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C F S
- Information International Exercise
and CFS/ FM
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Exercise and FM
FM patients are not generally unfit but have an
increased perception of exertion,
Nielens et al., 2000. A decreased peak oxygen
uptake indicate low fitness,
Valim et al., 2002. A
comprehensive review of 46 exercise studies in FM, jones.etal06.txt.
Exercise capacity is not correlated with well-being, ayan.etal07.txt. Patients with FM and/or CFS engage in less
high-intensity physical activities than recorded for sedentary control
subjects, kop.etal05.txt, kop.etal05.pdf. Types of Exercise Recommended
Aerobic
endurance exercise, Meiworm et al., 2000. FM-patients benefit
from strength training in the same manner as healthy controls, Hakkinen et al., 2001 and Hakkinen et al., 2001 (full paper). Growth
hormone response to strength training is normal in FM, Hakkinen et al., 2002. Whole body periodic
acceleration can be applied separately or supplementary to aerobic exercise
in the treatment of FM and CFS (hypothesis), sackner.etal04.txt, sackner.etal04.pdf. Exercise in FM - Specific Studies
The effect of a 24-wk walking
program, Meyer & Lemley, 2000, and pool exercise, Mannerkorpi et al., 2000 and Jentoft et al., 2001. A Dutch study
compares two forms of aerobic fitness training, van Santen et al., 2002,. Strength
training is recommended, Rooks
et al., 2002. A training program is recommended, Karper et al., 2001. The
difference between muscle training and stretching is studied, Jones et al., 2002, and Valim et al., 2003. Recommendations for
individualized training,
Jones & Clark, 2002. A Canadian study recommends combining training
with education, King
et al., 2002. A Cochrane review (=
review of all valid publications on the subject) concluded that exercise may
benefit FM, but studies on long-term benefits are lacking, Busch et al., 2002. and busch.etal07.txt.
Graded exercise under controlled circumstances, Richards & Scott, 2002 (txt), Richards & Scott, 2002 (pdf). Responses,
including one from Dr. Chaudhuri, letters, Richards & Scott, 2002. Pool exercise for FM had lasting
effects,
Mannerkorpi et al., 2002. A study on predictors of exercise
behaviors,
Oliver & Cronan, 2002. Drop out rates were
accounted for in this study comparing various exercise programs, Schachter et al., 2003. Moderately intensive
aerobic exercise is recommendable in FM, gowans.dehueck04.txt
and that 6 and 12 months follow-up proved exercise beneficial, gowans.etal04.txt.
However, according to another study, exercise and CBT has only short term
effects, absent at these intervals, redondo.etal04.txt. 6 months of
treatment with pyridostigmine and triweekly exercise fails to improve
Insulin-Like Growth Factor-I levels in FM, despite improvement in the AGH
response to exercise, jones.etal07.txt. Exercise and CFS
CFS status is not associated
with deconditioning, schmaling.etal05.txt,
schmaling.etal05.pdf. Premorbid exercise
level was higher in CFS than controls, smith.etal06.txt,
smith.etal.06.txt. CFS patients suffer
symptom exacerbation following physical stress, stiles.etal07.txt.
A single exercise test is insufficient to demonstrate functional
impairment, vanness.etal06.txt. Individuals who exercise
frequently are more likely to report a diagnosis of CFS in later life, harvey.etal08.txt,
harvey.etal08.pdf. After physically demanding
exercise CFS subjects demonstrate impaired cognitive processing, LaManca et al., 1998,. Cognitive deficits
arise with exercise, van.ness.etal07.txt.
Delayed recovery from fatiguing exercise, Paul et al., 1999, and exercise lowers pain
threshold in CFS, whiteside.etal04.txt, whiteside.etal04.pdf. Physical symptoms worsened after several
days delay in patients with CFS following exercise, while psychological
symptoms or cognitive function did not change after exercise, yoshiuchi.etal07.txt, yoshiuchi.etal07.pdf. A Japanese study found exercise
harmful to CFS patients,
Ohashi et al., 2002. The response of CFS patients to incremental
exercise associates a lengthened and accentuated oxidative stress together
with marked alterations of the muscle membrane excitability, jammes.etal05.txt, jammes.etal05.pdf. Belgian researchers have
proposed that the reason for abnormal exercise response in CFS is
intracellular immune deregulations, nijs.etal04.txt. There may be a limit to exercise
capacity in CFS, black.etal05.txt, black.etal05.pdf and black.mccully05.txt, black.mccully05.pdf.
