Prof Mark VanNess responds to the study published in the Lancet claiming that fear of exercise hinders recovery in CFS, in the Just ME blog:
I was saddened to see the press releases regarding the ME/CFS studies from Kings College London. It seems to me they’ve once again missed important nuances of the disease. Nearly all ME/CFS sufferers would either avoid or drop out of any experiment that employed exercise as a treatment because they know it exacerbates symptoms. The remaining subjects would either be very high functioning or consist of fatigued individuals that were incorrectly diagnosed as ME/CFS. Our studies clearly show that dynamic exercise like walking or jogging exacerbates symptoms associated with ME/CFS.
Fear and avoidance of what worsens symptoms is a natural defense mechanism against a harmful stimulus. In fact, many researchers here in the U.S. utilize graded aerobic exercise as a tool to worsen and amplify ME/CFS symptoms – not as a treatment meant to be beneficial. The therapeutic interventions we use are meant to improve quality of life for ME/CFS patients. These interventions focus primarily on strengthening muscles and improving range of motion; activities that get energy from normally functioning anaerobic metabolic mechanisms rather than impaired aerobic energy pathways. We even provide tools like heart rate monitors to help patients avoid significant aerobic exertion.
Fear of exercise is an understandable response in ME/CFS. For a patient with ME/CFS the fear of exercise is a reasonable, knowledgeable, and learned response to a noxious stimulus. If ME/CFS patients could exercise away their symptoms they most certainly would, regardless of the pain. But that is not the case. Our exercise physiologists carefully avoid aerobic exercise (which worsens the pathologies) and focus activity programs that utilize intact metabolic pathways with strength training and recumbent stretching (that help alleviate symptoms). These exercise recommendations are consistent with our understanding of ME/CFS pathology.
We would all hope that ME/CFS was viewed with attention given to immunological, metabolic, cardiovascular and neuroendocrinological dysfunction that has been demonstrated with previous research.
J. Mark VanNess, Ph.D.
Professor of the Departments of Health and Exercise Science and Bioengineering
University of the Pacific, Stockton, California, USA
From Workwell Foundation:
“Professor Mark VanNess received his doctorate in neuroscience from Florida State University in 1997 and did post-doctoral work in the department of pharmacology at the University of Texas Health Science Center at San Antonio. He teaches classes at the University of the Pacific in the College of the Pacific and College of Engineering in the areas of exercise science, nutrition and biology. He began working on CFS in 1999. His main research interest is on the role of the autonomic nervous system in immune dysfunction. He has a particular interest in the mechanisms that produce post-exertional malaise in women with CFS, especially as they contribute to physical and cognitive dysfunction.”
Video of Prof NanNess at Bristol Watershed: Exercise and ME/CFS
From the Argus Report: US neuroscientist says exercise is a noxious stimulus that worsens symptoms of ME/CFS