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Going to flog every possible last drop out of this really extremely dead horse.

Baseline and post-stimulation box plots for the real and sham TUS (20 people each) don't look like they've found anything especially gamechanging.

and the treatment lasted two weeks. So one thing they've confirmed is that lots of post-acute Covid symptoms clear up within a short time. The Five Elements are supposedly the stages of disease, and the patients in the treatment group received different herbal medicines according to which stage...

noting Rachael Maskell's contribution (my bolding):

The authors note the limitations of small sample sizes and the lack of a control group for the 'combined network'. They haven't spotted another limitation, which is that they only tested people with CFS (Fukuda) against healthy controls, no other disease condition.

So the intervention group had about a 50% greater likelihood of having an 'indication of ME/CFS diagnosis' than the standard care group after 3 months?

Thread for the BACME guide for severe & very severe is here https://www.s4me.info/threads/united-kingdom-bacme-guidelines-for-severe-me-2019-and-2024-update.21990/#post-139691

To be fair, p. 2 says but that's easy to miss. And the denial of reality throughout is still stark. (edited to add) There's nothing in the activity management sections saying that if a patient deteriorates, the therapist should switch to using the guide for severe patients. Because they don't...

But it might be a deterrent to hiring all the extra therapists and supervisors of therapists that the BACME plan entails.

There's one thread to pull that might unravel it - the fact that it's a waste of money, at a time when govt is looking for yet more cuts.

Internet search for 'grading in therapy' finds lots of explanations like this one: from https://www.otdude.com/students/introduction-to-grading-occupational-therapy-interventions/ So it's just the same assumption again: what pwME need is to be continually challenged to 'progress' by doing...

On page 29, in 'Section 4: Sustaining' ('To continue a focus on the person’s goals and an improved quality of life, whilst accommodating the demands of daily life over time') there's a subsection titled 'Emotional wellbeing', and the first bullet point under it is 'Self-management of grading'...

p. 31 Jobs for the boys (and girls).

nope

and there's no mention of PEM at all in that section about increasing activity. Like the only way they imagine things going is 'the new exertion feels bad to start with but then you get used to it'. Not 'feels OK the first time or the first few times and then you crash', which is the reality...

On rereading it, this line sums up the core issue for me: They're seeing the problem as 'patient does a bit more, feels tired/sore, gets anxious/discouraged, just needs a morale boost to carry on.' Rather than 'patient cleans the kitchen counters, then can't have a shower for the rest of the...

Always this tap-dance around 'flexibility' and 'as needed' (as decided by whom?) and 'likely to be successful but...', and putting the responsibility on the patient to know whether they're doing too much or not enough, but at the same time telling them they're not actually competent to decide...

especially as their model has no room for a scenario in which their involvement isn't needed. Patient recovers, or doesn't recover but grows more confident in managing despite the illness - tick in the box for therapeutic help. Patient shows no improvement or gets worse - more therapeutic help...

to confirm that you found nothing?

With the scattering of extra capital letters it reads like a random Facebook comment rather than something put out by a professional organisation.