# Exercise as it relates to Disease/The Effect of Exercise on Chronic Fatigue Syndrome
### What is Chronic Fatigue Syndrome?

The most commonly used definition of Chronic Fatigue Syndrome (CFS) characterises it as a condition in which patients suffer persistent fatigue (at least 50% of the time) for a minimum of 6 months. The fatigue is mental and physical, reducing the amount of activity the person can perform, and is worsened by exertion. In the 1980s, an outbreak of patients complaining of fatigue, pain and trouble sleeping led to the United States Centres for Disease Control and Prevention developing the name “Chronic Fatigue Syndrome” and the revision of the definition in 1994 still stands today. There are different categories of Chronic Fatigue Syndrome, based on the person's ability to complete daily tasks:
| Mild | The ability to perform everyday tasks is reduced by 50% |
| Moderate | The person can leave the house occasionally but is generally housebound |
| Severe | Completely housebound, and bed-bound for much of the day |
| Very Severe | Completely bed-bound, and dependent on help from others in all aspects of life |
Although scientists do not know exactly what causes Chronic Fatigue Syndrome, it is suggested that in almost all cases genes are a factor. Other problems associated with CFS include:
* How well the body can produce energy
* Immune/hormonal/neurological systems
* Viral infections and digestion problems
* Issues with blood pressure and the circulatory system
* Abnormalities in the body’s biochemistry

### Symptoms

The fatigue suffered by Chronic Fatigue Syndrome patients affects the mental, emotional and physical aspects of their life, and although occasionally lessened by resting, it is relatively unresolved through any form of sleep. As well as fatigue, at least four of the following must also occur:
* Memory/concentration impairment
* Regular sore throat and tender glands
* Aching/stiff muscles
* Multijoint pain
* Post-exertional Malaise (physical fatigue and cognitive dysfunction as a result of exercise)
* Headaches.
Patients often also admit experiencing:
* A need to rest and sleep more than usual
* A lack in motivation/attention to surroundings and a decreased capacity to complete mental and physical labour
* Dizziness due to a decrease in blood pressure
* Gastrointestinal changes and urinary problems
* Marked weight changes
* A decreased thermoregulatory ability

### Prevalence

Chronic Fatigue System is thought to affect up to 1% of the population, however this number can vary; depending on the criteria and research method used, prevalence has been reported from 0.0006% to 3% of the population. People who suffer from other conditions which produce similar symptoms to CFS (medical conditions, or psychiatric ailments such as eating disorders and substance abuse) are excluded from diagnosis.

### Diagnosis and Cure

To date there is no specific test to diagnose Chronic Fatigue Syndrome. Doctors and patients work together to eliminate any other conceivable reasons for the symptoms present, for example bipolar disorder and depression.
Similarly, there is no known cure for Chronic Fatigue Syndrome, although treatment can be effective in temporarily relieving some symptoms, and patients who are diagnosed with CFS early and can begin treatments sooner are better off than those who wait.

## The Effect of Exercise
### Can Exercise Help?

The effect of exercise on patients suffering from Chronic Fatigue Syndrome is highly dependent on the individual. Although in some cases exercise can worsen the symptoms being experienced, other patients find exercise to be a benefit with regards to their fatigue. Studies have shown that fatigue can be relieved through a continued exercise therapy program when compared to a control group. Due to the differing responses, people should choose whether or not to pursue exercise as a treatment. Anaerobic exercise, such as resistance training and stretching is suggested, since they possess less potential for harm.

### Considerations when Exercising

Before beginning an exercise program it is important to go to a doctor and obtain medical clearance since CFS can have an effect on blood pressure and thermoregulation.
Each exercise program should be specific to the individual undertaking it, maximising the amount of physical activity performed without causing an increase in post-exertional malaise. The patient should start the program at a very low level; in some more severe cases all that may be feasible at the start is some light stretching. As their ability to perform and cope with exercise increases, the program may be increased, however it is important to bear in mind that CFS patients should never be pushed further than where they are comfortable at as it could have serious future repercussions.

## Further reading

* http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Chronic_fatigue_syndrome
* http://www.mecfs.org.au/
* http://chronicfatiguesyndrome.net.au/

## References

* 1 2 3 Niloofar, A, and Buchwald, D, 2003. Chronic Fatigue Syndrome: A Review. The American Journal of Psychiatry, [Online]. 160 (2). Available at: http://ajp.psychiatryonline.org/article.aspx?articleID=176018&RelatedWidgetArticles=true [Accessed 16 October 2013].
* 1 2 3 4 Better Health Channel. 2012. Chronic fatigue syndrome (CFS). [ONLINE] Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Chronic_fatigue_syndrome. [Accessed 16 October 13].
* ↑ Trendall, J. (2000), Concept analysis: chronic fatigue. Journal of Advanced Nursing, 32: 1126–1131. doi: 10.1046/j.1365-2648.2000.01583.x
* 1 2 Edmonds M, McGuire H, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD003200. DOI: 10.1002/14651858.CD003200.pub2.