Gravity-induced exercise intervention in an individual with CFS/ME and POTS, 2019, Ballantine, Srassheim, Newton

From Figure 6: Weekly activity log at baseline, and at the conclusion of the intervention

Hours active: 41, increased to 46
Hours asleep: 55, decreased to 46. (average # of hours of sleep per day 7.9 hours, declined to 6.6 hours)
Hours sedentary (eg lying on sofa): 72, increased to 76

The paper noted:
It can also be noted that she is sleeping less and in a slightly more disjointed manner at the end of the study.
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Yeah. And she has learned to 'decrease the impact of gravity' :) when carrying out active tasks (eg use a perching stool when hanging out washing). So it sounds as though the active tasks became more sedentary.

Now, I'm probably giving this paper more analysis than a study of one person who may or may not have ME/CFS with an intervention of one hour of exercise a month warrants. But, if I had to make a conclusion, it looks like the person has managed to achieve a small increase in the number of active hours by increasing the amount of time she rests and by making the active hours less active. And this has resulted in sleep that is now less than the accepted optimum length and is more fragmented.

The authors note that this patient was extremely well supported as she lived at home with her parents.
Therefore, she really could recuperate in between the exercise intervention classes and allow supercompensation to occur.
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whatever supercompensation may be. It sounds rather like she collapsed in a heap after the monthly 1 hour of exercise. That suggests that if the activity log had been done in the week following the exercise class, the number of active hours would have decreased from the baseline significantly.

Following this case report, the exercise intervention documented in this case report was undertaken with a group of six individuals affected by CFS/ME and POTS over a six-month period at the CRESTA clinic. The overall conclusion from this was that the effect of the intervention was variable, but for the patients where an improvement was seen, the impact was momentous. The patient's background, medical and behavioural stability were significant components in their progress.
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Hmm, so really not replicable then. But, if it didn't work, it wasn't the program's fault.
 
The multi-faceted role of the autonomic nervous system meant that movements that directly challenge it can have profound effects on the rest of the body and its homeostatic processes. This was the reason why 1 month was given in between classes, to allow adequate recovery to occur.
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Sounds as though this anti-gravity intervention that induces supercompensation must be something quite extraordinary, perhaps even novel then?

From the paper:
Screen Shot 2019-06-12 at 3.19.07 PM.png

Given that the patient was not expected to do any exercises at home and given the supercompensation, the program sounds suspiciously like, no, surely it couldn't be?, but really, it does sound a lot like a 'push-crash cycle'.:eek:
 
Thanks Forbin. There are so many issues with that dissertation, it feels cruel to dissect it. There is no evidence that the intervention is worthwhile. And yet the conclusion is that, if only they could identify the right sort of patient with the right sort of behavioural stability, the intervention would work.
 
It seems as though the idea is that the autonomic response to changes in position can become deconditioned due to its disuse in people who stay off their feet (or experience extended weightlessness). The exercises seem intended to challenge the ANS with uncommon situations, as when the head is lower than the heart such that the blood leaving the brain must be pumped upward against the force of gravity. I'm guessing that challenges like this are intended to make the overall autonomic response to positional change more robust, thus ameliorating POTS symptoms when standing.

The idea that the nervous system's autonomic response itself can become decondtioned might not be the same thing as saying that the muscle fibers that implement that response have become deconditioned.



Of course, you have to take into account that everything I know about gravity I learned from Sandra Bullock.
 
Trish said:
So it's a case study of an individual with such severe ME and POTS she was unable to get out of bed for 10-15 years. So how did she manage to attend an exercise class?
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I think they have to explain how that is achieved the journey from bed to a journey to where the classes are held. What they mean by bedbound and why they were bedbound.

This does explain PEM and that is a big mistake (as always), why and how PEM exists before they try and treat someone with CFS/ME as they call it is advisable?

