, that we can increase our activity little bit by little but over time. He says:
For example, the overview of the Overview of the Canadian Consensus document on ME/CFS states
The severity of ME/CFS can fluctuate, of course, over time, so patients can sometimes increase their activities. But their symptom levels can go up and down, so they might have to alter their activities based on this. There is a huge difference between altering activity levels based on how one is feeling, and how severe the symptoms are (Pacing), and trying to stick to a pre-planned timetable of graded exercise, and believing that one can definitely increase activities over time through following a set programme .
While the idea that a person can keep increasing their activities until they are better is very attractive, there is no evidence that this actually works in ME/CFS. I am hoping to post on the ME (or "chronic fatigue" as he calls it) chapter tomorrow. I had forgotten just how bad this book was until I started to re-read this review that I wrote a few years ago. A lot of people see him as an ME expert and think he is knowledgable and sympathetic on ME.).
Dr. Joe Fitzgibbon argues, based on research done on athletes, that some of the same principles apply to us as it does to these athletes. Athletes sometimes use a method of training where they increase speed, or length of training, just a little bit at a time, so that gradually over time they become better and faster. By doing it gradually it doesn't feel like a huge effort at any point in time, so it is easier in the long run to increase one’s stamina.
Dr. Joe Fitzgibbon seems to think that we can retrain ourselves using the same principles as athletes. So he argues that, no matter how bad we are, that we can increase our activity little bit by little but over time. He says:
Later in the book (in the chapter covering CFS) he reiterates this point saying:"The implication for the profoundly fatigued is that they too can increase their output by tiny increments without doing themselves any harm, and these increments in activity can be further increased ever so slightly as time goes by" (p14) Feeling Tired all the Time, Dr Joe Fitzgibbon, 2001
But there is evidence that patients with ME/CFS do have a limit to their levels of functioning. Patients may not be able to get over this limit by exercising, no matter how much they want to, and they might make their symptoms worse if they try to push through continuously."whatever the severity of your fatigue it is always possible to do just a tiny bit more". (p.263) Feeling Tired all the Time, Dr Joe Fitzgibbon, 2001
For example, the overview of the Overview of the Canadian Consensus document on ME/CFS states
Elsewhere, two researchers Black and McCully wrote a piece about an exercise study they did with ME/CFS patients:“It is essential that the patient does not exceed his/her endurance limitations or activity boundaries too often or too deeply because this can cause a severe, long-term relapse". (Source: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners: An Overview of the Canadian Consensus Document 2005 ahmf.org/me_cfs_overview.pdf )
"our daily exercise program was accompanied by a worsening of CFS symptomology....The inability to sustain target activity levels, associated with pronounced worsening of symptomology, suggests the subjects with CFS had reached their activity limit." (Source: Black and McCully Dyn Med. 2005; 4: 10.)
The severity of ME/CFS can fluctuate, of course, over time, so patients can sometimes increase their activities. But their symptom levels can go up and down, so they might have to alter their activities based on this. There is a huge difference between altering activity levels based on how one is feeling, and how severe the symptoms are (Pacing), and trying to stick to a pre-planned timetable of graded exercise, and believing that one can definitely increase activities over time through following a set programme .
While the idea that a person can keep increasing their activities until they are better is very attractive, there is no evidence that this actually works in ME/CFS. I am hoping to post on the ME (or "chronic fatigue" as he calls it) chapter tomorrow. I had forgotten just how bad this book was until I started to re-read this review that I wrote a few years ago. A lot of people see him as an ME expert and think he is knowledgable and sympathetic on ME.).
Last edited: