Association of Young People with ME

If you find this information useful please consider making a donation and, if you're not already a member, joining. You can now join online and access our services even more quickly! It's completely free and the more members we have the bigger our voice is, so the more we can help young people with ME/CFS.

We apologise that many of the information pages have been temporarily withdrawn whilst all of the information is updated and reviewed. We will have them back online as soon as possible

Graded Exercise

There is currently no known cure for ME, nor a magic pill to take to help reduce all the symptoms. However, much can be done to help patients manage their illness and gain a degree of control over their lives.

There are currently three specific strategies clinically recognised in the CMO report as being potentially helpful in managing the illness: pacing, graded exercise and cognitive behaviour therapy. (There are many anecdotal reports of other approaches having positive effects on individual symptoms, but insufficient evidence exists to currently recommend them as overall management techniques.)

Opinions differ widely (amongst doctors and patients) on the benefits and disadvantages of each of these approaches, but the common aim of all of them should be sustainable improvement in physical functioning and adaptation to the illness. Different people respond in different ways to different treatments, and ME patients rarely suit a 'one size fits all' approach.

Graded exercise

Graded exercise is a rehabilitative approach based on the principle that prolonged inactivity causes physical deconditioning of the muscles, heart and lungs, which then maintains the effects of ME. Graded exercise programmes consist of structured supervised activities or exercises that are progressively increased by a therapist (usually a physio or occupational therapist) in order to improve a patient's physical condition. Controversy exists over whether graded exercise is a suitable treatment for ME because the primary disease process of ME may not be one that is responsive to a rehab approach, and many patients are already functioning at or very near their maximum level of activity. Research trials into the effectiveness of graded exercise in ME have been restricted to patients well enough to attend outpatient clinics, excluded anyone under the age of 18, and experienced a high drop out rate (one third of patients), thought to be related to the demands of the programme (University of York CFS/ME Review www.york.ac.uk/inst/crd/cfs.htm).

The CMO report states that graded exercise may help ambulant outpatients (ie. mildly affected patients able to attend regular outpatient appointments) if applied appropriately by a properly qualified therapist with activity levels being based on a patient's current physical capacity. It states: "The programme should be mutually agreed between patient and therapist, it should be regularly adapted according to clinical response (ie. the patient's physical reaction), and patients should be carefully monitored to ensure that exertion does not exceed target levels" (CMO report page 47). In other words people should be started off slowly, and should not be forced into exercising beyond their ability. Programmes should be "mutually agreed and non-coercive" (CMO page 61). Unfortunately this is often not the case and many patients are put through their paces with aggressive graded exercise programmes that take little or no regard of their physical response. In these situations patients may relapse and take days, weeks or months to recover back to their previous 'normal'. We urge anyone considering graded exercise to proceed with caution, to listen to their body, and to stop if they appear to be getting significantly worse as a result of the programme.
For information about physiotherapy and ME/CFS click here

Article last edited on Thursday 12th August 2010 Printable Version

Fundraising Events

Contact AYME - Telephone: 08451 23 23 89 - Post: AYME, 10 Vermont Place, Tongwell, Milton Keynes, MK15 8JA - Email: info@ayme.org.uk

Privacy & Data Protection: AYME exists for its members, who are young people and children. To ensure the protection of these members, their families and/or carers every effort is made to maintain the security/accuracy of any data held and to monitor the integrity of the advice and support given by AYME. AYME is registered under the Data Protection Act No: Z9020055. Please be aware that cookies are in use on this website. Please disable these if you do not want them stored on your computer as they contain user information. Please refer to your ‘Help’ menu or visit allaboutcookies.org (Note: this may affect your access to the members area and message board). Click through for full Privacy and DP Policy Statements or more DP information from ICO.