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Physical effects of a reconditioning programme in a group of chronic fatigue syndrome patients

  [ 15 votes ]   [ 9 Comments ]
By E. Guillamó et al. • • February 23, 2015

By E. Guillamó et al.


AIM: Physical exercise can be part of treatment in patients with chronic fatigue syndrome (CFS), where the aim would be to improve strength and endurance through increasing physical exercise (intensity and time) without aggravating symptomatology. The present study examines the effectiveness of a reconditioning programme (focusing on strength, endurance, balance and propioception) for achieving maximum functional capacity according to the clinical status of CFS patients.

METHODS: Sixty-eight patients with CFS were randomly assigned to two groups: a control group (CG) comprising 22 patients and an active group (AG) of 46 patients, the latter being invited to take part in a functional reconditioning programme based on 12 weeks of laboratory training followed by a further 12-week home training period. Functional assessments were as follows: before (I) and after (II) the laboratory training and after (III) the home training.

RESULTS: In the AG, 22 patients (67%) completed the intervention (laboratory) stage and 20 finished the whole protocol (61%). Patients in the AG showed improved static and dynamic balance, as well as significantly greater maximum strength (F=7.059, p<0.05). Differences in resistance strength were also observed, with the AG showing a 19.9% improvement between functional assessments I and II (p=0.04). We don't found changes in the CG.

CONCLUSION: A physical exercise programme of this kind might offer CFS patients the opportunity to improve their strength, balance and quality of life, there being only a very small risk of relapse and none of the adverse effects of other treatments.

Source: Guillamó E, Barbany JR, Blazquez A, Delicado MC, Ventura-Farré JL, Javierre C. Physical effects of a reconditioning programme in a group of chronic fatigue syndrome patients. J Sports Med Phys Fitness. 2015 Feb 18. [Epub ahead of print]

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Article Comments Post a Comment

How To Avoid Over Exertion
Posted by: lacste
Feb 23, 2015

I think there is little doubt that exercise can improve the health of people with ME/CFS (or Exertion Intolerance Disease, or whatever you want to call it) so long as the exercise does not "worsen symptomalogy."

Exercising and avoiding worsening symptomalogy of course is the big issue. This article does not mention how that is accomplished in each individual patient. Exercise tolerance varies from patient to patient (some having no exercise tolerance).

If patients have the energy to perform some physical exercise, they don't have a meter telling them when they should stop before causing a potentially severe relapse of fatigue. Then the patient has to wait days before he or she is able to reattempt exercise (if at all).

Researchers need to find a way patients can monitor some vital sign that would indicate when they should stop exercise before causing relapse.
Reply Reply

Posted by: simmons1
Feb 23, 2015

Exercise has very little benefit whatsoever in treating this long term disease.
No one would tell those with multiple sclerosis that exercise was best for them as it will not cure multiple sclerosis

Exercise is more appropriate for well people who are not ill .

Many out there in the public are deconditioned and being exploited by a greedy food industry they do not have ME .

why is it only ill people who have to climb mountains.

This seems like abuse to me

the IOM wants this disease to be treated as a serious one its about time everyone else treated it as one

From News Medical
IOM committee identifies five main symptoms to diagnose ME/CFS
Published on February 11, 2015 at 1:35 AM · No Comments

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome -- commonly referred to as ME/CFS -- is a legitimate, serious, and complex systemic disease that frequently and dramatically limits the activities of affected individuals, says a new report from the Institute of Medicine.

Emily Collingridge, 1981-2012 - ME Association
21 Mar 2012 - Emily Collingridge, who died in hospital on Sunday at the age of 30, had hardly lived – but she leaves a huge legacy. It will endure in the form ...


Reconditioning is the new graded exercise
Posted by: elusoria
Feb 23, 2015
It's already been established that graded exercise is neither a treatment nor cure. It's also known that graded exercise makes many patients worse. When are we going to get a real treatment?
Reply Reply

Exercise in ME/CFS
Posted by: IanH
Feb 23, 2015
From this report we do not know what the exercise consists of. They seem to have got some beneficial results for about 60% of their sample. We also do not know how their patients were diagnosed/selected ie which criteria.

Everyone benefits from exercise including people with ME/CFS but graduated exercise training (GET) is not the way to do it. Maybe in this study they have used a better process, but it doesn't look like they have the complete formulation of exercise because the other 40% of the active group dropped-out?

Reply Reply

I am not a car
Posted by: simmons1
Feb 24, 2015
Recondition your car we are people not cars that’s insulting.

Everyone doesn’t benefit from exercise its called being ill.

being well but eating a poor diet addicted to fat, salt, sugar unable to leave the house due to excessive weight causes deconditioning ,owning a car and doing no exercise whatsoever can be cured with exercise .

exercise will not cure those with an underlying illness it will not cure ME .

