Graded Exercise Therapy

Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review

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  By Mark Vink and Alexandra Vink-Niese in Health Psychology Open.   Abstract The analysis of the 2017 Cochrane review reveals flaws, which means that contrary to its findings, there is no evidence that graded exercise therapy is effective. Because of the failure to report harms adequately in the trials covered by the review, it cannot […]

A Statement In Support Of Cochrane

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  From the Virology Blog. Cochrane has decided to temporarily withdraw a review of exercise therapies for the illness variously known as ME, CFS, ME/CFS and CFS/ME. The review reported that exercise therapy is effective in treating the illness—a finding that has provided unwarranted support for recommendations that patients should undergo the intervention known as […]

GET Paper Withdrawal Shocks CBT/GET Proponents – Emboldens ME/CFS Advocates

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By Cort Johnson in Health Rising.   Our mission is to promote evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence. Our work is internationally recognized as the benchmark for high-quality information about the effectiveness of health care. Cochrane  The Cochrane Reviews are the gold standard – highly respected and […]

Guidelines For ME/CFS Outdated And Dangerous

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By Felicity Nelson in Medical Republic.   NICE’s clinical guidelines still recommend potentially damaging treatments for chronic fatigue syndrome, but they won’t be updated until 2020. The 2007 NICE guidelines currently recommend the use of graded exercise therapy (GET), a treatment that only helps a minority of patients and can cause significant harm in some […]

Trial By Error: The Cochrane Controversy

David Tuller

  By David Tuller, DrPH.   Cochrane–formerly called the Cochrane Collaboration–is respected worldwide for its systematic reviews of medical treatments. These reviews are often cited as the definitive source of information about treatment efficacy and safety. In taking on the thankless task of assessing the data on commonly used interventions, Cochrane performs an invaluable public […]

Trial By Error: Mayo Still Champions GET

David Tuller

  By David Tuller, DrPH.   Last week I admonished the US Centers for Disease Control for including fuzzy language about exercise in its new package of “information for healthcare providers.” The way the Mayo Clinic deals with the illness it calls chronic fatigue syndrome is an excellent illustration of why it is so important for the […]

Doctors ‘Do More Harm Than Good’ Sending ME Patients To Gym

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  By Lisa Smyth in The Belfast Telegraph.   A charity that supports people with Myalgic Encephalomyelitis (ME) has said patients in Northern Ireland are being failed by a shocking lack of understanding about the condition. People with ME can suffer a range of symptoms, from headaches and extreme sensitivity to light and sound, to […]

Trial By Error: Professor Sharpe’s Intemperate Remarks – For Whom Is He Speaking ?

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  By Steven Lubet in Virology Blog.   Steven Lubet is the Williams Memorial Professor at Northwestern University Pritzker School of Law, where he specializes in professional responsibility and ethics. Let’s assume that everyone on the PACE team, and all of their colleagues in the biopsychosocial school, always acted in complete good faith. Let’s agree […]

When You Can’t Just ‘Push Through the Pain’

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  By Stacey T in The Mighty.   This post may get a little soap-box-like, but it’s something I need to talk about because it’s become a huge issue for me. So, most people have heard the phrases “pushing through pain,” “no pain, no gain” and similar ones. But when you have chronic illnesses or […]

ME Sufferers Welcome ‘Unreliable’ Stamp On Exercise Report

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  From The Herald.   An Oxfordshire woman who has spent most of the past 28 years in bed has welcomed the conclusion that a controversial study recommending she exercise more was ‘unreliable’. ME sufferer Zoë Williams was among hundreds who celebrated the new report finding that the conclusions of the widely-criticised PACE study may […]

PACE Trial’s Findings Fundamentally Challenged By A New Study

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    By Simon McGrath in ME/CFS Research Review.   In a nutshell: Analysing PACE the way the authors originally promised to do showed that CBT and GET didn’t do much to improve self-reported physical function and fatigue and did not lead to recovery. Even the very limited self-reported gains in this unblinded trial are […]

The Mainstream Medical Community Just Declared War On People Living With ME

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  By Steve Topple in The Canary.   The publication of a study into what an MP called one of the “biggest medical scandals of the 21st century” has sparked a war of words between areas of the medical and science communities. Caught in the crossfire are between 17 and 24 million disabled people worldwide, on whom critics of […]

Rethinking The Treatment Of Chronic Fatigue Syndrome – A Reanalysis And Evaluation Of Findings From A Recent Major Trial Of Graded Exercise And CBT

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    By Carolyn E. Wilshire, Tom Kindlon, Robert Courtney, Alem Matthees, David Tuller,Keith Geraghty and Bruce Levin in BMC Psychology.   Abstract Background The PACE trial was a well-powered randomised trial designed to examine the efficacy of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for chronic fatigue syndrome. Reports concluded that both treatments were moderately effective, each leading to recovery in over a fifth of patients. […]

Stanford Exercise Study Shows Different Immune Response In Chronic Fatigue Syndrome (ME/CFS)

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  By Cort Johnson in Health Rising.   It’s always good to see an exercise test in chronic fatigue syndrome (ME/CFS). It’s harder on the patients – kudos to them for participating in the study –  but study after study has shown that exercise allows researchers to dig deeper into what’s going on. Dr. Montoya […]

PACE Trial: People With ME

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  From The House of Commons Hansard. [Mr Philip Hollobone in the Chair]  11.00 am Carol Monaghan (Glasgow North West) (SNP) I  beg to move, That this House has considered the PACE trial and its effect on people with ME. It is a pleasure to serve under your chairmanship, Mr Hollobone. “The doctor doesn’t see me crawl […]

NICE Announces Next Steps In Updating Its Guideline On ME/CFS

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From www.nice.org.uk   A workshop last month with stakeholders marked the formal start of NICE’s collaborative work to update its 2010 guideline on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The workshop was held so that stakeholders, including patient groups for people with ME/CFS and their carers, could help NICE identify at […]

Letters To Professor Mark Baker At NICE

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  From Invest in ME Research.   In July 2017 Invest in ME Research responded to the NICE 10 year surveillance (2017) – Chronic fatigue syndrome/myalgic encephalomyelitis click here This pdf is an easier format to read is here. Recently, whilst preparing for the planned Stakeholders’ Workshop (16 January 2018) to review the NICE guidelines for ME […]

Post-Exertional Malaise (PEM) And Graded Exercise Therapy (GET) In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

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By S. Eyssens.   Preface: “The public have an insatiable curiosity to know everything, except what is worth knowing.”Oscar Wilde. Until Europeans discovered Australia, Black Swans did not exist, let alone could they even be imagined. They did not make sense, nor could they be, as they challenged common sense and common knowledge at that time in our […]

Rethinking The Treatment Of Chronic Fatigue Syndrome—A Reanalysis And Evaluation Of Findings From A Recent Major Trial Of Graded Exercise And CBT

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    By Carolyn Wilshire et al in ResearchGate.   Abstract BACKGROUND: The PACE trial was a well-powered randomised trial designed to examine the efficacy of graded exercise therapy (GET) and cognitive behavioural therapy (CBT) for chronic fatigue syndrome. Reports concluded that both treatments were moderately effective, each leading to recovery in over a fifth of patients. […]

Trial By Error: Letter To British Journal Of Sports Medicine From CPET Experts

David Tuller

  By David Tuller, DrPH.   Last October, the British Journal of Sports Medicine published a short paper that was essentially a summary of Cochrane’s systematic review of graded exercise for chronic fatigue syndrome (as Cochrane calls the illness). This systematic review is problematic for a number of reasons—not least of which is that it includes the debunked PACE […]

An Offer You Can’t Refuse

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From the mrspoonseeker Blog.   In the previous post about the NICE Guidelines revision, it was reported that Prof Mark Baker of NICE had raised the issue of the right of patients to refuse treatment, in this case with CBT and GET in mind. Steve, who frequently contributes to this blog, left the following response in […]

A Letter To Professor Mark Baker – Centre For Guidelines Director, National Institute For Health And Care Excellence

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  From Invest in ME Research.   In July 2017 Invest in ME Research responded to the NICE 10 year surveillance (2017) – Chronic fatigue syndrome/myalgic encephalomyelitis. Recently, whilst preparing for the planned Stakeholders’ Workshop (16 January 2018) to review the NICE guidelines for ME it has, in our opinion, been necessary to make one […]

Chronic Fatigue Syndrome Is A PHYSICAL Condition Not A Mental Illness, Says Ellen Wiles