Physiological Responses to arm and leg exercise in women with CFS, javierre.etal07.txt, javierre.etal07.pdf. Powell et al., 2001 found
exercise beneficial for patients diagnosed by the Oxford criteria. The
validity of this study has been questioned, letter, Shepherd, BMJ, 2001. Following
this study came another - and again with patients diagnosed by Oxford
criteria after 2 years follow-up, powell.etal04.txt,
powell.etal04.pdf. Health psychologists from New Zeeland
recommend exercise despite they have high drop-out numbers, moss-morris.etal05.txt, moss-morris.etal05.pdf. An Australian study found graded exercise beneficial
compared to relaxation after 12 weeks follow-up, wallman.etal04.txt,
wallman.etal04.pdf, editorial.lloyd04.txt. The reliability of their test
system, wallman.et.al.04.txt. These
researchers believe in a psychological explanation for their findings, wallman.etal.04.txt, wallman.etal.04.pdf.
Exercise prescription, wallman.etal05.txt.
The same psychologist explain how CFS patients have a higher sense of effort during a fatiguing exercise protocol, wallman.sacco07.txt. A Belgian study found CFS-patients to have less
exercise capacity than healthy sedentary controls, de Becker et al., 2000, de Becker et al., 2000 (full paper), while a Dutch
study found CFS patients no more deconditioned than their neighbor
controls,
Bazelmans et al., 2001,. One study demonstrated
differences in cardiovascular functioning in CFS compared to normal after
incremental exercise,
Inbar et al., 2001. A psychiatric study addressed the fear of
exercise using the term "beliefs", Silver et al, 2002. Two New
Jersey studies compared CFS patients' perceived exertion with their peak
oxygen uptake during exercise,
Cook et al., 2003,
Cook et al., 2003 (pdf), Cook
et al., 2003, Cook
et al., 2003 (pdf). These authors continued ‘results
highlight the importance of disease heterogeneity in studies determining
acute exercise and cognitive function in CFS’, cook.etal05.txt,
cook.etal05.pdf. And cook.etal06.txt, cook.etal.06.txt,
cook.etal06.pdf. Exercise was carefully evaluated in one
particular CFS patient,
Friedberg, 2003 (pdf). An Australian research group found max oxygen uptake
to be normal in CFS,
Sargent et al., 2002. CFS patients
had more abrupt interruptions of voluntary physical activity during diurnal
periods in normal daily life possibly due to fatigue, ohashi.etal04.txt, ohashi.etal04.pdf. Belgian studies found lack of association between
pain-related fear of movement and exercise capacity and disability in CFS, nijs.etal.04.txt, and nijs.et.al.04.txt,
nijs.etal04.pdf. Prediction of peak oxygen
uptake in patients fulfilling the 1994 CDC criteria for CFS, nijs.demeirleir04.txt, nijs.demeirleir04.pdf. Exercise
Performance Related to Immune Dysfunction, nijs.etal05.txt,
nijs.etal05.pdf. Can submaximal exercise
variables predict peak exercise performance in women with CFS? nijs.etal07.txt, nijs.etal.07.txt,
nijs.etal07.pdf. CFS patients do not suffer from exercise phobia, gallagher.etal05.txt, gallagher.etal05.pdf. A Cochrane review concludes that exercise is
not harmful in CFS, edmonds.etal04.txt, edmonds.etal04.pdf. It is remarkable, however, that only 5
studies were included in this Cochrane review, and only one (!) study used
CDC-defined CFS patients. Dr. Lapp
argues that this is a very poor Cochrane review which sends all the wrong
messages, letter.cochrane.lapp04.txt.
Impact of a maximal
exercise test on symptoms and activity in CFS, bazelmans.etal05.txt,
bazelmans.etal05.pdf. More evidence on exercise needed
The use of self-report
inventory for evaluation of exercise is recommended, Coutts et al., 2001. UK-psychiatrists still recommend exercise for CFS
without testing for cognitive functioning, they just conclude 'exercise makes
CFS patients more fit',
Fulcher & White, 2000, Fulcher & White, 2000 (full article). Dr.
Shepherd of the MEA, UK warns against this belief, since graded exercise was
found detrimental to the majority of 2,300 ME/CFS patients asked in a
2001-survey,
Shepherd, 2001. Some of
the wrong beliefs held by psychiatrists can probably be explained by their
tendency to extrapolate results obtained from healthy human beings. Women with CFS respond differently in cardiovascular
measures to stress than controls, LaManca et al., 2001. Maximal
exercise testing found only small differences in CFS compared to
normal, Vanness et al., 2001, however, despite a
common diagnosis, the functional capacity of CFS patients varies
greatly, Vanness et al., 2003, Vannes et al., 2003 (pdf). |
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