Clinical Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome as a Curriculum Thread to Meet Accreditation Standards in Physical Therapy E

Sly Saint

Sly Saint

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Clinical Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome as a Curriculum Thread to Meet Accreditation Standards in Physical Therapy Education​


Sallie W. Rediske, Independent ScholarFollow
Heidi Shearin, Independent ScholarFollow
Todd E. Davenport, University of the PacificFollow
Melinda W. Maxwell, Independent Scholar

Abstract​

Purpose: ME/CFS is a debilitating, complex, chronic illness that is estimated to affect up to nine million Americans. It requires a paradigm shift in treatment approach to one of energy conservation due to metabolic effects resulting in exercise and activity intolerance. Including clinical management of ME/CFS as a curriculum thread in Doctor of Physical Therapy (DPT) programs is vital for safe and effective care of people with ME/CFS and can help meet accreditation standards.
Methods: ME/CFS significantly impacts quality of life. It has been recognized by the World Health Organization since 1969 as a biomedical neurological disorder. Prior to the COVID-19 pandemic it was reported to be post-infectious in as many as 80% of the cases associated with a multitude of infectious agents. It is now estimated that of the 35% who develop long COVID following COVID-19, 50% of these individuals go on to fit the case criteria for ME/CFS diagnosis after having long COVID for six months or more, dramatically increasing the numbers of people meeting the ME/CFS diagnostic criteria. ME/CFS is a uniquely stigmatizing “invisible disability.” Its symptomology is complex, and its underlying pathophysiology worsens with activity. Educating and training physical therapists who can meet the needs of people with ME/CFS poses a unique challenge to Doctor of Physical Therapy (DPT) programs organized on siloed systems models due to its multisystem presentation. Results: Opportunities to integrate ME/CFS learning into didactic, clinical, and interprofessional education are strategically important not only to improve the quality of care for people with ME/CFS but also to meet various standards, such as those from the Commission on Accreditation of Physical Therapy Education (CAPTE). Conclusion: In this paper, the authors provide novel strategies on how to thread a complex chronic disease like ME/CFS through DPT curricula for meeting accreditation standards and patient care needs.

Clinical Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome as a Curriculum Thread to Meet Accreditation Standards in Physical Therapy Education

Purpose: ME/CFS is a debilitating, complex, chronic illness that is estimated to affect up to nine million Americans. It requires a paradigm shift in treatment approach to one of energy conservation due to metabolic effects resulting in exercise and activity intolerance. Including clinical...
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Jonathan Edwards said:
I am unclear why physiotherapists should be taught anything about ME/CFS other than that it is not in their field.
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It would be pretty cool if they could have a basic idea of PEM. So when pwME show up for unrelated problems they can adapt to them.

Edit: Also they might be able to catch on to people who seem to fit the bill and be careful even if they don’t have a diagnosis.
 
Yann04 said:
Edit: Also they might be able to catch on to people who seem to fit the bill and be careful even if they don’t have a diagnosis.
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Careful at what though? Nobody needs to see a physio to exercise.

The concept of 'Doctor of Physiotherapy' fills me with dismay. A doctorate is an exercise in critical thinking and physiotherapy is not based on critical thinking.

Yann04 said:
It would be pretty cool if they could have a basic idea of PEM.
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Yes, but it is clear from the paper that physios will always think they have a basic idea of something but actually be wrong, yet still 'educate' the patients with their ill-informed ideas. Sorry to sound catty but this is the reality.
 
Jonathan Edwards said:
Careful at what though? Nobody needs to see a physio to exercise.
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Well while I was doing 8 hours per week ACL rehab for my knee and collapsing at the end of sessions.

It would have been nice instead of telling me to keep pushing they raised eyebrows.

I might be mild right now and not very severe.

I take your point tho that this is not something that would happen easily.
 
Yann04 said:
Well while I was doing 8 hours per week ACL rehab for my knee and collapsing at the end of sessions.
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As far as I know there is absolutely no need to exert yourself after ACL repair. It may be important to maintain full joint movement range but that can be done passively. The obsession with doing exercises is entirely unfounded as far as I know.

I take your point that it might be useful for physios to at least know to leave people with ME/CFS alone, even if they insist on exercising others.
 
Jonathan Edwards said:
As far as I know there is absolutely no need to exert yourself after ACL repair. It may be important to maintain full joint movement range but that can be done passively. The obsession with doing exercises is entirely unfounded as far as I know.
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I don’t have the energy to dig into this. And I trust you more than my physios.

But wow that’s kind of surreal to hear after pushing myself for like 1 hour + each day for a year because I was told otherwise I wouldn’t be able to play sports again. And basically losing my entire health in the process.
 
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