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Educational Programs for Chronic Fatigue Syndrome Need to Take Cognizance of the Condition's Abnormal Response to Exercise

      I read the article by Meeus et al
      • Meeus M.
      • Nijs J.
      • Van Oosterwijck J.
      • Van Alsenoy V.
      • Truijen S.
      Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.
      with interest, but question some of its logic. A “healthy eating” education program could be of benefit to most in society; however, unless it was specifically tailored for people with unusual reactions to some foods, for example people with coeliac disease, it might not be beneficial and could actually harm such individuals. Similarly, given the abnormal response of people with chronic fatigue syndrome (CFS) to exercise,
      • Twisk F.N.
      • Maes M.
      A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS.
      • Kindlon T.
      • Goudsmit E.M.
      Graded exercise for chronic fatigue syndrome: too soon to dismiss reports of adverse reactions.
      • Meeus M.
      • Roussel N.A.
      • Truijen S.
      • Nijs J.
      Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study.
      • Nijs J.
      • Paul L.
      • Wallman K.
      Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations.
      one cannot simply assume a pain management program that is suitable for other groups, such as those with chronic lower back pain (CLBP), will be appropriate and safe in CFS.
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      References

        • Meeus M.
        • Nijs J.
        • Van Oosterwijck J.
        • Van Alsenoy V.
        • Truijen S.
        Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.
        Arch Phys Med Rehabil. 2010; 91: 1153-1159
        • Twisk F.N.
        • Maes M.
        A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS.
        Neuro Endocrinol Lett. 2009; 30: 284-299
        • Kindlon T.
        • Goudsmit E.M.
        Graded exercise for chronic fatigue syndrome: too soon to dismiss reports of adverse reactions.
        J Rehabil Med. 2010; 42: 184
        • Meeus M.
        • Roussel N.A.
        • Truijen S.
        • Nijs J.
        Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study.
        J Rehabil Med. 2010; 42: 884-890
        • Nijs J.
        • Paul L.
        • Wallman K.
        Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations.
        J Rehabil Med. 2008; 40: 241-247

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