Effi, you are a love. This is basically what I was looking for. I had a 'friend' search sci-hub, and it appears that the original 1990 paper is irretrievable.
I recognize the authors there. The abstract is dazzling in its illogic. Here are the points they make in order.
- PW CFS and FM have significant pain and worsening of symptoms on or after exertion.
- This causes an understandable wariness of exertion.
- Despite that, we have pathologized this 'understandable' behavior and invented a questionnaire to measure it.
- Our study showed that fear of movement correlates to severity of symptoms: the worse your symptoms, the more you fear exertion
- Treatment with GET requires identifying these patients who are worst off and tailoring GET and CBT programs for them.
I think you leaned all your weight on the trick step of exercise being the answer to life, the universe, and everything, and fell straight through...
Did you hear that? What on EARTH is wrong with their logic circuits?
One must assume that the whole 'this is understandable' nonsense is to appease patients or soft-hearted clinicians; no one could really understand the pain and relapse created by exercise and push it, anyway. There is no long-term gain (as demonstrated in PACE) and there is often long-term loss. What is this worship of exercise all about? They
admit it causes patients to worsen in the bloody abstract, but apparently it's worth it to crash on day 2 so long as exercise is achieved on day 1.
Sorry, but my brain just can't handle the contradictions here.
I know the answer is money. No one has to inform me. Sorry.
All these researchers appear totally unfamiliar with the 24 hour lag many patients experience between exercise and problems. I guess it takes that long for the belief we should have been injured to 'fully sink in'.
I have actually really wondered about that one. I think that even with the 'flexibility'
@A.B. mentions, that one isn't explicable within the BS...
ahem... BPS model. Patients still try so hard to move/exercise if it's at all within their capabilities, and often suffer about 24 hours later.
-J