Correspendence is in press on this issue from:
Tom Kindlon & Ellen Goudsmit -
Graded exercise for Chronic Fatigue Syndrome: Too soon to dismiss reports of adverse reactions
Replies from
Lucy Clark & Peter White
&
Jo Nijs, Lorna Paul and and Karen Wallman
What follows are links to the earlier article and correspondence:
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http://jrm.medicaljournals.se/article/pdf/10.2340/16501977-0185
(I find this an odd article - the authors switch from say good things to bad things to good things throughout it, IMHO).
Tom Kindlon & Ellen Goudsmit -
Graded exercise for Chronic Fatigue Syndrome: Too soon to dismiss reports of adverse reactions
Replies from
Lucy Clark & Peter White
&
Jo Nijs, Lorna Paul and and Karen Wallman
What follows are links to the earlier article and correspondence:
--------
Full text is available for free at:Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations.
Nijs J, Paul L, Wallman K.
J Rehabil Med. 2008 Apr;40(4):241-7.
Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, University College Antwerp, Vrije Universiteit Brussel, Belgium. j.nijs@ha.be
Controversy regarding the aetiology and treatment of patients with chronic fatigue syndrome continues among the medical professions. The Cochrane Collaboration advises practitioners to implement graded exercise therapy for patients with chronic fatigue syndrome using cognitive behavioural principles. Conversely, there is evidence that exercise can exacerbate symptoms in chronic fatigue syndrome, if too-vigorous exercise/activity promotes immune dysfunction, which in turn increases symptoms. When designing and implementing an exercise programme for chronic fatigue syndrome it is important to be aware of both of these seemingly opposing viewpoints in order to deliver a programme with no detrimental effects on the pathophysiology of the condition. Using evidence from both the biological and clinical sciences, this paper explains that graded exercise therapy for people with chronic fatigue syndrome can be undertaken safely with no detrimental effects on the immune system. Exercise programmes should be designed to cater for individual physical capabilities and should take into account the fluctuating nature of symptoms. In line with cognitive behaviourally and graded exercise-based strategies, self-management for people with chronic fatigue syndrome involves encouraging patients to pace their activities and respect their physical and mental limitations, with the ultimate aim of improving their everyday functioning.
PMID: 18382818 [PubMed - indexed for MEDLINE]
http://jrm.medicaljournals.se/article/pdf/10.2340/16501977-0185
(I find this an odd article - the authors switch from say good things to bad things to good things throughout it, IMHO).