1. Guest, the 'News in Brief' for the week beginning 31st May 2021 is here.
    Dismiss Notice
  2. Welcome! To read the Core Purpose and Values of our forum, click here.
    Dismiss Notice
  3. Contribute to feedback on the CDC Evidence Review, for more details click here
    Dismiss Notice

Two-Year Follow-Up of Impaired Range of Motion in Chronic Fatigue Syndrome - Peter C. Rowe ,MD +

Discussion in 'BioMedical ME/CFS Research' started by Sly Saint, Jun 2, 2018.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    Messages:
    6,115
    Likes Received:
    50,206
    Location:
    UK
    THE JOURNAL OF PEDIATRICS

    "
    Performing the ROM examination was more likely to provoke increased fatigue and other abnormal symptomatic responses in those with CFS (40vs 4%;P<.001).19
    Subsequent work has shown that in response to a 15-minute passive straight leg raise maneuver, individuals with CFS develop an increased intensity of CFS symptoms immediately and for at least 24 hours afterward,20 consistent with the hypothesis that increased sensitivity to neuromuscular mechanical strain is a mechanism of symptom provocation in the illness.18"

    https://www.jpeds.com/article/S0022-3476(18)30659-0/pdf
     
  2. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

    Messages:
    2,298
    Likes Received:
    16,650
    But what is the multimodal therapy of which he speaks? Is he saying GET helps range of movement, or just that patients get better over time? It's really not clear to me from this paper.
     
    alktipping, Hutan and Invisible Woman like this.
  3. Denise

    Denise Senior Member (Voting Rights)

    Messages:
    316
    Likes Received:
    1,979
    @adambeyoncelowe - Rowe is not a proponent of GET.
    The multimodal therapy he refers to begins with passive straight leg raises. At this stage the patient does not do the work. The physical therapist does. It is only when the patient can tolerate the physical therapist doing the straight leg raise for them without repercussions, that the patient begins doing them themselves.
    The process is led by what the patient can manage.
    Rowe's premise is that improving range of motion can, in some patients, lead to improved level of function.

    (In case you/others are interested
    Guest Blog: Dr. Peter Rowe – Is The Physical Examination Normal in CFS? Part 3

    [see section on]
    Postural dysfunctions and movement restrictions

    https://solvecfs.org/guest-blog-dr-peter-rowe-is-the-physical-examination-normal-in-cfs-part-3/

    Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome
    [ see section on]

    Biomechanical and physiological considerations with SLR

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159386)
     
    Tilney, JaimeS, alktipping and 4 others like this.
  4. Trish

    Trish Moderator Staff Member

    Messages:
    32,875
    Likes Received:
    156,782
    Location:
    UK
    So do I understand correctly that it's the range of motion stretching that is being used as the therapy. And the observation is that as the ability to tolerate the range of motion treatment improves, so does the general physical functioning of the patient.
     
  5. Denise

    Denise Senior Member (Voting Rights)

    Messages:
    316
    Likes Received:
    1,979
    @Trish - yes, the therapy involves stretching.
    My understanding is that for at least some patients general function (cognitive and physical) improves.
    The usual caveat applies -- larger sample size needed etc.
     
  6. NelliePledge

    NelliePledge Moderator Staff Member

    Messages:
    8,113
    Likes Received:
    47,971
    Location:
    UK West Midlands
    I cant sit with my leg raised straight in front of me at 90 degrees long enough to get a pedicure these days without getting immediate symptom worsening and PEM. I have to lie down on a treatment couch instead for most of the treatment.
     
  7. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

    Messages:
    2,298
    Likes Received:
    16,650
    I suspected he was one of the good ones (remember seeing his name lots of times before), but I don't think the paper is super clear on what's helping. Multimodal therapy sounds like the multidisciplinary teams of existing CFS clinics. My suspicion is that this could be used to 'prove' the benefits of GET, because it's vague enough for the BPSers to twist it. And that's a real shame.
     
    alktipping, Hutan and Invisible Woman like this.

Share This Page