Thanks very much Starlight and also justinreilly.
If you are referring to the latest Staci Stevens paper I referred to, it's briefly discussed here:
http://www.forums.aboutmecfs.org/sh...l-for-Physical-Therapist-Management-of-CFS-ME
The reason I wasn't definite if it has changed or not is that I can't see any times mentioned in the previous version in the Jason et al. (2007) paper (abstract in above link) but in the latest paper, they appear to be shorter than anyone I've heard mention times before which makes me things there has been a change:
From latest paper:
Exercise Interventions
Exercise interventions for people
with CFS/ME must be carefully customized
to reflect the unique needs
of each individual. The existing literature
mentions 2 critical issues in
prescribing physical activity for people
with CFS/ME. First, clear communication
between the individual and
the physical therapist about the effects
of the exercise program is critical
to avoid the perception that
physical activity has been increased
because of increased physical capacity
instead of the self-fulfilling prophecy
associated with starting an exercise
program. Second, aerobic system
impairments associated with CFS/ME
result in functional impairments that
may not be amenable to training in
people with CFS/ME compared with
people who are sedentary.
We assert that exercise interventions
for people with CFS/ME require a
combination of compensation and
rehabilitation approaches to physical
training in which training begins with
activities that provide stress to the
unimpaired anaerobic energy system
before the impaired aerobic energy
system is stressed. Therefore, we advocate
a training approach in which
initial therapeutic activities are short
duration, low intensity, and directed
toward specific contributing impairments
in body structures and functions.
Because oxidative phosphorylation
serves as the primary metabolic
pathway in activities lasting longer
than 2 minutes (Fig. 2), aerobic sys-
tem impairments in people with
CS/ME would seem to limit activities
longer than 2 minutes because of the
risk of developing symptoms and functional
deficits associated with PEM.
Therefore, we recommend therapeutic
activities that last less than 2
minutes and are conducted at an intensity
consistent with an HR that is
10% below the HR at the AT or RPEs
below 13 to 15. Previous studies
demonstrated that reducing exercise
time and intensity is effective in reducing
symptoms of PEM in people
with CFS/ME.60 These recommendations
regarding duration and intensity
are flexible; clinicians should be
guided by the individual’s immediate
and latent responses to therapeutic
activities to determine appropriate
exercise volume.
We recommend that activities initially
consist of stretching and activerange-
of-motion (AROM) exercises
to improve region-specific strength
and flexibility, because deficits in
strength and flexibility may be the
source of increased energy expenditure
through suboptimal movement
mechanics. The specific exercises incorporated
into the flexibility and
AROM program depend on the clinician’s
thorough examination and
evaluation of potentially contributing
pathomechanics. After participating in
a stretching and AROM program that
does not reproduce symptoms of
PEM, people may advance to strength
training in which the focus is on shortduration,
low-intensity strengthening
with maintenance of adequate rest intervals.
Clinicians should use caution
during the creation and progression of
the resistance training program because
the safety and effectiveness of
these interventions in people with
CFS/ME require additional research.
Finally, people with CFS/ME may advance
to short-duration, low-intensity
interval training. As starting criteria,
the duration of the intervals should
not exceed 2 minutes, and the intensity
should not exceed an HR that is
10% below the HR at the AT. Progression
of interval training should involve
increasing the number and intensity
of intervals while maintaining
a training range that prevents excessive
use of the impaired aerobic system
in people with CFS/ME. Interval
training should involve functional retraining
whenever possible, according
to the physical therapist’s evaluation
of the individual’s disablement. When
short-duration interval training can
be completed successfully, clinicians
should consider initiating shortduration
aerobic interval training,
which can be advanced in an incremental
manner according to people’s
symptoms, as described elsewhere.39
Despite the importance of exercise
to address physical conditioning in
some people with CFS/ME, the healthrelated
quality of life of people with
CFS/ME is only weakly correlated
with exercise capacity measurements.
This fact underlines the importance
of multimodal treatment, including
individual education and pacing selfmanagement,
to address the activity
and participation limitations in people
with CFS/ME.