It does not cure athletes who fall ill with ME who have to give up their dreams ,it will not cure doctors with ME

Lack of exercise isn’t the cause this is not laziness it is not deconditioning

The Institute of Medicine (IOM) call this a disease like cancer they are saying it is not psychological

I am not a car recondition your car .

Do I trust psychiatrists who denounce me in the press as a vile militant read headlines?

No I don’t

Do I trust psychiatry based research pushed at me constantly by a nasty press but heavily criticised by the ME community and other researchers as unscientific NO.

I have nothing to be guilty about I am happy to say .

Research in japan shows up brain inflammation
By Richard N. Podell • • October 2, 2014

The CFS/ME Brain Is Inflamed
By Richard N. Podell, M.D., MPH

For most people with Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis (CFS/ME) central nervous system function is abnormal. However, we don’t understand the mechanisms involved. Many experts suspect an inflammatory component, but the results from cytokine studies of cerebrospinal fluid have been uncertain.

Now, researchers at the RIKEN Center for Life Science Technologies in Hyogo, Japan, have directly measured neural inflammation using a combination of PET scan and MRI imaging. (1)

Their key findings: Compared to healthy controls, nine patients with CFS/ME showed evidence of abnormal activation of microglia and/or astrocyte immune cells within the brain. In specific brain areas the degree of immune activation correlated closely with the severity of the patients’ symptoms.
Reply Reply

very weak study
Posted by: bosepchuk
Feb 24, 2015
This study is very weak.

Because of the small sample size and the 39% attrition rate, I'd be very reluctant to draw any conclusions about it's applicability to the general population of people with ME/CFS.

It's really unfortunate that the researchers couldn't get results for the 39% of treatment participants who dropped out of the program. I wonder how many relapsed? How would that change their conclusions about reconditioning?
Reply Reply

If exercise makes you feel better, then you don't have ME/CFS
Posted by: Laehcar
Feb 24, 2015
If you are suffering from chronic fatigue and exercise makes your fatigue go away, then I don't believe you don't have ME/CFS. The fatigue you are experiencing is most likely caused by depression (down-regulated, unmotivated, poor immune response); exercise gives you a lift; boosts you up, stimulates your immune system, makes you feel better.

However, people who have ME/CFS (MyalgicEncephalomyelitis/Chronic Fatigue Syndrome) are already suffering from an over-stimulated immune system. This hyper-immune response is what makes them feel so very unwell. They are up-regulated, wired, their immune systems overreact and are in chronic overdrive (autoimmunity). Because exercise boosts the immune response even further, stimulation from exercise will only cause ME/CFS sufferers to flare (crash and burn) making them feel even worse.
Reply Reply

Exercise in ME/CFS
Posted by: IanH
Feb 24, 2015
Of course exercise is not a cure for ME/CFS just as it is not a cure for MS but that does not mean people with ME/CFS should not exercise. The key is to exercise within your personal energy envelope. I have followed over 40 people with ME/CFS and those who do not exercise tend to worsen over time. Obviously those who over-exert themselves worsen their symptoms but that does not mean doing no exercise.

If the ME/CFS is severe and the person can not get out of bed then either pharmacological treatment or a carefully designed supplementation program is needed until they can move around.

From what I have seen, prolonged "stillness" worsens symptoms in both ME/CFS and in FM.

I suppose it depends on what you mean by exercise. For some just walking around is exercise whereas sitting at a computer for over an hour is not and must surely be bad for blood flow to the muscles.
Reply Reply

Flawed research misleads
Posted by: siebertesther
Feb 24, 2015
First, because your active group was able to come to the laboratory regularly, it is clear that your sample was biased in the first place, using people who if they indeed did have SEID, had milder cases.

Second, less than half of your active group was able to complete your program with only 22 being able to complete the laboratory part and only 20 the full program.

At least this article did not tell the story of what happened to the drop outs, whether they became more disabled, bedridden or home bound and for how long did their PEM relapses last.

So, while you are on the right track in looking for some form of exercise that might benefit us and including awareness that exercise can make us worse, I'm afraid your current work is not helpful.

Relapse comes an unknown amount of time after exercise and can come after a series of apparently successful exercise sessions as I've learned over 29 years of attempting exercise or something approximating it. It feels so good to move my body and no doubt helps my body in some ways but unfortunately it just is not worth the collapse that comes from it which may last long thereafter.

I think one thing that needs to be taken into consideration by exercise physiologists who want to help us is orthostatic intolerance. Any time those of us with OI exert ourselves when standing or even sitting up, we feel dizzy and ill. Studies in WW I
of soldiers with this problem indicated that it took 48 hours of rest to recover from an incident of low blood pressure like this.

I'd like someone to develop a program to keep us as strong and flexible as possible delivered by a physical therapist who would offer the option of coming to our homes when necessary. Thanks for trying. Much more to be revealed.
Reply Reply

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