Review Sport and exercise therapy for burnout and fatigue – a narrative review 2024 Gerland and Baumann

[Andy]

Abstract

Burnout and fatigue have overlaps in their symptoms. The common denominator is exhaustion. Physical activity has been shown to be a risk-reducing factor for the development or manifestation of symptoms. There is also evidence of an effect of physical activity in the acute phase, rehabilitation, and aftercare of burnout as well as in diseases that are associated with the occurrence of fatigue and their treatments.In burnout research, physical activity is considered a risk-reducing factor and coping strategy, but there are no specific exercise recommendations with regard to symptom severity.

In the area of tiredness/fatigue, the overall picture is inconsistent: there are already targeted recommendations for exercise therapy in a multimodal approach for individual clinical pictures. For example, there is high evidence for the use of appropriately dosed physical activity in cancer patients in adjuvant therapy and aftercare. Other diseases associated with the occurrence of fatigue, such as long- and post-COVID, have not yet been sufficiently researched to make clear statements about a dose-response relationship. For some diseases, there are already targeted recommendations for exercise therapy in a multimodal approach.

This paper aims to provide an overview of the current state of exercise research in burnout and fatigue and thus, on the one hand, make therapy recommendations for practitioners and patients, and on the other hand, shed light on the evidence in those areas in which there are (still) no general and individualized exercise recommendations and guidelines.

Open access, https://link.springer.com/article/10.1007/s00103-024-03967-6

 

[rvallee]

The heterogeneous collectives of the syndromes mentioned do not allow for general recommendations for exercise. However, it can be said that physical activity can break the downward spiral of exhaustion.

This field of research can really be summed up as: "we've got a lot of theories but not a lot of data". This paper does nothing to improve on it. Right below this line is the classic diagram with a loop of thoughts and behaviors of self-reinforcing fatigue. Because an infinite loop as a symbol for an infinitely looping ideology is just not obvious enough for some people.

It doesn't help that the definitions for all those concepts are generally terrible, at times completely wrong. Like this line:

Burnout and fatigue have overlaps in their symptom manifestations

Which is perfectly equivalent to "drugs and alcohol have overlaps in their symptom manifestations". There's just so much in the traditional writings of this ideology that basically involve objects that are contained within objects but also contain the larger outer object, all stacked on objects below that are also supported above. It's basically non-Euclidian medicine. Or maybe Escherian medicine. It just doesn't respect the normal rules of causality and basic phyics.

The review is not all terrible, which makes it slightly above average, but there's a lot of weird stuff in there. Just mass confusion. Some limited talk of ME/CFS and PEM, but more about LC and how 'novel' it is. Most of the focus is on cancer-related fatigue, but somehow makes the claim that there is high-quality evidence with highly specific recommendations. Even though it's just as bad as pretty much all the exercise-rehabilitation evidence out there.

Sports and exercise therapy is a comparatively inexpensive, diverse and motivating intervention, the type and form of which can be adapted to the patient

This really misunderstands how things are connected. It may seem inexpensive to have people "just exercise", it's basically free for the health care system that recommends it, but when you get stuck in loops for decades obsessing over "does this work? does this work? does it work? does it work now? what about now?" and never getting any result out of it, it becomes extremely expensive because the problems never get solved. This is simply failing to think in systems. Ironically, it's failing to think holistically, which is the entire premise of the biopsychosocial model. Which of course it doesn't do any more than North Korea is a democratic republic.

And because the only thing the loop does is loop around:

Exercise therapy occupies an important place in the multidisciplinary treatment approach. In order to take this place in all fatigue symptoms and in the prevention and treatment of burnout, the research approaches mentioned must be pursued with great urgency.

Decades of garbage-quality research with poor methodologies and, at best, ambiguous results, and the eternal answer is: yes, we've had years-of-researching-this-and-asserting-that-it-works, but what about second years-of-researching-this-and-asserting-that-it-works? Even though they're already on their 10th doubling down already. Because it just never stops. It can't. It has to loop around.