Two-Year Follow-Up of Impaired Range of Motion in Chronic Fatigue Syndrome - Peter C. Rowe ,MD +

[Sly Saint]

THE JOURNAL OF PEDIATRICS

"
Performing the ROM examination was more likely to provoke increased fatigue and other abnormal symptomatic responses in those with CFS (40vs 4%;P<.001).19
Subsequent work has shown that in response to a 15-minute passive straight leg raise maneuver, individuals with CFS develop an increased intensity of CFS symptoms immediately and for at least 24 hours afterward,20 consistent with the hypothesis that increased sensitivity to neuromuscular mechanical strain is a mechanism of symptom provocation in the illness.18"

https://www.jpeds.com/article/S0022-3476(18)30659-0/pdf

 

[adambeyoncelowe]

But what is the multimodal therapy of which he speaks? Is he saying GET helps range of movement, or just that patients get better over time? It's really not clear to me from this paper.

 

[Denise]

But what is the multimodal therapy of which he speaks? Is he saying GET helps range of movement, or just that patients get better over time? It's really not clear to me from this paper.

@adambeyoncelowe - Rowe is not a proponent of GET.
The multimodal therapy he refers to begins with passive straight leg raises. At this stage the patient does not do the work. The physical therapist does. It is only when the patient can tolerate the physical therapist doing the straight leg raise for them without repercussions, that the patient begins doing them themselves.
The process is led by what the patient can manage.
Rowe's premise is that improving range of motion can, in some patients, lead to improved level of function.

(In case you/others are interested
Guest Blog: Dr. Peter Rowe – Is The Physical Examination Normal in CFS? Part 3

[see section on]
Postural dysfunctions and movement restrictions

https://solvecfs.org/guest-blog-dr-peter-rowe-is-the-physical-examination-normal-in-cfs-part-3/

Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome
[ see section on]

Biomechanical and physiological considerations with SLR

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159386)

 

[Trish]

So do I understand correctly that it's the range of motion stretching that is being used as the therapy. And the observation is that as the ability to tolerate the range of motion treatment improves, so does the general physical functioning of the patient.

 

[Denise]

So do I understand correctly that it's the range of motion stretching that is being used as the therapy. And the observation is that as the ability to tolerate the range of motion treatment improves, so does the general physical functioning of the patient.

@Trish - yes, the therapy involves stretching.
My understanding is that for at least some patients general function (cognitive and physical) improves.
The usual caveat applies -- larger sample size needed etc.

 

[NelliePledge]

I cant sit with my leg raised straight in front of me at 90 degrees long enough to get a pedicure these days without getting immediate symptom worsening and PEM. I have to lie down on a treatment couch instead for most of the treatment.

 

[adambeyoncelowe]

@adambeyoncelowe - Rowe is not a proponent of GET.
The multimodal therapy he refers to begins with passive straight leg raises. At this stage the patient does not do the work. The physical therapist does. It is only when the patient can tolerate the physical therapist doing the straight leg raise for them without repercussions, that the patient begins doing them themselves.
The process is led by what the patient can manage.
Rowe's premise is that improving range of motion can, in some patients, lead to improved level of function.

(In case you/others are interested
Guest Blog: Dr. Peter Rowe – Is The Physical Examination Normal in CFS? Part 3

[see section on]
Postural dysfunctions and movement restrictions

https://solvecfs.org/guest-blog-dr-peter-rowe-is-the-physical-examination-normal-in-cfs-part-3/

Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome
[ see section on]

Biomechanical and physiological considerations with SLR

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159386)

I suspected he was one of the good ones (remember seeing his name lots of times before), but I don't think the paper is super clear on what's helping. Multimodal therapy sounds like the multidisciplinary teams of existing CFS clinics. My suspicion is that this could be used to 'prove' the benefits of GET, because it's vague enough for the BPSers to twist it. And that's a real shame.