Adam pwme
Senior Member (Voting Rights)
The PACE trial evaluated Graded Exercise (GET) Therapy and Cognitive Behavioural Therapy (CBT) as treatments for ME. Exercise as treatment seems counterintuitive when even minimal mental or physical exertion leads to a worsening of symptoms and reduced function [1]. The defining symptom of ME is that even minimal exertion can cause a crash (flare in symptoms) for days/months/weeks. In severe cases it can cause relapses and patients become significantly more disabled for months/years; some never recover. Multiple surveys have consistently shown that Graded Exercise makes over 50% of patients worse [2]. Over 85% of patients advised to maintain or increase their activity whilst feeling ill deteriorated [3].
The definition of harm in the PACE trial may not have been sensitive enough to record serious adverse events [4]. There is no evidence that UK clinics inform patients about the risk of permanent deterioration, screen for harm, or record harm effectively [5]. The yellow card system for adverse incidents and drug interactions in the UK does not allow harm to be reported from behavioural treatments [6]. A parliamentary debate voted unanimously to withdraw Graded Exercise and CBT in January 2019 [7]. The UK Government failed to take any action.
"The whole idea that you can take a disease like this and exercise your way to health is foolishness. It is insane." [8]
REFERENCES:
[1] http://www.workwellfoundation.org/w...T-Letter-to-Health-Care-Providers-v4-30-2.pdf
[2] https://journals.sagepub.com/eprint/hWSxVIBTzDtqisvafkhE/full
[3] https://cutt.ly/5twIHSO
[4] https://journals.sagepub.com/doi/full/10.1177/1359105317697323
[5] https://journals.sagepub.com/doi/abs/10.1177/1359105319854532?journalCode=hpqa
[6] https://www.meresearch.org.uk/cbt-get-parliamentary-question/
[7] https://me-pedia.org/wiki/UK_Parlia...anuary_2019#Appropriate_M.E._Treatment_Motion
[8] https://me-pedia.org/wiki/Paul_Cheney