Workwell’s two-day exercise tests and breaking the deconditioning dilemma in Chronic Fatigue Syndrome (ME/CFS) by Cort Johnson in Health rising blog, 19 Nov 2018

The first word in the first sentence of the paper says it all:

“Concise methodological directions for administration of serial cardiopulmonary exercise testing (CPET) are needed for testing of patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).”

Why concise? Because Workwell asserts that in the universe of diseases known to man Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) is so different when it comes to exercise that it needs a place all it’s own. It needs it’s own concise methodology, and above all it needs to be understood differently.

This methodology paper, then, is an attempt by the exercise physiologists at Workwell (Staci Stevens, Mark Van Ness, Chris Snell, Jared Stevens) and Betsy Keller to spread the word that something very different, something perhaps even unique in the annals of medicine, is occurring in people with chronic fatigue syndrome when they exercise.

Someone, it seems, is listening. This dry, seemingly obscure methodology paper (“Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome“) has proven to be a surprise hit. In the two months since its publication it’s been viewed by over 7400 people spread across the globe…

It’s a remarkable fact that even people with disabling diseases can exercise to exhaustion two days in a row without effecting their ability to produce energy

Workwell has been giving two-day CPETs for years. I asked Staci if the drop in energy production seen in an exercise test given one day after a previous test was really unique in ME/CFS. Her answer demonstrated just how much we have to learn:

Clinically we have seen patients with more than 30 different fatiguing conditions including POTS and fibromyalgia. ME/CFS is unique but more research is needed to determine ME/CFS CPET subsets and if other conditions have abnormal test 2 responses.

Our clinical patients often have comorbid conditions, so this makes it more difficult to sort out. That said, several distinct subsets of abnormal responses are emerging. We have a case series on this very topic comparing fatiguing conditions with ME/CFS which will be published soon.

Read more about:

  • POTS & deconditioning
  • Workwell’s plans for larger exercise tests
  • A Guide to Giving a Two-Day Exercise Test in ME/CFS – The Methodology Section
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