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Effects of a short-term aquatic exercise intervention on symptoms and exercise capacity in individuals with CFS/ME, 2018, Broadbent et al

Discussion in 'ME/CFS research' started by Andy, Jun 23, 2018.

  1. alex3619

    alex3619 Senior Member (Voting Rights)

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    Any severe patient with their typical symptoms would find just getting to aquatic exercise an unwinnable marathon. Maybe if they were brought there in a wheelchair ...?

    Fukuda (bad) or ICC (good)? OR ... ?
     
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  2. alex3619

    alex3619 Senior Member (Voting Rights)

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    It is not clear that more than a small subset with mono or post viral fatigue have ME. From what we know this is likely to be 10% or less.
     
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  3. alex3619

    alex3619 Senior Member (Voting Rights)

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    It sounds to me like patients are pushing themselves harder, and with ME that is probably not sustainable.
     
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  4. Milo

    Milo Senior Member (Voting Rights)

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    It’s not only going to and coming from. It’s changing into a bathing suit (from girl perspective, it can be hard) it’s facing the noise and smell of chlorine. Walking to and from the change room and the pool, to and from car and the center, and then to and from car and home. In my view like it was previously suggested, the people who submitted to the effort must have reduced the amount of activities they usually did.
     
  5. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I agree but if the increased heart rate is a sign of pushing harder it is not a sign of any cardiovascular improvement. I find it hard to know what to think but the way the abstract reads it looks as if the authors do not understand basic training physiology - yet they are sports medicine people?

    And I think it said the heart rates were also higher pre-exercise - which has to be a bad sign. This could almost be objective evidence of exercise therapy causing harm if it wasn't likely to be completely meaningless.
     
  6. Barry

    Barry Senior Member (Voting Rights)

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    And presumably there can be cognitive overload issues too, which all drain energy.
     
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  7. chrisb

    chrisb Senior Member (Voting Rights)

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    I thought the Ean Proctor case sufficient to disprove any general benefit from short-term aquatic exercise intervention.
     
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  8. Trish

    Trish Moderator Staff Member

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    Throwing someone with very severe ME into a swimming pool and leaving them to sink or swim reminds me more of the ducking stool used to test if someone is a witch - if they drown they were innocent.

    That is very different from modern hydrotherapy or pool based fitness regimes. I imagine there could be a case for hydrotherapy with people with ME who are immobile, so long as it is done using hoists, and lots of support and is designed purely to enable water supported passive joint mobilisation and very gentle movement.

    I can't see any case for using it to try to increase activity or fitness - it is then just another form of GET, and likely to be harmful.
     
  9. Dolphin

    Dolphin Senior Member (Voting Rights)

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    I suspect that generally exercise programmes for people with ME/CFS may be safer if there are 48+-hour gaps between exercise sessions. This allows one to have a better idea whether one has fully recovered from the previous session.

    The PACE Trial-type exercise programmes encourage exercise 5-6 days a week
    e.g.
    (Extracts from the PACE Trial GET therapist manual)
     
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  10. Sean

    Sean Moderator Staff Member

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    five or six aerobic sessions per week.

    These people live in another universe.
     
  11. Dolphin

    Dolphin Senior Member (Voting Rights)

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  12. Dolphin

    Dolphin Senior Member (Voting Rights)

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  13. Dolphin

    Dolphin Senior Member (Voting Rights)

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  14. Dolphin

    Dolphin Senior Member (Voting Rights)

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    This makes me wonder whether the participants could have been exercising harder for the six minute walking test postintervention. In which case an increase in six minute walking test distance would be less interesting.

    Saying this, the RPE [rating of perceived exertion] scores were lower in the postintervention group at each time point: one of these was significantly lower and another one was borderline (p= 0.057). However, these are self-reported measures, so might not be comparing like with like/could be biased.

    O2sat are also given at two, four and six minutes. I'm not sure whether they give any information on how hard people are pushing themselves.

    The baseline six minute walking test distance was 338.4 ± 39.1
    the postintervention distance was: 399.2 ± 58.1

    Healthy women of working age would generally score 500+.
     
  15. Dolphin

    Dolphin Senior Member (Voting Rights)

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    From the current paper:
    So this wouldn't be allowed with some exercise programmes.

    Though with GET, you are allowed skip exercise sessions if you have new infections. I know one person who did GET as an inpatient who goes for long walks but claims she constantly gets "throat infections" and so stops walking then. I suspect many of these are simply ME flareups.
     
    Last edited: Aug 16, 2018
  16. Dolphin

    Dolphin Senior Member (Voting Rights)

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  17. Dolphin

    Dolphin Senior Member (Voting Rights)

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  18. Dolphin

    Dolphin Senior Member (Voting Rights)

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  19. Dolphin

    Dolphin Senior Member (Voting Rights)

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  20. Mij

    Mij Senior Member (Voting Rights)

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    I have access to a heated pool in my building, its just a push of the elevator button and I'm there. The heat alone lowers my BP and my heart rate and pulse increases to compensate for this. I'm exhausted just trying to stay afloat.
     
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