Use of exercise for treatment of Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is a condition that results in
moderate to severe disability, the primary feature of which is
fatigue of unknown origin. There is a lot of interest in
classifying, characterising and treating patients with CFS.
Currently, the two major theories of a medical cause of CFS
are viral infection and immune dysregulation. Patients report
critical reductions in levels of physical activity, and many
experience 'relapses' of severe symptoms following even
moderate levels of exertion. Despite this, most studies report
CFS patients to have normal muscle strength and either normal
or slightly reduced muscle endurance. Histological and
metabolic studies report mixed results: CFS patients have
either no impairment or mild impairment of mitochondria and
oxidative metabolism compared with sedentary controls. Current
treatments for CFS are symptom-based, with psychological,
pharmacological and rehabilitation treatments providing some
relief but no cure. Immunological and nutritional treatments
have been tried but have not provided reproducible benefits.
Exercise training programmes are thought to be beneficial (if
'relapses' can be avoided), although few controlled studies
have been performed. CFS is a long-lasting disorder that can
slowly improve with time, but often does not. Further studies
are needed to better understand the multiple factors that can
cause chronic fatigue illness, as well as the effect that
exercise training has on the symptoms of CFS. [References: 78

McCully KK, Sisto SA, Natelson BH

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