Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: M.E. Beth Smith, Elizabeth Haney, Heidi D. Nelson
Journal: Annals of Internal Medicine (2015)

Letters1 December 2015Treatment of Myalgic Encephalomyelitis/Chronic Fatigue SyndromeM.E. Beth Smith, DO, Elizabeth Haney, MD, and Heidi D. Nelson, MD, MPHM.E. Beth Smith, DOFrom Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; and Providence Cancer Center, Providence Health and Services Oregon, Portland, Oregon.Search for more papers by this author, Elizabeth Haney, MDFrom Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; and Providence Cancer Center, Providence Health and Services Oregon, Portland, Oregon.Search for more papers by this author, and Heidi D. Nelson, MD, MPHFrom Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; and Providence Cancer Center, Providence Health and Services Oregon, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5176 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank the authors for their comments and Dr. Speedy for sharing his personal experience. Regarding Dr. White and colleagues' statements about the harms of exercise, we acknowledge that exercise testing differs from graded exercise programs. However, patients may consider both forms of exercise harmful. To clarify the results of Moss-Morris and associates' trial, whereas 44% of participants in the intervention group declined repeated exercise testing, 20% did so because of their perception of harm (1). Also, although the Cochrane review did not identify harms of exercise, the authors drew similar conclusions to ours, stating that, “limited information ...References1. Moss-Morris R, Sharon C, Tobin R, Baldi JC. A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. J Health Psychol. 2005;10:245-59. [PMID: 15723894] CrossrefMedlineGoogle Scholar2. Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2015;2:CD003200. [PMID: 25674924] MedlineGoogle Scholar3. Núñez M, Fernández-Solà J, Nuñez E, Fernández-Huerta JM, Godás-Sieso T, Gomez-Gil E. Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up. Clin Rheumatol. 2011;30:381-9. [PMID: 21234629] MedlineGoogle Scholar4. Ridsdale L, Hurley M, King M, McCrone P, Donaldson N. The effect of counselling, graded exercise and usual care for people with chronic fatigue in primary care: a randomized trial. Psychol Med. 2012;42:2217-24. [PMID: 22370004] CrossrefMedlineGoogle Scholar5. Darbishire L, Seed P, Ridsdale L. Predictors of outcome following treatment for chronic fatigue. Br J Psychiatry. 2005;186:350-1. [PMID: 15802694] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University; and Providence Cancer Center, Providence Health and Services Oregon, Portland, Oregon.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0114. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop Elizabeth Haney , M.E. Beth Smith , Marian McDonagh , Miranda Pappas , Monica Daeges , Ngoc Wasson , and Heidi D. Nelson Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Peter D. White , Daniel J. Clauw , Jos W.M. van der Meer , Rona Moss-Morris , and Renee R. Taylor Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Maik Speedy Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Alem Matthees Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Tom Kindlon and Charles Shepherd Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Lily Chu , Lucinda Bateman , Todd Davenport , Eleanor Stein , and Staci Stevens Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Sean B.M. Kirby Metrics 1 December 2015Volume 163, Issue 11Page: 888KeywordsCognitive behavior therapyDisclosureExerciseExercise therapyFatiguePerceptionPhysical functioningSafety ePublished: 1 December 2015 Issue Published: 1 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...