Chronic Fatigue Syndrome
Fatigue Management Programs for CFS / ME
Chronic fatigue syndrome is also known as Myalgic Encephalomyelitis (or Encephalopathy).
There are an estimated 25,000 people (2-4 / 1000)* in New Zealand who are affected by Chronic Fatigue Syndrome.
It can affect people of all ages, women more than men (4:1), and results in symptoms of physical and mental exhaustion. It most commonly develops following a viral infection. To be diagnosed with Chronic Fatigue Syndrome / Myalgic Encephalomyelitis, these symptoms must have persisted for at least 6 months.
Post-exertional malaise is the term given to the worsening of symptoms after completing either physically demanding or cognitively demanding tasks. For this reason, exercise must be done with caution.
*https://anzmes.org.nz/what-is-me/
The use of graded exercise for Chronic Fatigue Syndrome is controversial.
To be fair, there are a lot of grey areas and unknowns when it comes to the chronic fatigue space.
Have you experienced this yourself? The science does not yet have clear guidelines for how to best manage chronic fatigue conditions, but they’re getting there. In November 2020 last year, the National Institue for Health and Care Excellence (N.I.C.E.) updated its draft guidelines for the recommended best practice for fatigue management.
The verdict? Graded exercise is out, activity management is in.
You may ask… How can a clinical exercise physiologist help if not giving exercises? Admittedly, the approach taken is different from most other programs that we would put together. The emphasis moves away from exercise, and moves towards activity pacing. For many, their activity levels first need to be decreased before they can even think of being increased!
You can think of it in terms of working within an energy envelope. You have to be able to fit all the everyday activity requirements into the energy envelope - things like preparing food, getting dressed, doing the washing - before you can start adding in additional activities.
A chronic fatigue management program is based on determining your unique activity envelope, and managing those daily activities first. This involves task scheduling, allowing adequate rest periods, and careful monitoring of symptoms. Once we have achieved a sustainable reduction in fatigue, we can gradually add in additional activities to build your activity envelope and gently increase your tolerance to physical activity.
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