Do graded activity therapies cause harm in chronic fatigue syndrome? (Kindlon, 2017)

T

Tom Kindlon

Senior Member (Voting Rights)
It's the 2-year anniversary of this open access paper of mine, so I'm giving it a plug in a few places.

It could be useful if there is any suggestion that somebody should be coerced into doing graded activity or exercise programmes; also to counter claims that the PACE Trial showed graded activity programs are safe.

The word limit for the abstract was 100 words, so I couldn't say as much as I would have liked.

I would have liked to have mentioned the PACE trial in the title as a lot of the focus was the harms reporting in the PACE Trial but the journal's editor wanted something shorter.

https://journals.sagepub.com/doi/full/10.1177/1359105317697323


J Health Psychol. 2017 Aug;22(9):1146-1154. doi: 10.1177/1359105317697323. Epub 2017 Mar 20.

Do graded activity therapies cause harm in chronic fatigue syndrome?
Kindlon T1.

Abstract
Reporting of harms was much better in the PACE (Pacing, graded Activity, and Cognitive behavioural therapy: a randomised Evaluation) trial than earlier chronic fatigue syndrome trials of graded exercise therapy and cognitive behavioural therapy. However, some issues remain. The trial's poor results on objective measures of fitness suggest a lack of adherence to the activity component of these therapies. Therefore, the safety findings may not apply in other clinical contexts. Outside of clinical trials, many patients report deterioration with cognitive behavioural therapy and particularly graded exercise therapy. Also, exercise physiology studies reveal abnormalities in chronic fatigue syndrome patients' responses to exertion. Given these considerations, one cannot conclude that these interventions are safe and risk-free.

KEYWORDS:
adherence; adverse events; chronic fatigue syndrome; cognitive behavioural therapy; graded activity; graded exercise; graded exercise therapy; harms; myalgic encephalomyelitis

PMID:
28805516
DOI:
10.1177/1359105317697323
Click to expand...
 
maybe someone could enlighten the author of this blog:
4. The Development of Chronic Fatigue Syndrome (CFS)
Chronic Fatigue Syndrome is a sly and insidious disease. Those affected are seldom aware of the condition which usually goes untreated for this particular reason. It is characterized by heavy fatigue and even plain laziness to such an extent that the patient might appear unenthusiastic and dispassionate about everything.

Little is known about the specific causes of CFS but studies demonstrate that “a sedentary lifestyle is prominent in people with CFS”. (Newton et al. 2011) In cases when a person is diagnosed with CFS, the doctors usually recommend the gradual but steady introduction of physical activity which, so far, has shown to have tremendously positive outcomes.
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Code: 
https://medium.com/@djsan77/6-long-term-negative-effects-of-lack-of-physical-activity-b4970374d40b
 
Not sure if I have said this much but this was written for the PACE Trial special issue. The original title had the PACE Trial in it because that is what it focuses on but then the editor asked me to shorten it. If I was writing something from scratch on “Do graded activity therapies cause harm in chronic fatigue syndrome?” I would have written something more general.
 
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