# Interesting Info Relating To CBT And Graduated Exercise Therapy In CFS



## M&M (Jan 20, 2002)

This was recently posted to the Co-Cure list, and we've had lots of discussions on a few of the points listed, so I thought it would be worthwhile to share:


> quote: * Workgroup Presented to DHHS CFS Advisory Committee September * CFS, as defined by the Fukuda criteria, is not a disease, but a syndrome. Adisease is a distinct pathogenic process, a syndrome may have multipleetiologies producing a similar symptom complex. CFS is a non-specific termfor a mixed patient population suffering from various fatigue states,whether organic or psychiatric in nature. Recent studies have shown that anumber of somatic diseases can present with CFS symptoms and thus bediagnosed as CFS. This has allowed psychiatrists who treat chronic fatigueto claim to be CFS specialists - and thus allow the promotion of CBT andexercise as treatment......ME is not a condition defined purely by the exclusion of other "legitimised"conditions. ME is a specific clinical entity based on descriptions of anillness that has occurred in well documented outbreaks since the mid-1930's.Although ME patients can meet the CFS criteria, they are not synonymous bydefinition. The essential feature of ME is acquired CNS dysfunction andpost-exertional sickness; that of CFS is chronic fatigue. If patients canslowly increase activity levels and return to normal or near normalfunctioning, as in graded exercise therapy, then they do not have ME.


The article goes on to categorize which symptoms would be used to separate the subgroups, what the subgroups could accurately be referred to, and a suggested name change for the entire category of related syndromes. A good read!Article can be found here: http://listserv.nodak.edu/scripts/wa.exe?A...cure&F=&S=&P=61


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## Clair (Sep 16, 2000)

Thanks MrsMason  Hmm - I think this definition of CFS/ME is contentious. I personally have been diagnosed with ME - and yet the hospital I attend and my specialist both advocate gentle graded exercise over a long period. I have found some small improvements over the course of the last 18 months by changing my diet, lifestyle and adding gentle exercise has helped a little. This is not to say that it will necessarily help everyone with ME as we are all different...but by saying that anyone that benefits from a little exercise is in fact not suffering from ME is a bit insulting dont you think?So by their definition someone such as myself who has all the CNS dysfunction and post exertional malaise but who has benefited from gentle exercise...where do I fit in? Iwish these people would think before they publish their assumptions


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## M&M (Jan 20, 2002)

Aha! I see your point Clair! But, I must point out part of their criteria was that after graded exercise therapy you must:


> quote: slowly increase activity levels and return to normal or near normalfunctioning,


Somehow I doubt you're back to normal or even near normal activity levels. But I totally understand your point. I hadn't even thought of that!


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