Graded Exercise Treatment for CFS/ME/PVFS

The University of Maryland has the following to say regarding Graded Exercise:

A number of studies have suggested that a graded exercise program, in which patients perform increasingly more intense levels of exercise tailored to their individual abilities, has benefits for many patients with CFS. Exercise is best performed in combination with cognitive behavioral therapy.

Reports have found that 75% of CFS patients who were able to engage in exercise, particularly aerobic exercise, reported less fatigue and better daily functioning and fitness after a year. A review of clinical trials found that exercise therapy is beneficial for CFS, particularly when combined with patient education.

Some patient groups and experts contend that such studies use only patients with less severe conditions, and therefore the results do not apply to many CFS patients. Many patients have severe conditions, and some are very incapacitated (such as being wheelchair bound). These patients are unlikely to be able to do graded exercise. All CFS patients, in fact, have a lower exercise capacity than healthy individuals, and over-exercising can intensify symptoms. Some patients experience profound fatigue following even modest exercise. It is the primary reason for the low activity levels in these patients.

The following tips may be helpful for CFS patients when embarking on an exercise program:

• Work with your health care provider to determine a good starting level of activity for you. Start slowly and incrementally, beginning with as few as 3 - 5 minutes of moderate exercise a day. The goal is to increase activity by about 20% every 2 - 3 weeks, until you can handle about 30 minutes a day. Once you reach 30 minutes a day, start to increase the aerobic intensity of your workouts. (Capacity varies greatly among CFS sufferers, however, and some people may not be able to increase their aerobic intensity.)
• Establish limits and keep within them to avoid overexertion and relapse.
• Experiment with different forms of physical activity that suit your available energy levels. Some patients report great benefits from yoga or tai chi, which combine exercise with meditation.
• Setbacks will occur, but do not become discouraged.