Readers may find it helpful to understand the wide range of research evidence in that helps inform Graded Exercise Therapy for CFS/ME, along with its safety and effectiveness.
When looking into these concepts (and all treatments and theories), it’s important to understand the quality of the research published, the background of the study, and the scientific methodology behind it - as well as the numbers of people involved, how they were selected and any bias that might affect outcomes.
Once you start delving deeper, we often find that references supplied as 'evidence' and 'research' is not of sufficient rigour to draw any conclusions at all. Such conclusions can be inaccurate, and potentially harmful. Unfortunately, they can be presented so well and so credibly that it can be hard to tell 'good research' and 'bad research' apart. Understandably this is confusing for non-scientists, so I've included some articles that people might find helpful.
I will give you an example to consider: We shouldn’t trust research telling us the cure lies in eating lots of tomatoes if it’s sponsored by the tomato producers, had only 5 people participating, 3 drop-outs and wasn’t accepted by a credible publication. Before tomato producers get upset with me, that was just an example!!
1. Bagnall AM et al. A systematic review of interventions for the treatment and management of chronic fatigue syndrome and/or myalgic encephalomyelitis. http://www.york.ac.uk/inst/crd/cfs.htm
2. Department of Health (2002) A report of the CFS/ME Working Group http://www.dh.gov.uk/PublicationsAndSta ... chk=D8nces
3. Edmonds M, McGuire H, Price J. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2004(3):CD003200.
4. Fulcher KY & White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ 1997;314:1647-52
5. Paul McCrone, Michael Sharpe, Trudie Chalder, Martin Knapp, Anthony L. Johnson, Kimberley A. Goldsmith ,Peter D. White (2012) Adaptive Pacing, Cognitive Behaviour Therapy, Graded Exercise, and Specialist Medical Care for Chronic Fatigue Syndrome: A Cost-Effectiveness Analysis.
6. National Institute for Health and Clinical Excellence (2007) Chronic Fatigue Syndrome/ Myalgic Encephalomyalitis (or myalopathy): Diagnosis and management of Chronic Fatigue Syndrome/ Myalgic Encephalomyalitis (or myalopathy) in adults and children.
7. NHS Plus (2006) Occupational Aspects of the Management of Chronic Fatigue Syndrome: a National Guideline.
8. Powell P et al. A randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome. BMJ 2001;322:387-92.
9. Rona Moss-Morris, Cynthia Sharon, Roseanne Tobin, and James C. Baldi : A Randomized Controlled Graded Exercise Trial for Chronic Fatigue Syndrome: Outcomes and Mechanisms of Change Journal of Health Psychology 2005 10: 245-259
10. Royal Colleges. Chronic Fatigue Syndrome; Report of a joint working group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners. London, Royal College of Physicians, CR54, 1996.
11. Sandler H, Vernikos J. Inactivity: physiological effects. London: Academic Press, 1986.
12. Dalrymple W. Infectious mononucleosis: 2. Relation of bed rest and activity to prognosis. Postgrad Med 1961;35:345-349.
13. Shapiro CM et al. Fitness facilitates sleep. Eur J Appl Physiol 1984;53:1-4.
14. Wallman K, Morton A, Goodman C, et al. Randomised controlled trial of graded exercise therapy for chronic fatigue syndrome. Med J Australia 2004;180:444-8.
15. Wearden AJ et al. A randomised, doubleblind, placebo-controlled trial of fluoxetine and graded exercise for chronic fatigue syndrome. Br J Psychiatry 1998;172:485-90.
16. Prof PD White MD, KA Goldsmith MPH , AL Johnson PhD , L Potts MSc , R Walwyn MSc , JC DeCesare BSc HL Baber BSc ,M Burgess PhD , LV Clark PhD , DL Cox PhD , J Bavinton BSc BJ Angus MD , G Murphy MSc M Murphy FRCP H O'Dowd PhD j, D Wilks FRCP[Ed] Prof P McCrone PhD ,Prof T Chalder PhD, Prof M Sharpe MD (2011) Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial , The Lancet Volume 377, Issue 9768.
17. Whiting P, Bagnall A, Sowden A, Cornell J, Mulrow C, Ramirez G. Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. JAMA 2001;286:1360-8.