Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations

Jo Nijs, Lorna Paul, Karen Wallman

    Research output: Contribution to journalArticle

    Abstract

    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.
    Original languageEnglish
    Pages (from-to)241-247
    Number of pages7
    JournalJournal of Rehabilitation Medicine
    Volume40
    Issue number4
    DOIs
    Publication statusPublished - 1 Apr 2008

    Keywords

    • chronic fatigue sydrome
    • physical therapy
    • graded exercise therapy
    • evidence based
    • fibromyalgia

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