David Tuller has published a new blog on Virology Blog that includes a response that Workwell Foundation to an article promoting GET in the British Journal of Sports Medicine. David wrote:
The Workweek letter to the BJSM stated:
In response to the BJSM article, the experts on post-exertional malaise from University of the Pacific and the Workwell Foundation wrote a letter to the journal that has not yet been published. These investigators have documented this symptom through use of the two-day CPET test, which measures the impact of exercise. They wanted to register their evidence-based opposition to the recommendation for GET. Since the letter makes valuable points and will be useful for those seeking to rebut the BJSM paper’s fallacious claims about exercise, I am happy to post it below.
The Workweek letter to the BJSM stated:
We are opposed to graded exercise therapy as a treatment for ME/CFS as recommended in this article. Our experiences working with ME/CFS patients are that graded exercise – particularly aerobic exercise–not only fails to improve function, it is detrimental to the health of patients.
The rationale behind using GET as treatment for ME/CFS is that it can reverse a cycle of inactivity and deconditioning, and subsequently reduce the fatigue and disability associated with this disease [2,3]. However, it seems counterintuitive at best to employ exercise as treatment when the hallmark of ME/CFS is a distinctive post-exertional malaise or PEM, whereby even trivial mental or physical exertion can cause a worsening of symptoms and reduced function [4].