Why is explaining PEM important because the delay of onset of symptoms is not the beginning of PEM. The two day elation some patients find when they have done an activity including cognitive needs to be expressed as "Boom and Bust" is not a good enough understanding. So if participant had read the newspaper and then done the exercises that would be different to just doing the exercises and not thinking for the next 4-5 days.

PEM has little to do with symptoms and everything to do with the changes that goes on when you call for energy and that means thinking or digesting food. They are not taking life into consideration either. The more you do the more you need a shower.

Talking about a baseline also shows they understand nothing about PEM so no understanding of ME as for CFS well anyone can be put under that banner.

In my experience doing more does not mean living better as Emma Shorter explains

So there must be a measure of feet on the floor in an upright position hours counted symptom free to make sure life is getting easier and sustainable.
 
For all those that ask about anti gravity exercising means these are the swings that you exercise on

I am not going to say another word and this is an anti-gravity treadmill upload_2019-6-12_7-57-37.png
 
Another thing I thought was weird is that baseline measurements of heart rate were taken in 2013 and then there's a big gap until 2016 when improvement is noted. My POTS has also improved significantly in that time period with no gravity exercise intervention at all.
 
Forbin said:
It seems as though the idea is that the autonomic response to changes in position can become deconditioned due to its disuse in people who stay off their feet (or experience extended weightlessness).
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It's a nice idea @Forbin and sounds plausible. And I am certainly not arguing against activity of any sort for those who can do it.

But there's no evidence that this particular intervention worked in anyone. And really, at 1 hour per month, that's not very surprising.

Screen Shot 2019-06-12 at 7.29.50 PM.png

Patient 1 - the star of the case study, and Patient 6 were the only two who reportedly managed to increase their weekly active hours over the 5 months. But Patient 6 didn't even have any data on the number of repetitions completed at the final session. The final session (Month 5) is shown in dark blue in the chart above. Check it out for each patient. Look at how the number of reps at the final session compares with the earlier sessions.

Screen Shot 2019-06-12 at 7.34.03 PM.png

Or another analysis - look at how the participants assess overall health. See how the author is suggesting that Patient 4 had the biggest improvement in total score 'from their first month to the conclusion of the study'. But they didn't even turn up for the last session and, with no Month 1 data, it's hardly a progression. And given they attended the fewest number of sessions out of all the participants, it's hardly a ringing endorsement of the intervention.

Like I said, it's just too easy. It's an example of people finding exactly what they want to find in data. The real issue is what Julia Newton made of all this and why she felt able to put her name on the case study.
 
I've been laughing my head off since yesterday at that CRESTA Fatigue Clinic anti-gravity document. I know its not funny because this kind of nonsense could be causing real harm to the luckless sods who end up being treated at that clinic (and it does look like it did cause problems for the poor woman in the intervention in the paper). And they're sending students out into the world believing that lying down or standing up from a sitting position changes the way that spacetime curves around objects, which is a bit frightening.

But it's still pretty funny.
 
chrisb said:
Here is the CRESTA Fatigue Clinic Booklet.
https://www.ncl.ac.uk/media/wwwnclacuk/facultyofmedicalsciences/files/CRESTA Fatigue Booklet - reformatted 8th August 2017.pdf

Astonishing, but you get a good run for your money.
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It seems to be a booklet for 'fatigue'. I decided to take a look. Big mistake. Couldn't get past this patronising rubbish in the introduction, clearly written by someone who has never faced life changing serious chronic disabling illness:

Although this period of ill health is distressing, we hope that you will see that it could in fact be a blessing in disguise - an opportunity to do things a little differently, and to learn things that will stand you in good stead for managing difficulties for the rest of your life.
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I give up.

Edit: I couldn't resist reading a bit more. It gets worse. Looks like it's written for very stupid women who are trying too hard to be perfect housewives and need a bit of help to slow down for a bit.

aaaaargh.
 
Yep. It only seems to mention fatigue, but it mentions all the catch words needed to associate it with CFS. I can see that there may be people unable to manage their own fatigue who might possibly be helped by this. It has no relevance to CFS and less to ME, but it is clearly intended to cater for them.
 
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