# Exercise as it relates to Disease/Exercise and its role in living with Chronic Fatigue Syndrome
### WHAT IS CHRONIC FATIGUE SYNDROME?
##### Definition

Chronic Fatigue Syndrome is an “illness characterised by fatigue that occurs suddenly, improves and relapses. Bringing on delimitating tiredness or easy fatiguability in an individual who has no apparent reason for feeling this way’.’’

##### Clinical Diagnosis

“Cases of unexplained Chronic Fatigue can be defined if they meet both of the following criteria:
1. Clinically evaluated, unexplained persistent or relapsing chronic fatigue of new or definite onset that:
** Is not the result of ongoing exertion;
** Is not substantially alleviated by stress; and
** Results in substantial reduction in previous levels of occupational, educational, social or personal activities; and
2. The concurrent occurrence of four or more of the following symptoms:
** Substantial impairment in short-term memory or concentration;
** Sore throat;
** Tender lymph nodes;
** Muscle pain;
** Multi-joint pain without swelling or redness;
** Headaches of a new type;
** Sleep that is not refreshing.
These symptoms must have persisted or recurred during six or more consecutive months of illness and must have predated the fatigue”.

### CHRONIC FATIGUE SYNDROME AND EXERCISE

It is of general knowledge that exercise proves to be a crucial ingredient in leading a healthy lifestyle and improves an individuals quality of life. Yet when debilitating fatigue strikes that affects all major bodily organs, the choice of eliminating physical activity from daily life proves to be a simple and common one. Research indicates that this is indeed the wrong choice and that physical activity should be both encouraged and completed despite symptoms such as headaches, balance and proprioception issues and bodily aches. This was proven by Sharpe and Wessely (1998) who stated that: “Graded exercise has shown effectiveness in CFS. Treatment should be gradual starting at a low level of exercise and increasing incrementally under controlled conditions”.
Sharpe and Wessley (1998).

#### Relationship Complexity

An underlying issue that exists between Chronic Fatigue and Exercise lies in the patients attitude and support systems. It has been noted that positive affects result when the individual feels supported by family members and peers, despite these people not fully understanding the severity of this persons illness nor the pain and frustration they feel. These psychological and emotional battles reinforce the need for regular physical activity to act as a stress reliever and distraction.
A strong correlation exists between exercise and post-exertional dizziness via the vestibular system, this places a greater need upon the completion of exercise at intensities and frequencies that is at the participants discretion. The implementation and adherence to a graded exercise regime would prove to be the most beneficial. The monitoring of an individuals symptoms and their personal recording of their symptoms/general feeling is encouraged.

#### Exercise Prescription for a CFS Patient

The creation of an exercise regime for an individual with Chronic Fatigue should be based upon their daily symptoms. The major focus is upon getting the individual moving, despite the severity of symptoms. Exercise prescription should focus upon the functional capacity of the individual, including flexibility training and graded exercise therapy. The “monitoring of standard cardiovascular and ventilatory responses, (electrocardiogram, blood pressure, heart rate, respiratory gas exchange and ventilation)” would be most suitable, in correspondence with the rate of perceived exertion.

#### Treatment Options

With no formal prescription medicine available for sufferers this only increases the importance of focussing upon the reduction in frequency and intensity of symptoms. Many sufferers utilise medications such as “tricyclic agents, antidepressants, anxiolytic agents, anti-inflammatory agents and antihistamines” to deal with their symptoms. Some take a holistic approach to healing and focus upon diet and nutritional changes, herbal options, massage and chiropractic therapy and aromatherapy. Yet coping mechanisms such as stress management plans should continue to be individualised, dependent upon severity and at the individuals discretion.

## RECOMMENDATIONS

* Attention should be placed upon how the individual perceives their symptoms upon a daily basis, this should be recorded.
* Complete exercise at an incremental pace - despite feelings of frustration and worthlessness, be patient!
* The individual should seek support, from family or friends or via online groups such as the ‘Toby Morrison - Health and Lifestyle’ Facebook page.
* Focus upon increasing sleep, taking regular breaks to avoid crashing, nutrition, water intake, stress management and engaging in things that make the sufferer happy.

## RESOURCES

* The Chronic Fatigue Diet
* Dealing with Chronic Fatigue Syndrome
* What I did when the Dr’s couldn’t help.
* The Chronic Fatigue Diet

## References

* ↑ ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities
* ↑ ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities
* ↑ https://www.facebook.com/tobymorrisoncfs?fref=ts
* Johnson. S, Medically Unexplained Illness - Gender and Biopsychosocial Implications, (2008), ‘’American Psychological Association’’.
* Durstine. J, Moore. G, ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities (2nd Ed), (2002), ‘’Human Kinetics’'.