Effects of a short-term aquatic exercise intervention on symptoms and exercise capacity in individuals with CFS/ME, 2018, Broadbent et al

Any severe patient with their typical symptoms would find just getting to aquatic exercise an unwinnable marathon. Maybe if they were brought there in a wheelchair ...?

Fukuda (bad) or ICC (good)? OR ... ?

 

It is not clear that more than a small subset with mono or post viral fatigue have ME. From what we know this is likely to be 10% or less.

 

It sounds to me like patients are pushing themselves harder, and with ME that is probably not sustainable.

 

It’s not only going to and coming from. It’s changing into a bathing suit (from girl perspective, it can be hard) it’s facing the noise and smell of chlorine. Walking to and from the change room and the pool, to and from car and the center, and then to and from car and home. In my view like it was previously suggested, the people who submitted to the effort must have reduced the amount of activities they usually did.

 

I agree but if the increased heart rate is a sign of pushing harder it is not a sign of any cardiovascular improvement. I find it hard to know what to think but the way the abstract reads it looks as if the authors do not understand basic training physiology - yet they are sports medicine people?

And I think it said the heart rates were also higher pre-exercise - which has to be a bad sign. This could almost be objective evidence of exercise therapy causing harm if it wasn't likely to be completely meaningless.

 

And presumably there can be cognitive overload issues too, which all drain energy.

 

I thought the Ean Proctor case sufficient to disprove any general benefit from short-term aquatic exercise intervention.

 

I suspect that generally exercise programmes for people with ME/CFS may be safer if there are 48+-hour gaps between exercise sessions. This allows one to have a better idea whether one has fully recovered from the previous session.

The PACE Trial-type exercise programmes encourage exercise 5-6 days a week
e.g.
(Extracts from the PACE Trial GET therapist manual)

 

This makes me wonder whether the participants could have been exercising harder for the six minute walking test postintervention. In which case an increase in six minute walking test distance would be less interesting.

Saying this, the RPE [rating of perceived exertion] scores were lower in the postintervention group at each time point: one of these was significantly lower and another one was borderline (p= 0.057). However, these are self-reported measures, so might not be comparing like with like/could be biased.

O2sat are also given at two, four and six minutes. I'm not sure whether they give any information on how hard people are pushing themselves.

The baseline six minute walking test distance was 338.4 ± 39.1
the postintervention distance was: 399.2 ± 58.1

Healthy women of working age would generally score 500+.

 

From the current paper:

So this wouldn't be allowed with some exercise programmes.

Though with GET, you are allowed skip exercise sessions if you have new infections. I know one person who did GET as an inpatient who goes for long walks but claims she constantly gets "throat infections" and so stops walking then. I suspect many of these are simply ME flareups.

 

I have access to a heated pool in my building, its just a push of the elevator button and I'm there. The heat alone lowers my BP and my heart rate and pulse increases to compensate for this. I'm exhausted just trying to stay afloat.