It's just become standard at this point. More often than not the patients experiencing PEM who consult with clinicians will have tried exercising already, and failed many times. Still get recommended exercise, they must not have been doing it right, need a wise clinical hand. Or whatever.
Same with many trials that find no benefits to exercise, who have many times excused it on the fact that the participants were active enough to begin it. Or, in the case of PACE, will point to a similar trial that found no benefits. All of which negates the entire premise of the model.
It just never matters. The ideology is based around the idea that there is a right way to do it, that some people can't find it on their own, and that where rehabilitation specialists come into play. No one can explain that "just right way", it's always a unique special snowflake, but it can also be treated with the most generic bunch of bland ideas one can imagine.
