Chronic Fatigue Syndrome Treatment

• In two 2001 studies, between 69 - 80% of patients who engaged in a self-managed graded exercise program reported improvement. In one of the studies, the benefits persisted for at least a year. (Still, 32% of patients complained of fatigue at the end of this period.)
• Another 2001 study reported that patients recovering from mononucleosis who began a graded exercise program were significantly less likely to develop chronic fatigue syndrome within 7 months than patients who did not exercise. No proof exists, however, that CFS is actually caused by physical unfitness. Rather, most studies suggest that CFS itself limits exercise and causes a cycle of poor conditioning and worsening symptoms.

Other 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 2004 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 do not apply to many CFS patients. Many patients have severe conditions and some are very incapacitated (such as being wheel-chair bound). These patients are unlikely to undergo even 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 factor in perpetuating the low-activity levels observed in these patients.

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

• Start slowly and incrementally, beginning with as little as 3 - 5 minutes of moderate exercise a day. The goal is to increase activity by about 20% every 2 - 3 weeks. (Capacity varies greatly among CFS sufferers, however, and some may not be able to achieve this.)
• Establish limits and keep within them in order to avoid overexertion and relapse.
• Experiment with different forms of physical activity that suit 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.