Thread by @karenphysiocouk

Any treatment plan should be based on the best available evidence base.

So when considering exercise for ME, let’s take a look at the evidence.

A thread...

Some RCTs have shown improved subjective fatigue and physical function with graded exercise.

But there have been no demonstrable changes to objective outcome measures.

And subjective outcomes fail to remain significant in comparison to controls at 12 month follow up.

Subjectively, a review of 10 patient surveys from across the world found that 51% of respondents reported graded exercise therapy made their health worse

Objectively, the following has been found following exercise in ME

Reduced oxygenation of the prefrontal cortex

Impaired cognitive processing

Decreased pain threshold

Abnormal increases in lactic acid

Deterioration in cardiopulmonary function ...

... Decrease in general function

Early intracellular acidosis

Increased intramuscular acidosis and prolonged recovery

Early fatigue with prolonged recovery

Abnormally increased levels of oxidative stress with prolonged recovery

So when comparing the quality of evidence supporting the benefits of exercise against the range of adverse physiological effects found so far, it is logical to conclude that exercise is not an evidence based treatment for ME, and could in fact be harmful.

It's that simple.