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Exercise for Chronic Fatigue Syndrome & Myalgic Encephalomyelitis


Chronic Fatigue Syndrome & Myalgic Encephalomyelitis Exercise One of the ongoing debates among Chronic Fatigue Syndrome & Myalgic Encephalomyelitis (ME/CFS) clinicians, as well as their patients, is whether exercise is good or bad for patients with ME/CFS. The Centers for Disease Control and Prevention (CDC) maintains that patients with ME/CFS need to maintain a steady, low-impact exercise regimen to avoid becoming deconditioned. But while some physicians recommend exercise as one of their chief ME/CFS therapies, other clinicians disagree. They point out that exercise intolerance is a hallmark symptom of ME/CFS and that symptoms invariably worsen after any form of exercise.

Single-photon emission computed tomographic (SPECT) scans have shown that in ME/CFS patients who exercise, brain blood volume is reduced one to three days after exercising. In patients who are acutely or seriously ill, this could have profoundly negative effects on immune and endocrine system regulation. In patients with ME/CFS, exercise also lowers cortisol levels, which makes it more difficult for the body to control inflammation.


For patients who are mildly ill, or who are well on the way to recovery, most Chronic Fatigue Syndrome & Myalgic Encephalomyelitis clinicians advise a very gradual reintroduction of exercise. Subaerobic exercise, that is, exercise that does not increase heart rate, is recommended once a patient is showing a return of overall health. (On a scale of 1-10, this would be 5 - 7.) The main advantage of subaerobic exercise is that it helps with blood circulation. It also puts little strain on ATP production, making it appropriate for people with ME/CFS-induced metabolic disturbances. Walking and swimming are probably the best forms of exercise for this purpose.

A good measure of when you may be ready to exercise is when daily household activities (e.g., sweeping, washing dishes, doing laundry) are no longer a challenge. Once you can function normally in your home, you can begin to walk. The amount of time spent walking can be increased as you begin to feel better. When you are able to walk for six or seven minutes without feeling short of breath, you can consider gentle stretching, yoga or "weightless" weight training to strengthen specific sets of muscles. (Some ME/CFS patients have had success using weight-lifting equipment set at zero to help tone muscles.)

Once you begin to exercise, it is important to remember that you are not in a contest. How fast you go, how many laps you swim, how many blocks you walk, or how much weight you lift is not only irrelevant, it can be counterproductive. Symptoms in most patients fluctuate from day to day, which means if you force yourself to stick to a daily exercise regime - even if it's only walking around the block - you may very well cause a relapse. Your body will tell you when you can exercise, and when you shouldn't.

*Adapted from Chronic Fatigue Syndrome: A Treatment Guide, 2nd Edition by Erica Verillo.



Weight Loss, Diet and Exercise Tools


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Further Reading


Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome by Tom Kindlon

Managing my M.E.: What people with ME/CFS and their carers want from the UK's health and social services

101 Reasons why it is wrong to provide CBT and GET to ME patients


Keller Study Results: Is the two-day exercise test ready for the big time?
Dr. Betsy Keller's 2-day CPET test results show abnormal responses in patients with ME/CFS.
VIDEO: Julia Newton Talks About Muscle Abnormalities in ME Patients
The November 8, 2013 Action for M.E. conference featured recent research, as well as speakers from the M.E. community.
Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome
Research finds that low oxygen uptake by muscle cells causes exercise intolerance in a majority of CFS patients, indicating mitochondrial deficits in cellular metabolism.
 
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