Educational Programs for Chronic Fatigue Syndrome Need to Take Cognizance of the Condition's Abnormal Response to Exercise

Abstract

I read the article by Meeus et al 1 Meeus M. Nijs J. Van Oosterwijck J. Van Alsenoy V. Truijen S. Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Arch Phys Med Rehabil. 2010; 91: 1153-1159 Abstract Full Text Full Text PDF PubMed Scopus (156) Google Scholar with interest, but question some of its logic. A “healthy eating” education program could be of benefit to most in society; however, unless it was specifically tailored for people with unusual reactions to some foods, for example people with coeliac disease, it might not be beneficial and could actually harm such individuals. Similarly, given the abnormal response of people with chronic fatigue syndrome (CFS) to exercise, 2 Twisk F.N. Maes M. A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS. Neuro Endocrinol Lett. 2009; 30: 284-299 PubMed Google Scholar , 3 Kindlon T. Goudsmit E.M. Graded exercise for chronic fatigue syndrome: too soon to dismiss reports of adverse reactions. J Rehabil Med. 2010; 42: 184 Crossref PubMed Scopus (1) Google Scholar , 4 Meeus M. Roussel N.A. Truijen S. Nijs J. Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study. J Rehabil Med. 2010; 42: 884-890 Crossref PubMed Scopus (136) Google Scholar , 5 Nijs J. Paul L. Wallman K. Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations. J Rehabil Med. 2008; 40: 241-247 Crossref PubMed Scopus (78) Google Scholar one cannot simply assume a pain management program that is suitable for other groups, such as those with chronic lower back pain (CLBP), will be appropriate and safe in CFS. Pain Physiology Education Improves Pain Beliefs in Patients With Chronic Fatigue Syndrome Compared With Pacing and Self-Management Education: A Double-Blind Randomized Controlled TrialArchives of Physical Medicine and RehabilitationVol. 91Issue 8PreviewMeeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Full-Text PDF The Authors RespondArchives of Physical Medicine and RehabilitationVol. 92Issue 6PreviewWe are pleased with the discussion1 after the publication of our randomized controlled trial examining the effectiveness of pain physiology education in people with chronic fatigue syndrome (CFS).2 As we reported ourselves, too vigorous exercise can indeed be harmful for patients with CFS.3-5 Submaximal and even self-paced limited exercise causes a decrease in pain thresholds,3,5 increased symptom intensity,5 further immune dysregulation,6 and increased oxidative stress.7 Full-Text PDF