physical activity & exercise

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Does GET help us become more active?

Postby Valentijn on Mon Aug 19, 2013 3:24 pm

I have seen many statements from experts here that GET is supposed to help us. But other sources say that GET doesn't improve physical activity levels, etc, but just improves how fatigued we feel.

I have ME, and I don't really feel fatigued, but I am very physically disabled and largely housebound and can't even do much around the house due to my ME. Is there anything indicating that GET can help us to become more physically active in a sustainable manner, and without more post-exertional malaise?
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Re: Does GET help us become more active?

Postby Jessica Bavinton on Tue Aug 20, 2013 12:20 pm

Dear Valentijn

GET is exactly designed to support people becoming more active over time. We know that becoming gently and sustainably more active seems to be an important component in any therapy that has shown effectiveness in CFS/ME.

There are two concepts that have been explored in the physical activity management of CFS/ME:
1) An incremental approach
2) A non-incremental approach

The non-incremental approach (known as adaptive pacing , or 'APT') has been found to be ineffective at increasing activity levels: this is an approach that encourages people to stay a little below their capacity, so this is perhaps not surprising.

The incremental approach, which includes GET and CBT, have both been found to be effective in increasing activity levels. These approaches support people in gently moving beyond their activity capacity, and by doing so the body adapts to this new level.

Most people describe a slight but manageable increase in symptoms (which is entirely normal and to be expected), which then settle as the body adjusts to this new level. Post-exertional malaise therefore still happens, but at a progressively higher level of physical activity - eg if walking to the front door once caused a setback, once the body has adapted to this new level, a longer walk / over-exertion (including social, cognitive etc) might have the same response.

The idea therefore is to very carefully and progressively keep on 'raising the bar' - keeping to a level and not moving on until the body has adapted and it has become easier.

Please note that this post does not constitute individual therapy advice : specific advice to your situation should be sought in a one-to-one context with a specialist.
Jessica Bavinton
Specialist Physiotherapist
BSc (Hons) Physiotherapy, MCSP, PVRA, HG (Dip), MBACME
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