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  By Ellen Wiles in The Express.   Before I fell ill life was sweet and full of promise. Fresh out of Oxford University, where I had somehow come top in the year, I was working in consultancy while I figured out what I really wanted to do. Then just before Christmas I got flu. I spent […]

David Tuller And The (S)PACE Cake Eaters

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    By Anil van der Zee.   In 2015 David Tuller, DrPH, a Senior Fellow in Public Health in Journalism at the Center of Global Public Health, School of Public Health at Berkeley University started writing 3 very detailed blogs about the flaws of the now infamous PACE-trial. The patient community has been advocating for years, if […]

Trial By Error: Current NICE Guidance Stands, For Now

David Tuller

  By David Tuller, DrPH   Last week I sent an e-mail with some questions to Sir Andrew Dillon, the chief executive of the National Institute for Health and Care Excellence (NICE). In particular, the questions involved the status of the ten-year-old guidance for CFS/ME, CG53, and of references to the illness elsewhere within the NICE system. A […]

For People With Chronic Fatigue Syndrome, More Exercise Isn’t Better

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  By Michaeleen Doucleff in npr.org. Health organizations are emphasizing that myalgic encephalomyelitis/chronic fatigue syndrome is a serious long-term illness, not a psychological disorder, and that standard forms of exercise do not help. Instead, they’re acknowledging that exercise can make the disease much worse unless doctors and patients are very careful. The Centers for Disease Control and […]

Trial By Error: NICE Rejects Current Guidance, Plans “Full Update”

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  By David Tuller, DrPH.   Let’s give credit where it’s due. Apparently someone with decision-making authority at the National Institute for Health and Care Excellence (NICE) has a grasp on reality and is willing to challenge the claims of the biopsychosocial ideological brigades. That’s the only logical explanation for last Wednesday’s welcome but unexpected announcement that […]

Why Did It Take The CDC So Long To Reverse Course On Debunked Treatments For Chronic Fatigue Syndrome ?

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  By Julie Rehmeyer and David Tuller in statnews.com.   For years, people with chronic fatigue syndrome have wrangled with the Centers for Disease Control and Prevention over information on the agency’s website about this debilitating illness. The website highlighted two treatments that became the de facto standards of care: a gradual increase in exercise and a form of psychotherapy […]

NICE Agrees To Re-Visit Guidelines On Treatment Of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

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From The National Institute For Health And Care Excellence.   Surveillance report 2017 – Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management (2007) NICE guideline CG53.   Surveillance decision. Reason for the decision   We will plan a full update with a modified scope of the guideline on chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) (NICE guideline […]

What Should I Do When Someone Tells Me to Exercise ?

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  By Sleepy girl in her ‘How To Get On’ Blog.   Many people with ME and Chronic Fatigue Syndrome are told by their doctors that exercise will help them. This is often called “Graded Exercise Therapy,” though some doctors doctors will simply recommend “exercise”. Some people are also advised to exercise by their loved […]

Worse Than The Disease

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  A case study of Graded Exercise Therapy from UNDARK.   After living in Oklahoma for 40 years, Nita and Doug Thatcher retired in 2009 to the Rust Belt city of Lorain, Ohio, a Cleveland suburb that hugs Lake Erie. When Nita needed to find a new primary care doctor, a friend recommended someone from the Cleveland […]

Graded Exercise Therapy Causes Harm In ME/CFS. Everyone Knows That, Right ?

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    From The Self Taught Author Blog by Clark Ellis.   What is patently obvious to the majority of ME/CFS sufferers is not at all obvious to most others. It is not obvious to NHS staff. It not obvious to academics and politicians. It is not obvious to the public. There are many reports […]

Pacing And ME

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    From The Journal Of Health Psycology. By Keith Geraghty, Mark Hann, Stoyan Kurtev First Published August 29, 2017 Research Article   Myalgic encephalomyelitis/chronic fatigue syndrome patients’ reports of symptom changes following cognitive behavioural therapy, graded exercise therapy and pacing treatments: Analysis of a primary survey compared with secondary surveys.   Cognitive behavioural therapy and graded exercise therapy are […]

Post Seventeen – The PACE Trial Scandal

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    From the Blog, puffins&penguins&me   I have been wanting to write about The PACE Trial for some time, about the background, the controversy and where we are at today. I have tried, but unlike my usual posts it is very technical, involves a lot of research and there’s a lot to cover. I just don’t […]

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