Not sure I've seen the 2022 version before. From a quick look:
complex chronic multi system illness
(sigh)
There is evolving evidence to indicate a dysregulation of multiple dynamic physiological systems in explaining the symptom picture seen in ME/CFS. Research has demonstrated changes in Immune System responses, Autonomic Nervous System function, Neuroendocrine pathways including the Hypothalamus-Pituitary-Adrenal axis along with cellular metabolic changes.
This is just a chain of buzzwords that might as well have been produced by ChatGPT.
BACME supports clinicians to underpin rehabilitative and therapeutic processes with a grounding in dysregulation principles.
This sounds like they're in search of an explanation that will justify them continuing to do what they've been doing all along.
BACME does not support the deconditioning model of ME/CFS as a primary cause for the condition.
This is, by contrast, very carefully worded. Deconditioning was always a part of the cognitive-behavioural model, but it was never considered a "primary cause" but a perpetuating factor. They do not disavow the cognitive-behavioural model.
BACME believes that patients should have access to the best available clinically effective treatments, therapy and support with rehabilitation to relieve, reduce and manage symptoms where possible. This will allow patients to make informed choices as to how to manage the impact of ME/CFS on their quality of life and optimise the potential for recovery
The evidence, where it does exist, is mainly from trials of PACE-style CBT & GET, and it's clear from trial data that those interventions don't really work. What evidence is there for more nebulous rehabilitative approaches? And "optimise the potential for recovery" implies that they believe there is no underlying disease process. In truth we have no idea what may or may not alter the potential for recovery, if anything.
BACME supports the delivery of flexible, person specific programmes that take into account the underlying biological processes.
Presumably, then, they have evidence of these biological processes being altered favourably by their flexible, person-specific programmes.
BACME does not support inflexible Graded Exercise Therapy (GET) built on a primary deconditioning model. A deconditioning based approach would involve an inflexible, structured approach where regular increases in activity are encouraged regardless of how the patient is responding.
This isn't even true. Who says to highly deconditioned patients who have, for instance, spent a long time in an ICU that they are going to be treated inflexibly and that they must increase their activity regardless of how they're responding to physiotherapy? They've set up a strawman, and are busy knocking it down.
BACME supports the use of Cognitive Behavioural Therapy (CBT) strategies and other psychological interventions with the aim of developing management strategies delivered by a specialist ME/CFS clinician who has a good understanding of ME/CFS. BACME does not support the use of inflexible CBT programmes delivered by practitioners who do not have a good understanding of the biological aspects of ME/CFS.
There is absolutely no-one who has a "good understanding of the biological aspects of ME/CFS". BACME should not pretend that they do.
