3 ms·
>good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS). No, there is certainly no evidence that exercise can be permanently ha
by cpncrunch 7y ago
>good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS).
No, there is certainly no evidence that exercise can be permanently harmful for CFS. In fact, all the studies show that graded exercise is beneficial.
It's certainly true that exercising too hard for too long can be detrimental and can cause a crash, and patients do need to be careful. Exercise certainly isn't a cure for CFS, and I wouldn't recommend graded exercise myself, but it's untrue to say that there is evidence that it makes patients permanently worse.
- H_Pylori 7y agoAnother name for cfs is "systemic exertion intolerance disease". This alternative name never caught up, but it does describe the reality of the ilness quite accurately. Post exertional malaise is literally the defining symptom of cfs, so yes exercise in cfs makes you worse. You can tolerate some mild forms of exercise if you have a mild form of cfs, but that's about it. Also stop spreading lies, Simon Wessely's studies are deeply flawed, to say the least.
- GordonS 7y agoIt's not true to say there is no evidence[0-9]. The Cochrane review[10] that includes the PACE trial has also been beset with complaints about its methodology[11]. [0] https://www.ncbi.nlm.nih.gov/pubmed/21334061/ https://www.ncbi.nlm.nih.gov/pubmed/21334061/ [1] https://huisartsvink.files.wordpress.com/2018/09/severely-affected-me.pdf https://huisartsvink.files.wordpress.com/2018/09/severely-af... [2] https://www.ncbi.nlm.nih.gov/pubmed/19521443/ https://www.ncbi.nlm.nih.gov/pubmed/19521443/ [3] https://huisartsvink.files.wordpress.com/2018/08/bringsli-2014-me-nat-norwegian-survey-abr-eng-ver-2.pdf https://huisartsvink.files.wordpress.com/2018/08/bringsli-20... [4] https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-2016-rapport-2.pdf https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-20... [5] https://www.nivel.nl/sites/default/files/bestanden/Rapport-draagvlakmeting-CVS-ME-2008.pdf https://www.nivel.nl/sites/default/files/bestanden/Rapport-d... [6] https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem-get-primer-december-2017.pdf https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem... [7] https://www.ncbi.nlm.nih.gov/pubmed/28847166/ https://www.ncbi.nlm.nih.gov/pubmed/28847166/ [8] https://www.ncbi.nlm.nih.gov/pubmed/28805516/ https://www.ncbi.nlm.nih.gov/pubmed/28805516/ [9] http://www.meassociation.org.uk/wp-content/uploads/2010/09/2010-survey-report-lo-res10.pdf http://www.meassociation.org.uk/wp-content/uploads/2010/09/2... [10] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub7/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/
- cpncrunch 7y agoWhile it's true that patient surveys generally report worsening after GET, that isn't quite the same standard of evidence as a Cochrane review. The Cochrane review had similar conclusions in 2004, long before PACE [1]. A detailed survey by Action 4 ME found that of patients who reported undergoing GET: "11 Had NO professional input (had they therefore paced themselves ?) – mostly with positive outcomes 6 Were supervised by occupational therapists – all with negative outcomes 3 Had been sent to the gym- all negative outcomes!" [2] When GET is done properly, it generally involves reducing activity first of all if the patient is already overdoing it, reducing stress, replacing stressful with non-stressful activity, using heart rate monitors, etc. [1] https://www.ncbi.nlm.nih.gov/pubmed/15266475 https://www.ncbi.nlm.nih.gov/pubmed/15266475 [2] http://web.archive.org/web/20071019011737/http://www.afme.org.uk/res/img/resources/AfME%20members%20survey.PDF http://web.archive.org/web/20071019011737/http://www.afme.or...
- GordonS 7y agoWe could argue back and forth in perpetuity about the quality of both the Cochrane review (for example, there are claims that their diagnostic criteria for even having CFS were not good enough) and the data against GET :) My point was simply that there does exist a large body of evidence supporting my original comment, even if there is also evidence against it.